Question

QUESTION 21

Joey's parents don't believe in punishing him when he does something wrong. They have just moved from New York to Texas and Joey is acting out. He is having tantrums and bites his mom on occasion. What is Joey's most likely diagnosis?

	a.	Tourette's disorder
	b.	conversion disorder
	c.	oppositional defiant disorder
	d.	Münchausen's syndrome by proxy

Betty, an 11-year-old, is constantly fidgeting. Her mom repeatedly asks her to pick up her toys, but she is unable to do so. In school the teacher has to continually refocus Betty's attention to her school work. How would the physician diagnose Betty's condition?

	a.	inattention > 6 months at home and school
	b.	inattention > 6 months at home
	c.	inattention > 6 months at school
	d.	inattention > 3 months at home and school

Jerry comes into the ED complaining of a headache, photophobia, and vomiting. The doctor notices that he also has nuchal rigidity. A lumbar puncture is ordered. The results are as follows: increased WBC, increased protein, and decreased glucose. What is Jerry's most likely diagnosis?

	a.	trigeminal neuralgia
	b.	hydrocephalus
	c.	postpolio syndrome
	d.	meningeal irritation or meningitis

Answer 1

21. Answer

* c. Oppositional defiant disorder

Reason: It is behavioural disorder with frequent outbursts and chronic aggression.

* a. Inattention >6 months at home and school

Reason:The diagnostic criteria for inattention is often fidgets,and other hyperactive impulsive symptoms. It present before 12 year and it present in two or more settings.

* d. Meningeal irritation or meningitis

Reason: Nuchal rigidity is a typical symptom of meningitis. The CSF study reports also reveals it is a clear case of meningitis.