| Author | 10 Posts |
DrVirgo
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Migratory joint pains and sad. Should we R/O LYME first before thinking about depression?
Attached Files:
2.33.JPG (89 KB, 105 downloads)
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| khorshid
Forum Guru
Topics: 32
Posts: 591
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I believe you should first rule out lyme for sure!! I remember this scenario from step 1, chronic fatigue and migratory joint pain due to untreated lyme
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| elitoki
Forum Guru
Topics: 54
Posts: 508
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Any patient with depression should be ask about suicidal ideation to rule out life threating situation.
Fatigue and migratory pain for 3 yrs without other manifestations of findings of Lyme disease such as neurological manif, AV block, neither history of skin rash~
I'll go with C.
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| DeltaF508
Forum Junior
Topics: 15
Posts: 67
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He very well could have Lyme, but the way the question is phrased, it seems like the correct answer is C) ask about suicidal feelings. He seems depressed and is preoccupied with his symptoms. I wouldn't rule out him being hypochondriac either.
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| robin082006
Forum Hero
Topics: 471
Posts: 5,125
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C
Dysthymia
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| mytime
Kick my butt!
Topics: 39
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C.
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| dr in trouble
Forum Guru
Topics: 60
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C
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| dr_arc
Forum Senior
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Posts: 156
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time duration of symtoms =3 years plus the fact that he has this big bunch of files he is carrying around makes me think of depressn, rather dysthymia.and in any case of depressn the first thing to ask for is sucide intent.
also if the answer was lyme, the question would have dropped afew more hints such as visit to connecticut , went camping etc.
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| DrVirgo
Forum Hero
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I think we DO have to rule out Lyme,
BUT it only takes a few seconds to ask about suicide and can be lifesaving if he is depressed, so do that FIRST, and then you can R/O Lyme or do any other diagnostic tests later... Just seems like the logical thing to do.
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| gr8doc
Forum Senior
Topics: 8
Posts: 210
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C
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