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NBME Step 2 CK Form 6 Answers

step2ck_form6/Block 1/Question#21 (reveal difficulty score)
A 25-year-old woman comes to the physician ...
Borderline personality disorder ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: psych

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submitted by โˆ—sugaplum(487)
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These people always have extreme unstable relationships. And do things to gain attention. Self harm, suicidal behavior, splitting. The buzz word for treatment is dialectaial behavioral therapy

I think of these as the people who seemed very cool in middle school because they could get a new boy friend every week

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submitted by โˆ—step_prep7(71)
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  • Patient has persistent history of unstable relationships and self-injurious behaviors
  • Delusional disorder and adjustment disorder are transient pathologies
  • Major depressive disorder = Depressed mood and SIGECAPS
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submitted by โˆ—jlbae(159)
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submitted by โˆ—lindasmith462(73)
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Bipolar Disorder characterized by: Unstable moods, behaviors, interpersonal relationships. Fear abandonment have poorly formed identity. Relationships begin w/ intense attachments and end w/ the slightest conflict. Aggression is common. Impulsive. May have hx of repeated suicide attempts/gestures or episodes of self mutilation. Higher rates of childhood physical, emotional, sexual abuse than gen pop

DSM 5: Pervasive pattern of impulsivity and unstable relationships, affects, self image and behaviors. Present by early adulthood in variety of contexts. At least 5 of:

  • Frantic efforts to avoid real or imagined abandonment
  • Unstable intense interpersonal relationships (extreme love hate relationships )
  • Unstable self image (overestimation of work abilities, refer to self as loser)
  • Impulsivity in AT LEAST 2 potentially harmful ways (spending, sexual activity, substance use, binge eating)
  • Recurrent suicidal threats or attempts of self mutilation
  • Chronic feelings of emptiness
  • Difficulty controlling anger
  • Transient stress related paranoid ideation or dissociative symptoms

Tx: dialectical behavior therapy (CBT w/ mindfulness, group therapy)

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lindasmith462  imma also throw it out there this is a real weak borderline pic for a question - it's the best answer and she very well may have it but it certainly doesn't actually meet the DSM5 criteria (only romantic relationship issues - not multiple contexts, relationships aren't necessarily "intense" - def shows issues with attachment/abandonment/ impulsivity but doesn't fit full BPD relationship pic. maybe some splitting there w/ the doc but that seemed romantic too.) like TBH I have friends who just suck at dating in their 20s you could technically describe this way. (booty calling exes when desperate, trying to "bump into" exes). Like its not healthy but its not a personality disorder. You would need more history to actually diagnose her. +

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