Posted by kING from IP 71.196.92.103 on September 30, 2006 at 15:32:06:
A 27-year-old woman who was trained as a psychiatrist comes to the office for the first time because of
recurrent intermittent abdominal pain. She complains of "vague" pain that is usually present at night
and typically resolves by mid-morning the following day. She denies any change in bowel habits, blood
per rectum, or weight loss. Her husband is a professional football player and he was recently
transferred to your city's team from across the country. The patient is tearing small pieces from a tissue
that she is holding as she relays her past medical history, which is unremarkable. She does not have
any children yet, but tells you that her husband wants her to have a "son" for him soon. Abdominal
examination is unremarkable. There is a 2 cm yellowish ecchymosis on her left buttock and a 3.2 cm
purple ecchymosis on her right upper arm. When asked about these findings, she tells you with a
clenched fist and watery eyes averted to the ground that she is "accident-prone." The most appropriate
remark at this time is:
A. "For such a smart woman, you seem to have gotten yourself in a dangerous position."
B. "I can't help but notice that you seem to be feeling anxious about something."
C. "These bruises are more consistent with spousal abuse than accidents."
D. "You are leaving out the most important part of the story."
E. "You are lucky that you do not have children because your husband would probably abuse
them, too."