Question

[bigfrank]

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A patient has DSM-IV Bulimia Nervosa. What psychiatric condition is most likely likely to be a comorbid concern?

- BDD
- OCD
- MDD

??????????? I "recently" got this question and have no idea.

Thanks, bigfrank

 

[nuclearrabbit77]

i think MDD would be the most likely.

 

[bigfrank]

That's what I put, as I thought BDD (body dysmorphic d/o) was a distracter

P.S. Your signature is absolutely hysterical.

 

[FoxyDoc]

Yep, I would have to agree with MDD. But if the question had said anorexia I think then BDD would have probably been correct.

P.S. bigfrank, Thanks for all of your feedback it has been really helpful!

 

[gmendese]

Hey Bigfrank,

I don't know what the right answer is, but I read in my books that Bulemia is highly correlated with OCD. The others sound right, too, so I don't know!

 

[EMBess]

I remember reading OCD correllating with bulemia also...but all I can find in BRS is Depression.

 

[FoxyDoc]

I think the correlation is if a patient has OCD, he/she is likely to have Bulimia, but not the other way around. The question was asking about a patient who has Bulimia, so I'm still pretty sure that MDD is the right answer.

 

[nuclearrabbit77]

i have a behavioral question from qbank.

75y.o. widow who was in a caraccident with husband who died. 4months later, she has lost 11 pounds, uncontrolled spontaneous crying, and auditory hallucinations of her husband calling from the other side of the house.

your reply:
-few of the answer choices-

-"do you think about your husband often?"
-"i'm going to give you something to make you feel better and help you sleep"
-"you have all the symptoms about depression. do you understand what that means"


the explanations say that this is the normal grief response and that this isn't depression, and that the first choice answer is correct.
what i want to know is, how isn't this depression? according to pg.24 brs behavioral sciences, she's lost more than 8 pounds, and has hallucinations...seems like its more than the normal grief response in my opinion.

 

[Jalby]

The 11 pounds is greater than the 3 that I remember as being normal, but the hallucinations and crying is "supposedly" normal grief. And it is less than 6 months, the cut off.

 

[Jalby]

Oh, and I remember N Bolemia (or some spelling) being related to depression. You treat both of them with SSRI's, after all.

 

[bigfrank]

Thanks, I hope you all are right. It's these stupid little questions like this that will probably determine a good vs. great vs. fantastic score -- know what I mean?

Best wishes to all.

 

[nuclearrabbit77]

The 11 pounds is greater than the 3 that I remember as being normal, but the hallucinations and crying is "supposedly" normal grief. And it is less than 6 months, the cut off.

from brs, illusions are normal but hallucinations and delusions aren't. pg. 24 brs. you are right about the length of time though.

 

[EMDrMoe]

Oh, and I remember N Bolemia (or some spelling) being related to depression. You treat both of them with SSRI's, after all.

Thanks for that! I would have put OCD. And they say we're just procrastinating when we hang out on SDN all the time!

 

[gmendese]

The timeline for normal grief is 3 months. Anything longer than that is MDD. Also, if the grief reaction includes suicidal thoughts or plan, then it's MDD right from the get go. And aside from the reaction to a loss, MDD can be diagnosed after 2 weeks.

Hope this helps!

Gary

 

[BellKicker]

from brs, illusions are normal but hallucinations and delusions aren't. pg. 24 brs. you are right about the length of time though.

Weird, my BRS says 2 months on p. 24 (mine is old, though; 3rd edition).

With these questions, the answer is almost always normal grief for some reason.

In real life, this woman would be treated for depression one way or another.

 

[DrQuinn]

You can have "normal grief" for up to ONE year. It is exactly the same as depression, but with an obvious trigger (usually the boards give you a spouse dying). As long as the patient udnerstands the "visions" of the dead spouse are just that, hallucinations, adn do not believe them to be real, it is a normal grief response.

Q, DO

 

[nuclearrabbit77]

another qbank question...

they ask when a reagent strip will test positive for urine glucose. i was trying to decide between the answer choices
200 and 300mg/dl.

according to brs physio pg 172, they say glucose splay is between 250 and 350. if this is the case, why is the correct answer 200mg/dl according to qbank?

 

[nuclearrabbit77]

another contested qbank question. renal...again.

Q: a certain substance that is freely filtered and secreted, is being maximally secreted. As the plasma concentration increases, the renal clearance:

-decreases and approaches that of inulin
-increases and approaches that of inulin
-increases to the renal plasma flow
-will remain the same




the correct answer according to qbank is the first one. i have a problem with this. i agree that the substance has the same slope as inulin at saturated levels, which is of neither being secreted or reabsorbed. however, i don't believe that the clearance will decrease. if you increase the plasma concentration of the substance, you do saturate the secretion transporters, but the increased concentration is still going to increase the urinary concentration of that substance, and clearance = U V/ P

am i missing something here? i understand the idea of saturation of the secretion proteins, but nevertheless, even though the kinetics of clearance of this substance at saturated concentrations is the same as inulin, it still has the added clearance due to the secretion proteins.

look at pg. 173 brs physio. the excreted line of PAH has the same SLOPE as the filtered (inulin) line, but nevertheless, the PAH line is still HIGHER. since there is more substance being excreted at every point compared to inulin, the clearance must always be higher.