2. A 32-year-old woman has excessive worry and restlessness for 6 months, worries about many things, and feels her condition is incurable because it’s a mental disorder.

3. A 55-year-old man drinks 1L of vodka daily for 5 years. After stopping, he develops anxiety, restlessness, confusion, sweating, and irritability. Definitive treatment:

4. A 10-year-old boy stopped speaking in class for a month but speaks normally at home. The teacher recalls he was scolded by the principal before this started. Most likely diagnosis:

5. A 75-year-old man believes his wife is unfaithful, checks her phone, and installed CCTV. Despite reassurance, he remains convinced she is lying. Most suitable management:

6. A 28-year-old man has depressed mood, poor motivation, insomnia, and loss of appetite for 6 months. He feels better briefly when with family but quickly returns to low mood.

7. A 25-year-old woman was admitted with a femur fracture after jumping from the first floor following a fight with her boyfriend. Most appropriate response:

8. A 28-year-old lady with bipolar disorder, stable for 8 years on quetiapine 600 mg, now 10 weeks pregnant. She and her husband are concerned about the medication.

9. A 16-year-old with MDD, recently hospitalized twice, now with self-harm and low mood.

10. A 23-year-old student brought to ED after becoming agitated and violent, claiming the TV told him to complete a mission. Initial management:

11. A 42-year-old male post-major surgery becomes fearful of aliens taking him away, is tremulous, and has elevated MCV and GGT. Most likely diagnosis:

12. A 20-year-old woman overdosed on paracetamol and refuses treatment, asking to go home.

13. A 60-year-old man presents with SOB and palpitations after an argument with his son.

14. A 56-year-old post-stroke patient with right hemiplegia feels hopeless and unmotivated for rehab.

15. A 17-year-old girl reports being abused by her uncle, with bruises on her arms.

16. A 70-year-old man now flirts with women and watches sexual videos in front of grandchildren.

17. A 20-year-old with temporal lobe epilepsy has visual and olfactory auras. After levetiracetam, seizures persist and aggression noted.

18. Homosexuality is:

19. An 8-year-old boy with speech delay presents to clinic.

20. Alcoholic man says he drinks because he argues with his wife. Defence mechanism:

21. A 22-year-old girl who self-harmed now asks to go home. Initial step:

22. A 42-year-old woman starts crying during interview while describing life problems.

23. A 55-year-old man presents to ED for psychiatric problem. Possible organic sign:

24. Chronic alcoholic says he drinks because of wife quarrels.

25. Patient with snake phobia shown a picture of cobra while doing relaxation.

26. Children who develop antisocial personality disorder are least likely to:

27. 4-year-old with speech delay, suspected autism.

28. 40-year-old man presents with visual hallucinations and aggression after drinking 6 cans of beer daily.

29. Patient refusing to meet others and isolates at home.

30. 38-year-old man with schizophrenia relapse 6 months ago, now with low mood, anhedonia, poor appetite.

31. A 6-year-old girl cries when leaving for kindergarten, worrying about her mother.

32. A 40-year-old man with femur fracture develops visual hallucinations, tremors, and irritability on day 3.

33. Patient with delirium tremens and visual hallucination during cellulitis admission.

34. Borderline personality disorder — likely childhood history:

35. 22-year-old woman with MDD, recent pesticide ingestion.

36. 40-year-old female patient tells her therapist she wishes he were her husband.

37. 15-year-old orphaned girl reports abuse by aunt and uncle.

38. 27-year-old woman believes her nose is too big and wants repeated surgeries.

39. 85-year-old woman on donepezil shouts for her deceased husband.

40. 35-year-old woman anxious with palpitations, tremor, and weight loss.

41. 15-year-old girl post-parental divorce with low mood and anhedonia. Symptom most suitable for MDD diagnosis:

42. 80-year-old with mild cognitive impairment develops hallucinations after UTI.

43. 19-year-old student hears voices, sees visions, after relationship stress. Most important investigation:

44. 40-year-old housewife repeatedly washes hands for fear of infection.

45. 35-year-old man with erectile dysfunction post-robbery trauma.

46. 28-year-old burn victim becomes agitated and hallucinates about “lizards.”

47. 40-year-old lady with palpitations and chest discomfort for 3 months under stress at work.

48. 20-year-old man breaks into shop claiming government control via TVs, becomes violent.

49. 38-year-old hypothyroid woman remains depressed after normalizing TFTs.

50. Bipolar patient develops eye-rolling, pain, and fear of being alone.

51. 2 days postpartum, first-time mother anxious and fatigued.

52. Schizophrenia patient on risperidone 2 mg for 6 months reports 3 months of amenorrhea.

53. Patient on treatment for panic disorder — which indicates improvement?

54. A 25-year-old restaurant worker was brought to the ETD by his manager after threatening a customer with a knife. He has been restless and irritable for one week, with anhedonia, insomnia, lethargy, and vivid unpleasant dreams. He has misused methamphetamine for 6 months, last used 1 week ago. Most suitable diagnosis:

55. A 35-year-old lady presents with mild depression. On examination, there is a midline neck swelling. Next appropriate step:

56. A 19-year-old office assistant presents tearfully after her boyfriend broke up with her yesterday. She did not sleep well, feels hopeless, and has lost appetite. Most appropriate management:

57. A 20-year-old lady complains of sudden blindness before her final exams. Pupils respond to light, and she avoids obstacles when walking. Parents reduce expectations for exams. Most likely diagnosis:

58. An 18-year-old boy was brought to the ETD after smashing furniture without reason. He’s talkative, irritable, and paranoid for 3 days after relationship stress. Next investigation:

59. A 38-year-old man with pulse 100 bpm, BP 170/95 mmHg, sweating, tremulous, seeing spiders on walls after stopping alcohol for 3 days. Most appropriate initial treatment:

60. A 28-year-old woman with schizophrenia relapsed after her mother’s sudden death. She hears voices and believes people will harm her. Symptoms worsened gradually over 3 years. Her father has MDD. Poor prognostic factor:

61. A 25-year-old engineer working offshore complains of painful intercourse (dyspareunia). She has not had sex for 3 years due to pain and marital conflict. Most appropriate initial management:

62. Mr. M, 70, presents with progressive forgetfulness and recent wandering. He sees strangers in his house and eats imaginary food. Treated syphilis 10 years ago. Diagnosis:

63. Mdm A, 30, with schizophrenia on risperidone 6 mg, now has 3 months of amenorrhea. First management:

64. A 40-year-old housewife fears infection and washes hands up to 20 times daily, gaining temporary relief only. Most suitable treatment:

65. A 17-year-old female becomes blind after witnessing a fight between parents. She is calm about her blindness, pupils reactive, avoids obstacles. Diagnosis:

66. A 30-year-old woman has nervousness, irritability, tremor, sweating, weight loss despite increased appetite for 2 months. Next investigation:

67. A 23-year-old man with schizophrenia seeks employment after 1 year unemployed. Most evidence-based vocational rehabilitation:

68. A 60-year-old lady believes her stomach is rotten, stopped eating, has insomnia and anhedonia. Diagnosis:

69. A 70-year-old post-stroke patient presents with irritability, impulsivity, and poor executive function. Lesion site:

70. A 21-year-old with MDD has poor peer relationships. First treatment priority:

71. A 22-year-old student overdosed, found unconscious, dilated pupils, QTc 583 ms, warm skin. Likely drug:

72. A 26-year-old postpartum woman (4 weeks) with irritability, anxiety about baby, poor bonding. Diagnosis:

73. A 65-year-old man with stage IV cancer feels depressed. Symptom most diagnostic of MDD:

74. A 68-year-old woman with memory loss, inappropriate disinhibition, and forgetfulness. Neurotransmitter deficit:

75. A 26-year-old paranoid schizophrenic needs medication review.

76. A 30-year-old divorced man attains arousal only when wearing women’s clothes. Diagnosis:

77. A 28-year-old woman with mild depression and anxiety for 1 month. Best first-line treatment:

78. On the 7th day postpartum, a woman says, “I feel overwhelmed. I don’t know what to do.” Next best question:

79. A 19-year-old with irrelevant speech, auditory/visual hallucinations for 8 hours. Next investigation:

80. A 16-year-old girl lost 15 kg, BMI 14, amenorrhea, fears weight gain. Nature of belief:

81. Least useful in diagnosing MDD in medical inpatients:

82. An 80-year-old lady with hallucinations after UTI. Diagnosis:

83. 53-year-old with tremor, falls, hallucinations, Parkinson’s disease. Drug to avoid:

84. 56-year-old man post-hip surgery with anxiety, sweating, ↑GGT, ↑MCV. Diagnosis:

85. A 30-year-old woman falls in love with her boss whom she actually dislikes. Defense mechanism:

86. A 26-year-old postpartum woman (4 weeks) with low mood, poor bonding, irritability. Diagnosis:

87. A 35-year-old woman on risperidone 6 months, now amenorrheic. Next step:

88. A man believes aliens twist his bowels. Delusion feature suggesting schizophrenia:

89. An 8-year-old boy with multiple fractures from stepfather. Immediate step:

90. A 65-year-old man convinced his wife is unfaithful; checks clothes, phone. Diagnosis:

91. A 15-year-old girl with vomiting, found to be pregnant after rape by uncle. Immediate management:

92. EMDR is treatment for:

93. A 20-year-old student experiences panic and palpitations during presentations. Diagnosis:

94. A baby born with small eyes, microcephaly, smooth philtrum, failure to thrive, seizures. Causative substance:

95. A 65-year-old man develops erectile dysfunction after new medication. Most likely drug:

96. A 30-year-old lady with tremor, palpitations, sweating, weight loss, poor sleep. Investigation:

97. Patient with panic disorder improving when says:

98. Postpartum day 7 woman says, “I feel overwhelmed.” Most appropriate next question:

99. A 30-year-old with borderline personality alternates between idealizing and devaluing therapist. Defense mechanism:

100. A 28-year-old day-6 postpartum woman wandering, fearful, ignoring baby. Diagnosis:

101. A young man with increased energy, grandiosity, jumped from 2nd floor, now depressed. Diagnosis:

102. A 60-year-old man with tremors, confusion, agitation, no alcohol smell. Drinks daily. Diagnosis:

103. A 12-year-old sniffing glue and truant from school. Most important management:

104. A 12-year-old physically and sexually abused by father. Initial step:

105. Elderly with gradual cognitive decline, paranoia, inappropriate touching. Diagnosis:

106. Charming man with multiple divorces, enjoys deceiving others. Diagnosis:

107. Female patient falls in love with male therapist who was kind. Psychoanalytic concept:

108. Medical patient with depression — least reliable symptom:

109. Man achieves arousal by wearing wife’s clothes; wife divorced him. Diagnosis:

110. Alcoholic man post-surgery on day 2 becomes agitated, tremulous, sweating, disoriented. Diagnosis:

111. 30-year-old woman with fear of contamination, spends hours cleaning. Most appropriate therapy: