Ms. Smith is a 35 year-old female diagnosed with paranoid ty…

Ms. Smith is a 35 year-old female diagnosed with paranoid type schizophrenia. On MSE you identify auditory hallucinations telling the patient to harm herself by cutting.  Her mood is extremely dysphoric. She also exhibits, alogia, avolition and apathy. She denies suicidal thinking or intent and demonstrates good cognitive ability including understanding that the hallucinations are not real. Your best choice for medication management is:

A 67 year old woman comes to the clinic because she is havin…

A 67 year old woman comes to the clinic because she is having difficulty “controlling her movements”. The patient explains that her symptoms have become worse with emotional stress and fatigue. Her past medical history is notable for hypertension, hyperlipidemia, osteoarthritis, and schizophrenia. During the exam the PMHNP notices that she exhibits facial grimacing, smacking of the lips, and twisting movements of her fingers. The patient feels self conscious going to the store because she feels others stare at her. She lives alone and feels isolated. She denies having any delusions or hallucinations. What is the most likely diagnosis?