docnikki
Forum Guru
Topics: 93
Posts: 680
|
1) Five months after beginning fluoxetine to treat obsessive-compulsive disorder, a
19-year-old man states that he discontinued his medication 2 months ago because
he had begun to worry about taking his medication every day. His initial response
to the medication was good. His symptoms have now returned, and his morning
ritual of cleaning and grooming consumes so much time that his job is in jeopardy.
In addition to education about the nature of his disorder and its treatment, which
of the following is the most appropriate next step in management?
A) Tell the patient to schedule a return visit as needed
B) Offer to change the medication
C) Request that the patient's parents superviseadministration of medication
D) Monitor the patient's compliance by weekly blood tests
E) Begin a trial of cognitive-behavior therapy
2) A 23-year-old man is brought to the physician by his mother because he has heard
a voice over the past month telling him to hurt himself. His mother says that her
son has no friends and is a lifelong loner; since graduating from high school, he
has been unable to hold a job. He admits to smoking marijuana occasionally and
drinking six beers weekly. Examination shows a poorly groomed man with poor
eye contact. He has a flat affect and limited facial expression. He says he has no
intention of harming himself or others. Which of the following is the most
appropriate next step in management?
A) Schedule a follow-up visit in 4 weeks
B) Prescribe oral risperidone and schedule a follow-up visit in 2 weeks
C) Admit him to the partial hospital program and prescribe oral lithium carbonate
D) Admit him to the psychiatric unit for detoxification
E) Admit him to the psychiatric unit and prescribe oral imipramine
3) A 35-year-old woman is brought to the physician
by her husband
because of increasing memory loss and involuntary
"dancing" movements
over the past 6 weeks. She has had difficulty
remembering things,
particularly recent events. She has had no
disturbances in sleep or appetite.
Her medical history is unremarkable. She does not
remember her mother
who died 25 years ago, but her father told her that
her mother had
similar symptoms several years before her death.
Neurologic examination
shows involuntary choreiform movements. She has a
childlike affect. She
describes her mood as good. On recall testing, she
can remember one out
of three objects after 3 minutes with distraction; she
cannot remember
the other objects with prompting. She cannot remember
the date of her
marriage or her previous address. The most likely
cause of these
symptoms is a lesion at which of the following
locations?
A
) Caudate nucleus
B
) Parietal lobe
C
) Prefrontal lobe
D
) Putamen
E
) Temporal lobe
4)A 67-year-old man comes to the physician
because of insomnia for
2 years. He goes to bed at 11:00 PM after taking a
bath but does not
fall asleep until midnight. He usually wakes up twice
each night: once
around 3:00 AM to void and again at 6:00 AM. He stays
in bed until his
alarm goes off at 7 AM. He is concerned because he
used to sleep 8
hours daily. He recently retired from his job as an
attorney. He takes
no medications. He drinks one beer with lunch 3 days
each week and one
glass of wine with dinner each evening. He walks 1
mile daily after
dinner. Physical examination shows no abnormalities.
His mood is
neutral, and cognition is intact. Urine toxicology
screening is negative.
Which of the following is the most likely cause of
this patient's
symptoms?
A
) Advanced sleep phase syndrome
B
) Alcohol abuse
C
) Delayed sleep phase syndrome
D
) Major depressive disorder
E
) Melatonin deficiency
F
) Poor sleep hygiene
G
) Normal aging
5) A 22-year-old man with schizoaffective disorder
is brought to
the emergency department 2 hours after the sudden
onset of neck and back
pain. The symptoms began after taking one of his
medications for his
psychiatric disorder. The dosage was increased
yesterday, but he does
not recall the names of either of his medications. He
has no other
history of serious illness. Physical examination
shows rigid contraction
of the neck and back muscles with arching. On mental
status
examination, he is alert and cooperative and hears a
faint voice that tells him to
wash windows. He is oriented to person, place, and
time. Which of the
following medications is most likely responsible for
this patient's
symptoms?
A
) Clozapine
B
) Haloperidol
C
) Lithium carbonate
D
) Trazodone
E
) Valproic acid
|
| sera
Forum Senior
Topics: 14
Posts: 141
|
1 E
2B
3 A
4 F
5 B
___________________
syra
|
| fongch
Forum Elite
Topics: 71
Posts: 316
|
1 E
2 B
3 A - Hungtinton
4 F?
5 B
|
| usmle12
Forum Senior
Topics: 19
Posts: 194
|
EBAGB
|
| mister
Forum Newbie
Topics: 0
Posts: 5
|
EBAGB
|
| robin082006
Forum Hero
Topics: 471
Posts: 5,119
|
1 E
2B
3 A
4 B
5 B
___________________
The Key to Succeed is Patience.
|
| lq2006
Forum Elite
Topics: 25
Posts: 355
|
E
B
A
G
B
|
| Markus2009
Forum Senior
Topics: 9
Posts: 189
|
E
B
A
F
B
|
|
| |
| | | | | | | | |
