Patient History Quiz on Psychiatric Cases

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Questions and Answers

What is the primary reason for the patient's current mental health treatment?

Unresolved grief from parental loss.

Work-related stress and anxiety.

Drug-induced psychosis and related episodes. (correct)

Underlying depression and lack of coping mechanisms.

Which of the following BEST describes the patient's behavior during the interview?

Aggressive and hostile, immediately denying any problems.

Distressed, exhibiting symptoms of anxiety and defensiveness. (correct)

Calm and cooperative, readily admitting any issues.

Withdrawn and apathetic, declining to engage in conversation.

What is the main target of antipsychotic medications in treating this patient?

To reduce general anxiety and stress levels.

To elevate mood and overcome traumatic experiences.

To alter brain activity by influencing dopamine. (correct)

To manage symptoms of withdrawal from illegal drugs.

According to the information provided, how should this patient take antipsychotic medications?

Both during and continuously, to manage and prevent symptoms. Signup and view all the answers

What is the patient's current functional status?

Functioning averagely, except during psychotic episodes. Signup and view all the answers

What is the patient's approximate annual church service attendance?

Once a month Signup and view all the answers

What was the reported relationship between the patient and her mother?

Strained Signup and view all the answers

What mode of death did the patient's mother experience?

Fatal stroke Signup and view all the answers

What is the patient's current living situation?

Lives alone Signup and view all the answers

At what age did the patient start formal education?

2 years old Signup and view all the answers

What are the patient's highest academic achievements?

Associates and Bachelor’s Degree with first class honors Signup and view all the answers

How was the patient fed as an infant?

Artificially fed Signup and view all the answers

What is Sherdina Antoine’s current marital status?

Single Signup and view all the answers

What was the patient's behaviour like during childhood?

No behavioral or emotional problems noted Signup and view all the answers

What is Sherdina Antoine’s primary occupation?

HR Manager Signup and view all the answers

What is the mode of onset of Sherdina’s current illness?

Abrupt Signup and view all the answers

What is a reported aggravating factor in Sherdina’s condition?

Slamming her head on hard objects Signup and view all the answers

Which of the following is NOT a symptom reported by Sherdina?

Visual hallucinations Signup and view all the answers

What medication was Sherdina taking prior to her admission?

Ibuprofen and antibiotics Signup and view all the answers

What is Sherdina Antoine's annual income?

$75,000 Signup and view all the answers

Based on the provided information, what is a possible cause of the patient's current condition?

Occupational stress Signup and view all the answers

What was the patient's initial reaction to menarche?

Shock and surprise Signup and view all the answers

Which of the following best describes the patient’s interpersonal relationships?

Strained and introverted Signup and view all the answers

Which of these best describes the patient's use of leisure time?

Engaging in solitary intellectual pursuits, such as reading and slam poetry, and hobbies like kayaking. Signup and view all the answers

What is the patient's typical reaction to stressful life events?

Introverted and non-sharing with others Signup and view all the answers

Which of the following is accurately mentioned about the patient's work habits?

She tries to be flexible in dealing with work matters, and is good at making decisions as well. Signup and view all the answers

What was the patient's stated predominant mood?

Optimistic yet prone to anxiety Signup and view all the answers

Which of these is most accurately a symptom of the patient's current state?

Regular drug use, with worse episodes during withdrawals Signup and view all the answers

What is the final diagnosis based on the provided information?

Drug Induced Schizophrenia Signup and view all the answers

Study Notes

Patient History

Patient Name: Sherdina Antoine
Age: 29
Sex: Female
Marital Status: Single
Occupation: HR Manager at Jolly's Pharmacy Ltd.
Income: $75,000 annually
Address: St. Aroment, Roseau, Dominica
Date of Admission: September 25, 2023
Hospital Number: 71532
Psychiatric Ward: DCFH APU
Informant: Patient is of age.

Chief Complaint

Patient reports piercing headache and constant shivers, along with "hearing things."

History of Present Illness

Duration: 2 weeks
Mode of Onset: Abrupt
Course: Fluctuating
Precipitating Factors: Stress from work, repeatedly slamming head on objects to stop "voices."
Aggravating Factors: Repeatedly slamming head on objects, leading to physical wounds.
Relieving Factors: Pain medication and sleeping pills.
Other Symptoms: Impaired sleep schedule, due to nightmares, loss of appetite.
Recent Head Injury: Sustained due to repeatedly slamming head on work desk.

Symptoms of Illness

Auditory hallucinations
Frenzied movement
Nail biting
Episodic headaches
Symptoms noted by colleagues 2 weeks prior.

Treatment

Patient started taking Ibuprofen and antibiotics 2 weeks prior, but hasn't taken any medication recently.

Past Surgical/Medical Illness

Sustained head injury.
Medication: Naproxen.

Past Psychiatric History

No prior hospitalizations for mental disorders.
First time clinical psychiatric case.

Family History

Orphaned: Patient is currently orphaned. Parental figure passed away in the past year.
No hereditary illnesses: No known hereditary illnesses in family.
Substance abuse: Patient admits to occupational stress causing alcohol and illegal drug abuse (cocaine & ecstasy).

Personal History

Perinatal history: Nil
Childhood history: Raised by mother, artificial feeding, age 1 at weaning, normal development, no behavioural or emotional problems (age 1 year 6 months able to toilet independently).
Educational history: Started formal education at 2 years old, finished at a mature age (23 years). Holds an Associate's and Bachelor's Degree in Management with first-class honors. Professional relationship with teachers, no grand relationship with peers, no school phobia, perfect attendance, no learning disabilities. Employed, pursuing Master's degree. Attended primary, secondary school and tertiary at Dominica State College and Midwestern State University.
Played with classmates: Rarely played unless compulsory.
Emotional problems: Nil during adolescence
Puberty: 13 years of age. No anxiety related to puberty changes.
**Menarche:**12 years old
Cycle: Normal cycle and normal flow
Obstetrical history: Nil
Occupation: Assistant HR to HR manager. Stated job as appropriate to qualifications and interests.
Current Job Satisfaction: The job involved maintaining good working relationships for a period of time, before becoming strained.

Lives alone: With no other home circumstances noted.
Household income: EC $6250.00
Financial stability: Patient poses no financial instability.
Cultural and religious activities: Patient lacks the energy for cultural and religious events. No social support system.
Church service attendance: Approximate yearly church service attendance is 12 times per year.
Relationship with parents: Stated relationship is strained.

Personal Relationships

Stated introverted personality impacting interpersonal relationships with friends and colleagues; strained.

Use of Leisure Time

Enjoys reading, kayaking, poetry, especially slam poetry events.

Predominant Mood

Optimistic but prone to anxiety.
Patient's reaction to stressful life events is introverted and non-sharing with others.

Attitude to Self and Others

Fluctuating self-confidence level.
High self-criticism and self-consciousness.
Thoughtful of others but has low self-appraisal of abilities.
Helpful personality.

Attitude to Work and Responsibilities

Good decision-making, responsible, tries to be flexible
Catholic-Christian faith.
Spaces out/loses focus at times.

Habits

Irregular eating and sleep patterns

Frequent use of Drugs

Frequent use of drugs worsens during withdrawals.

Diagnosis

Drug-induced Schizophrenia (probable)

Medications

Benzodiazepines and antipsychotics prescribed.

Referring Physician

Dr. Dolapo Oladapo

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Description

Test your knowledge on patient history taking and psychiatric evaluations with this quiz based on a specific case study. This exercise will help you understand the assessment of psychiatric symptoms and the impact of stress on mental health. Perfect for those studying psychology or healthcare-related fields.