08-11-2015, 04:50 PM
18 yo man comes to the physician for an initial examination because of a 3 year hx of fatigue and migrating joint pain. He has brought a large folder containing information about previous medical consultations, laboratory tests, and xrays. He takes no medications. he weights 50 kg and is 173 cm tall. Physical examination shows no other abnormalities. on mental status examination he is preoccupied with his symptoms. When asked about his mood he states that the future appears bleak, and that he is too tired to think about it. Which is the most appropriate next step in management:
a ask about further symptoms of obsessions and compulsions
b ask about sexual hx including sexual orientation and practices
c ask about suicidal feelings
d ask about travel hx over the past 6 months
e obtain a detailed exercise hx
f measurement of serum lyme titers
g urine toxicology screening
a ask about further symptoms of obsessions and compulsions
b ask about sexual hx including sexual orientation and practices
c ask about suicidal feelings
d ask about travel hx over the past 6 months
e obtain a detailed exercise hx
f measurement of serum lyme titers
g urine toxicology screening