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What a question?....CMS Psych Form 4 Question - goatmilk
#1
2. Five weeks after being discharged from the hospital after treatment for a psychotic episode, a 27-year-old man comes to the physician for a follow-up examination. During hospitalization, he claimed that he was instructed by the Lord to found a new religion and that a famous gospel singer was in love with him. Today, he says that he still hears the voices of the Lord and members of the church he attends in his apartment and when he shops in the supermarket. He no longer believes the world needs a new religion because the Lord is no longer instructing him to create one. He states, “My father in heaven tells me he is at peace, and therefore, so am I.” Current medications include risperidone and lorazepam. He drinks one to two beers on weekends. He used marijuana regularly in college but has abstained for the past 5 years. He appears clean and is casually dressed. His temperature is 36.7°C (98°F), pulse is 72/min, respirations are 20/min, and blood pressure is 130/72mm Hg. Physical examination shows no abnormalities. Mental status examination shows a calm effect. He is cooperative, alert, and oriented to person, place, and time. Based on this information, which of the following is the most likely current diagnosis for this patient?
A) Bipolar disorder
B) Cyclothymic disorder
C) Delusional disorder
D) Schizoaffective disorder
E) Substance induced mood disorder

Why is C wrong????????????????? None of the other answers seem to fit??
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#2
is it A// since he has grandiose feelings??
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#3
Failed it too. But I think delusional disorders are non bizarre hallucinations. So, it may be schizoaffective disorder.
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#4
Answer is D- Schizoaffective

Hx of Psychotic Episodes, with current auditory hallucinations (hearing things in supermarket), and Manic mood disorder (Grandiose delusions)

Delusional disorder does not approach psychosis or grandiosity (on top of the world) feelings.
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