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USMLE Step 2 CS SP Challenges Challenging situations presented by the Standardized Patient (SP) during the the USMLE Step 2 CS Encounter.

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Old 03-13-2012
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Help Is my son faking symptoms

I was wondering what to tell a mother of an 8 yr old child who has abdominal pain that is not relieved but OTC. She adds that she gave birth to twins a couple of weeks ago, so she is not able to take good care of her older son as before. He also misses school and hates science teacher.
She is concerned that her son is faking this out?

The mother asks for medications over the phone because she can't leave her twins....
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Old 03-17-2012
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I think, Firstly, you have to take detailed history about other behavioral changes like hyperactivity or inattention or any other sings and symptoms. If nothing in the history goes with a behavioral diagnosis. It is better to tell her that her son is stressed due to the less importance that is given to him after the delivery of the two newborns and then council her about other expected changes like regression so tell her that some children may return to wet them selfs or get constipated. She has to address his needs and provide assurance for him and advice her to call his school teacher to find out if she has any notes about her child behavior to address why he hates the science class? . At the end assure her that this is may be a normal developmental changes and probably he will return back to his usual state few weeks later. But advice her to call you again if she noticed other changes or if it persist for a longer period.
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