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NBME Form1, 18Y man, fatigue
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Author7 Posts
  #1

An 18-year-old man comes to the physician for an initial examination because of a 3-year history of fatigue and migrating joint pain. He has brought a large folder containing information about previous medical consultations, laboratory tests, and x-ray films. He takes no medications. He weighs 50 kg (110 lb) and is 173 cm (68 in) tall. Physical examination shows no other abnormalities. On mental status examination, he is preoccupied with his symptoms. When asked about his mood, he states that the future appears bleak, and that he is too tired to think about it. Which of the following is the most appropriate next step in management?

A) Ask about further symptoms of obsessions and compulsions

B) Ask about sexual history including sexual orientation and practices

C) Ask about suicidal feelings

D) Ask about travel history over the past 6 months

E) Obtain a detailed exercise history

F) Measurement of serum Lyme (Borrelia burgdorferi) antibody level





  #2

C) Ask about suicidal feelings


___________________
"Obstacles are those frightful things you see when you take your EYES off your goal."

  #3

A ask about other symp of ocd

  #4

c


  #5

Me thinks it is "A" I would have chosen C but there is one specific line in the question
"On mental status examination, he is preoccupied with his symptoms" suggesting some OCD or something.
Concerning his future, he didn't indicated he wants to terminate it, only that he is "too tired to think about it" Thankfully, his future still exists, too bad he is too tired to think about it,


  #6

c first
most dangerous one, have to confront first

  #7

i think it's C










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