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Mental Health 1

1. Mr. Louis Tremblay, 46, visits the clinic after his employer noticed changes in his performance. He reports persistent fatigue over the past month and states he “no longer cares about anything.” He used to enjoy cooking and hiking but stopped participating in both. He sleeps 10–12 hours per night yet wakes up unrefreshed. He denies substance use but admits to significant guilt about “not being good enough” for his family. His appetite has decreased, and he has unintentionally lost 4 kg in three weeks. Which clinical manifestation is MOST consistent with major depressive disorder? *
2. A 29-year-old woman, Marie-Claire, arrives at urgent care stating she felt like she was “going to die” while shopping. She experienced sudden chest tightness, trembling, shortness of breath, and tingling in her fingers. These symptoms peaked within 10 minutes. She denies cardiac history. EKG and vitals are normal except for tachycardia. She reports having similar episodes twice in the past month, triggered without warning. What manifestation is most characteristic of a panic attack? *
3. Ms. Irina Popov, 32, reports feeling “anxious every day” for at least 6 months. She worries excessively about finances, work performance, and her children’s safety, even when there is no real threat. She has difficulty concentrating and complains of muscle tension and headaches. Sleep is poor because she wakes up frequently worrying. Which clinical manifestation strongly supports GAD? *
4. Mr. Julian Morin, 38, a firefighter, seeks help after surviving a recent apartment fire. Over the past month, he wakes up with nightmares of the incident. Loud noises trigger sudden panic and sweating. He avoids watching news stories involving fires and refuses to return to the fire station. Which manifestation is typical of PTSD? *
5. A 25-year-old man arrives accompanied by his sister, who reports that he has not slept in 48 hours and has been pacing around the house. He speaks rapidly, jumps from idea to idea, and insists he has a genius business plan that will make him a millionaire. He appears overly energized and irritable when questioned. Which manifestation is most reflective of a manic episode? *
6. Isabelle (consistent with your preference for continuity), 27, arrives at the mental health clinic after an argument with her partner. She reports feeling abandoned and states, “I can’t handle it when people leave me.” Her mood shifts from tearful to angry within minutes. She admits to impulsively spending $600 last night “to feel better,” and has a history of unstable relationships. Which manifestation best reflects borderline personality disorder? *
7. Mr. Benoit, 41, has stopped taking his antipsychotic medication. He reports hearing voices telling him to “stay inside.” He believes the neighbors are spying on him through the walls. He appears distracted, responding to internal stimuli. Which manifestation is most characteristic of schizophrenia? *
8. A 34-year-old woman states she cannot leave the house without checking every door lock at least 15 times. She recognizes the behavior is unreasonable but feels extremely anxious if she tries to stop. Which finding is characteristic of OCD? *
9. A 52-year-old man with a long history of heavy alcohol use presents with tremors, sweating, nausea, and anxiety 12 hours after his last drink. His hands shake visibly, and he says he “feels like something bad is about to happen.” Which manifestation is typical of early alcohol withdrawal? *
10. A 17-year-old girl comes with her mother, who is concerned about rapid weight loss. The teen avoids meals, says she feels “fat,” and insists on exercising twice a day. Physical signs include bradycardia and fine body hair on her arms. Which manifestation strongly supports anorexia nervosa? *
11. Ms. Florence G., 52, has been off work for two months after losing her sister. Today she moves slowly into the clinic, speaking softly with long pauses between sentences. She reports constant sadness, difficulty concentrating, and “feeling like her body is too heavy to move.” Her family notes she sometimes sits in the same spot for hours without initiating activity. Appetite is poor, and she sleeps excessively. Which clinical manifestation is MOST consistent with her condition? *
12. A 33-year-old man diagnosed with bipolar disorder arrives stating he has no motivation to shower, cook, or leave his bed. He reports feeling worthless and has been sleeping 14 hours per day. He denies mania symptoms like increased activity, risky behaviors, or elevated mood. Which symptom aligns most with a bipolar depressive episode? *
13. Mr. Alain S., a paramedic, experienced a violent accident two months ago. Since then, he sleeps lightly and wakes at the slightest noise. At the clinic, he sits facing the door, scanning the room repeatedly. He avoids driving past the accident site and reports sudden panic when sirens sound. Which manifestation is MOST consistent with PTSD? *
14. Ms. Nadia, 40, has a history of unstable mood episodes and intermittent auditory hallucinations. Today she reports hearing a male voice commenting on her behavior. She also shows depressive symptoms such as hopelessness and decreased appetite. Mood instability occurs even when psychotic symptoms stabilize. Which finding strongly supports schizoaffective disorder? *
15. Isabelle returns to the mental health clinic after abruptly quitting her job following a disagreement with her supervisor. She says she felt “completely rejected.” The night before, she engaged in binge drinking and impulsive spending to “numb the feeling.” She cycles between intense anger and tearfulness within minutes. Which manifestation is MOST typical of BPD? *
16. A 26-year-old pharmacy student states she keeps imagining germs covering her textbooks. These thoughts intrude daily, causing intense anxiety. She spends hours mentally repeating “I am clean” to reduce the fear. She recognizes the thoughts are irrational but cannot control them. Which symptom represents an obsession? *
17. Mr. Renaud, 79, hospitalized for pneumonia, becomes disoriented overnight. He tries to climb out of bed and attempts to remove his IV line. He is restless, easily distracted, and fluctuates between agitation and drowsiness. His baseline cognitive function was normal two days ago. Which manifestation best supports delirium? *
18. A 19-year-old college student avoids presentations and refuses to eat in front of peers. She reports intense fear of being judged and becomes visibly flushed and shaky during class discussions. She prepares excuses to skip group activities. Which manifestation is most consistent with social anxiety disorder? *
19. A 28-year-old new mother arrives with her partner, who reports she cries daily and says she feels “disconnected” from the baby. She expresses guilt for not feeling joy and states she has difficulty sleeping even when the baby is resting. Symptoms began three weeks postpartum. Which manifestation best supports postpartum depression? *
20. A 46-year-old man with a history of chronic back pain has been taking opioids for years. His partner reports he isolates himself, falls asleep unexpectedly, and has pinpoint pupils. He states he often feels “foggy” and admits needing higher doses to feel the same effect. Which manifestation strongly suggests opioid intoxication? *