Assessment and diagnosis challengesDownloads

A 69-year-old male presents to his primary care physician for a checkup. He has not seen a doctor in 15 years and thought he may need an exam. The patient’s past medical history is unknown and he is not currently taking any medications. The patient lives on a rural farm alone and has since he was 27 years of age. The patient works as a farmer and never comes into town as he has all his supplies delivered to him. The patient is oddly adorned in an all-denim ensemble, rarely makes eye contact with the physician, and his responses are very curt. A physical exam is performed and is notable for an obese man with a S3 heart sound on cardiac exam. The patient is informed that further diagnostic testing may be necessary and that it is recommended that he begin taking lisinopril and hydrochlorothiazide for his blood pressure of 155/95 mmHg. Which of the following is the most likely personality disorder that this patient suffers from?

A 19-year-old woman comes to the physician because of a 2-day history of difficulty sleeping. She worries that the lack of sleep will ruin her career prospects as a model. She has been coming to the physician multiple times over the past year for minor problems. She is dressed very extravagantly and flirts with the receptionist. When she is asked to sit down in the waiting room, she begins to cry and says that no one listens to her. When she is called to the examination room, she moves close to the physician, repeatedly intends to touch his cheek, and makes inappropriate comments. She does not have a history of self-harm or suicidal ideation. Which of the following is the most likely diagnosis?