SMLE Psychiatry 3

Question 1

A 28-year-old woman presents with recurrent episodes of binge eating followed by self-induced vomiting.
She is of normal weight.
Physical examination reveals dental enamel erosion and parotid gland enlargement.
What is the diagnosis?

Accepted Answer

Bulimia nervosa

Answer

Anorexia nervosa, binge-purge type

Answer

Binge eating disorder

Answer

Rumination disorder

Question 2

A patient being treated with clozapine develops fever, sore throat, and a WBC count of 1,500/μL with an absolute neutrophil count of 400/μL. What is the immediate action?

Accepted Answer

Discontinue clozapine immediately and isolate the patient

Answer

Continue clozapine and add antibiotics

Answer

Reduce the clozapine dose by half

Answer

Add granulocyte colony-stimulating factor and continue clozapine

Question 3

A 10-year-old boy has difficulty sustaining attention, is easily distracted, fidgets constantly, talks excessively, and has difficulty waiting his turn. Symptoms have been present since age 5 and affect school and home. What is the most likely diagnosis?

Accepted Answer

Attention deficit hyperactivity disorder (ADHD), combined type

Answer

Conduct disorder

Answer

Oppositional defiant disorder

Answer

Autism spectrum disorder

Question 4

A 40-year-old man presents with persistent preoccupation that he has cancer despite multiple normal investigations and reassurance from specialists. The preoccupation has lasted 8 months and causes significant distress. What is the most likely diagnosis?

Accepted Answer

Illness anxiety disorder (hypochondriasis)

Answer

Somatic symptom disorder

Answer

Conversion disorder

Answer

Factitious disorder

Question 5

In Saudi Arabia, according to the Mental Health Act and SCFHS guidelines, involuntary psychiatric admission is permitted under which condition?

Accepted Answer

When there is imminent danger to self or others due to mental illness

Answer

When the patient refuses any medication

Answer

When the family requests admission

Answer

When the patient is homeless

Question 6

A 20-year-old soldier presents after witnessing an explosion with inability to move his legs. Neurological examination and MRI are completely normal. He appears indifferent to his symptoms (la belle indifférence). What is the most likely diagnosis?

Accepted Answer

Conversion disorder (functional neurological symptom disorder)

Answer

Malingering

Answer

Somatic symptom disorder

Answer

Factitious disorder