Day 15
Diagnose the case, Give the investigations, suggest the management and select the rubrics

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1. A 5-year-old boy is brought to the clinic by his mother because she is worried about changes in his behavior during the past few months. The patient's mother says he has had episodes that occur sporadically at night during which he sits up in bed screaming, crying incoherently, and intensely frightened. She says it is initially difficult to calm him down, and he is usually sweating, breathing rapidly, and tremulous. The patient eventually calms down after 10 to 15 minutes and then falls asleep. Which of the following questions is most appropriate to confirm the suspected diagnosis of sleep terror disorder in this patient?   (A) Do his arms and legs jerk during sleep? (B) Does he have nightmares? (C) Does he go to sleep late? 
(D) Does he watch violent movies? 
(E) Does he wet the bed? Explain, take rubrics fro the case
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2.   A 32-year-old woman is admitted for severe depression. The patient has been ruminating about suicide and guilt feelings. She believes that she has committed a sin and deserves to be punished. The physician thinks that the patient is obsessed with thoughts of guilt and suspects that the patient has a primary obsessional disorder. The attending doctor explains that the patient is not obsessional but severely depressed because  A. The patient has suicidal ideation.B. The patient has indeed committed a sin.C. The patient is not distressed by the guilt feelings and is mood congruent.D. The psychiatrist thinks so.E. Antidepressants alone were not effective. Justify your answer and give related rubrics
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3.  A young man is brought to the hospital by his wife, who states that her husband has been demanding more sex, repeating the demand sometimes up to 10 to 15 times per day for the past 8 to 10 days. She also observes that he has been working late into the night, sleeping only 2 to 3 hours, and seems full of energy. He has been talking a lot and has taken on at least four new projects at work during the past 10 days. The woman denies any other physical health problems or drug abuse in her husband. The man himself sees no problem and believes that his wife is “just wasting” his time. As you are assessing the case, his colleague calls you and tells you that the man has been “making a mess” at work for the past few days. What is the most probable diagnosis? .A. Bipolar II disorder B. Bipolar I disorder C. Bipolar disorder, mixed type D. CyclothymiaE. Rapid-cycling bipolar disorder.  Differentiate given choices and select rubrics for the case
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4.  A 32-year-old mother brings her 7-year-old son to a hospital. The child is found to be restless and displaying stereotyped hand movements. The mother reports that he was “normal” until 1 year ago and had achieved childhood developmental milestones at the appropriate times. For the past year, the child has shown progressive deterioration in social interactions and communication abilities and recently has lost control over the bowel training that he had attained earlier. Which of the following is the most appropriate diagnosis?   A. Rett syndrome B. Heller syndrome C. Asperger syndrome D. Minimal brain damage. Differentiate the choice and give rubrics.
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5.   A 1-year-old girl has been hospitalized on numerous occasions for periods of apnea. Each time, her mother called an ambulance after her daughter had stopped breathing suddenly. All work-ups in the hospital have been negative, and the patient has never had an episode in front of anyone but her mother. The patient’s mother seems very involved with the child and the staff on the unit, and she does not seem hesitant about consenting to lab tests on her daughter, even if the tests are invasive. Which of the following statements is true about the disorder described in this case? a. It is usually self-limited. b. The father is usually the perpetrator. c. It constitutes a form of child abuse. d. Usually, only one child in a family is victimized. e. The caregiver’s motivation is watching the child suffer. Explain. Give rubrics for the case
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