Day 16
Diagnose the case, Give the investigations, suggest the management and select the rubrics

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1.   A 28-year-old woman is seen for postpartum blues by the psychiatrist. She states she is depressed because she “did this to her child.” The infant has growth retardation, microphthalmia, short palpebral fissures, midface hypoplasia, a short philtrum, a thin upper lip, and microcephaly. Which is the most likely diagnosis of the mother (besides the postpartum blues)? a. Bipolar disorder b. Major depression c. Hypochondriasis d. Alcohol dependence e. Cocaine dependence. Explain and give related rubrics
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2. A lady college student comes to the clinic because she has had symptoms of depression for the past three months since she was a victim of date rape at a party. The patient says she was heavily intoxicated when the incident occurred and has little memory of the event, but she was embarrassed and ashamed when she awoke at the scene and realized what had happened. She did not seek medical care at that time. The patient says she has not told her friends about the incident, and she has continued to attend classes and work part-time. However, she says she constantly feels sad and anxious, has become tearful and withdrawn, and has had difficulty sleeping because of frightening nightmares. This patient most likely has which of the following psychiatric conditions? (A) Acute stress disorder (B) Adjustment disorder, unspecified 
(C) Generalized anxiety disorder (D) Major depressive disorder (E) Post-traumatic stress disorder. How you will handle this situation? Differentiate given choices and give related rubrics for the case and choices given.
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3.  A middle-aged man is referred to the clinic for mental health evaluation. The patient says he has a long-standing fear of criticism and rejection. He also has feelings of inadequacy and refuses to try new activities because of his fear of embarrassment. The patient has held the same entry-level position at his workplace for the past 14 years despite several opportunities for promotion. The patient is unmarried and has only had one intimate relationship, which lasted only a few weeks. He has few friends other than those in his club. Which of the following personality disorders is the most likely diagnosis? (A) Avoidant (B) Dependent (C) Paranoid (D) Schizoid. Differentiate given choices and give rubrics for the case .
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4.  A young woman is admitted to a for hypoglycemia. A psychiatry consultation is requested because the patient’s story “doesn’t fit.” The patient tells the psychiatrist how bad the problem is and uses medical jargon. She appears to be an intelligent person with strong dependency needs. The nurse interrupts the psychiatrist and tells him that she found insulin-filled syringes beneath the patient’s pillow. This upsets the patient and before anything can be done about it, she elopes from the hospital. The most likely diagnosis in this patient is A. Somatization disorder 
B. HypochondriasisC. Factitious disorder D. Malingering E. Munchausen syndrome by proxy. Justify your answer and give rubrics
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5. A 22-year-old woman comes to the physician with complaints of problems in sleeping. She notes that she has a hard time falling asleep, and when she does finally get to sleep, she awakens multiple times during the night. The patient says that this problem has been getting worse over the last 2 months. She states that she has also noted that she feels both nervous and fatigued during the day. Her mental status examination is otherwise normal. A toxicology screen is negative. Which of the following is the most likely diagnosis? a. Sleep apnea b. Marijuana intoxication c. Caffeine-induced sleep disorder d. ADHD e. Major depression. Explain your answer and give rubrics for the choice given
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