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A 28-Year-Old Woman Comes to the Office for a Routine

question 460

Multiple Choice

A 28-year-old woman comes to the office for a routine evaluation. During the review of systems she reports weight gain, fatigue, bloating, flatulence, constipation, mild acne, and menstrual irregularity. The patient describes difficulty losing weight despite trying numerous low-calorie diets. She is depressed about her weight and feels that her appearance has always been a source of insecurity. She is also unhappy with her current position as an administrative assistant but lacks the motivation to look for another job. The patient has an active social life with friends but is not in a relationship. She smokes marijuana 1 or 2 times a month and has used cocaine at parties twice in the past year.
Temperature is 37.1 C (98.8 F) , blood pressure is 110/60 mm Hg, and pulse is 68/min. On physical examination, the patient has mild facial acne and is slightly overweight. BMI is 27 kg/m². The oropharynx is remarkable for painless, mildly swollen parotid glands. The remainder of the physical examination is normal.
Complete blood count is normal and serum electrolytes are notable for mildly decreased serum potassium, slightly elevated serum bicarbonate, and mildly decreased serum chloride levels. Thyroid function tests, liver function tests, and urinalysis are unremarkable.
Which of the following is the most likely diagnosis in this patient?

Definitions:

Early Termination

The process of ending an agreement or contract prior to its originally agreed upon conclusion date.

Self-Handicapping

A cognitive strategy by which individuals avoid effort in the hopes of keeping potential failure from hurting self-esteem.

Anticipatory Excuses

Refers to justifications provided in advance of an action to preemptively excuse or rationalize possible failure or poor performance.

Social Psychological

Pertaining to the scientific study of how individuals think, feel, and behave in social contexts.