Property:AnswerCExp
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Münchausen syndrome is a psychiatric factitious disorder wherein those affected feign disease, illness, or psychological trauma to draw attention, sympathy, or reassurance to themselves. It is also sometimes known as hospital addiction syndrome, thick chart syndrome, or hospital hopper syndrome. True Münchausen syndrome fits within the subclass of factitious disorder with predominantly physical signs and symptoms, but they also have a history of recurrent hospitalization, travelling, and dramatic, untrue, and extremely improbable tales of their past experiences. There is discussion to reclassify them as somatoform disorders in the DSM-5 as it is unclear whether or not people are conscious of drawing attention to themselves. +
Involuntarily admission is required if the patient is harm to himself or others. One may not have accurate history of ingestion in an suicidal attempt. Complete lab and toxicology screen is required. The patient has to be medically and psychiatrically stabilized before hospital discharge and he is allowed to back to community. +
The following features are found in delusional disorder:
# It is a primary disorder.
# It is a stable disorder characterized by the presence of delusions to which the patient clings with extraordinary tenacity.
# The illness is chronic and frequently lifelong.
# The delusions are logically constructed and internally consistent.
# The delusions do not interfere with general logical reasoning (although within the delusional system the logic is perverted) and there is usually no general disturbance of behavior. If disturbed behavior does occur, it is directly related to the delusional beliefs.
# The individual experiences a heightened sense of self-reference. Events which, to others, are nonsignificant are of enormous significance to him or her, and the atmosphere surrounding the delusions is highly charged. +
'''Incorrect'''- Only after thyroidectomy, radioactive iodine is either used as an adjuvant in the ablation of residual thyroid tissue and possible microscopic residual cancer or to detect a metastatic disease and in the further treatment of the known residual or metastatic thyroid cancer during followup. +
Morning sunlight may promote vit D synthesis, and is recommended in osteoporosis. However levothyroxine dose reduction is the indicated in this patient. +
MRI is not indicated, and will not be helpful in the change in the bone density. If osteoporosis results in fracture nerve entrapment, a MRI is done to dignose and manage bone compression. +
Incorrect! Although glucose tolerance test is suggestive of impaired glucose tolerance, HbA1C is 7.1, the American Endocrine Society recommends, HbA1C 6.5% or higher as the primary criterion for the diagnosis of diabetes mellitus. +
'''Incorrect''' - After diagnosing papillary carcinoma of thyroid with a histopathological analysis, ultrasound of the neck is the primary modality that is used for staging the disease. It is not of much use following surgery and in the post operative follow up period. +
Invasion beyond the muscular propria indicates a T3 tumor. T2 tumors include those that have invaded, but not extended beyond the muscular propria. +
The key question in nasogastric tube placement is whether one accidentally inserted the tube through the trachea rather than the esophagus. A KUB X-ray would be unable to address this question. +
Serum LDH > 350 is one of Ranson's criteria. LDH is released from dying liver cells and is a sensitive measure of liver injury that can be secondary to leakage of pancreatic digestive enzymes. +
Airbags often cause abrasions or contusions of the arms, face and chest. The collision in this vignette was a fairly low velocity collision, making the likelihood that the airbag would cause substantial harm smaller. It would be highly unlikely that an airbag would cause a posterior shoulder dislocation, especially given the speed of the collision. +
Trimethoprim-Sulfamethoxazole (TMP-SMX) is often used as a second agent in regimens against Toxoplasmosis. TMP-SMX is synergistic in combination with Pyrimethamine. However, TMP-SMX is not recommended as a monotherapy against Toxoplasmosis. +
CT scan in this case revealed diffuse intraparenchymal hemorrhage. Unfortunately, there is no hematoma to evacuate in this case. +