A 54-year-old Latino man receives a phone call that his mother has had a stroke and is in ICU at his local hospital. Soon after, he begins trembling, then shouting and screaming. The impression is that he is completely out of control. Which culture-bound syndrome should the PMHNP include in the differential diagnosis?
Khayal
Ataque de nervios
Amok
Dhat
The Correct Answer is B
Choice A reason: Khayal is a South Asian culture-bound syndrome associated with anxiety and somatic complaints, not acute episodes of shouting and aggression.
Choice B reason: Ataque de nervios is a Latino culture-bound syndrome triggered by acute stress or trauma, characterized by shouting, trembling, and emotional outbursts, matching this patient’s presentation.
Choice C reason: Amok is a Southeast Asian syndrome involving sudden aggressive outbursts, but it is culturally specific to Malaysia and the Philippines.
Choice D reason: Dhat is a South Asian culture-bound syndrome involving anxiety about semen loss, not acute aggressive episodes.
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Correct Answer is D
Explanation
Choice A reason: The MMR vaccine is contraindicated during pregnancy because it is a live attenuated vaccine, which could pose a risk to the fetus.
Choice B reason: The Varicella vaccine is also live attenuated and not recommended during pregnancy; vaccination is advised prior to conception.
Choice C reason: The MenB vaccine is generally not part of routine prenatal immunization unless there is a specific risk factor.
Choice D reason: The Tdap vaccine protects against pertussis, which is critical during pregnancy to confer passive immunity to the newborn. It is recommended in the third trimester regardless of previous vaccination status.
Correct Answer is D
Explanation
Choice A reason: Decreased need for sleep can be present in both hypomania and mania; it does not differentiate the two.
Choice B reason: Irritability is also common in both hypomanic and manic episodes and is not specific for hypomania.
Choice C reason: Psychotic symptoms, such as delusions or hallucinations, are indicative of mania, not hypomania.
Choice D reason: Increased productivity, heightened energy, and elevated mood without significant functional impairment or psychotic features suggest a hypomanic episode rather than full mania.
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