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  #1  
Old 05-18-2011
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Question Frequent nose bleeds and bipolar disorder?

A 19-year-old man comes to the physician because of frequent nosebleeds over the past 3 weeks. He has bipolar disorder currently well controlled with lithium carbonate, bupropion, and valproic acid. Physical examination shows no abnormalities except for dried blood in the nares. Mental status examination shows an anxious mood and slight motor restlessness. Serum studies show a lithium carbonate level of 1.3 mEq/L (therapeutic range=0.61.2), and valproic acid level of 77 μg/mL (therapeutic range=40100). Which of the following is the most appropriate next step in management?

A ) Measurement of serum aspartate aminotransferase (AST, GOT) activity
B ) Measurement of serum bupropion level
C ) Platelet count
D ) Discontinuation of lithium carbonate therapy
E ) Discontinuation of valproic acid therapy
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  #2  
Old 05-18-2011
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It may be D but I could not find any specific reason for that except serum levels opt me to go with this. Do you have the answer and any explanation of it please share
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  #3  
Old 05-18-2011
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C
valporic acid cause thrombocytopenia so measure plt count
AND TOXIC LEVEL OF lithium is >1.5 so not D answer
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Old 05-18-2011
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i am confused between C & D
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  #5  
Old 05-18-2011
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Kemoo I would appreciate it if you could label your questions as 'NBME' or not please. Thanks
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  #6  
Old 05-18-2011
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Quote:
Originally Posted by add1 View Post
kemoo i would appreciate it if you could label your questions as 'nbme' or not please. Thanks


ok i will.........this is nbme form 1

and i will not post any nbme question again because of the new forum rules which i just know it .

Sorry bro for this . And thanks for your kindness and patience
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  #7  
Old 05-18-2011
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would really appreciate if u stop postin nbme questions, as it wld affect others performance will writin nbme's.....
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