CLINICAL SCENARIOS EXAM QUESTIONS AND ANSWERS GRADED A+
A 30yo man says his wife has been cheating on him because he does not have a good enough
job to provide for her needs. He also claims that in his previous job, his boss laid him off
because he did a better job than his boss. He has initiated several lawsuits. Refuses couples
therapy because he believes the therapist will side with his wife. Believes neighbors are critical
of him.
What is the diagnosis? Treatment? - Answers Paranoid personality disorder
(Cluster A)
Tx: psychotherapy +/- short course of antipsychotics for transient psychosis
**avoid group therapy**
A 45yo scientist works in the lab most of the day and has no friends, according to his coworkers.
Has not been able to keep his job because of failure to collaborate with others. He expresses no
desire to make friends and is content with his single life. He has no evidence of a thought
disorder.
What is the diagnosis? Treatment? - Answers Schizoid personality disorder
(Cluster A)
Tx: maybe day programs or drop-in centers
+ antidepressants if comorbid MDD
A 35yo man dresses in a wizard costume every weekend with friends as part of a live action role
-playing community. He spends a great deal of time on his computer set up in his basement for
video games and to "detect the presence of extraterrestrial communications in space." He has
no auditory or visual hallucinations.
What is the diagnosis? Treatment? - Answers Schizotypal personality disorder
, (Cluster A)
Tx: psychotherapy for social skills +/- short course of low-dose antipsychotics for transient
psychosis
A 30yo unemployed man has been accused of killing three senior citizens after robbing them.
He is surprisingly charming in the interview. In his adolescence, he was arrested several times
for stealing cars and assaulting other kids.
What is the diagnosis? Treatment? - Answers Antisocial personality disorder
(Cluster B)
Tx: none really!
pharmacotherapy *sometimes* used for sx of anxiety or depression, but may be addictive
A 23yo medical student attempted to cut her wrist because things did not work out with a man
she had been dating over the past 3 weeks. She states that guys are jerks and "not worth her
time." She often feels that she is "alone in this world."
What is the diagnosis? Treatment? - Answers Borderline personality disorder
(Cluster B)
Tx: psychotherapy (DBT)
+ pharmacotherapy for psychotic or depressive sx
A 33yo scantily clad woman comes to your office complaining that her fever feels like "she is
burning in hell." She vividly describes how the fever has affected her work as a teacher.
What is the diagnosis? Treatment? - Answers Histrionic personality disorder
(Cluster B)
A 30yo man says his wife has been cheating on him because he does not have a good enough
job to provide for her needs. He also claims that in his previous job, his boss laid him off
because he did a better job than his boss. He has initiated several lawsuits. Refuses couples
therapy because he believes the therapist will side with his wife. Believes neighbors are critical
of him.
What is the diagnosis? Treatment? - Answers Paranoid personality disorder
(Cluster A)
Tx: psychotherapy +/- short course of antipsychotics for transient psychosis
**avoid group therapy**
A 45yo scientist works in the lab most of the day and has no friends, according to his coworkers.
Has not been able to keep his job because of failure to collaborate with others. He expresses no
desire to make friends and is content with his single life. He has no evidence of a thought
disorder.
What is the diagnosis? Treatment? - Answers Schizoid personality disorder
(Cluster A)
Tx: maybe day programs or drop-in centers
+ antidepressants if comorbid MDD
A 35yo man dresses in a wizard costume every weekend with friends as part of a live action role
-playing community. He spends a great deal of time on his computer set up in his basement for
video games and to "detect the presence of extraterrestrial communications in space." He has
no auditory or visual hallucinations.
What is the diagnosis? Treatment? - Answers Schizotypal personality disorder
, (Cluster A)
Tx: psychotherapy for social skills +/- short course of low-dose antipsychotics for transient
psychosis
A 30yo unemployed man has been accused of killing three senior citizens after robbing them.
He is surprisingly charming in the interview. In his adolescence, he was arrested several times
for stealing cars and assaulting other kids.
What is the diagnosis? Treatment? - Answers Antisocial personality disorder
(Cluster B)
Tx: none really!
pharmacotherapy *sometimes* used for sx of anxiety or depression, but may be addictive
A 23yo medical student attempted to cut her wrist because things did not work out with a man
she had been dating over the past 3 weeks. She states that guys are jerks and "not worth her
time." She often feels that she is "alone in this world."
What is the diagnosis? Treatment? - Answers Borderline personality disorder
(Cluster B)
Tx: psychotherapy (DBT)
+ pharmacotherapy for psychotic or depressive sx
A 33yo scantily clad woman comes to your office complaining that her fever feels like "she is
burning in hell." She vividly describes how the fever has affected her work as a teacher.
What is the diagnosis? Treatment? - Answers Histrionic personality disorder
(Cluster B)
