QUESTION # 1 

A mother brings her 4 - year old son to you for an evaluation with concerns that her son has struggled with speech articulation since very young. He has not sustained any head injuries, and is otherwise healthy and has a normal IQ. His pre-school teacher rep0orts that she does not always understand what he is saying and that other children tease him by calling him a “baby” due to his difficulty with communication. He does not have trouble relating to other people understanding nonverbal social cues. What is the mostly likely diagnosis?

A. Selective mutism

B. Global Development Delay

C. Speech Sound Disorder

D. Avoidant Personality Disorder

QUESTION # 2 

After a routine chest X-ray, a 53-year old man with a history of heavy cigarette use is told that he has a suspicious lesion in his lung. A bronchoscopy confirms the diagnosis of adenocarcinoma. The man delays scheduling a follow-up appointment with the oncologist for more than 2 weeks, describes feeling as if “all of this is not real” is having nightly dreams of seeing his own tombstone and is experiencing intrusive flashbacks to the moment when he heard the physician saying,“The tests strongly suggest that you have cancer of the lung.” He is tearful and is convinced that he will die. He also feels intense guilt that his smoking caused the cancer and expresses the thought that he “deserves” to have cancer. What diagnosis best fits this clinical picture?

A. Acute Stress Disorder

B. Post Traumatic Stress Disorder

C. Adjustment Disorder

D. Major Depressive Disorder

Bonus Question

A 25 year old medical student presents to the student health serviced at 7 A.M complaining of having a “panic attack”. He reports that he stayed up all night studying for his final gross anatomy exam, which starts in an hour, but he feels too anxious to go. He reports vomiting twice. The patient is restless and appears flushed, with visible muscle twitching. He is urinating excessively, has tachycardia, and his electrocardiogram shows premature ventricular complexes. His thoughts and speech appear to be rambling in nature. His urine toxicology report is negative. What is the most likely diagnosis?

A. Panic Disorder

B. Amphetamine intoxication, amphetatmine-like substance 

C. Caffeine Intoxication

D. Cocaine Intoxication

E. Alcohol Withdrawal