nbme7 blk4 q24 - lady

[ArchivalUser]

a 19y/o student arrested by police because of writing literary phrases on walls of parking lot.his freinds describe him as a happy ,papullar,intelligent,fun loving student who avoid alcohol and drug. his roommate says that he recently had a burst of energy. he has been awake around the clock and wrighting furiosly at his desk and said 'he is onto something big with this novel' he has no history of psychiatry illness and no family history,lab exams are normal.what is the diagnosis?


a.adjustment disorder
b.bipolar
c.delirium
d.major depressive disorder
e.personality disorder,not other specifid
f.schizophrenia

[ArchivalUser]

It can't be adjustment, because the information does not indicate him confronting any different situation than he had before; bipolar would also involve phases of alternating depression- not indicated in the general description or account of the patient. Delirium would be more acute and related to an electrolyte imbalance. MDD is not related to his description; Schizophrenia requires a minimum of 6 months for diagnosis; it could be some sort of schiz but the situation seems more engrained in his personality; he might just be hitting a high in some type of personality disorder he has.

However thinking between E and F.

However, my instinct for this is leaning more towards Schizophrenia (F); perhaps previously undiagnosed.