Behavioral Health


{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/M22_F1.jpg"}},{"insert":"\n\n"},{"insert":"You scratch your head and pour over the clue in front of you - \u002212-letters, an interjection or intrusion\u0022 - tapping the table rapidly as you search for the answer.\r\n \r\n\u002212 letters, an interjection or intr-\u0022\n"}]}


{"ops":[{"insert":"A loud knock on your office door has you exclaiming triumphantly, \u0022Interruption!\u0022\r\n \r\nYou hurriedly stuff the newspaper into your overflowing desk drawer and call your next patient in.\n"}]}


{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/M22_F3.jpg"}},{"insert":"\n\n"},{"insert":"A young, sharply dressed man in a navy suit with bejeweled cufflinks greets you.\r\n \r\nYour attention, however, is drawn to his sunken face and the heavy bags around his eyes.\n"}]}


{"ops":[{"insert":"He introduces himself as Alex, and you invite him to have a seat as you quickly peruse his medical records, which are quite unremarkable. \r\n \r\n\u0022How can I help you today, Alex?\u0022\n"}]}


{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/M22_F5.jpg"}},{"insert":"\n\n"},{"insert":"\u0022I\u0027ve been feeling off color lately, doctor. I feel listless but edgy and irritable at the same time, not quite like my usual self at all.\u0022\n"}]}


{"ops":[{"insert":"\u0022The weekends are all right, you know, I go out and have a good time, but during the week I\u0027m back to square one. I\u0027m on edge all the time, and I get annoyed with my co-workers so easily. I\u0027m a bag of nerves.\u0022\n"}]}


{"ops":[{"insert":"You listen carefully and request to examine him, to which he consents.\n"}]}


{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/M22_F8.jpg"}},{"insert":"\n\n"},{"insert":"Alex\u0027s resting heart rate is 75bpm with a blood pressure of 110\/75 mmHg. His weight is 62 kg and has not fluctuated meaningfully in the last year.\r\n \r\nYou notice a slight arrhythmia while auscultating over his chest, which does not seem significant.\r\n \r\nYou then shift your focus to Alex\u0027s mental health.\n"}]}


{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/M22_F9.jpg"}},{"insert":"\n\n"},{"insert":"As he begins to tell you about an extremely demanding job at a large financial institution, you suspect that he may be suffering from work-related anxiety. You\u0027re about to inquire further about his job when he suddenly interjects -\n"}]}


{"ops":[{"insert":"\u0022I actually had one other thing I wanted to talk to you about...\u0022 He trails off, rubbing his nose absently, then looks around the room, seeming suddenly very nervous.\n"}]}


{"ops":[{"insert":"Puzzled by his change in demeanor, you reassure him of your intentions to help him out and respect his confidentiality, encouraging him to go on.\n"}]}


{"ops":[{"insert":"\u0022I, um, go to a lot of parties and mixers, and a lot of - stuff - gets passed around.\u0022 He pauses, shuffling nervously in his seat and looking up at you cautiously. You give him an encouraging nod.\n"}]}


{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/M22_F13.jpg"}},{"insert":"\n\n"},{"insert":"He sighs deeply, leaning forward. \u0022A few months ago I was at this party in the city and I did some cocaine. I\u0027ve been using it quite regularly since.\u0022\r\n \r\n\u0022I never have any while at work or before driving, though!\u0022 he adds hurriedly.\r\n \r\n\u0022I don\u0027t do any other drugs - I\u0027m deathly afraid of needles and have always hated pills.\u0022\n"}]}


{"ops":[{"insert":"You nod slowly and reconsider Alex\u0027s symptoms.\n"}]}