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+--- Thread: q6000 - sami2004 (/showthread.php?tid=594160)
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q6000 - sami2004 - ArchivalUser - 06-23-2011
A 34-yr old woman with a history of bipolar disorder
comes to the clinic for a routine healthcare visit. She has
no current healthcare complaints but wishes to discuss
her bipolar condition. For the last 7 years she has been
treated successfully with lithium and has had no manic
or depressive episodes. The associated weight gain and
tremor bother her immensely, though she has put up
with these side effects to avoid further manic episodes,
of which she has had five since her teenage years.
Further, she finds herself needing to use the bathroom
frequently, which is disturbing her sleep. She wishes to
stop treatment as soon as possible and wants to know if
this is okay. An appropriate medical management strategy
for this patient is to
(A) begin paroxetine, stop lithium in 1 month
(B) change lithium to long-term carbamazepine
© continue lithium therapy, treat side effects
(D) prescribe lithium to be taken as needed only
(E) stop lithium, follow clinically for recurrence
A 41-year-old white man comes to the emergency
department feeling œextremely depressed and suicidal
for the past several hours. He also feels œachy, œtired
like I can™t move, and œlike I could eat anything.
Physical examination shows conjunctival injection and
a perforated nasal septum. Urine toxicology is positive
for cocaine and cannabis.
The most likely cause of his current condition is
(A) cannabis intoxication
(B) cocaine intoxication
© cocaine withdrawal
(D) factitious disorder
(E) major depressive disorder
0 - ArchivalUser - 06-23-2011
fOR q 1 .........
ITS LIKELY THAT PT IS DEVELOPNG LITHIUM INDUSED DI....
WILL GO FOR E.......
For Q2
A...........
0 - ArchivalUser - 06-23-2011
(B) change lithium to long-term carbamazepine
© cocaine withdrawal
0 - ArchivalUser - 06-23-2011
what are the criteria for discontinuing lithium?
0 - ArchivalUser - 06-24-2011
B and C
0 - ArchivalUser - 06-24-2011
b and c
0 - ArchivalUser - 06-24-2011
The second one is cocaine withdrawl.
Symptoms include fatigue, lack of pleasure, anxiety, irritability, sleepiness, and sometimes agitation or extreme suspicion.
But I don't know about the first one.
What is the ans?
0 - ArchivalUser - 06-24-2011
C and C.......... Lithium is working well for her, maybe we can treat the side effect? Not sure
0 - ArchivalUser - 06-24-2011
or maybe switch over to carbamazepine due to side effects........
0 - ArchivalUser - 06-24-2011
E , A?