Lesson: Mood disorders(Vinhean)

Objective: Student be able to recognize symptoms and identify depression and manic feature and how to make the diagnosis. Senario 22- Mrs. W is 33 years old, lives in SvayRieng province, married, garment worker.The previous 4 years, she had been seeking at medical setting because she believed she was having a heart attack.The disorder began 2 months after the delivery of her only child. She suddenly increase in her heartbeat, chest pain and had difficulty breathing. She started 1-2 times a month of sweating and tremblingand feared of dying from a heart attack and currently unable to leave home alone. BP140/ 86- 150/ 90 mmhg, Pulse= 92/mn.

2- Which is the differential diagnostic should be consider?

3- Which is the most probably diagnosis for Mrs. W?

Senario 23- Ms.S is a 17-year-old, student, lives in Phnom-Penh. Her heart started racing, and she became so dizzy that she felt she was going to faint while the teacher asked her a question in the classroom. 4 months before prior, she had not been able to join other students at lunchtimebecause she felt terribly anxious. She always felt like hiding from others (behaving in an embarrassing). Her medical condition has been no abnormal detected. Her BP= 120/70mmhg Pulse= 84/mn. 1- Which is the differential diagnostic should be consider?

2- Which is the most probably diagnosis for Ms. S?

Scenario 24- Mr. J is a 23-year-old, single, farmer, lives in Takeo province. He came to general practitioner because of extreme slowness and indecision. His condition had grown gradually worse over the preceding 6 months. He felt a need to spend a lot of time checking his behavior to make sure that he had caused no harm. He felt compelled to keep checking that he had shut off the water or switched off the light and the electrical appliances. His BP= 125/70 mmhg Pulse= 80/mn. 1- Which is the most suitable thought should be consider?

2- Which is the most probably diagnosis for Mr. J?

Scenario 25- Mrs. His 38-year-old lives in P-Penh with four children. She is a Muslim. She was restless, frightened, apprehensive, sweating on both hands, and breathing rapidly. He explained that the preceding day there had been a quarrel with some neighbors, during which the husband had been seriously threatened with a knife. She was immediately taken to a general practitioner, who gave her an intravenous injection of diazepam. Her BP= 135/85 mmhg Pulse= 92/mn. 1- Which is the differential diagnostic should be consider first?

2- Which is the most probably diagnosis for Mrs. H?

3- What is the intervention should do after an intravenous injection of diazepam?

Scenario 26- Mrs. M is a 32-year-old, garment worker, married and has just given birth to a child. She was angry excitement couple, accused her husband of went out at night. Mrs. M began talking and scolding incessantly, showed hyperactivity; extreme talkativeness that had developed after her delivery 10 days. BP= 120/70 mmhg, Pulse= 80/mn. 1- Which is the most suitable mood should be consider?

2- Which is the differential diagnostic should be consider first?

3- Which is the most probably diagnosis for Mrs. M?

Scenario 27- Mr. T is 36 years old and married, with two children. He was admitted at the general hospital after he had taken an overdose of diazepam. For some weeks he had felt overwhelmed by his workload. He felt tired and had difficulties in concentrating, and experienced feelings of inadequacy. Since that age of 26, he had experienced constantly recurring upset mood. He sometimes he had trouble falling asleep. Mr.T had occasionally seen his general practitioner for a prescription of diazepam to help him get to sleep, 1- Which is the differential diagnostic should be consider first?

2- Which is the most probably diagnosis for Mr. T?

Scenario 28- Ms. D is a 27-year-old nurse in a surgical ward, lives alone in a rented house. She had tried to cut her wristssuperficially. The symptoms started since she was 16 years old, her mood was ups and downs in the current period of 2-3 months. She had difficulty keeping pace with her colleagues and lost her self-confidence. She did not want to go out and thoughts of suicide. BP= 110/70 mmhg, Pulse= 64/mn. 1- Which is the most suitable mood should be consider?

4- Which is the differential diagnostic should be consider first?

3- Which is the most probably diagnosis for Ms. D?

Scenario 29- A is a 40-year-old male, worker, married and lives in Kampong Speu province, 3 children. For 3 months he had been very sad, especially in the morning. At times hehad guilty and wished to die because his wife left him. He had gradually lost interest and enjoyment. His appetite gradually decreased and epigastric pain. He had become irritable and headaches. BP= 120/74 mmhg, Pulse= 84/mn. 1-Which is the differential diagnostic should be consider first?

2- Which is the most probably diagnosis for Mr. A?