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  #1  
Old 02-07-2015
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Default NBME 4 question

A 25-yo woman comes to the emergency department because of nausea, diarrhea, and anxiety for 2 days. She also has noticed dizziness and tingling sensations shooting down her forearms. Her sleep and appetite have been normal. She has a 3 year history of social phobia well controlled for the past year with paroxitine. She is attending an out-of-town conference and forgot to pack her medication; her last dose was 3 days ago. She does not drink alcohol or use illicit drugs. She is 163cm tall and weighs 89 kg. BMI is 30 kg/m2. Her temperature is 37C, pulse is 80/min, and blood pressure is 110/75 mm Hg. Physical examination shows no other abnormalities. Mental status examination shows an irritable mood with a full range of affect. Her speech is of normal rate and rhythm. There is no evidence of suicidal ideation or hallucination. She can recall three objects after 5 minutes. Long-term memory is intact. Serum studies show no traces of paroxitine. Which of the following is the most appropriate next step in management?
A) Begin behavioral therapy
B) Begin alprazolam therapy
C) Begin bupropion therapy
D) Begin clomipramine therapy
E) Begin gabapentin therapy
F) Resume paroxetine

Why is the anwer F and not B considering SSRI's take a long time to work?
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israaoday (02-09-2015)



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Old 02-07-2015
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I chose B and it was wrong, guess its F, would apreciate an explanation
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Old 02-08-2015
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Yeah i was so sure it was B :/
what did you answer to that thrombophlebitis question? Was the answer warm compresses or enoxeparin?
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Old 02-08-2015
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I don't have it in my wrong answers can you post the question please
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Old 02-08-2015
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Quote:
Originally Posted by ICUinWonderland View Post
I chose B and it was wrong, guess its F, would apreciate an explanation
If I remember correctly her case is explained by something called SSRI Discontinuation Syndrome, and it's safe to resume treatment as the best next step.
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  #6  
Old 02-08-2015
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Ohhh i just googled this and it makes sense now. Thanks! Thats question was really bugging me.
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