Oh, the power of cheese.

So, I’m in my third year of medical school now, and rotating through different services in the hospitals.  Each rotation ends with a mandatory exam, usually a nationally standardized exam we call the “shelf”.  The most common comment I’ve heard or read about shelf exams is, “it was a pretty hard test.” Needless to say, there’s usually a fair amount of stressing about these exams, and I don’t know anyone who would say they enjoyed any part of the studying for them, because it just feels so hectic.

Until now.

An amusing question from one of the practice exams I did preparing for my Psychiatry shelf exam today:

A 24-year-old man presents to the ED with symptoms of PCP intoxication and a positive urine toxicology screen.   What is the best treatment for extreme agitation in this patient?

1. Trihexphenidyl
2. Bupropion
3. A phenothiazine antipsychotic
4. A Butyrophenone antipsychotic
5. Fluoxetine

If this patient is not experiencing extreme agitation, what is the best treatment?

1. Vitamin B12
2. Supportive care
3. Vitamin E
4. Lorazepam
5. cheese

(emphasis mine)

It’s a very, very good thing that question was on a practice exam, and not the shelf today, because as it stands, only my wife had to experience the laughing meltdown as I lost it after reading that question.  Had it been on the shelf, I’m quite certain I’d have been removed from the room.

Now, cheese does get discussed when talking about pharmacotherapy for psychiatric issues, because it can cause adverse effects when eaten by patients taking a specific class of antidepressants, but I can’t recall ever having actually heard or read it discussed as a therapy unto itself.

Who knows.  Maybe we’re missing out.  The American Dairy Association certainly thinks there’s something there.

I, however, am going to go to bed tonight, still laughing at the thought of treating PCP withdrawal with cheese.