A 48-Year-Old Man Comes to the Office for a Follow-Up

question 54

Multiple Choice

A 48-year-old man comes to the office for a follow-up appointment.  He has a history of type 2 diabetes, hypertension, and major depression.  Over the past year, the patient has been treated with fluoxetine 20 mg for depression, which was subsequently increased to 40 mg.  He says, "I feel about 50% better.  I'm definitely less sad, and I'm somewhat more interested in my work and spending time with family.  However, I still feel like my energy is low.  I used to go to the gym or attend my son's soccer games on weekends, but now all I want to do is rest in bed or on the couch.  I'm frustrated because I'm eating too much and haven't been able to lose any weight."  Physical examination and routine laboratory tests are unremarkable.  Which of the following medications would be most appropriate to augment this patient's antidepressant therapy?

• A)Bupropion
• B)Buspirone
• C)Citalopram
• D)Methylphenidate
• E)Mirtazapine
• F)Olanzapine
• G)Phenelzine

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Definitions:

Publicly Funded Health Care

A health care system financed by taxes collected by the government to provide health services to all citizens free or at a minimal cost at the point of service.

Equity

Fairness and justice in the way people are treated, achieved by recognizing and addressing differing needs and circumstances.

Equality

The state of being equal, especially in status, rights, and opportunities; involves the promotion of uniform treatment and absence of discrimination.

Personal Identity

The part of a person’s identity determined by their individual attributes and characteristics.