05-22-2006, 08:24 AM
A 28-year-old man comes to the emergency department complaining of a
3-month history of fatigue, depression, insomnia, and weight loss. He states
he also has had difficulty with feelings of guilt over his occasional intravenous
heroin use. On a mini-mental status examination, he has some mild cognitive
defects, scoring 24 of 30. He is married and has always used condoms during
sexual intercourse. Which of the following is the most appropriate next step in management
of this patient?
A. Order fluoxetine
B. Order imipramine
C. Order an HIV test
D. Order a urine drug screen
3-month history of fatigue, depression, insomnia, and weight loss. He states
he also has had difficulty with feelings of guilt over his occasional intravenous
heroin use. On a mini-mental status examination, he has some mild cognitive
defects, scoring 24 of 30. He is married and has always used condoms during
sexual intercourse. Which of the following is the most appropriate next step in management
of this patient?
A. Order fluoxetine
B. Order imipramine
C. Order an HIV test
D. Order a urine drug screen