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{{WBRQuestion
{{WBRQuestion
|QuestionAuthor=Mahmoud Sakr M.D.
|QuestionAuthor=Mahmoud Sakr M.D.
|ExamType=USMLE Step 3
|ExamType=USMLE Step 3

Latest revision as of 23:26, 27 October 2020

 
Author PageAuthor::Mahmoud Sakr M.D.
Exam Type ExamType::USMLE Step 3
Main Category MainCategory::Primary Care Office
Sub Category SubCategory::Psychiatry
Prompt [[Prompt::38 y/o female patient of yours has been complaining of vigorous mood swings, with some days she’s having irritability, restlessness, increased energy, racing thoughts, high sex drive, and a tendency to make grand and unattainable plans. Other days, she’s too tired to get out of bed and feels hopless. You decide to start her on lithium for bipolar disorder. Which of the following blood test should you order first:]]
Answer A AnswerA::TSH, BUN, creatinine, Pregnancy test
Answer A Explanation AnswerAExp::TSH, BUN, creatinine, Pregnancy test are necessary tests to perform prior to starting patients on lithium due to associated teratogenicity, renal injury and thyroid disorders with lithium therapy.
Answer B AnswerB::TSH, BUN, creatinine and LFTs
Answer B Explanation AnswerBExp::Liver injury is not known to occur with lithium.
Answer C AnswerC::TSH, LFTS, pregnancy test
Answer C Explanation AnswerCExp::Liver injury is not known to occur with lithium.
Answer D AnswerD::TSH, BUN, creatinine, cortisol and pregnancy test
Answer D Explanation AnswerDExp::Adrenal injury is not known to occur with lithium.
Answer E AnswerE::LFTs, BUN, creatinine and pregnancy test.
Answer E Explanation AnswerEExp::Liver injury is not known to occur with lithium.
Right Answer RightAnswer::A
Explanation [[Explanation::TSH, BUN, creatinine, Pregnancy test are necessary tests to perform prior to starting patients on lithium due to associated teratogenicity, renal injury and thyroid disorders with lithium therapy. Liver or adrenal injury is not known to occur with lithium as indicated in the distractors.

Educational Objective:
References: ]]

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