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* nbme3
 #137024  
  archie11 - 11/09/06 15:56
 
  A 15-year-old girl is brought by her mother for a routine health maintenance examination. The girl asks to speak to the physician alone and reports that her father fights with her constantly about grades, friends, and after-school activities. She says that he has raised his hand as if to strike her on one or two occasions. She says that recently she "lost it" and told him that she hates him and can hardly wait to leave home. She admits that she often cries. Her mother has a history of severe migraines, and the patient is reluctant to tell her mother about her problems because it might cause a migraine. The patient weighs 50 kg (110 lb) and is 157 cm (62 in) tall. Her temperature is 36.9°C (98.4°F), blood pressure is 98/68 mm Hg, pulse is 76/min, and respirations are 16/min. Physical examination shows no abnormalities. On mental status examination, she is animated, articulate, and relates well to the examiner. Which of the following is the most appropriate next step in management?

A
) Reassurance that this is normal adolescent stress

B
) Notifying child protective services

C
) Admission to the psychiatric unit

D
) Family therapy

E
) Trial of fluoxetine
 
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* Re:nbme3
#551269
  ramya123 - 11/09/06 16:07
 
  d)family therapy  
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* Re:nbme3
#551320
  docfoofoo - 11/09/06 16:17
 
  hey archie i think this is normal growing pains......... A reassurance  
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* Re:nbme3)
#551636
  xwxf - 11/09/06 18:25
 
  Family therapy  
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