jean robert
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A 24-year-old man was recently hospitalized in a psychiatric unit, where he was started on olanzapine. Upon visiting his new primary care physician for a routine physical examination prior to participating in a vocational rehabilitation program, his physician notices that his thoughts are quite illogical. For example, when she asks the young man what sort of employment he hopes to work toward, he answers, "if you subtract some yellow from the sky, it becomes greener." After a brief silence, he then states, "telephone bills should never exceed twenty dollars ... according to the Book of Numbers." Which mental status examination finding most accurately describes this patient's thought processes?
A. Clang associations
B. Concrete thinking
C. Loose associations
D. Tangential thoughts
E. Thought blocking
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Le découragement, c’est du temps perdu.Ce qui est fait n’est plus à faire. Vouloir ce que l’on veut ; le vouloir constamment est le secret des forts.Great works are performed not by strength but PERSEVERANCE.
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| drduck
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I go with...........C
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| GoodGirl
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Looks like C to me - loose associations.
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| doctor4usmle
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C
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| doctor4usmle
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I think we all asnwered in the same minute
 
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Determination is the ability to see past a challenge rather than stare at it...."When the Going Gets Tough, the Tough Get Going"
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| GoodGirl
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yeap 
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| navitha
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C...
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| UsmleUSA
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Yup loose association
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| jean robert
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The correct answer is C.
This patient exhibits thought processes characterized by loosening of associations. His ideas are disconnected and seem to jump from one topic to an unconnected topic. Loose associations are one of the characteristic signs of a primary thought disorder, such as schizophrenia.
Clang associations (choice A) occur when the selection of words or themes is based on a sound of the words rather than on thought content. Words that rhyme are frequently associated. Clang associations, like most other signs of thought disorder, can either be due to a primary thought disorder, a primary mood disorder (e.g., during a manic episode), or related to other problems (such as substance intoxication or delirium).
Concrete thinking (choice B) is characterized by poor ability to think in abstract terms, despite normal intelligence. This case presentation gives no evidence of impairment in abstract thinking.
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Le découragement, c’est du temps perdu.Ce qui est fait n’est plus à faire. Vouloir ce que l’on veut ; le vouloir constamment est le secret des forts.Great works are performed not by strength but PERSEVERANCE.
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| jean robert
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Tangential thoughts (choice D) describe thoughts that go off on a tangent, unrelated, or minimally related to the original idea. With such tangentiality, the patient abandons his ideational objective in pursuit of thoughts peripheral to the original goal. The interviewer is commonly left with the sense that a question to the patient elicited a long string of thoughts that ended up having nothing to do with the original question.
Thought blocking (choice E) occurs when thoughts and speech halt, often in mid-sentence, as if forgotten. The thought may be picked up later, after a period of apparent confusion.
___________________
Le découragement, c’est du temps perdu.Ce qui est fait n’est plus à faire. Vouloir ce que l’on veut ; le vouloir constamment est le secret des forts.Great works are performed not by strength but PERSEVERANCE.
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| claudia_i
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