Addiction Psychiatry
1. A 28-year old man admitted in the hospital with profuse rhinorrhoea, agitation, and piloerection. On examination, his pupils were widely dilated.
a) What is most likely diagnosis? 4
b) What is your management plan for this case? 6
2. A 55-year old man with alcohol dependence admitted for fracture femur after RTA and necessary operation has been done. On 3rd post-operative day he develops tremors, sweating and confusion and starts picking on his bed sheet and complains of seeing spider all over for that he has psychiatric referral. He is apprehensive and fearful.
a) What could be best possible diagnosis? 4
b) What is your assessment plan for this case? 4
c) What is your immediate treatment for his problems? 2
3. A 32-year old man complains of episodes of hearing music and sometimes threatening voices within a couple of hours of heavy drinking.
a) What is the most likely diagnosis? 4
b) Outline the management plan. 6
4. A 26-year old male presents in psychiatry OPD who had been arrested for the charge of snatching act with gang. After getting bell, he has been forcefully confined at home. Since then he develops insomnia, low mood and bad dreams. Parents report his long lasting challenging, aggressive, demanding behaviours. He had previously been treated for opiate misuse.
a) What could be your best possible diagnostic impression? 5
b) Make a check list of your assessment plan. 5
5. A 28-year old man is treating form his manic episode in psychiatry OPD. On subsequent follow up it explored that he misuses amphetamine and cannabis.
a) Mention the assessment areas that you need to explore. 5
b) How would you manage this case? 5
6. A 22-year old boy is brought to emergency by his father because of his son is found “abnormal and non communicative”. Father suspects the boy is addict. Preliminary examination shows the boy to be drowsy, with slurred speech, pupilary constriction, lethargy and generally positive effect.
a) Based on the initial presentation what could be possible diagnosis? 4
b) How will you proceed for diagnostic confirmation? 2
c) What is your immediate management plan for this boy? 4
7. A 46-yaer old is persistently engage with gambling that he cannot control in anyway. Gradually, he fall in huge debt for which her family is the worse sufferer.
a) Make a checklist of information necessary to assess this case. 6
b) Summarize the treatment plan. 7