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  1. #1
    md90's Avatar
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    #7

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    A 34-year-old female is brought to her family physician by her brother. He states that the patient's husband had run away with another woman the previous day. After discovering this, the patient arrived at her brother's home in a "dazed state," was unable to function appropriately the remainder of the evening, and slept fitfully all night. Early in the morning she began to talk to people who were not present, and debated whether or not to kill her children and herself. He denies anything like this ever happening before. Which of the following is the most likely diagnosis?

    1. Schizoaffective disorder

    2. Schizophrenic disorder
    3. Bipolar disorder
    4. Brief psychotic disorder
    5. Schizophreniform disorder











    Answer: #4: Brief Psychotic Disorder, why? Bipolar and Schizoaffective disorders are OUT because it needs to say somewhere that she is having depression or manic episodes, and it does not.. schizoaffective disorder is schizophrenia + mood disorder; Schizophrenia is not a good choice either because the lady just started to have symptoms.. and for schizophrenia to be a diagnosis, it needs to be > 6 months; that leaves us with schizophreniform and brief psychotic disorder.. well, again, it's r/t "time"; schizophreniform is diagnosed after a month of symptoms and it says in the question "the next day"; that leaves us with Brief Psychotic Disorder.

    Please add, question, comment, correct... thank you.

  2. #2
    qwwerty is offline Newbie
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    The correct answer is 4. Your explanation is sufficient.

    nuf-qwwerty

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    Scott1981's Avatar
    Scott1981 is offline Super Moderator 10511 points
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    you will get very very few of this type of question on the usmle.
    the med psych questions are mostly the "what would you say next" type.

    although, good explanation.
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    can you give an example?

    you will get very very few of this type of question on the usmle.
    the med psych questions are mostly the "what would you say next" type.
    Can you give an example, please?

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    Scott1981's Avatar
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    you just diagnosed a patient with prostate cancer 1 month ago. on his most recent visit, mets have been found in his liver. the patient asks how much time he has left and if he is gonna die.

    what would be the most proper response.
    a. " "
    b. " "
    c. " "

    those type of questions.
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    md90's Avatar
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    appropriate response?

    you just diagnosed a patient with prostate cancer 1 month ago. on his most recent visit, mets have been found in his liver. the patient asks how much time he has left and if he is gonna die.

    what would be the most proper response.
    that is a tough one... because you want the patient to know the "facts" about his disease but at the same time to talk about his thoughts and feelings... also want family to be there if possible, and to give him not only medical support, but the emotional support; and to refer him to a support group where others can help him; since they are going through the same type of cancer...

    It's important for us as physicians to give that emotional support even in this "time-constraint" medical world today...

  7. #7
    Scott1981's Avatar
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    Quote Originally Posted by md90
    that is a tough one... because you want the patient to know the "facts" about his disease but at the same time to talk about his thoughts and feelings... also want family to be there if possible, and to give him not only medical support, but the emotional support; and to refer him to a support group where others can help him; since they are going through the same type of cancer...

    It's important for us as physicians to give that emotional support even in this "time-constraint" medical world today...
    just make sure that the patient wants the family there.

    you will see many of these types of questions. they will usually have one potential answer that is completely stupid and rediculous, so you can cross that off and only have to deal with 3-4 potential answers.
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    thank you, scott1981.. will keep that in mind

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