Darryl is 35 and presents to urgent care with the following complaints: Redness of the left eye. He says it feels like there is something in his eye, though the sensation persisted even after he flushed the eye. The eye feels itchy and very dry. He noticed the dryness several days ago and has been treating it with OTC lubricant eye drops. On physical exam, the eye is very inflamed and tears easily. A check for a foreign body was negative. The patient does have a pterygium near the nasal side of the eye. Darryl was given a referral to an ophthalmologist for definitive treatment.
Dx. Pterygium
First-listed diagnosis: ________
Fill in the blank with correct word.
Question 2
Chloe is an almost 40-year-old woman who was referred for psychiatric evaluation by her family physician. She has been having trouble at work and they actually did an intervention where she was told that if she did not seek help, she could not keep her job. In talking with Chloe over the course of several hours she acknowledged the following:
She has problems with interpersonal relationships. She has had any number of best friends with whom she is particularly close at the beginning of the friendship, but then realizes they don't like me; they're jealous in fact and that causes a rift in the friendship. She has had many relationships with men. She falls in love easily and it is very intense, but then they end up hating me after awhile. The difficulties in the relationships are never Chloe's fault, at least according to her.
She has problems with impulsivity. She spends money she does not have on things she does not need, and has substantial credit card debt. She is convinced that the credit card companies don't need the money to be repaid because, they factor non-payment into their financial plans.
She has problems with inappropriate anger. She is still angry at her boss for the intervention that was staged at work. She knows she doesn't have a problem and doesn't understand the big deal. She thinks her employer should just let her do and act as she pleases and that something is wrong with them, not her. She is very bitter, in fact, over numerous jobs she has lost over the years. She also gets upset when friends cancel plans, especially at the last minute, and though she does not act out, she fantasizes about getting even.
She is 40 years old and has never married, though she wants to marry and have children. She feels empty inside but believes she will be whole and complete once she finds a husband. In fact, life will be perfect once she has a husband whose money she can spend, and who will do half the housework, including cooking. She seems to have put her life on hold until then. When asked what she thought of the following statement, Life is not a dress rehearsal, she got angry and refused to comment on it.
Based on the evaluation and psychological testing, Chloe was diagnosed with borderline personality disorder. Antidepressants were prescribed, though it is unknown if she will be compliant in taking them. She was asked to return in a week to start psychotherapy. The medication will be monitored and changed, if needed.
First-listed diagnosis: ________
Secondary diagnoses: ________
It is important to ask patients what other health care providers they are seeing, such as the dentis
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