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nbme 2 - shaziachoudry
#1
Five months after beginning fluoxetine to treat obsessive-compulsive disorder, a
19-year-old man states that he discontinued his medication 2 months ago because
he had begun to worry about taking his medication every day. His initial response
to the medication was good. His symptoms have now returned, and his morning
ritual of cleaning and grooming consumes so much time that his job is in jeopardy.
In addition to education about the nature of his disorder and its treatment, which
of the following is the most appropriate next step in management?


A) Tell the patient to schedule a return visit as needed

B) Offer to change the medication

C) Request that the patient's parents superviseadministration of medication

D) Monitor the patient's compliance by weekly blood tests

E) Begin a trial of cognitive-behavior therapy
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#2
D)
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#3
what blood test ???
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#4
d seems the most reasonable among the choice, though I thought it would be the best to educate the pt at the same time. correct me if i am wrong.
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#5
(E)

Not sure about this..
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#6
i was confusedb/w A and E
b/c the prob is that he thinks that he would get dependent on it or something?
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#7
in blueprint p77, Blood levels ...but may be useful in assessing adherence. ....... Nonadherence is often the cause of apparent therapeutic failure.
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#8
E......
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#9
i think ccc
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#10
consensus last time was E
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