Donna is a 41-year-old woman who is being evaluated at the request of her primary care provider for obsessive-compulsive disorder

 

Donna is a 41-year-old woman who is being evaluated at the request of her primary care provider for obsessive-compulsive disorder

Answer:

Donna’s family history should prompt an immediate referral to a neurologist. Her father is affected by Huntington’s disease, a degenerative condition that causes involuntary muscle movements and cognitive decline.

If you have a family history of neurological disorders, there is an increased risk for the same disorders to occur within your own family. While no one in Donna’s immediate family exhibits any neurological disorders, she does have a sister-in-law who suffers from Tourette’s syndrome. In addition to the diagnosis of obsessive compulsive disorder (OCD), Donna’s sister-in-law has a number of other neurological problems that plague her family on a fairly consistent basis. Some of these include explosive anger, seizures, and short-term memory loss. Given that Donna’s sister-in-law’s case is considered mild, it is quite possible that her children may be affected more severely by the same neurological disorders than their mother. If this is the case, then Donna should be referred to a neurologist as soon as possible so that he can examine her and provide her with adequate medical care before her family begins to suffer from these various disorders.

Donna’s family medical history is significant for:

Donna’s obsessive quality should be evaluated by a doctor, because in the past there has been a history of brain tumors in her family.

Donna’s grandfather, mother, sister, and brother-in-law all have schizophrenia. In addition, her father had Alzheimer’s dementia. Given that the course of SZ is not clear in all family members, Donna should be seen in consultation by a neurologist for evaluation.

Your primary care provider suspects that you may have obsessive compulsive disorder. Your family medical history may provide clues into the cause of this disease.

The information below is intended to help you understand obsessive compulsive disorder in relation to Donna’s family history.

Donna’s family history is remarkable because of her mother’s history of depression, her father’s death in a car accident, and her brother’s stroke at age 36.

A person with a family history of neurologic conditions, such as epilepsy or migraine disorder, should be monitored closely over time to look for symptoms suggestive of stroke and other neurologic disorders.

You’re an anxious person and feel under a lot of pressure because of work. You’ve tried to talk to your boss about the problem, but he won’t listen. At home, you have a snappy and critical husband who resents you because you don’t make enough time for him. And your kids are really acting out, so much that you had to take them to see your doctor. For all these reasons, you are very tense and on edge most of the time.

Question:

Donna is a 41-year-old woman who is being evaluated at the request of her primary care provider for obsessive-compulsive disorder. Which of the following aspects of Donna’s family medical history should prompt an immediate referral to a neurologist?

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