nbme 2 block 1 q 27 - stranger016

[ArchivalUser]

Five months after beginning fluoxetine to treat obsessive-compulsive disorder, a
19-year-old man states that he discontinued his medication 2 months ago because he had begun to worry about taking his medication every day. His initial response to the medication was good. His symptoms have now returned, and his morning ritual of cleaning and grooming consumes so much time that his job is in jeopardy. In addition to education about the nature of his disorder and its treatment, which of the following is the most appropriate next step in management?

A) Tell the patient to schedule a return visit as needed

B) Offer to change the medication

C) Request that the patient's parents superviseadministration of medication

D) Monitor the patient's compliance by weekly blood tests

E) Begin a trial of cognitive-behavior therapy


please help guyss

[ArchivalUser]

B
Change medication to a weekly medication...

[ArchivalUser]

He is not compliant and in my opinion there is small chance that he will be taking pills, he will discontinue again. So in OCD - cognitive behavioral therapy.

[ArchivalUser]

i thought CC because the medication is working and the only problem is compliance so educate the patient about theneed to be compliant ask the parents to supervise?

any comments

[ArchivalUser]

it is E cognitive -Behavioral therapy

[ArchivalUser]

Stranger, he is 19 year old and he is competent so you can eliminate c.

[ArchivalUser]

hmmmm...E looks good to me as well because CBT is the first line management of OCD and pharmacotheraphy is second line...since this patient is non compliant switch to first line treatment looks better choice...

thanks guys

[ArchivalUser]

I agree too, E looks good. Hey stranger can we skype. I'm doing NBME 2 now. ID: ronnysplash

[ArchivalUser]

E better choice than B as he is not complaining about any side effect he is showing worries about forgetting to take med so probably CBT address his issue