Psychiatry/Behavioral Science (7%)

A case where a 4-year-old boy presents with a spiral fracture, multiple bruises of different healing stages, and cigarette burns, indicating possible child abuse.

Child Abuse & Neglect

An incident involving an 82-year-old woman showing signs of fear, undernourishment, bruising, and dependency on her son, signaling potential elder abuse.

Elder Abuse

A condition where a 30-year-old woman experiences chronic fatigue, concentration issues, and anxiety impacting daily life.

Generalized Anxiety Disorder (GAD)

A disorder characterized by recurrent episodes of panic attacks in a 27-year-old man, including symptoms like chest tightness and fear of losing control.

Panic Disorder

An affliction where a 19-year-old college student has intense fear of public speaking and social gatherings, thus affecting her academic performance.

Social Anxiety Disorder (Social Phobia)

A situation where a 38-year-old woman avoids public spaces due to fear of panic attacks, resulting in significant functional impairment.

Agoraphobia

A condition in which a 6-year-old girl speaks normally at home but is silent in social settings, hindering her education.

Selective Mutism

A case involving a 10-year-old boy who shows distress and physical complaints when separated from his parents, indicating separation anxiety.

Separation Anxiety Disorder

A scenario where a 45-year-old woman presents with persistent sadness, sleep issues, and feelings of guilt over a month.

Major Depressive Disorder (MDD)

A long-term condition where a 32-year-old man feels 'down' for three years with low self-esteem and lack of interest.

Persistent Depressive Disorder (Dysthymia)

A disorder in which a 28-year-old woman experiences mood swings and physical symptoms linked to menstruation.

Premenstrual Dysphoric Disorder (PMDD)

A specific anxiety disorder where a 24-year-old woman has intense fear of spiders, impacting her daily life.

Specific Phobia

A case involving a 23-year-old man showing social withdrawal and bizarre beliefs, indicative of schizophrenia.

Schizophrenia

A short-term condition where a 22-year-old college student has hallucinations and disorganized behavior lasting three months.

Schizophreniform Disorder

A disorder characterized by delusions and mood symptoms in a 30-year-old woman.

Schizoaffective Disorder

A case of a 46-year-old man with a well-functioning demeanor but holds a firm belief of being poisoned.

Delusional Disorder

A sudden onset of psychotic symptoms lasting five days in a 19-year-old woman following a breakup.

Brief Psychotic Disorder

A situation where a 26-year-old man battles intrusive thoughts about contamination and compulsive hand washing.

Obsessive-Compulsive Disorder (OCD)

A psychological state observed in a 35-year-old man with elevated mood, sleep disruption, and impulsive behavior.

Bipolar I Disorder

A condition involving periods of increased energy and a previous major depressive episode in a 29-year-old woman.

Bipolar II Disorder

A case of a 47-year-old man presenting withdrawals after alcohol cessation, illustrating alcohol dependence.

Alcohol Use Disorder

A scenario involving a 65-year-old woman experiencing cravings and withdrawal symptoms after quitting smoking.

Tobacco Use Disorder

An incident with a 21-year-old man experiencing symptoms from excessive marijuana consumption.

Cannabis Use Disorder

A condition seen in a 38-year-old woman developing headaches and irritability after cutting caffeine.

Caffeine Withdrawal

A case of a 29-year-old man presenting with agitation and paranoia after cocaine use.

Stimulant Intoxication

A presentation of withdrawal symptoms in a 33-year-old man post-heroin use.

Opioid Use Disorder

A scenario involving a 55-year-old man experiencing seizures and withdrawal after stopping benzodiazepines.

Sedative-Hypnotic Withdrawal

An incident with a 23-year-old man exhibiting violent behavior and physical signs of PCP use.

PCP Intoxication

A case of a 19-year-old woman with altered perceptions following LSD usage.

LSD Intoxication

An instance involving a 15-year-old boy found unconscious after inhaling fumes from a glue can.

Inhalant Use Disorder

A disorder where a 17-year-old girl is obsessed with her appearance despite family reassurances.

Body Dysmorphic Disorder (BDD)

A condition in which a 13-year-old girl pulls her hair when stressed, leading to noticeable hair loss.

Trichotillomania (Hair-Pulling Disorder)

A case reflecting a difficulty for a 70-year-old woman to part with belongings, despite clutter.

Hoarding Disorder

A scenario where a 25-year-old woman exhibits compulsive skin-picking behavior associated with stress.

Excoriation (Skin-Picking) Disorder

A case involving a 38-year-old man struggling emotionally post-divorce.

Adjustment Disorder

A condition where a 54-year-old woman continues to struggle with grief over a year after her husband's death.

Prolonged Grief Disorder

A condition seen in a combat veteran displaying flashbacks and anxiety after returning from service.

Post-Traumatic Stress Disorder (PTSD)

A case where a 30-year-old woman repeatedly seeks medical help for chronic pain with no physical cause.

Somatic Symptom Disorder

A scenario involving a 40-year-old man who obsessively fears having cancer without medical evidence.

Illness Anxiety Disorder

A case with a 19-year-old woman experiencing paralysis following emotional distress without physical cause.

Conversion Disorder

A situation where a 28-year-old inmate presents inconsistent pain symptoms to avoid therapy.

Malingering

A case of a healthcare worker who feigns illness for medical attention.

Factitious Disorder

A condition where a 5-year-old child consumes non-nutritive substances despite iron deficiency anemia.

Pica

A case involving a 6-month-old infant who chews and re-swallows food post-feeding regularly.

Rumination Disorder

A case showing a 9-year-old boy who avoids solids due to a choking fear, impacting his health.

Avoidant/Restrictive Food Intake Disorder (ARFID)

A serious condition in a 19-year-old woman presenting after malnutrition rehabilitation.

Refeeding Syndrome

A situation involving a 16-year-old athlete with low BMI and disordered eating habits.

Anorexia Nervosa

A case of a college student indulging in binge eating followed by purging behaviors.

Bulimia Nervosa

A disorder presented by a 30-year-old woman involving episodes of overeating without compensatory behaviors.

Binge-Eating Disorder

A scenario where a 17-year-old runner faces amenorrhea and stress fractures, linked to disordered eating.

Female Athlete Triad

A case where an 8-year-old boy exhibits disruptive behavior and inattention in school.

Attention-Deficit/Hyperactivity Disorder (ADHD)

A situation in which a 3-year-old child shows limited communication and focuses on solitary play.

Autism Spectrum Disorder (ASD)

A case involving a 14-year-old boy exhibiting destructive behavior and school issues.

Conduct Disorder

A scenario where a 10-year-old girl disobeys rules and argues frequently at school.

Oppositional Defiant Disorder (ODD)

A case in a 23-year-old man characterized by uncontrollable outbursts of anger.

Intermittent Explosive Disorder (IED)

A disorder involving a fascination with fire and compulsive fire-setting behavior in a 12-year-old boy.

Pyromania

A situation where a 27-year-old woman steals items she does not need, experiencing tension relief afterwards.

Kleptomania

An incident with a 29-year-old man showing memory loss for personal identity without a clear cause.

Dissociative Amnesia

A case where a 24-year-old woman exhibits signs of multiple identities due to severe childhood trauma.

Dissociative Identity Disorder (DID)

A condition where a 19-year-old college student feels disconnected from her body while maintaining awareness of the unreal perception.

Depersonalization/Derealization Disorder

A situation involving a 40-year-old man who shows profound distrust of others without justification.

Paranoid Personality Disorder

A case of a 35-year-old man preferring solitude over social relationships, showing indifference to feelings from others.

Schizoid Personality Disorder

A scenario with a 22-year-old woman displaying odd beliefs and anxiety in social contexts.

Schizotypal Personality Disorder

A situation involving a 28-year-old man with a history of aggressive and criminal behavior since adolescence.

Antisocial Personality Disorder

A case reflecting unstable relationships and emotional reactions in a 23-year-old woman.

Borderline Personality Disorder

An incident involving a 30-year-old woman who is excessively dramatic and seeks attention.

Histrionic Personality Disorder

A case where a 33-year-old CEO exhibits grandiosity and lack of empathy.

Narcissistic Personality Disorder

An affliction seen in a 26-year-old man who fears social situations and actively avoids them.

Avoidant Personality Disorder

A condition of a 35-year-old woman who struggles to make decisions independently and clings to unhealthy relationships.

Dependent Personality Disorder

A personality disorder seen in a 40-year-old accountant emphasizing order and perfectionism, with rigid behaviors.

Obsessive-Compulsive Personality Disorder (OCPD)

A disorder presented by a 10-year-old boy experiencing detailed nightmares at night.

Nightmare Disorder

A condition where a 6-year-old girl experiences episodes of intense terror during sleep.

Sleep Terror Disorder

A case involving a 9-year-old child walking at night while being unresponsive.

Sleepwalking (Somnambulism)

An affliction where a 21-year-old man sleeps excessively but remains fatigued.

Hypersomnolence Disorder

A scenario depicting a 25-year-old man who unexpectedly falls asleep in conversation and experiences muscle weakness.

Narcolepsy

A case where a 45-year-old woman struggles to maintain sleep patterns over four months.

Insomnia Disorder

A condition presented by a 60-year-old woman with an overwhelming urge to move her legs at night.

Restless Leg

What is the underlying pathophysiology of child abuse and neglect?

Intentional harm or failure to meet basic needs (physical, sexual, emotional, medical neglect, Munchausen by proxy).

What are the most common risk factors for child abuse?

Poverty, substance use, poor parenting skills, domestic violence.

What are physical red flags of abuse in children?

Spiral fractures, patterned bruises, stocking-glove burns, bite marks.

What behavioral signs may suggest abuse or neglect in a child?

Failure to thrive (FTT), anxiety, aggression, PTSD, dissociation.

What steps are involved in diagnosing child abuse?

1. Complete H&P from child and all caregivers 2. Skeletal survey (if <2y) 3. CT/MRI if neuro signs present 4. Labs for bleeding disorders 5. Rape kit if within 72 hours.

What is the management plan for suspected child abuse?

1. Mandatory reporting to CPS 2. Involve law enforcement (for physical/sexual abuse) 3. Treat injuries and involve social services 4. Ensure a safe discharge plan.

What is the hallmark finding of child abuse?

Injury inconsistent with history + mandatory reporting required.

What is the pathophysiology of elder abuse?

Physical, sexual, emotional abuse or neglect of adults ≥60–65y by a caregiver.

What are the most common risk factors for elder abuse?

Cognitive impairment, depression, and dependence on others for care.

What are typical clinical signs of elder abuse?

Often vague—may include injury, fearfulness, poor hygiene.

Who is the most common perpetrator of elder abuse?

A family member in 90% of cases.

What is the first step in management of elder abuse?

Mandatory reporting to Adult Protective Services (APS).

What additional steps are required in elder abuse cases?

Assess safety and decision-making capacity.

What is the hallmark finding in elder abuse?

Abuse by a family member in a patient ≥60y with signs of neglect or injury.

What is the hallmark feature of GAD?

Excessive worry and anxiety about multiple topics lasting ≥6 months.

What are the diagnostic criteria for GAD?

1. Excessive worry ≥6 months 2. ≥3 of the following: restlessness, fatigue, difficulty concentrating, irritability, muscle tension, sleep disturbance.

How is GAD severity measured?

Mild:

What is the first-line treatment for GAD?

SSRIs or SNRIs.

What are adjunct treatments for GAD?

1. Buspirone 2. BZDs (short-term use) 3. Hydroxyzine/Gabapentin if substance use history.

What defines a panic attack?

Sudden, unexpected episodes peaking within 10 minutes, lasting ~30 minutes.

What are the diagnostic criteria for panic disorder?

1. Recurrent unexpected attacks 2. Persistent worry or behavior change ≥1 month 3. ≥4 symptoms: palpitations, sweating, trembling, SOB, CP, nausea, choking, fear of dying/losing control.

What is the treatment for panic disorder?

1. CBT (first-line) 2. SSRIs, SNRIs (venlafaxine) 3. BZDs (short-term).

What is the core feature of social anxiety disorder?

Fear of embarrassment or negative evaluation in social situations.