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New cases in Pous 2064, HIV = 175, AIDS = 26, Death = 2. HIV rate is very high in Housewives than sex workers in Nepal ! ! ! HIV status in Nepal till 2005: Total Adult=70000, Adult Prevalence (15-49)=0.55%, Number of Women (15-49) LWHA=15,310 (22%), HIV Prevalence rate in IDUs=32.7%, HIV prevalence rate in sex worker=3.8%, HIV prevalence rate in client of SW=2.1%. The latest U.N. report shows that 65 million people have been infected with HIV since it was first identified 25 years ago. Twenty five million people have died of AIDS.

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Clinical Vignette A clinical vignette is a concise presentation of an interesting or challenging patient encounter that stimulated an interesting learning issue.

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Clinical MCQs 3 - 06-06-2006, 04:43 AM

A 28-year-old female complains to her doctor that she is in danger of losing her job. She states that she is late to work almost everyday because, before she leaves for work, she must check all of the faucets to make sure the water is turned off. She also needs to repeatedly check to make sure that her stove is off. When she is finally ready to leave, she returns from her car several times to ensure that her doors and windows are locked. Which of the following drugs will her physician most likely prescribe?
A. Buspirone
B. Chlorpromazine
C. Clomipramine
D. Imipramine
E. Phenelzine
F. Zolpidem
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Arrow Option C - 06-06-2006, 05:06 AM

Here the patient shows the features of Obessive Compulsive Disorder. She has been directed to neutralizing anxitey arosen out of Obsession and has typical Features of Compulsive Disorder.
For the treatment of such patients, we can use anti-obessive drug like Clomipraminine ( found in 25 mg or 50 mg tablets). 75-250 mg per day for at least 3 months.
For the adjuctive therapy, we can use Buspirone ( found in 5 mg or 10 mg Tablets) 20-40 mg per day for 6 months.
So i will go for option C.
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Re: Clinical MCQs - 06-06-2006, 06:25 AM

Great job man

The correct answer is C. This patient is suffering from obsessive-compulsive disorder. Clomipramine, a tricyclic antidepressant, and the selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine, are effective in this disorder. None of the other answer choices listed constitute effective therapy for this disorder.
  • Buspirone (choice A) is a non-benzodiazepine anxiolytic that does not have marked sedative or euphoric effects. Unlike the benzodiazepines, buspirone is devoid of hypnotic, anticonvulsant, and muscle relaxant properties.
  • Chlorpromazine (choice B) is an antipsychotic (phenothiazine) drug.
  • Imipramine (choice D) is a tricyclic antidepressant.
  • Phenelzine (choice E) is a monoamine oxidase inhibitor type of antidepressant.
  • Zolpidem (choice F) is a non-benzodiazepine hypnotic agent.
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