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* NBME-psych form 4
  kennychan - 12/28/17 16:49
  A 32-yo woman comes to the physician because of depressed mood for 2 weeks; she went on a drinking binge over the weekend and has been binge eating for 2 days but has not purged. She has a history of bulimia nervosa. She has been sexually active with multiple sexual partners over the past month; she uses an oral contraceptive, and her partners use condoms. She takes paroxetine for dysthymic disorder. Abdominal examination shows mild tenderness in the right upper quadrant. She has poor eye contact and appears close to tears. She describes many new stressors in her life and has thought about taking a full bottle of aspirin. Which of the following is the most appropriate to ask this patient?
a) “Do you exercise regularly to relieve stress?”
b) “How do you feel about attending an alcohol treatment program?”
c) “How would you feel about entering the hospital?”
d) “Is there someone I could call to get some support for you”
e) “what would you like me to do?”

Thank You for your opinions!
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* Re:NBME-psych form 4
  kennychan - 12/28/17 17:05
  Five weeks after being discharged from the hospital after treatment for a psychotic episode, a 27 yo M comes to the physician to the physician for a follow –up examination. During hospitalization, he claimed that he was instructed by the Lord to found a new religion and that a famous gospel singer was in love with him. Today, he says that he still hears voices of the Lord and members of the church he attends in his apartment and when he shops in the supermarket. He no longer believes the world needs a new religion because the Lord is no longer instructing him to create one. He states, “My father in heaven tells me that he is at peace, and therefore, so am I.” Current medications include risperidone and lorazepam. He drinks one to two beers on weekends. He used marijuana regularly in college but has abstained for the past 5 years. He appears clean and is casually dressed. His temperatures is 36.7 C, pulse is 72/min, respirations 20/min, an blood pressure is 130/72 mm Hg. Physical examination shows no abnormalities. Mental status examination shows a calm effect. He is cooperative, alert and oriented to person, place, and time. Based on this information, which of the following is the most likely current diagnosis for this person?
a) Bipolar disorder
b) Cyclothymic disorder
c) Delusional disorder
d) Schizoaffective disorder
e) Substance-induced mood disorder

Thank You for your opinions!

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* Re:NBME-psych form 4
  faith16 - 12/28/17 17:56
  1. C due to Sucidal Ideation
not sure about 2
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* Re:NBME-psych form 4
  movingtaughtme - 12/29/17 12:53
  1C due to suicidal ideation
2C beacuse his symptoms are majorly delusional and no manic or depressive episodes.
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