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+--- Thread: qs...........???? - usmle31dec (/showthread.php?tid=631538)
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qs...........???? - usmle31dec - ArchivalUser - 11-16-2011
26 y/o man has 6 month h/o losing consciousness when he laughs. He sleeps 12 hours every night, has vivid dreams and nightmares, and feels tired during the day. He was recently in a motor vehicle accident. Findings on physical are normal. What is most likely diagnosis?
A) Malingering
B) Narcolepsy
C) Sleep Apnea
d)complex partial seizures
0 - ArchivalUser - 11-16-2011
B Narcolepsy
0 - ArchivalUser - 11-16-2011
B...please lable the NBME Q
0 - ArchivalUser - 11-16-2011
AA
0 - ArchivalUser - 11-16-2011
Hey Sarim ,Please explain about the Malingering....because he sleeps 12 h/night ??...how about feeling of tiredness during the day,and losing consciousness when he laughs for 6 months.
Thank you
0 - ArchivalUser - 11-16-2011
Can u explain me how it is not malingering ?
0 - ArchivalUser - 11-16-2011
I know this Q is discussed for many times....I can not see any reason for patient to get attention possibly for his car accident,I think the information is not enough to make dessicion that he is malingering,
0 - ArchivalUser - 11-16-2011
Please Refer to the DSM-IV for the diagnosis of Malingering. I cannot copy it all here.
The description given in the question DOES NOT CLEARLY FULFILL the points required for the diagnoses of malingering.
0 - ArchivalUser - 11-16-2011
Nbme#5..qs..10
0 - ArchivalUser - 11-16-2011
On the other hand, DSM defines "cataplexy" as : brief episodes of sudden bilateral loss of muscle tone, most often in association with intense emotion.
There is NO LOSS OF CONSCIOUSNESS............only loss of muscle tone..........
That rules out choice B for me.
I believe the right answer is B then because he must be pretending or faking illness.
So the answer is AA
Thank you