A 24-year-old man comes to the physician with the chief complaint that his nose is too big, to the point of being hideous. The patient states that his nose is a constant embarrassment to him, and he would like it surgically reduced. He tells the physician that three previous surgeons had refused to operate on him because they said his nose was fine, but the patient asserts that “they just didn’t want such a difficult case.” The physician observes that the patient’s nose is of normal size and shape. Based on this patient’s clinical picture, which of the following is the most likely diagnosis?
b. Narcissistic personality disorder
c. Body dysmorphic disorder
d. Anxiety disorder not otherwise specified
e. Schizoaffective disorder
the answer is below…
The United States Medical Licensing Examination, or USMLE for short, is a three-part licensing examination that is required in order to receive a license to practice medicine within the United States.
The USMLE assesses a physician’s ability to apply knowledge, concepts, and principles, and to determine fundamental patient-centered skills that are important in health and disease and that constitute the basis of safe and effective patient care.Examination committees composed of medical educators and clinicians from across the United States and its territories prepare the examination materials each year.
This exam is designed by the Federation of State Medical Boards and the National Board of Medical Examiners to determine whether or not an individual understands and can apply the knowledge necessary to practice medicine safely and intelligently.
The USMLE is actually comprised of three different exams that are referred to as steps, which examine the individual’s knowledge of specific topics related to the field of medicine such as basic science, medical knowledge, medical skills, clinical science, and the application of all of these skills and areas of knowledge in the medical field.
All three steps of the USMLE include a series of computerized multiple-choice questions, but the format of the exam and the information covered in each multiple-choice section is different for each step of the USMLE. The USMLE Step II also has a clinical skills portion that examines an individual’s ability to work with real patients and the USMLE Step III has a computerized patient simulation portion in addition to the multiple-choice section of the exam. In order for an individual to receive a license to practice medicine, the individual must pass all three steps of the USMLE.
The correct answer is c; Body dysmorphic disorder.
An extreme feeling of dislike for a part of the body in spite of a normal or nearly normal appearance is the main characteristic of body dysmorphic disorder. The fear of being ugly or repulsive is not decreased by reassurance and compliments and has almost a delusional quality. The social, academic, and occupational lives of individuals with this disorder are greatly affected, due to avoidance of social interactions for fear of embarrassment, the time spent in checking mirrors and seeking surgical treatment or cosmetic remedies, and the chronic emotional distress that accompanies the disorder.