03-26-2009, 05:23 AM
32. A 25-year-old woman comes to the physician because of a 3-month history of the unexplained
urge to eat a few tablespoons of cornstarch daily. The amount of cornstarch ingested has increased
gradually during this time. She has leiomyomata uteri; she is otherwise healthy. Her weight is
unchanged from her last visit 1 year ago; she weighs 61 kg (135 lb) and is 168 cm (66 in) tall. Her
blood pressure is 120/80 mm Hg, and pulse is 100/min. Physical examination shows mild pallor.
Neurologic examination shows no abnormalities. She is embarrassed about her problem. She has no
compulsive behavior or obsessive thoughts. An ECG shows sinus tachycardia. Which of the following
is the most appropriate next step in management?
A
) Psychiatric assessment
B
) Complete blood count
C
) Thyroid function studies
D
) Urine toxicology screening
E
) Admission to an eating disorders clinic
F
) Antipsychotic therapy
G
) Folic acid supplementation
H
) Selective serotonin reuptake inhibitor therap
urge to eat a few tablespoons of cornstarch daily. The amount of cornstarch ingested has increased
gradually during this time. She has leiomyomata uteri; she is otherwise healthy. Her weight is
unchanged from her last visit 1 year ago; she weighs 61 kg (135 lb) and is 168 cm (66 in) tall. Her
blood pressure is 120/80 mm Hg, and pulse is 100/min. Physical examination shows mild pallor.
Neurologic examination shows no abnormalities. She is embarrassed about her problem. She has no
compulsive behavior or obsessive thoughts. An ECG shows sinus tachycardia. Which of the following
is the most appropriate next step in management?
A
) Psychiatric assessment
B
) Complete blood count
C
) Thyroid function studies
D
) Urine toxicology screening
E
) Admission to an eating disorders clinic
F
) Antipsychotic therapy
G
) Folic acid supplementation
H
) Selective serotonin reuptake inhibitor therap