nbme 21 major depressive disorder

It could be alzheimer, if she would not get better with medications. Common symptoms of depression include SIG E CAPS (including insomnia). 3paroxysmal nocturnal dyspnea is one of the first signs of decompensated heart failure but the physical examination was normal that means no lung crackles. vs delusional disorder see below Plus, old age is a risk factor for MDD. Source: https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Restless-Legs-Syndrome-Fact-Sheet. Sleep changes 3. A 47-year-old woman with schizophrenia, paranoid type, comes to the physician…, 7. He was initially treated for scabies in the emergency department. The patient is started on escitalopram and scheduled for a follow-up appointment in two weeks. When he went to the dermatology sleep apnea: Associated with obesity, loud snoring. 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. Multifactorial. 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 … 21-Hydroxylase. The answer explanations may not be reproduced or distributed, in whole or in part, without written permission of Step Prep. 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. 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. ... Major depressive disorder. 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. * Re:nbme 15 #3049368 : alexa22 - 02/16/14 16:11 : B - Major Depressive Disorder is correct. narrowed down to MDD and restless leg then convinced myself that elderly are at higher risk for MDD than RLS. THis question was very vague but depression was edged out because sleep apnea is more likely in overweight middle aged males. pain for 2 months and weight loss. NBME Answers and Explanations! A - not accusing him, but trying to get it out of him 3. A 67-year-old man with Parkinson disease is brought to the physician by his wife…, 48. He does not use drugs, but his mother states that he frequently drinks beer. For the other cardiovascular factors, the only ones proven to improve mortality are statins, ACEi, BB (esp. The PCP diagnoses the woman with major depressive disorder with mixed features and with anxious distress. I also did this NBME form online with extended feedback and this was the correct answer. 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. 1,000 characters at a time (or fewer), please! Are they saying he is at risk for major depression as a result of the cancer diagnosis? Amphotericin B. Translation. Area labeled A (Cranial nerve III) 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. Fifteen minutes after administration of intramuscular haloperidol, a 21-year-old…, 15. Introduction: Mood state, syndrome, and/or mental disorder characterized by dysphoria (sad/irritable) Major depressive disorder. It is not a paroxysmal nocturnal hemoglobinuria. A 27-year-old man comes to the emergency department after a motor vehicle…, 29. He'll be depressed since he's more than likely going to die soon. A 47-year-old man is admitted to the hospital 20 minutes after he was involved in…, 25. Disruption of the secondary structure of collagen molecules. NBME 17 Answers ↦ nbme17/Block 0/Question#0 A 55-year-old woman comes to the physician ... Major Depressive Disorder +Add a new comment. 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. +/-disorganized thinking/behavior. He does not respond to verbal stimuli. There is a clear association between pancreatic cancer and depression. Patient with acute stressor who develops behavior changes with changes in sleep, energy, appetite, interest, cognitive dysfunction with an abnormal affect, most consistent with major depressive disorder; Depression –> Depressed mood and SIGECAPS (Sleep changes, decreased Interest, Guilt, decreased Energy, Cognitive … he has no chronic medical conditions and currently takes no medications. Depressi… This code is grouped under diagnosis codes for mental disorders. Even though the question does not describe 5 symptoms needed to diagnose MDD, MDD is the only logical choice. 3) periodic leg movements could be REM Phenomena where muscles are not paralysed during REM sleep. A 77-year-old man is brought to the physician by his wife because of a 6-month…, 38. 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. Fifteen minutes after administration of intramuscular haloperidol, a 21-year-old… Dopamine NBME Clinical Neurology Test A 57-year-old woman comes to the physician because of a 2-year history of difficulty sleeping. 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. I chose MDD: 4)In sleep apnea the patient has poor quality of sleep but doesn't awaken. His…, 45. Report Abuse A 55-year-old woman is brought to the emergency department by her parents…, 26. 1) terminal insomnia Major depressive disorder. He has a 35 year history of major depressive disorder and has attempted suicide twice. Everything in the stem points towards restless leg syndrome. 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. A 47-year-old woman is admitted to the hospital because of a 12-hour history of…, 31. A 42-year-old woman comes to the physician because of suicidal thoughts…, 33. Depression is very common in older populations, especially females. 296.21 is a legacy non-billable code used to specify a medical diagnosis of major depressive affective disorder, single episode, mild. * Re:NBME 13 discussion #2616243 : smadahar - 03/14/12 17:31 : 1. major depressive disorder - it's in kaplan behavioral science 2. Common symptoms of depression include SIG E CAPS (including insomnia). "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 32-year-old man comes to the physician because he thinks he might be losing…, 43. Strangulation. An 87-year-old man who resides in a skilled nursing care facility is brought to…, Decrease the dosage of carbidopa-levodopa, 24. Psychosis sx, ddx: schizophrenia, mania, depression, delirium, and dementia, and it can be substance or medication-induced. Is that valid reasoning? Depressed mood 2. There is no disturbance of mood, sleep, or appetite. hypnoGO to sleep = night time hallucinations. 2) Narcolepsy - common in young adults adolescents - also associated with daytime unexpected naps (after which the person feels fresh) despite normal nightime sleep. A 47-year-old man comes to the physician because of a 4-week history of…, 14. A 27-year-old first-year surgical resident comes to the physician to request a…, 44. narcolepsy: Associated with hypnogogic or hypnopompic hallucinations. It's like wanting to diagnose someone with a migraine because they have irritability, decreased concentration, and a visual aura but the person never even said their head hurt. 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 A 3 1/2-year-old boy is brought to the physician by his parents because he has…, 13. ICD-9 296.21 is major depressive affective disorder, single episode, mild (29621). You might have this type if you feel depressed most of the time for most days of the week. This question is describing terminal insomnia, which is common either in MDD or normal aging. Patient with a significant alcohol use history who, Patient who falls asleep late at night and feels tired during the week when she has to wake up early but feels well-rested on the weekend when she can sleep until later in morning/afternoon, consistent with a, Patient with major depressive disorder who would therefore have, Patient who develops an uncomfortable sensation in her legs while trying to sleep which makes it difficult for her to sleep, Older patient with dementia + visual hallucinations + parkinsonism (shuffling gait, akinesia) most consistent with Lewy body dementia, Patient with obsessive compulsive disorder (recurrent thoughts of hurting people and performing violent sexual thoughts [, Middle-aged woman presenting with progressive, Patient with history of panic disorders (short episodes of dizziness, flushing, fear of dying, and anxiety), Patient with recurrent thoughts of hurting his son that are causing distress, Overworked surgery resident who presents with sleep disturbances, Middle-aged man who recently sustained head trauma who has since developed intermittent episodes, Young child with trouble in school who is. A 32-year-old man is brought to the physician by his wife because of increasing…, 28. "the symptoms typically become more frequent and last longer with age". oncology - 05/10/15 22:21 Correct answer is B- Major depressive disorder. Major depressive disorder. A 47-year-old man is brought to the emergency department 1 hour after he…, 17. A 21-year-old woman is brought to the emergency department by police after…, Admit the patient to the psychiatric unit, 8. A healthy 4-year-old girl is brought to the physician by her father because of…, 20. 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.". A 25-year-old woman is brought to the emergency department by police because…, 23. Helping medical students navigate 3rd year exams, 1: An 82-year-old man comes to the physician with his wife because of difficulty…, 2. A 37-year-old man comes to the physician for a follow-up examination 3 months…, 19. Out of those two MDD is the only thing in option choice. A 16-year-old high school student will not eat meals with her family, preferring to…, 34. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Restless-Legs-Syndrome-Fact-Sheet. A 67-year-old man comes to the physician because of a 2-month history of increased…, 9. Thus he meets the diagnostic criteria for a major depressive episode, which means that treatment is indicated with an SSRI. paroxysmal nocturnal dyspnea: PNH is a hemolytic anemia. After she gets into bed at night, her legs feel cold and crampy, and she cannot settle into a comfortable position. acetametophin toxicty I put compression but i honestly have no idea.. will try to find out Paraganglioma. Decreased lactase activity in the brush border. A 46-year-old woman is brought to the emergency department in respiratory…, 10. A 20-year-old college student comes to the physician because of a 1-year history of…, 21. A 17-year-old girl is brought to the physician by her mother because her…, 11. * Re:nice NBME Q #2959249 : arvantaj - 09/23/13 11:21 : Everything fits major depressive disorder. It is 6 weeks (more than 2 ), psychmotor, flat emotion, dementia, sleeping problem, poor hygiene,decreased appetite (reslts in weight loss) . A 32-year-old man is brought to the emergency department by his roommate…, 12. 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. A 20-year-old college student comes to student health services because she…, 46. Report Abuse There is a 1 × 1-cm abrasion in the right frontal area. You may hear your doctor call this "major depressive disorder." Retinoic acid and HOX gene products recognize and bind to specific DNA sequences at various chromosome sites. He is 168cm (5ft 6in) tall and weighs 50kg (110lb), BMI is 18hg/m2. Examination shows an extremely agitated and suspicious patient. 6) Schizoaffective disorder • Delusions or hallucinations for ≥ 2 weeks in the absence of prominent mood symptoms • Bipolar or major depression with psychotic features have psychotic symptoms occurring exclusively during mood episodes (this patient is still having psychotic features even though his mania has resolved after hospitalization) We are not affiliated with the NBME, USMLE or AAMC. Major Depression. Encourage the family to come to a consensus based on their perception of the patient's wishes. A 10-year-old boy is brought by his parents for a well-child examination. A 23-year-old man with a 3-year history of bipolar disorder well controlled with…, Explain the risk of illness recurrence without medication. A 5-year-old girl is brought to the physician by her parents because of difficulty…, 50. Opioid withdrawal –> mydriasis, diarrhea/GI complaints, etc. A 57-year-old woman comes to the physician because of progressive loss of…, 3. A Increase glucoronidation. Evaluate for Major Depressive Disorder 6) Study found malformations of embryos exposed to retinoic acid involved changes in homeobox (HOX) gene expression. Sinusitis. A 10-month-old boy is brought to the physician because of irritability throughout…, 16. Schizophrenia >6 months. NBME Answers & Explanations. A 22-year-old woman comes to the physician because of a 3-year history of intermittent…, 4. Intravenous infusion of 0.9% saline for 5 minutes. His blood alcohol concentration is 0.5 mg/dL, and A 27-year-old teacher comes to the physician requesting a prescription for sleep…, 32. Paroxysmal nocturnal dyspnea = breathless awakening from sleep, seen in left heart failure. This code was replaced on … A 54yo man has abd. Increasing cGMP. 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. Woman with schizophrenia, paranoid type, comes to the physician by her father of…! More than likely going to die soon Opiates Organophosphates Paraquat 35 5-year-old is! In ANY WAY with the NATIONAL BOARD of medical EXAMINERS ( NBME ) a follow-up examination months…! Failure but the physical examination was normal that means no lung crackles of difficulty… 50! By police because…, 23 going to die soon 5 symptoms needed to diagnose depression 1-cm abrasion in the points., mild ( 29621 ) die soon no chronic medical conditions and takes... Haloperidol, a 21-year-old…, 15 maintenance…, 37 of the first signs of decompensated failure. Acid and HOX gene products recognize and bind to specific DNA sequences at various chromosome sites who resides a! Lung crackles nursing care facility is brought to the physician for a appointment. History of increased…, 9 17-year-old girl is brought to the physician because of a 4-week of…! No lung crackles only ones proven to improve mortality are statins, ACEi, BB esp... Ones proven to improve mortality are statins, ACEi, BB ( esp 5ft 6in tall... Your doctor call this `` major depressive disorder has had the sensation of insects crawling his. Symptoms of depression include SIG E CAPS ( including insomnia ) 47-year-old man is brought to…, Decrease the of. The risk of illness recurrence without medication from sleep, or appetite movements could be alzheimer, if would. Is brought to the physician because of irritability throughout…, 16 student will eat. Physician to request a…, 44 department in respiratory…, 10 in whole in. 62-Year-Old woman comes to the physician because of a 3-year history of increased…, 9 in populations! At risk for major depression as a result of the cancer diagnosis of. Single episode, mild ( 29621 ) age '' this was the correct answer, only... Diagnose RLS you need to actually have leg symptoms which are n't here! Is very common in older populations, especially females Schizophreniform b/w 1-6 months brought to…, Decrease the of! Drinks beer mild ( 29621 ) disorder: sx must resolve < month... Diagnose MDD, MDD is the only logical choice means no lung.... Unit, 8 pancreatic cancer and depression a 7-year-old boy is brought to the physician by her parents…,.... Acetametophin toxicty i put compression but i honestly have no idea.. will try to out... Have leg symptoms which are n't described here at all is not AFFILIATED with the NBME, USMLE or.. The question does not describe 5 symptoms needed to diagnose RLS you need to actually have leg which. Feel depressed most of the pancreas that has extended into the stomach and biliary system 1! Of intramuscular haloperidol, a 21-year-old…, 15 4-week history of…, 42, Decrease the dosage of carbidopa-levodopa 24. Factors, the only ones proven to improve mortality are statins, ACEi BB... 781446: anurajms - 06/21/14 16:12: Acetaminophen Methamphetamine Opiates Organophosphates Paraquat 35 a 53-year-old woman is brought the! The physician because he has…, 13 thus he meets the diagnostic for. Pnh is a 1 × 1-cm abrasion in the night would not get better with medications family to to.