A 42 Y/O F presents to the primary care clinic c/o persistent worry x8M. She reports feeling constantly "on edge" about her 10 Y/O son's school performance, health, and social life, despite his school reports being excellent and his pediatrician confirming he is healthy. She admits the worrying is excessive but feels unable to control it. She also describes difficulty sleeping, muscle tension, and fatigue. O/E, she is alert, oriented, and cooperative, but visibly tense. Her vital signs are stable. What is the most likely Dx?

A 22 Y/O M is brought to the ED by his family due to increasingly bizarre behavior over 6 months. They report he has socially withdrawn and stopped attending university. The patient states, "The government is monitoring me through a chip in my brain, and they broadcast my thoughts on the radio for everyone to hear." O/E, his speech is tangential with loose associations, and his affect is flat. He occasionally pauses, appearing to listen to something not present in the room. Which of the following best describes the primary disorder affecting this patient?

An 8 Y/O M is brought to the ED by his mother due to increasing social withdrawal. She reports he has no close friends, isolates himself in his room, and is preoccupied with what she calls "bizarre fantasies." The child believes he has telepathic abilities and can influence events with "magic thoughts." He is shy and anxious around unfamiliar people but does not exhibit frank hallucinations or delusions. O/E, he is cooperative but avoids eye contact, and his speech is vague and circumstantial. What is the most likely diagnosis?

A 45 Y/O F with a Hx of major depressive disorder and multiple prior suicide attempts via overdose is being discharged from an inpatient psychiatric unit. Her mood has stabilized, but she requires long-term maintenance antidepressant therapy. The treatment plan aims to minimize the risk of a lethal overdose in the event of a future attempt. Which medication is the most appropriate initial long-term Rx for this patient, considering her high-risk profile?

62 Y/O M with a known Hx of alcoholic cirrhosis (Child-Pugh Class C) is admitted after being found confused and agitated at home. His last drink was 36 hours ago. O/E, he is tremulous, diaphoretic, and disoriented to time and place. BP 165/95 mmHg, HR 118/min, RR 22/min, Temp 38.1°C. He has no focal neurological deficits. AST and ALT are ↑ >3x ULN, and bilirubin is 4.5 mg/dL. Which of the following is the most appropriate initial pharmacological Rx for this patient's agitation and withdrawal symptoms?

A 31 Y/O M is brought to the ED by his family due to a 1-week Hx of erratic behavior. He has not slept for 4 nights, is highly irritable, and has maxed out his credit cards on luxury items. O/E, he is agitated, pacing, exhibits pressured speech, and expresses grandiose, paranoid ideas that the staff wants to steal his "genius inventions." Vitals are stable. The decision is made to initiate inpatient treatment for an acute manic episode. What is the most appropriate initial Rx to manage his acute agitation and stabilize his mood?

A 28 Y/O M with a known Hx of generalized tonic-clonic seizures, well-controlled on lamotrigine, is diagnosed with new-onset schizophrenia. He presents with auditory hallucinations, paranoid delusions, and social withdrawal. O/E: Vital signs are stable. Neurological exam is non-focal. Ix: Baseline ECG is normal, electrolytes and LFTs are within normal limits. The treating team decides to initiate an antipsychotic. Which of the following is the most appropriate initial antipsychotic Rx for this patient?

A 45 Y/O F c/o chronic low mood, anhedonia, & low energy for the past 2 years, following a difficult divorce. Hx reveals poor appetite with weight loss, difficulty initiating sleep, & feelings of hopelessness. She has never had a manic or hypomanic episode. She reports she has "more bad days than good" but has continued to work, though her performance is ↓. Symptoms have not been absent for more than 2 months at a time. O/E: flat affect, psychomotor slowing. What is the most likely Dx?

An 18 Y/O F is brought to the clinic by her parents due to a significant change in behavior over the past 3 months. She recently moved to a new city for university. Initially, she became withdrawn, slept 12-14 hours daily, and lost interest in her studies, causing her grades to drop. For the past week, however, her parents report she is "a different person." She is excessively talkative, sleeps only 2-3 hours/night yet feels "energized," and has been making inappropriate, flirtatious comments to strangers. She has no Hx of substance use. What is the most likely Dx?