United State Medical Licensing Examination (Step 3) Set 16

A 3-year-old boy spends hours rocking in a chair or spinning the blades of a toy windmill; his parents say he never cries when he falls. Select the diagnosis with which it is most likely to be associated.

A35-year-old man comes into the hospital with deep sadness and suicidal thoughts. He reports having experienced similar episodes in the past; he says he has also experienced two periods of extremely elated moods, during which he talked nonstop, went without sleep, and believed he was God. Identify the diagnosis below that best describes the situation.

A24-year-old cocaine addict with no previous psychiatric history, reports that he had been bingeing on cocaine for 2 months earlier in the year. He stopped using cocaine 2 months ago, and he has been very sad and tearful for the entire period since he stopped his cocaine use. Identify the diagnosis below that best describes the situation.

A32-year-old woman reports that she has been in a low-grade, chronically depressed mood for more days than not for the past 3 years. She reports that she has never had a period of severely depressed mood, but the low-grade feeling of sadness has not gone away for more than 2 or 3 days at a time over the past 3 years. Identify the diagnosis below that best describes the situation.

A 53-year-old man reports that he is currently in one of his "up" periods. He states that he feels very good, and he is quite talkative, but he reports that he is having no trouble keeping his job, and he is sleeping well. He has never had any periods of elevated mood that have substantially interfered with his working, and he has never needed hospitalization for his "up" periods. However, he has suffered two periods of severe depression, each requiring hospitalization for suicidal thoughts, the most recent having occurred 3 years ago. Identify the diagnosis below that best describes the situation.

A23-year-old university student has lost interest in his master's degree program. His two friends who bring him to the psychiatrist say he has been isolating himself in his room and has covered all electrical appliances and outlets with duct tape claiming that "electromagnetic waves are disturbing the microchip in my brain." He acknowledges that he once took a medication for the same problem with the "microchip," but then he became unbearably restless, could not sit still, and felt that he was "crawling" inside. According to the patient's psychiatric symptoms, select the most appropriate medication. Presume no medical problems other than those mentioned.

A40-year-old man has a history of severe alcohol dependence and is very interested in whatever help he can get to avoid relapsing in his alcohol use. According to the clinical vignette, select the pharmacotherapeutic agent which is most likely to be helpful to the patient.

A21-year-old male college student reports a 1- month period of intensely depressed mood, with marked anxiety, sleep disturbance, and weight loss. He has never before experienced an episode of a mood disorder. According to the clinical vignette, select the pharmacotherapeutic agent which is most likely to be helpful to the patient.

A 41-year-old woman has a long history of chronic paranoid schizophrenia. She experiences auditory and visual hallucinations and has had difficulty maintaining a job. According to the clinical vignette, select the pharmacotherapeutic agent which is most likely to be helpful to the patient.

A 45-year-old woman reports a 6-month history of free-floating anxiety, which makes her feel tense most of the time on most days. According to the clinical vignette, select the pharmacotherapeutic agent which is most likely to be helpful to the patient.