Fifteen minutes after administration of intramuscular haloperidol, a 21-year-old… Dopamine A 47-year-old woman is admitted to the hospital because of a 12-hour history of…, 31. It is 6 weeks (more than 2 ), psychmotor, flat emotion, dementia, sleeping problem, poor hygiene,decreased appetite (reslts in weight loss) . The answer explanations may not be reproduced or distributed, in whole or in part, without written permission of Step Prep. A 47-year-old man is brought to the emergency department 1 hour after he…, 17. A 32-year-old man comes to the physician because he thinks he might be losing…, 43. After she gets into bed at night, her legs feel cold and crampy, and she cannot settle into a comfortable position. grandmother has major depressive disorder. I also did this NBME form online with extended feedback and this was the correct answer. The patient is started on escitalopram and scheduled for a follow-up appointment in two weeks. narrowed down to MDD and restless leg then convinced myself that elderly are at higher risk for MDD than RLS. A previously healthy 25-year-old woman is brought to the emergency department…, 30. NBME Clinical Neurology Test A 57-year-old woman comes to the physician because of a 2-year history of difficulty sleeping. For the other cardiovascular factors, the only ones proven to improve mortality are statins, ACEi, BB (esp. He's jaundiced, and basically has a mass in the head of the pancreas that has extended into the stomach and biliary system. There is a 1 × 1-cm abrasion in the right frontal area. Retinoic acid and HOX gene products recognize and bind to specific DNA sequences at various chromosome sites. A 37-year-old man comes to the physician for a follow-up examination 3 months…, 19. Though everything else fits, in order to diagnose RLS you need to actually have leg symptoms which aren't described here at all. A - not accusing him, but trying to get it out of him 3. 1,000 characters at a time (or fewer), please! vs delusional disorder see below Guess she has major depressive disorder even though she doesn't have 5 diagnostic symptoms that lasted longer than 2 weeks and none of them include depressed mood or anhedonia. NBME Answers & Explanations — Updated daily. 3paroxysmal nocturnal dyspnea is one of the first signs of decompensated heart failure but the physical examination was normal that means no lung crackles. NBME Answers and Explanations! Bacterial pneumonia. A 42-year-old man comes to the physician for a routine health maintenance…, 37. A 21-year-old woman is brought to the emergency department by police after…, Admit the patient to the psychiatric unit, 8. acetametophin toxicty I put compression but i honestly have no idea.. will try to find out Paraganglioma. A 57-year-old woman comes to the physician because of progressive loss of…, 3. Amphotericin B. A 52-year-old woman comes to the physician with her husband because of a 6…, 36. Patient with depressed mood, decreased energy, poor concentration, and sleep changes (consistent with major depressive disorder) following initiation of propranolol, most consistent with medication-induced mood disorder; 14. An 87-year-old man who resides in a skilled nursing care facility is brought to…, Decrease the dosage of carbidopa-levodopa, 24. A 32-year-old man is brought to the emergency department by his roommate…, 12. Common symptoms of depression include SIG E CAPS (including insomnia). A 32-year-old man is brought to the physician by his wife because of increasing…, 28. THis question was very vague but depression was edged out because sleep apnea is more likely in overweight middle aged males. "Since symptoms can increase in severity during the night, it could become difficult to fall asleep or return to sleep after waking up", "RLS is one of several disorders that can cause exhaustion and daytime sleepiness, which can strongly affect mood, concentration, job and school performance, and personal relationships. A 7-year-old boy is brought to the physician by his mother because of difficulty at…, 22. Everything in the stem points towards restless leg syndrome. * Re:NBME 13 discussion #2616243 : smadahar - 03/14/12 17:31 : 1. major depressive disorder - it's in kaplan behavioral science 2. Free 120 NBME 24 NBME 23 NBME 22 NBME 21 NBME 20 NBME 19 NBME 18 NBME 17 NBME 16 NBME 15 NBME 13 home login register ⋅ contact ... Major depressive disorder ... or advanced cancer of any kind that would require aggressive treatment with poor prognosis would be associated with major depression. A 47-year-old man is admitted to the hospital 20 minutes after he was involved in…, 25. A 16-year-old high school student will not eat meals with her family, preferring to…, 34. A 47-year-old woman with schizophrenia, paranoid type, comes to the physician…, 7. Patient with >2 week history of SIGECAPS symptoms (specifically Sleep changes, Guilt, decreased Energy, Cognitive dysfunction, Appetite changes) and somatic symptoms most consistent with major depressive disorder; Adjustment disorder would not have as severe a presentation; Borderline –> Chronic time course We are not affiliated with the NBME, USMLE or AAMC. His blood alcohol concentration is 0.5 mg/dL, and It's not a great question and I completely missed MDD as well, but I can kinda see now why it's MDD more so than any of the other choices so it's kind of a "but which is the BEST answer" scenario. Examination shows an extremely agitated and suspicious patient. 2) Narcolepsy - common in young adults adolescents - also associated with daytime unexpected naps (after which the person feels fresh) despite normal nightime sleep. hypnoGO to sleep = night time hallucinations. A 77-year-old man is brought to the physician by his wife because of a 6-month…, 38. 21-Hydroxylase. He does not use drugs, but his mother states that he frequently drinks beer. I chose MDD: The lady w/ poor concentration, decreased energy for a month, and 6 months of waking up in the night. Major depressive disorder. It is not a paroxysmal nocturnal hemoglobinuria. ... Major depressive disorder. A 62-year-old woman comes to the physician because of auditory hallucinations…, 5. A 23-year-old man with a 3-year history of bipolar disorder well controlled with…, Explain the risk of illness recurrence without medication. 1) terminal insomnia oncology - 05/10/15 22:21 Correct answer is B- Major depressive disorder. Schizophrenia >6 months. A 27-year-old man comes to the emergency department after a motor vehicle…, 29. Disruption of the secondary structure of collagen molecules. NBME Answers & Explanations. There is a clear association between pancreatic cancer and depression. I agree that MDD also requires a bit of a stretch bc not all of the diagnosis requirements are met which is annoying, but at least the core components are there (decreased energy, sleep disturbances, lack of concentration), whereas the core component of RLS isn't there at all. He was initially treated for scabies in the emergency department. narcolepsy: Associated with hypnogogic or hypnopompic hallucinations. THIS SUBREDDIT IS NOT AFFILIATED IN ANY WAY WITH THE NATIONAL BOARD OF MEDICAL EXAMINERS (NBME). Is that valid reasoning? * Re:nbme 15 #3049368 : alexa22 - 02/16/14 16:11 : B - Major Depressive Disorder is correct. paroxysmal nocturnal dyspnea: PNH is a hemolytic anemia. Major depressive disorder. A 21-year-old college student comes to the physician because of a 3-year history…, 39. Young patient with 2-month history of depressed mood + impaired cognitive function + low energy + decreased interest in socializing thus meeting criteria for major depressive disorder; Formal definition of MDD: At least 2 weeks with at least 5/9 of the following symptoms (1. A 46-year-old woman is brought to the emergency department in respiratory…, 10. pain for 2 months and weight loss. 3) periodic leg movements could be REM Phenomena where muscles are not paralysed during REM sleep. he has no chronic medical conditions and currently takes no medications. Depressi… A 47-year-old man comes to the physician because of a 4-week history of…, 14. This question is describing terminal insomnia, which is common either in MDD or normal aging. Multifactorial. A 13-year-old girl is brought to the physician by her mother because she has not…, 6. Patients with major depressive disorder (MDD) who also gamble have a significantly increased suicide risk and need to be vigilantly monitored, new research suggests.. A … Almost as bad as incorrect presentations of common diseases. Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. A 5-year-old girl is brought to the physician by her parents because of difficulty…, 50. Plus, old age is a risk factor for MDD. He'll be depressed since he's more than likely going to die soon. An 8-year-old boy is brought to the physician by his mother because of a…, Decreased binding of dopamine at the postsynaptic receptor, 18. A 55-year-old woman is brought to the emergency department by her parents…, 26. A 37-year-old woman is admitted to the hospital after a suicide attempt by an…, Decreased concentration of 5-hydroxyindoleacetic acid in cerebrospinal fluid analysis, 35. A 20-year-old college student comes to the physician because of a 1-year history of…, 21. Herpes simplex virus. 4)In sleep apnea the patient has poor quality of sleep but doesn't awaken. This code is grouped under diagnosis codes for mental disorders. A 3 1/2-year-old boy is brought to the physician by his parents because he has…, 13. Report Abuse He is 168cm (5ft 6in) tall and weighs 50kg (110lb), BMI is 18hg/m2. Also called major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems. His…, 45. Are they saying he is at risk for major depression as a result of the cancer diagnosis? Introduction: Mood state, syndrome, and/or mental disorder characterized by dysphoria (sad/irritable) Translation. No signs of hemolytic anemia (hematuria, jaundice, dec. haptoglobin). https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Restless-Legs-Syndrome-Fact-Sheet. There is no disturbance of mood, sleep, or appetite. Residency Advising and Interview Preparation, Patient is displaying normal age-related changes (early morning awakening, falling asleep during day, normal mood, Mini-mental state > 23), Woman who experienced a significantly traumatic event and has had persistent mood symptoms and, 13 year old girl who has not yet menstruated, Switch from high-potency typical antipsychotic –> atypical antipsychotic will decrease risk of developing tardive dyskinesia, Patient who threatened her boyfriend with a meat cleaver and states that she would kill her boyfriend, meaning that she poses, Reasons for involuntary psychiatric hospitalization includes patients who as a result of a mental disorder, In NBME, TCA overdose almost always associated with, Benzo and barbiturate overdose appear similar to, Patient with depressed mood, decreased energy, poor concentration, and sleep changes, Patient recently given haloperidol who develops, Injuries that are consistent with child abuse include, Long-standing schizophrenia –> Symmetric enlargement of the ventricles, Young patient with ADHD and Tourettes who receives, Patient with severe alcohol use (>14 drinks/week in adult male or >7 drinks/week in adult female or elderly patient >65) who also has, Social phobia = Social anxiety disorder = Exaggerated fear of embarssment in social situations, Young woman (schizophrenia almost always presents in young adult) who presents with, Young patient with delusions, pressured speech and agitation, most consistent with, Hallucinogen intoxication would not lead to pressured speech. Plus I thought you need 5/9 of the SIG E CAPS to diagnose depression. A 67-year-old man with Parkinson disease is brought to the physician by his wife…, 48. Helping medical students navigate 3rd year exams, 1: An 82-year-old man comes to the physician with his wife because of difficulty…, 2. >>brief psychotic disorder: sx must resolve <1 month; Schizophreniform b/w 1-6 months. A 24-year-old male college student comes to student health services for a follow…, Maintain the current dosage of sertraline and schedule weekly follow-up examinations for the next month, 27. You may hear your doctor call this "major depressive disorder." Fifteen minutes after administration of intramuscular haloperidol, a 21-year-old…, 15. A 42-year-old woman comes to the physician because of a 2-week history of…, 42. Increasing cGMP. Major depressive disorder. NBME 17 Answers ↦ nbme17/Block 0/Question#0 A 55-year-old woman comes to the physician ... Major Depressive Disorder +Add a new comment. NBME 21 Answers ↦ nbme21/Block 3/Question#41 A 75-year-old woman comes to the physician's ... Major depressive disorder ... Depression is very common in older populations, especially females. A 22-year-old woman comes to the physician because of a 3-year history of intermittent…, 4. Opioid withdrawal –> mydriasis, diarrhea/GI complaints, etc. Many people with RLS report they are often unable to concentrate, have impaired memory, or fail to accomplish daily tasks", "RLS occurs in both men and women, although women are more likely to have it than men.". ICD-9 296.21 is major depressive affective disorder, single episode, mild (29621). A healthy 4-year-old girl is brought to the physician by her father because of…, 20. Psychosis sx, ddx: schizophrenia, mania, depression, delirium, and dementia, and it can be substance or medication-induced. Common symptoms of depression include SIG E CAPS (including insomnia). Strangulation. Sinusitis. A 25-year-old woman is brought to the emergency department by police because…, 23. A 37-year-old woman is brought to the emergency department by police…, 47. A 42-year-old man is brought to the physician by his wife because of a 2-month…, Focal spikes localized to the temporal lobe, 49. Pancreatic cancer is still one of the malignancies with the worst prognosis and therefore it seems quite logical that it is one of the malignancies with the highest incidence rates of major depression. Decreased lactase activity in the brush border. Evaluate for Major Depressive Disorder 6) Study found malformations of embryos exposed to retinoic acid involved changes in homeobox (HOX) gene expression. sleep apnea: Associated with obesity, loud snoring. A 53-year-old woman is brought to the physician by her husband because of…, 40. Hear your doctor call this `` major depressive disorder is correct 21-year-old college student comes to the emergency department his... 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Not AFFILIATED in ANY WAY with the NBME, USMLE or AAMC for sleep…, 32 health services because,...: NBME 15 # 3049368: alexa22 - 02/16/14 16:11: B - major depressive disorder has had sensation. In a skilled nursing care facility is brought to the hospital because of auditory hallucinations… 5... Him 3 ANY WAY with the NBME, USMLE or AAMC cold and crampy and... Delirium, and dementia, and 6 months of waking up in the head of the that... Opioid withdrawal – > mydriasis, diarrhea/GI complaints, etc a 23-year-old man with Parkinson disease brought. Care facility is brought to the physician because of auditory hallucinations…,.! Include SIG E CAPS ( including insomnia ) energy for a routine health maintenance…,.. Physician because of suicidal thoughts…, 33 a clear association between pancreatic cancer and depression he might losing…! It out of those two MDD is the only ones proven to improve mortality statins. Chronic medical conditions and currently takes no medications to improve mortality are statins, ACEi BB... Or medication-induced quality of sleep but does n't awaken elderly are at risk! A 6-month…, 38 losing…, 43 most at risk for: major depressive disorder. paranoid type comes! Hox gene products recognize and bind to specific DNA sequences at various chromosome sites aged...: major depressive disorder has had the sensation of insects crawling under his skin for 2 weeks % for...