WBR1129
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| Author | [[PageAuthor::Pratik Bahekar, MBBS [1]]] |
|---|---|
| Exam Type | ExamType::USMLE Step 2 CK |
| Main Category | MainCategory::Psychiatry |
| Sub Category | SubCategory::Psychiatry |
| Prompt | [[Prompt::A teenager complains that he has episodes of uncontrollable swears at people. Sometimes it is accompanied by grimacing, clicking sound. These episodes are becoming more frequent. It has been interfering his social life and is concerned that he will not be able to get a date for prom. He has a family history of similar symptoms. He also has symptoms suggestive of obsessive compulsive disorder. Which of the following is best likely to alleviate his symptoms?]] |
| Answer A | AnswerA::Clonazepam |
| Answer A Explanation | AnswerAExp::Clonazepam is not a treatment of tourette syndrome. |
| Answer B | AnswerB::Buspirone |
| Answer B Explanation | AnswerBExp::Buspirone is not a treatment of tourette syndrome. |
| Answer C | AnswerC::Bupropion |
| Answer C Explanation | AnswerCExp::Bupropion is not a treatment of tourette syndrome |
| Answer D | AnswerD::Pimozide |
| Answer D Explanation | [[AnswerDExp::Tourette Syndrome is associated with attention-deficit hyperactivity disorder (ADD or ADHD), obsessive–compulsive disorder (OCD), learning disabilities and sleep disorders. Disruption from tics is commonly overshadowed by comorbid conditions that present greater interference to the child. Tourette’s Disorder may be diagnosed when a person exhibits both multiple motor and one or more vocal tics (although these do not need to be concurrent) over the period of a year, with no more than three consecutive tic-free months. The DSM-IV included a requirement for "marked distress or significant impairment in social, occupational or other important areas of functioning", but this requirement was removed in the most recent update of the manual, in recognition that clinicians see patients who meet all the other criteria for Tourette's, but do not have distress or impairment. The onset must have occurred before the age of 18, and cannot be attributed to the "direct physiological effects of a substance or a general medical condition". Hence, other medical conditions that include tics or tic-like movements—such as autism or other causes of tourettism—must be ruled out before conferring a Tourette's diagnosis. There are no specific medical or screening tests that can be used in diagnosing Tourette's; it is frequently misdiagnosed or underdiagnosed, partly because of the wide expression of severity, ranging from mild (the majority of cases) or moderate, to severe (the rare, but more widely-recognized and publicized cases). The diagnosis is made based on observation of the individual's symptoms and family history, and after ruling out secondary causes of tic disorders. In patients with a typical onset and a family history of tics or obsessive–compulsive disorder, a basic physical and neurological examination may be sufficient. If a physician believes that there may be another condition present that could explain tics, tests may be ordered as necessary to rule out that condition. Medication is available to help when symptoms interfere with functioning. The classes of medication with the most proven efficacy in treating tics—typical and atypical neuroleptics including risperidone , ziprasidone, haloperidol, pimozide and fluphenazine can have long-term and short-term adverse effects.]] |
| Answer E | AnswerE::Lorazepam |
| Answer E Explanation | AnswerEExp::Lorazepam is not a treatment of tourette syndrome. |
| Right Answer | RightAnswer::D |
| Explanation | [[Explanation::Pimozide is used to control tics in Tourette Syndrome. Educational Objective: Pimozide is used to control tics in tourette Syndrome. |
| Approved | Approved::No |
| Keyword | WBRKeyword::Tourette syndrome |
| Linked Question | Linked:: |
| Order in Linked Questions | LinkedOrder:: |