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Tourette syndrome — USMLE Step 2 CK MCQ

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ModeratePsychiatryTourette syndromeUSMLE Step 2 CK

A 42-year-old Middle Eastern man comes to the emergency department because of changes in mood, behavior, or thinking. History and focused examination are notable for multiple motor tics and vocal tics for more than one year. Temperature is 98.6°F (37.0°C), blood pressure is 126/78 mmHg, pulse is 84/min, respirations are 16/min, and oxygen saturation is 98% on room air. Physical examination confirms the key finding and shows no unrelated abnormality that would better explain the presentation. There is no evidence of intoxication, delirium, or a primary neurologic disorder unless described in the vignette. Which of the following is the most appropriate next step in management?

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Reveal the answer and explanation

Correct answer: D — Habit reversal training

The vignette describes Tourette syndrome, supported by multiple motor tics and vocal tics for more than one year. Habit reversal training is the single best answer because it matches the diagnostic or management priority in this clinical setting. The other choices are plausible alternatives in related presentations, but they do not best fit the timing, findings, and guideline-directed approach described here.

Reference: https://www.ncbi.nlm.nih.gov/books/#stage-9-order-94