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You are seeing a 6-year-old boy with nausea and vomiting. His symptoms began acutely last evening, starting with malaise, headache, lowgrade fever, body aches, and diarrhea. On examination, he has dry mucous membranes, but no orthostatic symptoms. He has diffuse mild abdominal pain without rebound or involuntary guarding. Which of the following is the best treatment for his condition? a. Nothing by mouth until his symptoms improve b. Oral rehydration with clear liquids, advancing the diet as tolerated c. IV rehydration, advancing to oral as tolerated d. Antiemetics, given intravenously or intramuscularly e. Trimethoprim/sulfamethoxazole therapy B. loss of interest or changes in
Depression is commonly seen in primary care settings. In fact, it is estimated that only about 20% of depression-related health care occurs in mental health care settings. Nonpsychiatrists write approximately 80% of the prescriptions for antidepressants. Patients with major depressive disorder often present with vague physical symptoms rather than emotional complaints. To make the diagnosis of depression using DSM criteria, the patient must describe either depressed mood for most of the day nearly every day for at least 2 weeks, or loss of interest in usually enjoyable activities. Irritable mood may take the place of depressed mood to make the diagnosis as well. In addition to one of those two symptoms, the patient must experience other symptoms of depression, including sleep changes, feelings of guilt or worthlessness, loss of energy, loss of concentration, change in appetite, psychomotor speeding or slowing, or suicidal thoughts, plans, or intent. ;