患者男性，17岁，高三学生。半年前无明显诱因出现凭空闻人语，即使在没人的时候也经常听到一些同学在议论自己的声音，并感觉周围同学要联合起来陷害自己，老师也故意刁难自己，为此患者难以集中精力学习，成绩明显下降，回避与人交往。此病人最可能的诊断是

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• 1患者女性，20岁，大学生。家人诉患者近3年来逐渐变得少语少动，孤僻离群，对亲友冷淡，个人卫生需督促，有时发呆，学习成绩明显下降，对自己的前途无打算。未发现幻觉妄想。患者病前性格内向，但学习成绩良好。家族中其叔叔患精神病于15年前离家出走，至今下落不明。此病人最可能的诊断是

  A.青春型精神分裂症

  B.品性障碍

  C.单纯型精神分裂症

  D.抑郁症

  E.人格障碍

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• 2患者男性，30岁。近半年来觉得有人跟踪自己，有人在屋里放了窃听器而不敢大声讲话，常听见有人在议论如何对付他但又看不到人，街上的陌生人对他也心怀恶意，因而表现闷闷不乐，闭门不出，写信到公安局请求保护。此病人最可能的诊断是

  A.青春型分裂症

  B.偏执型分裂症

  C.单纯型分裂症

  D.偏执性精神病

  E.紧张型分裂症

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• 3患者女性，22岁，大学生。自诉近1个月来出现间歇性头胀不适，注意不能集中，入睡困难并经常在早晨4点多就醒来，醒后难以入睡。同时觉得自己比不上别人，喜欢卧床，不愿去教室，说同学看不起她，说同学经常在说话时暗暗地贬低她。交谈时低着头，语音低，流泪，后悔自己不该来读大学而浪费了父母的钱。家属反映患者1个月来体重至少下降了3千克。此病人目前最可能的诊断是

  A.偏执型分裂症

  B.恶劣心境障碍

  C.抑郁症

  D.神经衰弱

  E.单纯型分裂症

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• 4患者男性，18岁。3个月前无明显诱因急性起病，意识清晰，表现说话难以理解，行为幼稚怪异，傻笑，当众裸体，玩弄自己的生殖器。有片段的耳闻远方亲友声音的幻觉，有时觉得有人跟踪。此病人最可能的诊断是

  A.青春型精神分裂症

  B.偏执型精神分裂症

  C.单纯型精神分裂症

  D.病毒性脑炎

  E.分裂样精神病

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• 5You are assigned to a client with schizophreni

  A.You find that this client has lessened reactivity to the environment，rigid posture，resistance to being moved，and even bizarre posturing.Which of the following words is used to describe these behavioursA.Catatonia

  B.Posture fixation

  C.Neuroleptic malignant syndrome

  D.Post synaptic paralytic condition

  E.Disorganized

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• 6女性，43岁，已婚，公务员。近5年来，坚信本单位同部门的两个同事嫉妒自己能力强，因此采取多种方式来恶意陷害、诬陷自己，因此搜集了很多所谓的证据、多次向领导反映、向法院诉讼，家人、朋友解释劝说都无法阻止其上诉。患者一直坚持工作，与其他大多数同事尚能正常交往。该患者最可能的诊断是

  A.心境障碍

  B.妄想性障碍

  C.精神分裂症

  D.急性短暂性精神障碍

  E.无精神病

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• 7A 55-year-old woman presents with 5 weeks of significant depression following the sudden death of her husband. She reports difficulty sleeping，a 5kg weight loss，frequent crying spells，and profound guilt over surviving her. For the last week，she has been convinced that her body is literally decaying. She admits to seeing her husbands face during the day，as well as hearing his voice telling her to kill herself and join him. Which of the following diagnosis is most likely

  A.Major depression with psychotic features

  B.Schizophrenia

  C.Schizoaffective disorder

  D.Adjustment disorder

  E.Psychosis secondary to a general medical condition

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• 8Smith believes that the devil has chosen him for a special mission in the Underworld.He refuses food saying that he has to be pure for his mission.He draws symbols on himself and the walls saying that this will show the way to the devil.Although he cannot explain why and how he was chosen，he cannot accept that his belief is illogical.What symptoms of schizophrenia is Michael showing

  A.Hallucinations

  B.Delusions

  C.Thought blocking

  D.Derealization

  E.Ideas of reference

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• 9Michaels parents are divorced；his father lives in a boarding house and has residual schizophreni

  A.What Symptoms are associated with this subtype of schizophreniaA.Flat affect，lack of motivation social isolation，lack of interest or pleasure in most things， hallucinations or delusions are not prominent

  B.Motoric immobility，waxy flexibility，stupor，negativism or mutism

  C.Persecutory delusions and frequent auditory hallucinations，in the absence of disorganised speech or behaviour or inappropriate affect

  D.Persecutory delusions and frequent auditory hallucinations，in the absence of disorganised speech or behaviour or inappropriate affect

  E.Manifested by two or more of the following：delusions，hallucinations，disorganized speech，grossly disorganized behavior，and negative symptoms

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• 10精神分裂症患者常见的前驱期症状包括

  A.行为改变：如社交退缩或丧失兴趣，多疑敏感，社会功能水平下降等

  B.思维改变：如坚信不疑的认为周围的同事和朋友要陷害自己

  C.认知改变：出现一些古怪或异常观念，学习或工作能力下降等

  D.躯体改变：睡眠和食欲改变，乏力，活动和动机下降等

  E.情绪改变：抑郁，焦虑，情绪波动，易激惹等

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