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Ms. Smith, your client, has been to her internist for a physical checkup due to fatigue and loss of appetite. The internist has referred Ms. Smith to you after finding nothing physiologically wrong with her. During your intake interview, Ms. Smith states, “This has never happened to me before, but since Janie started the university last fall semester, I have just been feeling so down… so blue (she sighs).  I am just so tired, even when I get up in the morning.  I don’t have an appetite… and I have lost about 20 pounds… I just seem so listless, like nothing is fun anymore.  I’ve just about stopped going to my bridge games, and I haven’t been to the health club for months now.  I have never felt this way before… And you know, I forget stuff…. can’t focus on reading….just mope about the house. My husband and son are worried about me, maybe I have some disease or cancer…. I’m just a mess (cries a little) This has been going on for 3 months now…I just can’t even stand myself…”  You diagnose a likely what for this client?  

Sam, 26, is a person with schizophrenia who has had hallucinations and delusions since he was 19, his first psychotic break. Sam believes that he has been cursed by a demon that inhabits his body. He believes that this demon puts creatures inside him, such as snakes, which he believes inhabit his stomach and bowel. He has tried several times to “cut out” these animals. His delusional type is what?

The organization of the DSM-5 is different from that of the DSM-IV-TR. Bipolar Disorder has been put between Schizophrenia and Depressive Disorders, because of one of the following statements. Which is correct?

Will has been extremely energetic and abnormally elevated in mood for two days. He is more talkative and expansive than he usually is. He is extremely energetic and has completed a major project at work that he had been bogged down on. Although he felt good, he was not sleeping well or eating very much. His wife noted his excess energy and made him work on a number of home repairs the third day of his elevated mood. This lasted for four days, after which Peter was rather tired and said he even felt a bit depressed. It appears that Will experienced a what?  

Which of the following are correct statements about suicide?

This test measures the social skills of people from birth to 19 years of age. It is not administered directly to the child, whereas questions are directed to primary caregivers and other people familiar with the child. The test contains four sections: communication, daily living skills, socialization, and motor skills. It is also used for children with behavioral disorders and physical handicaps, and is called what?  

A 55-year-old sedentary office worker with a family history of venous disease presents with dilated, tortuous superficial veins, lower extremity aching, and edema that worsens at the end of the day. These findings are most consistent with varicose veins due to which underlying pathophysiologic mechanism?

The image below shows a map of series of magnetic anomalies (magnetic seafloor stripes) near a mid-ocean ridge, as well a a magnetic reversal timescale. From the information given, what is the age of the oceanic crust at point X?      

A 48-year-old patient presents with persistent throat irritation, intermittent hoarseness, and a chronic nonproductive cough that is worse at night. He denies fever, nasal congestion, or lower extremity swelling. His symptoms have been ongoing for several months. Which of the following symptoms is most commonly associated with gastroesophageal reflux disease (GERD) and should raise clinical suspicion during evaluation?

A 27-year-old female presents with progressive fatigue, palpitations, and generalized weakness. On physical examination, she has pale conjunctiva and nail beds, tachycardia, a soft systolic flow murmur, angular cheilitis, stomatitis, glossitis, and spoon-shaped nails (koilonychia). Which of the following is the most likely diagnosis?