u*****o
发帖数: 125 | 1 是form里的，如果没有做过，可以跳过了。
A 38 yo woman with SLE, but no evidence of nephritis comes to the office
because of a 3 weeks history of mood swings with crying spells, irritability
and insomnia. She is especially upset because she started corticosteroid
therapy. She is currently taking prednisone, 60mg/day. Her other medications
include an oral contraceptive (the same one for the past 6 yrs) and
ibuprofen. She smokes one-half pack of cigarettes daily, drinks one to two
beers 5 weeks weekly and 3 cups of coffee each morning. Which of the
following is the most appropriate intervention for her mood disturbance?
A) Add amitriptyline at bedtime
B) Discontinue the oral contraceptive
C) Reduce the prednisone dosage
D) Replace ibuprofen with acetaminophen
E) Urge her to stop smoking and to reduce her alcohol and coffeine intake | s*****h
发帖数: 937 | | a*********1
发帖数: 872 | 3 prednisone induced depression | u*****o
发帖数: 125 | 4 我觉得这个病人抽烟，同时还有口服OCP,年龄〉35岁， 很容易有血栓形成，所以应该
是B.但是她目前的主诉如果是抑郁，这个可能是激素引起的，应该是C.
但是题干里说，She feels upset because she is taking steroids,这个比较迷惑，
而且病人的表现，是irritability, insomnia,这都是过于兴奋的表现，所以应该是减
轻她的激惹，这样想，应该是E.
这个题别人讨论过的答案是C.但是这个也难说是不是就一定正确。 | s*****h
发帖数: 937 | 5 This is steroid related emotion swings. However, steroid is for her SLE.
Since the Step 3 is for PCP, I would assume that it's her Rheumotologist's
job to touch that med. I know it sounds silly but C is the first one to be
ruled out in my opinion. E will help her insomnia and the side effects of
OCP. |
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