+- USMLE Forum - Largest USMLE Community (https://www.usmleforum.com)
+-- Forum: USMLE Forum (https://www.usmleforum.com/forumdisplay.php?fid=1)
+--- Forum: Step 3 (https://www.usmleforum.com/forumdisplay.php?fid=6)
+--- Thread: Ethics - sveta4 (/showthread.php?tid=235387)
Ethics - sveta4 - ArchivalUser - 10-25-2007
. A 32-year-old African-American woman with a history of major depressive disorder comes to the health center because of palpitations and dizziness for the past week. She has been taking fluoxetine for the past 3 years and had been doing well until her mother died several months ago. At that time she became despondent with frequent crying and inability to sleep at night. Six weeks ago her psychiatrist increased the dose of fluoxetine but she did not think it helped. A friend recommended St. John's wort, which she began taking several weeks ago. She also takes calcium carbonate daily, occasional antihistamines for seasonal allergies, and amoxicillin-clavulanate, which was prescribed 10 days ago by another physician for a sinus infection. Vital signs now are: temperature 37.2°C (99.0°F), pulse 90/min, respirations 18/min and blood pressure 140/90 mm Hg. On physical examination she is somewhat tremulous. Thyroid is normal and chest is clear. Cardiovascular examination discloses a regular rhythm with slight tachycardia. Abdominal and neurologic examinations are normal. Which of the following is the most likely cause of her symptoms?
A
) Anxiety reaction due to her mother's death
B
) Hyperthyroidism
C
) Interaction between fluoxetine and amoxicillin-clavulanate
D
) Interaction between fluoxetine and antihistamines
E
) Interaction between fluoxetine and St. John's wort
-I think she is in grief.
0 - ArchivalUser - 10-25-2007
EE
0 - ArchivalUser - 10-25-2007
fluoxitene plus st john wort = serotonin syndrome
but fluoxitene is cyt inhibitor so I am confused with option D