Antipsychotics, correctors

# 77

*! Patient S., 42 years old. Received repeatedly. Mental status at the time of the examination: during a conversation with the doctor, he sits with his hands clasped in his head, and at times looks around. Contact is difficult. Talks about his experiences not very willingly. He complains that it’s hard to control his behavior, as the last 4 days have been “pestering voices”, “voices in the head and throat”. Voices scolded the patient, ordered to chop off his wife’s finger, threatened with reprisal if he disobeyed. Emotionally dull. Outwardly untidy.. Treatment.

Antipsychotics, correctors

# 78

*! Patient L., 18 years old, student. From the anamnesis: about six months ago I stopped attending classes. In the morning I lay down in bed, often just lay with my eyes open. I did not respond to the appeal. Recently, she’s stopped washing, changing clothes. Relatives of the patient invited a folk healer, who determined that the patient was "obsessed with genie", "healed" with Kamcha, prayers. After one of the sessions, the patient attacked him with fists and refused to continue treatment. After this incident, the patient's relatives took her to a mosque, drove her to holy places. The mother of the patient even noted a slight improvement in her daughter's condition. Recently, the patient completely stopped eating, began to harden in one position and could stand for such a long time without changing position, not answering questions. Attempts to feed her were unsuccessful. Relatives of the patient turned to psychiatrists. At admission: does not answer questions. The muscle tone is sharply increased: the patient’s hand, raised by a doctor, hangs in the air for several minutes.

. What treatment method is most appropriate for the condition

The diagnosis is the catatonic form of malignant schizophrenia (100%), the treatment is antipsychotics

# 79

Patient K., 45 years old. Reappears. A few days before admission to the hospital became closed, secluded. Asked monotonous questions "What's next?" At the same time, he stared at his wife. At night, on the eve of hospitalization, he tried with a fork to injure a sleeping wife. During a conversation with a doctor, he said that "green radio waves are emitted from a neighboring house using a special transmitter." He hears the voices of women, men, children. From the content of the votes, I realized that this is a spy group. The voices speak of the need to kill people, to burn at home. I heard that his wife is a member of this organization. He believes that, by order of the votes, his wife sprinkled poison in his food, in milk. Explains his attack on his wife with a desire to end the "gang of criminals."

Your treatment tactics.

Antipsychotics, correctors

# 80

*! Patient A., 45 years old. Received repeatedly. A history of affective-delusional seizures followed by long-term (up to 4-5 years), high-quality remissions. Admission to the hospital is associated with a worsening condition a week before hospitalization. The dream was upset, he became eloquent, all the time he was trying to run somewhere. At the time of examination, psychomotor agitation is noted, easily distracted, without a sense of distance. Discusses on unfamiliar topics with a clear reassessment of one’s own capabilities and abilities. Laughing for no reason, plans for the future are unrealistic. Believes that he knows the thoughts of those around him. Feels the influence of a "laser" that sends "mental information."

Determine your mental status. Estimated diagnosis. Treatment.

Recurrent schizophrenia. Antipsychotics, correctors

# 81

*! Which of the following MOST corresponds to the concept of "mood"?

-long emotional process of low intensity, forming an emotional background for ongoing mental processes

# 82

*! Which of the following MOST corresponds to the concept of "affect"?

Short-term expressed emotional reaction

# 83

*! A man who has been suffering from epilepsy for 10 years with large unfolded convulsive seizures suddenly became angry, aggressive, unreasonably hit his child.

Which of the following conditions is MOST probable?

Twilight stupefaction

# 84

*! Woman, 68 years old, complains of general malaise, headaches. The mood is lowered, inhibited, she considers herself "sinful, unworthy of life." There was an attempted suicide. Depressed, lying in bed.

Which of the following syndromes is MOST probable?

Depressive-delusional syndrome

# 85

*! A 42-year-old man, engineer, married. At the time of inspection, calm, no complaints. Reports that from 25 years periodically with an interval of 1-2 years there were attacks of either causeless longing, or uncontrollable fun and joy. He was treated several times in a hospital. The duration of the attacks is 2-3 months. No other mental disorders were noted. During periods of intermissions it works productively.

Which of the following diagnoses is MOST probable?

Manic-depressive psychosis-bipolar type

Bipolar Affective Disorder

# 86

*! A 62-year-old woman has a state of severe anguish and anxiety. Facial expression reflects suffering. At times, excitement arises with lamentations, crying, demands to punish her for “sins, indecent behavior”.

Which of the following disorders is MOST likely?

Agitated depression

# 87

*! A woman, 60 years old, over the past 2 years suffered a series of psycho-traumatic events (robbery of an apartment, a heart attack in her husband), after which her mood gradually decreased, her sleep was disturbed, she became tearful. She constantly worries about the future, sometimes finds no place for herself, calls adult children several times a day to find out if everything is in order, she has lost 10 kg. At the doctor’s appointment, she looks depressed, expresses thoughts of her low value, considers herself a bad wife and mother, as she has ceased to cope with household chores. Actively seeking help, critical of painful manifestations.

Which of the following syndromes is MOST likely?