DAMS PSYCHIATRY 2022 CLINICAL VIGNETTES SAMPLE CASES FOR PRACTICE
Case 1: A 51-year-old woman presents to her
primary care physician because she is
disturbingly anxious about everything. She is
unable to identify a precipitating event or
particular concern. She worries about her
family, health, and finances. She has little
respite and is frequently irritable, tired, and
unable to concentrate. She has been a
lifelong “worrier,” but the symptoms have
become so intense in the past 6 months that
she thinks she may have to stop working.
Case 2) A 24-year-old woman comes to the
psychiatrist with a 2-month history of short
episodes of “feeling like I am going to die.”
During these episodes, she also notes feelings
of dizziness and nausea, along with a feeling
of choking. She describes these episodes as
very frightening and she is terrified of having
another. She denies substance use of any
medical problems.
Case 3) A 34-year-old secretary climbs 12
flights of stairs every day to reach her office
because she is terrified by the thought of
being trapped in the elevator. She has never
had any traumatic event occur in an elevator;
nonetheless, she has been terrified of them
since childhood.
Case 4) A middle aged person reported to
Psychiatry OPD with the complaints of the
fear of leaving home, fear of travelling alone
and fear of being in a crowd. He develops
marked anxiety with palpitations and swelling
if he is in any of these situations and avoids
public transport to go to his place of work.
Case 5) A 12-year-old boy is very distraught
because every time he thinks or hears the
word God or passes in front of a church,
swear words pop into his mind against his
will. He also feels compelled to repeat the
end of every sentence twice and to count to
20 before answering any question. If he is
interrupted, he has to start from the
beginning.
Case 6: A patient with complaints of having a
deformed nose. He has visited several plastic
surgeons but they have assured that there is
nothing wrong with his nose. In spite of these
reassurances, he continues to believe that his
nose is deformed, He also complains that
nobody takes him seriously because of the
deformity of his nose, and he is extremely
embarrassed because of this.
Case 7. A 35 year old man presents to
psychiatry OPD, he has a history of RTA 2
months back with multiple bone fractures. He
recovered physically, but for last one and half
months, he has been having sleep
disturbances with dreams in which the
incident of accident was getting repeated and
he wakes up often feeling anxious. Also he
used to get startled while walking on road
hearing the sounds of vehicles
Case 8: A 45-years-old woman comes to the
psychiatrist requesting help in coping with
her life. The patient states both of her parents
have recently been diagnosed with cancer
and her husband has just instituted divorce
proceedings. She states she feels
overwhelmed and anxious, with bouts of
crying and panic attacks.
Case 9. A 35 year old male, with pre-morbid
anxious traits and heavy smoker, believes
that he has been suffering from 'lung
carcinoma' for a year. No significant clinical
finding is detected on examination and
investigations. He continues to stick to his
belief despite evidence to the contrary. In the
process, he has spent a huge amount of
These cases are sample questions of different scenarios, student must try to practice making a
diagnosis himself about these in class itself. No separate answer key is available.
Dr. Sachin Arora, Psychiatry Faculty, DAMS
DAMS PSYCHIATRY 2022 CLINICAL VIGNETTES SAMPLE CASES FOR PRACTICE
money, time and energy in getting himself
unduly investigated.
Case 10) A 29-year-old man is brought to the
emergency room by his wife after he woke
up with paralysis of his right arm. The patient
reports that the day before, he had gotten
into a verbal altercation with his mother over
her intrusiveness in his life. The patient notes
that he has always had mixed feelings about
his mother, but that people should always
respect their mothers above all else.
Case 11) A 65-year-old man, who had been
hospitalized for an acute pneumonia 3 days
previously, begins screaming for his nurse,
stating that “there are people in the room
out to get me.” He then gets out of bed and
begins pulling out his IV line. On examination,
he alternates between agitation and
somnolence. He is not oriented to time or
place. His vital signs are as follows: pulse, 126
beats per minute; respiration, 32 breaths per
minute; blood pressure (BP), 80/58;
temperature, 39.2°C (102.5°F).
Case 12) A 65-year-old male is brought to the
outpatient clinic with one year illness
characterized by marked forgetfulness, visual
hallucinations, suspiciousness, personality
decline, poor self care and progressive
deterioration in his condition. His Mini
Mental Status Examination (MMSE) Score is
10.
IDENTIFY THE PERSONALITY DISORDER
Case 13) A 52-year-old man is sent to see a
psychiatrist after he is disciplined at his job
because he consistently turns in his
assignments late. He insists that he is not
about to turn in anything until it is “perfect,
unlike all of my colleagues.” He has few
friends because he annoys them with his
demands for “precise timeliness” and
because of his lack of emotional warmth. This
has been a lifelong pattern for the patient,
though he refuses to believe the problems
have anything to do with his personal
behavior.
Case 14) A demanding 25-year-old woman
begins psychotherapy stating that she is both
desperate and bored. She reports that for the
past 5 or 6 years she has experienced
periodic anxiety and depression and has
made several suicidal gestures. She also
reports a variety of impulsive and selfdefeating behaviors and sexual promiscuity.
She wonders if she might be a lesbian,
though most of her sexual experiences have
been with men. She has abruptly terminated
two previous attempts at psychotherapy. In
both cases she was enraged at the therapist
because he was unwilling to prescribe
anxiolytic medications.
Case 15) A 65-year-old woman lives alone in
a dilapidated house, although her family
members have tried in vain to move her to a
better dwelling. She wears odd and out-offashion clothes and rummages in the garbage
cans of her neighbors to look for redeemable
cans and bottles. She is very suspicious of her
neighbors. She was convinced that her
neighbors were plotting against her life for a
brief time after she was mugged and thrown
onto the pavement by a teenager, but now
thinks that this is not the case. She believes
in the “power of crystals to protect me” and
has them strewn haphazardly throughout her
house.
For queries
Email id psychiqueries@gmail.com
Facebook group : “DAMS EXCLUSIVE CLUB
2022” and tag “Dr Sachin Arora”
These cases are sample questions of different scenarios, student must try to practice making a
diagnosis himself about these in class itself. No separate answer key is available.
Dr. Sachin Arora, Psychiatry Faculty, DAMS