A 35-Year-Old Woman Comes to the Office Due to Insomnia

question 162

Multiple Choice

A 35-year-old woman comes to the office due to insomnia and fatigue over the past month.  She has felt increasingly depressed, irritable, and worthless since being let go from her job 5 weeks ago.  The week prior to her last menstrual period was particularly difficult, and she stayed in bed most of the day.  Over the last month, the patient has lost 3.6 kg (8 lb) and has felt unmotivated and unable to concentrate on looking for new work.  Other medical conditions include hypothyroidism and migraine headaches.  The patient drinks 1 or 2 glasses of wine a few times a week and smokes marijuana once a month.  Medications include levothyroxine and naproxen.  Physical examination is normal.  TSH level is 0.9 µU/mL.  Which of the following is the most likely diagnosis in this patient?

• A)Adjustment disorder with depressed mood
• B)Bipolar II disorder
• C)Depressive disorder due to another medical condition
• D)Major depressive disorder
• E)Persistent depressive disorder
• F)Premenstrual dysphoric disorder
• G)Substance-induced depressive disorder

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Definitions:

Fair Values

The valuation received for disposing of an asset or the expense of moving a liability in an organized market activity on the assessment date.

Acquisition

The process of obtaining control of another corporation, purchasing its shares, or assets, to expand or diversify operations.

Voting Common Stock

Shares that give the shareholder voting rights in corporate decisions, typically one vote per share owned.

Preferred Stock

A class of ownership in a corporation with a fixed dividend that is paid out before any dividends to common stockholders.