A 20-Year-Old College Student Comes to the Office Due to Worsening

question 152

Multiple Choice

A 20-year-old college student comes to the office due to worsening abnormal movements.  The symptoms initially started in middle school when he would repeatedly blink and then shrug his shoulders.  The patient worked with a counselor who taught him techniques to suppress movements for periods of time, although these did not completely resolve them.  Over the past few years, the symptoms have gradually worsened.  Episodes now occur multiple times daily, particularly around highly stressful times at school.  His grades have declined, and he is embarrassed during class presentations.  The patient has no history of serious illness and takes no medications.  He occasionally smokes marijuana on weekends.  Family history is notable for the death of his father at age 50 from a stroke.  Vital signs are normal.  During the examination, the patient is visibly anxious.  He repeatedly blinks, clears his throat, and shrugs his shoulders.  The remainder of the physical examination shows no abnormalities.  Which of the following is the most appropriate treatment for this patient?

• A)Antisense oligonucleotide therapy
• B)Copper chelation therapy
• C)GABA agonist therapy
• D)Serotonin reuptake inhibition therapy
• E)VMAT2 inhibitor therapy

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Definitions:

Supporting Behavior

Actions aimed at assisting or aiding others to achieve a task or improve performance.

Personal Problem

An issue or difficulty that is specific to an individual's life or circumstances.

Behavior Categories

Classifications of actions or reactions of individuals or groups based on specified criteria.

Objective Sense

A viewpoint or perception based on observable and measurable facts, devoid of personal feelings, interpretations, or bias.