WBR1146

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Author [[PageAuthor::Pratik Bahekar, MBBS [1]]]
Exam Type ExamType::USMLE Step 2 CK
Main Category MainCategory::Internal medicine, MainCategory::Psychiatry
Sub Category SubCategory::Poisoning, SubCategory::Psychiatry, SubCategory::Miscellaneous
Prompt [[Prompt::A 23 year old woman is complaning of repeated thoughts about germs, and dirt. She tries to be overly tidy and followed same rituals over and over, such as washing hands, washing silverware, changing sheets and cleaning floor. She neither can control the unwanted thoughts and behaviors nor gets a pleasure out of it. This is causing distress and disrupts daily life. Which of the following will curtail her symptoms?]]
Answer A AnswerA::Doxepin
Answer A Explanation AnswerAExp::Doxepin is not used in the treatment of obsessive compulsive disorder.
Answer B AnswerB::Buspiron
Answer B Explanation AnswerBExp::Buspiron is not used in the treatment of obsessive compulsive disorder.
Answer C AnswerC::Risperidone
Answer C Explanation AnswerCExp::Risperidone is not used in the treatment of obsessive compulsive disorder.
Answer D AnswerD::Haloperidol
Answer D Explanation AnswerDExp::Haloperidol is not used in the treatment of obsessive compulsive disorder.
Answer E AnswerE::Clomipramine
Answer E Explanation [[AnswerEExp::Obsessions are thoughts that recur and persist despite efforts to ignore or confront them. The patient frequently performs tasks, or compulsions, to seek relief from obsession-related anxiety. Within and among individuals, the initial obsessions, or intrusive thoughts, vary in their clarity and vividness. A relatively vague obsession could involve a general sense of disarray or tension accompanied by a belief that life cannot proceed as normal while the imbalance remains. They understand that their notions do not correspond with reality; however, they feel that they must act as though their notions are correct. For example, an individual who engages in compulsive hoarding might be inclined to treat inorganic matter as if it had the sentience or rights of living organisms, while accepting that such behavior is irrational on a more intellectual level. It's treatment of choice is a behavioral therapy, called as, Exposure and ritual prevention (also known as "exposure and response prevention") or ERP; this involves gradually learning to tolerate the anxiety associated with not performing the ritual behavior.

Clomipramine is the only FDA approved treatment of obsessive compulsive disorder, besides SSRIs.]]

Right Answer RightAnswer::E
Explanation [[Explanation::Clomipramine is the only FDA approved treatment of obsessive compulsive disorder, besides SSRIs.

Educational Objective:
References: http://ocd.stanford.edu/treatment/pharma.html http://www.ncbi.nlm.nih.gov/pubmed/6159865]]

Approved Approved::No
Keyword WBRKeyword::Clomipramine, WBRKeyword::OCD
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