Mehl. bullet: disociated + somatic

Question 1

M. Child being dropped off at summer camp + says he can’t move his finger -> child is likely stressed by being separated from parents. Dx?

Answer 1

Conversion disorder

Question 2

M. Hoarseness of voice shows up on NBME form where answer is conversion disorder.

Answer 2

.

Question 3

M. NBME also gives guy with blindness in one eye, but there’s no relative afferent pupillary defect (indicating CN II isn’t fucked up), so Dx =?

Answer 3

NBME also gives guy with blindness in one eye, but there’s no relative afferent pupillary defect (indicating CN II isn’t fucked up), so Dx = conversion disorder.

Question 4

M. 40F + headaches + abdo pain + mild weight loss + fatigue + 5/9 SIGECAPS not met + no mention of low
mood; Dx?

Answer 4

NBME wants somatization disorder, not MDD;

this Q is a little challenging, as mere weight loss/gain + low mood will often be MDD, particularly in elderly; somatization disorder Dx is recurring, multiple, current somatic complaints; Tx = CBT.

Question 5

M. 33M + witnessed construction accident at work where many people were injured + found by police in bowling alley parking lot talking to himself + unable to respond to questions about his identity; Dx?

Answer 5

answer = dissociative fugue (dissociative disorder); fugue = amnesia for personal identity + travel.