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* NBME form 5 block 1
 #757120  
  whatsfordinner - 11/06/13 15:08
 
  this is question 10 from the offline version i was doing
a 26 year old man comes to the doc becuase of a 6 month history of losing consciousness when he laughs. he sleeps 12 to 14 hrs every night, has vivid dreams and nightmares and feels tired during the day. he was recently involved in a motor vehicle collision. finding on phyical examination are unremarkable. Whiich of the following is the most likely diagnosis?
a) absence seizures
b)complex partial seizures
c) major depressive disorder
d) malingering
e) narcolepsy
f) post traumatic stress disorder
g) sleep apnea
h) sleep terror disorder
 
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* Re:NBME form 5 block 1
#3000931
  dh1026621 - 11/06/13 15:16
 
  BB. complex partial seizures  
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* Re:NBME form 5 block 1
#3000935
  usmlemle2013 - 11/06/13 15:18
 
  e.  
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* Re:NBME form 5 block 1
#3000941
  shahad1234 - 11/06/13 15:27
 
  narcolepsy  
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* Re:NBME form 5 block 1
#3000942
  whatsfordinner - 11/06/13 15:27
 
  dh1026621 explain please  
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* Re:NBME form 5 block 1
#3000949
  dh1026621 - 11/06/13 15:35
 
  narcolepsy's characteristic is excessive daytime sleepiness and cataplexy in some patients.so i did not pick up EE.  
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* Re:NBME form 5 block 1
#3000954
  whatsfordinner - 11/06/13 15:49
 
  yess narcolepsy  
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* Re:NBME form 5 block 1
#3000955
  usmlemle2013 - 11/06/13 15:50
 
  though excessive day time sleepiness is primary characteristic, look for other features of narcolepsy...
starts off with REM sleep.......... vivid dreams and night mares
he's sleeping 12-14 hrs still he is tired,
cataplexy - loss of muscle tone following strong emotional stimulus
 
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* Re:NBME form 5 block 1
#3000988
  dh1026621 - 11/06/13 16:35
 
 
@usmlemle2013

I agree with you, but still not quite sure for this question.

Is cataplexy - a sudden transient loss of muscle tone same as losing consciousness?

narcolepsy's classic characteristic:
Cataplexy
Sleep paralysis
Hypnagogic hallucinations
excessive daytime sleepiness

@whatsfordinner

please provide a correct answer.
 
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* Re:NBME form 5 block 1
#3001003
  whatsfordinner - 11/06/13 16:50
 
  i chose narcolepsy, but based on some answer keys iv seen online ( i was doing this nbme offline) some were saying malingering but i dont see how that makes sense, there is no evidence of any gain. the vast majority of people say narcolepsy including maryam2009 in an older post.  
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* Re:NBME form 5 block 1
#3001006
  whatsfordinner - 11/06/13 16:51
 
  i posted the question to see if anyone else felt malingering would be a viable answer  
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