docdoc9
Forum Guru
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10. A 77-year-old man comes to the physician because of a 3-month history of fatigue and decreased appetite resulting in a 4.5-kg (10-Ib) weight loss. He also has had depressed mood and decreased concentration. He is no longer interested in participating in his weekly golf outing and rarely attempts to visit with friends. He is no longer motivated to clean his house and keep up with his bills. He says he
can hear his wife, who has been dead for 4 years, telling him that his loss of appetite is due to cancer and that he should end his life before he goes through the same painful death that she did. Physical examination shows no abnormalities. Mental status examination shows a depressed mood. He is able to recall two of three objects after 5 minutes. There is no evidence of suicidal ideation. Which of the following is the most likely diagnosis?
O A) Adjustment disorder with depressed mood
O B) Dysthymic disorder
O C) Major depressive disorder with psychotic features
O D) Pathological bereavement
0 E) Schizoaffective disorder
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| jmkhanzada
Forum Junior
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ITS ........D
OTHER R NO FIT IN THIS CRITERIA
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| nightflight1945
banned
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C) Major depressive disorder with psychotic features
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| docdoc9
Forum Guru
Topics: 63
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@ nightflight
can you explain your answer
why cant it be schizoaffective disorder?(depressed mood + auditory hallucinations
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| nightflight1945
banned
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First : it is a nonscientific suggestion , but schizoaffective is rarely if ever the answer in the questions because it needs a lot of description and also it is a controversial entity and diagnosis of exclusion
However:
for schizoaffective there should be 2 weeks of shizo symptoms without mood disorders , but it is not explained in the question
the patient's hallucinations are mood congruent (a characterisric of hallucinations in mood disorder) .
In DSM4 when symptoms can be defined by better diagnosis , then that is the diagnosis.
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| alb123
Forum Newbie
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I agree I say C..
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