A 46-Year-Old Man with a History of Medication-Controlled Hypertension Comes

question 292

Multiple Choice

A 46-year-old man with a history of medication-controlled hypertension comes to the office for a routine checkup.  Blood pressure is 115/80 mm Hg and physical examination findings are normal.  The physician notes that the patient's mood seems low.  The patient admits that he has been "stressed out" for the past 2 months as a few people at work recently quit and he has had to take on more responsibility while management finds replacements.  He has not been able to exercise or eat right as he is so busy.  The patient feels irritable and tense at work and has had neck and shoulder pain.  He is also worried about not being able to spend time with his wife, who complains that he works too much.  The patient has occasional difficulty falling asleep at night after working long hours and feels tired during the day.  Although he doesn't enjoy his job, he has no choice but to stay.  He continues to get his work done and enjoys social activities, including playing golf on weekends.  The patient drinks 2-3 cans of beer on weekends and smokes marijuana twice a month.  Which of the following is the most likely diagnosis?

• A)Acute stress disorder
• B)Adjustment disorder with depressed mood
• C)Generalized anxiety disorder
• D)Major depressive disorder
• E)Normal stress response
• F)Substance/medication-induced depressive disorder

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Definitions:

Relationships

A connection, association, or involvement between people or entities.

Attitudes Toward Environment

The opinions, beliefs, and feelings individuals hold regarding the environment and environmental practices.

Inner-directed

A characteristic of individuals who are motivated by their own values and standards rather than external expectations.

Outer-directed

A personality trait characterized by being more influenced by external factors and the environment than by personal thoughts or feelings.