Final Set of Case-Based Questions - DSM-5-TR Focused PDF

Final Set of Case-Based Questions – DSM-5-TR Focused (Application-Based Scenarios to Prepare for High-Level Midterm Questions) Section 1: Case Vignettes (Diagnosis, Treatment, & Research Application) Case 1: Schizophrenia vs. Schizoaffective Disorder A 23-year-old man has been experiencing hallu...

Final Set of Case-Based Questions – DSM-5-TR Focused (Application-Based Scenarios to Prepare for High-Level Midterm Questions) Section 1: Case Vignettes (Diagnosis, Treatment, & Research Application) Case 1: Schizophrenia vs. Schizoaffective Disorder A 23-year-old man has been experiencing hallucinations and paranoid delusions for the past two years. He believes that government agents are following him and sending him secret messages through TV broadcasts. His parents note that he has become increasingly withdrawn and disorganized in his speech. However, during this time, he has also had several major depressive episodes lasting for months. Question: Based on DSM-5-TR, what is the most likely diagnosis? a) Schizophrenia b) Schizoaffective Disorder c) Major Depressive Disorder with Psychotic Features d) Brief Psychotic Disorder Case 2: PTSD vs. Generalized Anxiety Disorder A 32-year-old combat veteran reports having nightmares and intrusive thoughts about an explosion that killed members of his unit. He avoids crowded places, has frequent mood swings, and becomes easily startled by loud noises. He also constantly worries about his future and struggles to sleep. Question: What is the best diagnosis based on DSM-5-TR? a) Generalized Anxiety Disorder (GAD) b) Post-Traumatic Stress Disorder (PTSD) c) Acute Stress Disorder d) Panic Disorder Case 3: Bipolar I vs. Bipolar II Disorder A 28-year-old woman presents with periods of elevated mood, high energy, and impulsivity lasting about four days. During these times, she sleeps very little but still feels energized, talks excessively, and spends large amounts of money impulsively. However, she has also experienced severe depressive episodes lasting weeks. Her job performance has declined significantly, but she has never had a full manic episode. Question: What is the most likely diagnosis? a) Bipolar I Disorder b) Bipolar II Disorder c) Cyclothymic Disorder d) Major Depressive Disorder Case 4: OCD vs. Hoarding Disorder A 40-year-old woman collects newspapers, magazines, and other items, filling every room in her home. She refuses to discard anything, even if it is broken or no longer useful. When family members try to clean her home, she becomes extremely anxious and distressed. Question: What is the most appropriate DSM-5-TR diagnosis? a) Obsessive-Compulsive Disorder (OCD) b) Hoarding Disorder c) Generalized Anxiety Disorder (GAD) d) Persistent Depressive Disorder Case 5: ADHD vs. Oppositional Defiant Disorder (ODD) A 10-year-old boy struggles to stay focused in class, often gets up from his seat, interrupts others, and frequently loses his school supplies. His teacher reports that he is easily distracted and has trouble following instructions. His parents say he has always been "high-energy," but he does not display significant defiant behavior toward authority figures. Question: What is the most likely diagnosis? a) Attention-Deficit/Hyperactivity Disorder (ADHD) b) Oppositional Defiant Disorder (ODD) c) Conduct Disorder d) Autism Spectrum Disorder (ASD) Section 2: Treatment Selection Case Questions Case 6: PTSD Treatment Selection A 29-year-old woman survived a violent car accident six months ago and now has frequent flashbacks, nightmares, and avoids driving. She experiences intense anxiety and dissociation when near roads and highways. Question: Which treatment is most appropriate? a) Cognitive-Behavioral Therapy (CBT) with Exposure Therapy b) Electroconvulsive Therapy (ECT) c) Psychoanalysis d) Benzodiazepines for long-term symptom management Case 7: Schizophrenia Treatment Selection A 21-year-old man with paranoid schizophrenia has been taking a first-generation antipsychotic for two years but has developed involuntary facial and tongue movements. Question: What is the best next step? a) Switch to a second-generation (atypical) antipsychotic b) Increase the dose of the current medication c) Discontinue medication completely d) Add a stimulant medication to reduce side effects Section 3: Research & Ethics in DSM-5-TR Application Case 8: Longitudinal Study on Depression Risk A researcher is studying the long-term effects of childhood trauma on the risk of developing Major Depressive Disorder (MDD) in adulthood. Question: Which research method is most appropriate? a) Cross-sectional study b) Longitudinal study c) Case study d) Experimental study Case 9: Ethical Considerations in Trauma Research A clinical researcher is conducting a study on childhood trauma and PTSD risk. The study involves interviewing participants about past traumatic events. Question: What is the primary ethical concern? a) Ensuring participants receive financial compensation b) Preventing re-traumatization and providing appropriate psychological support c) Using deception to enhance the realism of the study d) Only including participants with diagnosed PTSD Answer Key with Explanations Section 1: Diagnosis Case Vignettes 1. (b) Schizoaffective Disorder o Schizoaffective Disorder = psychotic symptoms + mood episodes (depression or mania). o Schizophrenia (a) does not require mood episodes. o MDD with Psychotic Features (c) requires psychotic symptoms only during mood episodes. 2. (b) PTSD o PTSD symptoms include intrusive flashbacks, avoidance, hyperarousal, and mood disturbances lasting >1 month. o GAD (a) lacks trauma-related symptoms. 3. (b) Bipolar II Disorder o Bipolar II = hypomanic episodes (≤4 days) + major depressive episodes. o Bipolar I requires a full manic episode. 4. (b) Hoarding Disorder o Hoarding is distinct from OCD and involves distress about discarding items. 5. (a) ADHD o ADHD includes inattention, impulsivity, and hyperactivity. o ODD (b) involves defiance and hostility, which is not present in this case. Section 2: Treatment Selection 6. (a) Cognitive-Behavioral Therapy (CBT) with Exposure Therapy o CBT with Exposure Therapy is the gold standard for PTSD. 7. (a) Switch to a second-generation (atypical) antipsychotic  o Tardive Dyskinesia is a side effect of first-generation antipsychotics. o Atypical antipsychotics have fewer movement-related side effects. Section 3: Research & Ethics 8. (b) Longitudinal study o A longitudinal study tracks participants over time, ideal for studying the development of depression from childhood trauma. 9. (b) Preventing re-traumatization and providing appropriate psychological support o Trauma research requires ethical safeguards to minimize emotional harm.