NMS Q&A Family Medicine

chapter 52Somatic Symptoms withoutOrganic BasisExamination questions: Unless instructed otherwise, choosethe ONE lettered answer or completion that is BEST ineach case.1 A 45-year-old woman university faculty person wasreferred to a family physician because of her chairman’sand her husband’s concerns for her light weight.Her body mass index is calculated as 21. Examinationalso reveals swelling of the parotid glands, erosionson the lingual surfaces of her teeth, and linear abrasionson the dorsal surfaces of her right hand, mostprominently over the proximal phalanges. Which ofthe following is the most likely diagnosis?(A) Chronic gastritis(B) Generalized sialoadenitis(C) Bulimia nervosa(D) Chronic pancreatitis(E) Regional enteritis2 Which of the following constellations of symptoms ismost likely to be psychologically based dizziness?(A) Imbalance when standing or walking(B) Motion sickness, visual vertigo, nausea(C) Light-headedness, tunnel vision, or “graying out”(D) Chronic floating, rocking, or fatigue(E) Spinning, turning, or toppling sensation3 A family doctor has been evaluating a 15-year-oldboy for several weeks for nausea and vomiting. Whichof the following would tend to allow a diagnosis ofpsychologically based nausea and vomiting?(A) Nausea worst in the morning(B) Nausea and vomiting associated with earlysatiety(C) Nausea and vomiting over many weeks in theabsence of weight loss(D) Nausea and vomiting associated with vertigo(E) Nausea and vomiting associated with epigastricpain4 A family physician sees 30 patients a day, 5 days perweek. Included in his practice are both sexes and allage groups. What percentage of the symptoms givenby these patients will have no biomedical basis ofexplanation?(A) 5% to 10%(B) 10% to 20%(C) 20% to 40%(D) 40% to 60%(E) 60% to 80%5 A 22-year-old woman has been brought home from aprivate college on a medical basis because of theoccurrence of seizures that often occurred in herroom in a women’s dormitory and, as described,would seem to be grand mal seizures. She is hospitalizedand her family doctor visits her at her hospitalbed. He witnesses a seizure and suspects that they arenot organically based; that is, they are “hysterical” orpseudoseizures. Each of the following would be evidenceof a pseudoseizure, except for which one?(A) The patient is found to be urine incontinent.(B) Her limbs flail in an asynchronous manner.(C) She resists when her nose and mouth are heldclosed.(D) She remains conscious as evidenced by herdirectional gaze.(E) She began to manifest the seizure as soon as thedoctor entered her hospital room for the firsttime since her admission.6 Which of the following somatoform disturbances ispresent in the patient featured in Question 2?(A) Conversion disorder(B) Somatization disorder(C) Pain disorder(D) Hypochondriasis(E) Malingering299