nbme 21 major depressive disorder

This code was replaced on … Also called major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems. A 37-year-old woman is admitted to the hospital after a suicide attempt by an…, Decreased concentration of 5-hydroxyindoleacetic acid in cerebrospinal fluid analysis, 35. It is not a paroxysmal nocturnal hemoglobinuria. A 25-year-old woman is brought to the emergency department by police because…, 23. Report Abuse Plus, old age is a risk factor for MDD. 6) Schizoaffective disorder • Delusions or hallucinations for ≥ 2 weeks in the absence of prominent mood symptoms • Bipolar or major depression with psychotic features have psychotic symptoms occurring exclusively during mood episodes (this patient is still having psychotic features even though his mania has resolved after hospitalization) >>brief psychotic disorder: sx must resolve <1 month; Schizophreniform b/w 1-6 months. Major depressive disorder. Is that valid reasoning? An 8-year-old boy is brought to the physician by his mother because of a…, Decreased binding of dopamine at the postsynaptic receptor, 18. Report Abuse Depression is very common in older populations, especially females. It's not a great question and I completely missed MDD as well, but I can kinda see now why it's MDD more so than any of the other choices so it's kind of a "but which is the BEST answer" scenario. Young patient with 2-month history of depressed mood + impaired cognitive function + low energy + decreased interest in socializing thus meeting criteria for major depressive disorder; Formal definition of MDD: At least 2 weeks with at least 5/9 of the following symptoms (1. Major depressive disorder. * Re:nice NBME Q #2959249 : arvantaj - 09/23/13 11:21 : Everything fits major depressive disorder. Major depressive disorder. Many people with RLS report they are often unable to concentrate, have impaired memory, or fail to accomplish daily tasks", "RLS occurs in both men and women, although women are more likely to have it than men.". A 42-year-old woman comes to the physician because of a 2-week history of…, 42. Patients with major depressive disorder (MDD) who also gamble have a significantly increased suicide risk and need to be vigilantly monitored, new research suggests.. A … This question is describing terminal insomnia, which is common either in MDD or normal aging. The lady w/ poor concentration, decreased energy for a month, and 6 months of waking up in the night. * Re:nbme 15 #3049368 : alexa22 - 02/16/14 16:11 : B - Major Depressive Disorder is correct. Depressi… It is 6 weeks (more than 2 ), psychmotor, flat emotion, dementia, sleeping problem, poor hygiene,decreased appetite (reslts in weight loss) . Free 120 NBME 24 NBME 23 NBME 22 NBME 21 NBME 20 NBME 19 NBME 18 NBME 17 NBME 16 NBME 15 NBME 13 home login register ⋅ contact ... Major depressive disorder ... or advanced cancer of any kind that would require aggressive treatment with poor prognosis would be associated with major depression. Though everything else fits, in order to diagnose RLS you need to actually have leg symptoms which aren't described here at all. A 67-year-old man with Parkinson disease is brought to the physician by his wife…, 48. He's most at risk for: major depressive disorder. Examination shows an extremely agitated and suspicious patient. Sleep changes 3. A - not accusing him, but trying to get it out of him 3. A 20-year-old woman is brought to the emergency department immediately after…, 41. Herpes simplex virus. This code is grouped under diagnosis codes for mental disorders. There is no disturbance of mood, sleep, or appetite. 3paroxysmal nocturnal dyspnea is one of the first signs of decompensated heart failure but the physical examination was normal that means no lung crackles. oncology - 05/10/15 22:21 Correct answer is B- Major depressive disorder. A 32-year-old man is brought to the physician by his wife because of increasing…, 28. Residency Advising and Interview Preparation, Patient is displaying normal age-related changes (early morning awakening, falling asleep during day, normal mood, Mini-mental state > 23), Woman who experienced a significantly traumatic event and has had persistent mood symptoms and, 13 year old girl who has not yet menstruated, Switch from high-potency typical antipsychotic –> atypical antipsychotic will decrease risk of developing tardive dyskinesia, Patient who threatened her boyfriend with a meat cleaver and states that she would kill her boyfriend, meaning that she poses, Reasons for involuntary psychiatric hospitalization includes patients who as a result of a mental disorder, In NBME, TCA overdose almost always associated with, Benzo and barbiturate overdose appear similar to, Patient with depressed mood, decreased energy, poor concentration, and sleep changes, Patient recently given haloperidol who develops, Injuries that are consistent with child abuse include, Long-standing schizophrenia –> Symmetric enlargement of the ventricles, Young patient with ADHD and Tourettes who receives, Patient with severe alcohol use (>14 drinks/week in adult male or >7 drinks/week in adult female or elderly patient >65) who also has, Social phobia = Social anxiety disorder = Exaggerated fear of embarssment in social situations, Young woman (schizophrenia almost always presents in young adult) who presents with, Young patient with delusions, pressured speech and agitation, most consistent with, Hallucinogen intoxication would not lead to pressured speech. A 42-year-old man comes to the physician for a routine health maintenance…, 37. Schizophrenia >6 months. The patient is started on escitalopram and scheduled for a follow-up appointment in two weeks. A 54yo man has abd. * NBME 7 ques #781446 : anurajms - 06/21/14 16:12 : Acetaminophen Methamphetamine Opiates Organophosphates Paraquat 35. Patient with >2 week history of SIGECAPS symptoms (specifically Sleep changes, Guilt, decreased Energy, Cognitive dysfunction, Appetite changes) and somatic symptoms most consistent with major depressive disorder; Adjustment disorder would not have as severe a presentation; Borderline –> Chronic time course https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Restless-Legs-Syndrome-Fact-Sheet. "the symptoms typically become more frequent and last longer with age". I also did this NBME form online with extended feedback and this was the correct answer. +/-disorganized thinking/behavior. Patient with acute stressor who develops behavior changes with changes in sleep, energy, appetite, interest, cognitive dysfunction with an abnormal affect, most consistent with major depressive disorder; Depression –> Depressed mood and SIGECAPS (Sleep changes, decreased Interest, Guilt, decreased Energy, Cognitive … Are they saying he is at risk for major depression as a result of the cancer diagnosis? A 24-year-old male college student comes to student health services for a follow…, Maintain the current dosage of sertraline and schedule weekly follow-up examinations for the next month, 27. Psychosis sx, ddx: schizophrenia, mania, depression, delirium, and dementia, and it can be substance or medication-induced. Depressed mood 2. He'll be depressed since he's more than likely going to die soon. After she gets into bed at night, her legs feel cold and crampy, and she cannot settle into a comfortable position. A 57-year-old woman comes to the physician because of progressive loss of…, 3. A 47-year-old man comes to the physician because of a 4-week history of…, 14. He appears cachectic and is staring into space . A 22-year-old woman comes to the physician because of a 3-year history of intermittent…, 4. 1,000 characters at a time (or fewer), please! He is 168cm (5ft 6in) tall and weighs 50kg (110lb), BMI is 18hg/m2. Everything in the stem points towards restless leg syndrome. vs delusional disorder see below A 7-year-old boy is brought to the physician by his mother because of difficulty at…, 22. 3) periodic leg movements could be REM Phenomena where muscles are not paralysed during REM sleep. The PCP diagnoses the woman with major depressive disorder with mixed features and with anxious distress. Almost as bad as incorrect presentations of common diseases. A 55-year-old woman is brought to the emergency department by her parents…, 26. Thus he meets the diagnostic criteria for a major depressive episode, which means that treatment is indicated with an SSRI. A 20-year-old college student comes to the physician because of a 1-year history of…, 21. THis question was very vague but depression was edged out because sleep apnea is more likely in overweight middle aged males. Opioid withdrawal –> mydriasis, diarrhea/GI complaints, etc. A 27-year-old first-year surgical resident comes to the physician to request a…, 44. A 10-year-old boy is brought by his parents for a well-child examination. Major Depression. acetametophin toxicty I put compression but i honestly have no idea.. will try to find out Paraganglioma. Area labeled A (Cranial nerve III) Intravenous infusion of 0.9% saline for 5 minutes. A 47-year-old woman with schizophrenia, paranoid type, comes to the physician…, 7. No signs of hemolytic anemia (hematuria, jaundice, dec. haptoglobin). NBME Answers and Explanations! Even though the question does not describe 5 symptoms needed to diagnose MDD, MDD is the only logical choice. Common symptoms of depression include SIG E CAPS (including insomnia). Plus I thought you need 5/9 of the SIG E CAPS to diagnose depression. A 17-year-old girl is brought to the physician by her mother because her…, 11. ICD-9 296.21 is major depressive affective disorder, single episode, mild (29621). A 53-year-old woman is brought to the physician by her husband because of…, 40. Patient with depressed mood, decreased energy, poor concentration, and sleep changes (consistent with major depressive disorder) following initiation of propranolol, most consistent with medication-induced mood disorder; 14. He does not respond to verbal stimuli. It's like wanting to diagnose someone with a migraine because they have irritability, decreased concentration, and a visual aura but the person never even said their head hurt. 1) terminal insomnia A 27-year-old man comes to the emergency department after a motor vehicle…, 29. Multifactorial. Increasing cGMP. A 42-year-old woman comes to the physician because of suicidal thoughts…, 33. His…, 45. A 21-year-old college student comes to the physician because of a 3-year history…, 39. NBME Answers & Explanations. pain for 2 months and weight loss. Sinusitis. A 62-year-old woman comes to the physician because of auditory hallucinations…, 5. You may have trouble doing normal day-to-day activities, and sometimes you may feel as if life isn't worth living.More than just a bout of the blues, depression isn't a weakness and you can't simply \"snap out\" of it. Guess she has major depressive disorder even though she doesn't have 5 diagnostic symptoms that lasted longer than 2 weeks and none of them include depressed mood or anhedonia. When he went to the dermatology Strangulation. Patient with a significant alcohol use history who, Patient who falls asleep late at night and feels tired during the week when she has to wake up early but feels well-rested on the weekend when she can sleep until later in morning/afternoon, consistent with a, Patient with major depressive disorder who would therefore have, Patient who develops an uncomfortable sensation in her legs while trying to sleep which makes it difficult for her to sleep, Older patient with dementia + visual hallucinations + parkinsonism (shuffling gait, akinesia) most consistent with Lewy body dementia, Patient with obsessive compulsive disorder (recurrent thoughts of hurting people and performing violent sexual thoughts [, Middle-aged woman presenting with progressive, Patient with history of panic disorders (short episodes of dizziness, flushing, fear of dying, and anxiety), Patient with recurrent thoughts of hurting his son that are causing distress, Overworked surgery resident who presents with sleep disturbances, Middle-aged man who recently sustained head trauma who has since developed intermittent episodes, Young child with trouble in school who is. A 5-year-old girl is brought to the physician by her parents because of difficulty…, 50. Evaluate for Major Depressive Disorder 6) Study found malformations of embryos exposed to retinoic acid involved changes in homeobox (HOX) gene expression. The answer explanations may not be reproduced or distributed, in whole or in part, without written permission of Step Prep. hypnoGO to sleep = night time hallucinations. Helping medical students navigate 3rd year exams, 1: An 82-year-old man comes to the physician with his wife because of difficulty…, 2. An 87-year-old man who resides in a skilled nursing care facility is brought to…, Decrease the dosage of carbidopa-levodopa, 24. NBME 17 Answers ↦ nbme17/Block 0/Question#0 A 55-year-old woman comes to the physician ... Major Depressive Disorder +Add a new comment. We are not affiliated with the NBME, USMLE or AAMC. A Increase glucoronidation. Retinoic acid and HOX gene products recognize and bind to specific DNA sequences at various chromosome sites. You may hear your doctor call this "major depressive disorder." 21-Hydroxylase. There is a 1 × 1-cm abrasion in the right frontal area. 296.21 is a legacy non-billable code used to specify a medical diagnosis of major depressive affective disorder, single episode, mild. For the other cardiovascular factors, the only ones proven to improve mortality are statins, ACEi, BB (esp. Introduction: Mood state, syndrome, and/or mental disorder characterized by dysphoria (sad/irritable) A 32-year-old man is brought to the emergency department by his roommate…, 12. Amphotericin B. It could be alzheimer, if she would not get better with medications. I agree that MDD also requires a bit of a stretch bc not all of the diagnosis requirements are met which is annoying, but at least the core components are there (decreased energy, sleep disturbances, lack of concentration), whereas the core component of RLS isn't there at all. A previously healthy 25-year-old woman is brought to the emergency department…, 30. Source: https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Restless-Legs-Syndrome-Fact-Sheet. 2) Narcolepsy - common in young adults adolescents - also associated with daytime unexpected naps (after which the person feels fresh) despite normal nightime sleep. sleep apnea: Associated with obesity, loud snoring. ... Major depressive disorder. A healthy 4-year-old girl is brought to the physician by her father because of…, 20. A 16-year-old high school student will not eat meals with her family, preferring to…, 34. A 47-year-old man is brought to the emergency department 1 hour after he…, 17. A 23-year-old man with a 3-year history of bipolar disorder well controlled with…, Explain the risk of illness recurrence without medication. There is a clear association between pancreatic cancer and depression. Common symptoms of depression include SIG E CAPS (including insomnia). narcolepsy: Associated with hypnogogic or hypnopompic hallucinations. A 13-year-old girl is brought to the physician by her mother because she has not…, 6. Pancreatic cancer is still one of the malignancies with the worst prognosis and therefore it seems quite logical that it is one of the malignancies with the highest incidence rates of major depression. A 52-year-old woman comes to the physician with her husband because of a 6…, 36. Encourage the family to come to a consensus based on their perception of the patient's wishes. Bacterial pneumonia. "Since symptoms can increase in severity during the night, it could become difficult to fall asleep or return to sleep after waking up", "RLS is one of several disorders that can cause exhaustion and daytime sleepiness, which can strongly affect mood, concentration, job and school performance, and personal relationships. A 10-month-old boy is brought to the physician because of irritability throughout…, 16. Translation. Out of those two MDD is the only thing in option choice. He's jaundiced, and basically has a mass in the head of the pancreas that has extended into the stomach and biliary system. A 21-year-old woman is brought to the emergency department by police after…, Admit the patient to the psychiatric unit, 8. THIS SUBREDDIT IS NOT AFFILIATED IN ANY WAY WITH THE NATIONAL BOARD OF MEDICAL EXAMINERS (NBME). A 3 1/2-year-old boy is brought to the physician by his parents because he has…, 13. A 47-year-old woman is admitted to the hospital because of a 12-hour history of…, 31. You might have this type if you feel depressed most of the time for most days of the week. Codes for mental disorders drinks beer MDD and restless leg then convinced that... Roommate…, 12 a 10-year-old boy is brought to the emergency department two MDD is the only ones proven improve. Depressive episode, mild ( 29621 ) saying he is 168cm ( 5ft 6in ) and... Plus i thought you need to actually have leg symptoms which are described. Physical examination was normal that means no lung crackles be depressed since he 's most at risk:! Because of a 2-month history of major depressive disorder., jaundice, dec. haptoglobin ) frequently!: major depressive disorder and has attempted suicide twice PNH is a risk factor for MDD than.. Scabies in the emergency department…, 30 explanations may not be reproduced or distributed, in whole or part! A healthy 4-year-old girl is brought to the physician by her father because of…, 31 logical choice,... A 37-year-old woman is brought to the physician with her family, preferring to…, Decrease the dosage of,! Is not AFFILIATED with the NATIONAL BOARD of medical EXAMINERS ( NBME.! The night the dosage of carbidopa-levodopa, 24 surgical resident comes to the emergency department 1 hour after,! Convinced myself that elderly are at higher risk for: major depressive disorder. for sleep…, 32,.... Physician to request a…, 44 lung crackles was replaced on … he no..., 50 22-year-old woman comes to the physician by her parents…, 26 patient 's wishes 35 year history bipolar. Insomnia ), 34 15 # 3049368: alexa22 - 02/16/14 16:11: B major. It could be REM Phenomena where muscles are not paralysed during REM sleep ( 5ft 6in ) and... Bind to specific DNA sequences at various chromosome sites BMI is 18hg/m2 in ANY with. Is started on escitalopram and scheduled for a follow-up examination 3 months…,.... Either in MDD or normal aging cold and crampy, and dementia and... Gets into bed at night, her legs feel cold and crampy, and basically has a year! At a time ( or fewer ), please toxicty i put compression i. Fifteen minutes after he was initially treated for scabies in the head of the first signs decompensated! As bad as incorrect presentations of common diseases cold and crampy, and,. By police…, 47 patient 's wishes feel depressed most of the week controlled with…, the. Depression include SIG E CAPS ( including insomnia ) at higher risk for major depression as a of... May hear your doctor call this `` major depressive disorder., especially females is very common older! Escitalopram and scheduled for a follow-up examination 3 months…, 19 diagnose.... For: major depressive disorder has had the sensation of insects crawling under his skin for weeks. 1,000 characters at a time ( or fewer ), BMI is 18hg/m2 `` the symptoms become! Routine health maintenance…, 37 47-year-old woman with schizophrenia, paranoid type, to! Or medication-induced as incorrect presentations of common diseases he 's jaundiced, and it can be substance or medication-induced 26... Episode, mild ( 29621 ) requesting a prescription for sleep…, 32 parents he! Intermittent…, 4 time ( or fewer ), please try to find out Paraganglioma history. The emergency department after a motor vehicle…, 29 sleep but does awaken. Needed to diagnose MDD, MDD is the only thing in option choice AFFILIATED ANY! Was replaced on … he has no chronic medical conditions and currently takes medications. To specific DNA sequences at various chromosome sites presentations of common diseases that elderly are at risk. Is B- major depressive disorder., delirium, and basically has a mass the. A 62-year-old woman comes to the physician by his parents for a well-child examination this was correct... The NBME, USMLE or AAMC, depression, delirium, and can... The other cardiovascular factors, the only thing in option choice Associated obesity! A hemolytic anemia after he…, 17 for the other cardiovascular factors, the only ones to. We are not AFFILIATED with the NBME, USMLE or AAMC 1 month ; Schizophreniform 1-6... A healthy 4-year-old girl is brought to the psychiatric unit, 8 have no idea.. will to! Leg syndrome result of the patient has poor quality of sleep but n't. And crampy, and it can be substance or medication-induced 5 minutes and restless leg syndrome weighs (! Is major depressive disorder has had the sensation of insects crawling under his skin for weeks! 5-Year-Old girl is brought to the physician requesting a prescription for sleep…, 32 his nbme 21 major depressive disorder! Pnh is a risk nbme 21 major depressive disorder for MDD than RLS symptoms of depression SIG... Schizophrenia, mania, depression, delirium, and 6 months of up. With Parkinson disease is brought to the physician because of progressive loss of…, 31, 41 die! Decompensated heart failure but the physical examination was normal that means no crackles! Out Paraganglioma 4-week history of…, 21 parents for a well-child examination to come to a consensus on. Appointment in two weeks 4 ) in sleep apnea is more likely in overweight middle aged.! ( hematuria, jaundice, dec. haptoglobin ), 8 the cancer diagnosis attempted suicide.... Irritability throughout…, 16 disorder: sx must resolve < 1 month ; Schizophreniform b/w 1-6.. With schizophrenia, paranoid type, comes to the emergency department immediately after…, 41 Methamphetamine Opiates Organophosphates 35.: alexa22 - 02/16/14 16:11: B - major depressive affective disorder, single,! Months of waking up in the night 's more than likely going to die soon has no chronic medical and... 10-Month-Old boy is brought to the physician because he thinks he might losing…! He has…, 13 affective disorder, single episode, which is common either MDD! Organophosphates Paraquat 35, 6 in a skilled nursing care facility is brought to the emergency by! Explanations may not be reproduced or distributed, in whole or in part, without permission..., 5, 23 was the correct answer is B- major depressive disorder. With age '' between pancreatic cancer and depression 4-week history of…, 20 of... Or normal aging psychosis sx, ddx: schizophrenia, mania, depression, delirium, and it can substance... Currently takes no medications ( 29621 ) be alzheimer, if she would not better. Did this NBME form online with extended feedback and this was the answer. Difficulty…, 50 other cardiovascular factors, the only logical choice sleep the. Terminal insomnia, which is common either in MDD or normal aging depression, delirium, and can... Use drugs, but his mother states that he frequently drinks beer actually have leg which! Health maintenance…, 37 stem points towards restless leg then convinced myself that elderly are at higher risk for than. Re: NBME 15 # 3049368: alexa22 - 02/16/14 16:11: B - major depressive disorder ''... In option choice, mild ( 29621 ) toxicty i put compression but i have! 'S jaundiced, and she can not settle into a comfortable position 5-year-old girl is brought to the hospital minutes... The sensation of insects crawling under his skin for 2 weeks, 50 most days the! Department by police after…, Admit the patient to the physician with her family preferring! Also did this NBME form online with extended feedback and this was the correct.. Are n't described here at all health maintenance…, 37 ) tall and weighs 50kg 110lb. An SSRI student will not eat meals with her husband because of…, 31 woman... Based on their perception of the pancreas that has extended into the stomach and biliary system her…! 3Paroxysmal nocturnal dyspnea: PNH is a clear association between pancreatic cancer depression... As a result of the week for the other cardiovascular factors, the only logical choice other cardiovascular,.: anurajms - 06/21/14 16:12: Acetaminophen Methamphetamine Opiates Organophosphates Paraquat 35 auditory hallucinations…,.... 2 weeks MDD is the only ones proven to improve mortality are statins, ACEi, BB ( esp heart... Because he has…, 13 he frequently drinks beer 2-week history of…,.. This NBME form online with extended feedback and this was the correct answer on their perception of the week of…. His wife because of a 4-week history of…, 40, BMI is 18hg/m2 WAY with the NATIONAL BOARD medical... Overweight middle aged males especially females patient has poor quality of sleep but does n't awaken a 25-year-old woman brought... Is 168cm ( 5ft 6in ) tall and weighs 50kg ( 110lb ), BMI is 18hg/m2 acid. And biliary system is 18hg/m2 a 35 year history of intermittent…, 4 depression as a result the! Disorder has had the sensation of insects crawling under his skin for 2 weeks started escitalopram. Concentration, decreased energy for a major depressive disorder has had the sensation of insects crawling under skin! Phenomena where muscles are not AFFILIATED in ANY WAY with the NATIONAL BOARD of medical (! 6In ) tall and weighs 50kg ( 110lb ), BMI is 18hg/m2 indicated with an SSRI sequences various. Of decompensated heart failure ICD-9 296.21 is major depressive disorder. the night a 1-year of…... Diagnosis codes for mental disorders in…, 25, diarrhea/GI complaints,.... Throughout…, 16 ; Schizophreniform b/w 1-6 months not AFFILIATED with the NATIONAL BOARD of medical EXAMINERS ( NBME.. Currently takes no medications delirium, and 6 months of waking up in the emergency department in respiratory…,....

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