A 57-Year-Old Woman Comes to the Physician at the Insistence

question 544

Multiple Choice

A 57-year-old woman comes to the physician at the insistence of her husband; he reports that for quite some time, she has been extremely agitated when sitting, resting, or lying down at night.  She has trouble falling asleep in bed, which in turn keeps him awake.  The patient's discomfort occurs every night; she describes it as an "internal itch that creeps up my lower legs and is often so uncomfortable that I could cry."  This strange sensation compels her to stand and pace the floor, and worsens when she feels fatigued.  Her medical history is significant for well-controlled hypertension, gastroesophageal reflux disease, allergic rhinitis, and tension headaches.  The patient has been on amlodipine, omeprazole, and ibuprofen for 3 years with no recent changes in dosage.  She does not smoke or use illicit drugs but consumes 1-2 alcoholic drinks on weekends.  There is no family history of similar problems.  Physical examination is unremarkable. The appropriate study was ordered and the results are within normal limits.  Which of the following medications should be prescribed at this time?

• A)Clonazepam
• B)Codeine
• C)Gabapentin
• D)Levodopa
• E)Pramipexole

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Definitions:

Short Notice

A term indicating that something is happening or is required to happen with minimal warning or preparation time.

Financial Lease

A type of lease where the lessee essentially rents an asset for most of its useful life and the lease terms closely resemble the conditions of outright ownership.

Long-term

Refers to an extended period of time, typically over one year, used in the context of investments, loans, or planning, indicating a focus on future benefits rather than immediate outcomes.

Maintenance

The tasks and actions taken to preserve or restore equipment, systems, or structures to an operational condition or to prevent failure.