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A 30-Year-Old Woman Is Brought to the Office by Her

question 139

Multiple Choice

A 30-year-old woman is brought to the office by her husband. He says that over the past 2 months, the patient has become increasingly depressed to the point that she rarely gets out of bed. She has called in sick to work, does not answer the phone when her friends call, and has lost 4.5 kg (10 lb) . The patient has a history of 2 psychiatric hospitalizations. She was first hospitalized at age 27 for a period of extreme irritability and agitation that lasted a week. At that time, she spoke so rapidly that she was difficult to understand and stayed up for nights dictating letters to government officials about her solution to world hunger. Last year, the patient was hospitalized for severe depression and a suicide attempt. She responded within days to venlafaxine but discontinued the medication shortly after discharge because she "felt fine." On mental status examination, the patient shows a depressed and tearful affect. She admits to "hearing the devil saying I'm a useless waste of time." Which of the following medications would be most appropriate for the long-term treatment of this patient's condition?

Definitions:

Microscopic Analysis

The examination of small objects or samples using a microscope to identify structures and materials not visible with the naked eye.

Urinary Tract Infections

Infections that occur in any part of the urinary system, including the bladder, kidneys, ureters, and urethra, often caused by bacteria.

Void

In medical terminology, to empty or evacuate waste material, especially urine, from the body.

Perineum Area

The region of the body between the pubic symphysis and the coccyx, including the genital and anal areas.