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nbme2 q - medplus254
#1
A previously healthy 24-year-old woman isbrought to the physician by her husband because of several episodesof loss of consciousness over the past 4 days. Her husband reports that duringepisodes, she jerks her arms and legs wildly. Each episode lasts up
to 1 hour; between episodes, her behavior is normal. She is planning to
move to another state because of her husband's work. She has been
extremely anxious and upset about the move because she will have to leave
her mother, who was recently diagnosed with breast cancer. There is no
family history of seizure disorder. Her temperature is 36.7 C (98 F),
blood pressure is 130/80 mm Hg, pulse is 84/min, and respirations are
18/min. Neurologic examination shows no abnormalities.
Electroencephalography shows normal findings during an episode of shaking. Which
of the following is the most likely underlying cause?

A
) Catatonia

B
) Complex partial seizure

C
) Conversion reaction

D
) Dissociative fugue

E
) Malingering

F
) Tonic-clonic seizure
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#2
No Catatonia=as only 4days history

No complex partial seisure=as no automatism

No dissiciative fuge =no h/o flight

No tonic clonic=normal during attack no tongue biting no urine incontinence

Most probably Conversion disorder as every test is normal.
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#3
c conversion reaction

i found this explanation in one forum "The answer to this question is conversion reaction. I shall explain why the answer is not malingering first. Malingering requires the patient to have a secondary gain therefore the patient will act sick to gain a benefit. Now I understand most of you think the secondary gain is avoiding to move however the fact that this question mentions she is Extremely stressed out rather than saying she does not want to move (as not wanting to move will not stress you out it will just make you sad) really points towards conversion disorder. Now conversion disorder is definetly the correct answer because first she has a stressor, secondly she has had loss of consciousness for over an hour, and shaking. These are neurological signs that occur in conversion disorder commonly due to a stressor. "
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#4
close to C)
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#5
thanks everyone
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