Psychiatry First Aid: Differential Diagnosis And Management

Front 1

tx for delusional disorder

Back 1

1. psychotherpy is first line
2. antipsychotics are not helpful unless severe psychosis/delusion and there's a potential for harm

Front 2

ddx NMS vs:
1. anticholinergic syndrome
2. malignant hyperthermia
3. CNS infection

Back 2

1. anticholinergic syndrome (from overdose) doesn't have rigidity and elevated CPK
2. malignant hyperthermia occurs after inhaling anesthetic agents e.g. surgery procedure
3. CNS finection would have lab finding on lumbar puncture, may have elevated CPK if seizures occur

Front 3

time period criteria :
1. PTSD
2. Acute stress disorder
3. GAD
4. Adjustment disorder

Back 3

1. 1 month
2. < 1 month
3. 6 months
4. sx within 3 months of stressor; sx resolves in 6 months

Front 4

organic cause vs psychiatric disorder

Back 4

ALWAYS R/O ORGANIC CAUSES; e.g. likely dx is cardiovascular disease over panic attack
e.g. kid taking amphetamines has seizures ==> most likely dx is epilepsy and not amphetamine toxicosis

Front 5

tx of severe mania in bipolar w/ additional sx of depression and suicide

Back 5

1. lorazepam to keep the patient calm
2. valproic acid: can be loaded rapidly to achieve therapeutic blood levels in 3-5 days

Front 6

psychodynamic psychotherapy

Back 6

intensive, long-term therapy helpful for people who wish to better understand the nature of their relationship with others

Front 7

what do the following test:
1. Wechsler Intelligence Scale for Children
2. Stanford-Binet Intelligence Scale
3. Minnesota Multiphasic Personality Inventory 2 (MMPI-2)
4. Goodenough Draw-a-Person Test
5. Kohs Block test
6. Peabody-Vocabulary Test

Back 7

1. IQ
2. IQ
3. personality structure
4. Visual motor coordination
5. Visual motor coordination
6. Assess language barrier

Front 8

What other disorders are associated with Tourette?

Back 8

- OCD and ADHD
- note: these may always be comorbid with Tourette or separate entities
- but dx with tourette even if pt presents with sx of OCD as well

Front 9

With antipsychotic is associated with QT prolongation?

Back 9

Pimozide

Front 10

hepatic encephalopathy sx

Back 10

*** asterixis (characteristic, but not specific)
- tremors, increased deep tendon reflexes, altered sensorium
- physical stigmata (reflects changes in liver function): ecchymosis, peripheral edema, ascites formation, palmar erythema, spider angiomas
- psychiatric sx: personality change, mood swings, changes in cognitive ability
- acute decompensation: depression, catatonia, psychosis, delirium

Front 11

HIV-associated dementia sx

Back 11

- can present in many ways: motor abnormalities, cognitive decline, behavioral changes
- typical behavioral changes: apathy, social withdrawal
- neurologic abnormalities: weakness, imbalance, ataxia

Front 12

hyperthyroidism sx

Back 12

- psychiatric sx: depressive, hypomanic, cognitive deficits
- neurologic: tremor, lid lag, brisk deep tendon reflexes, proximal myopathy, muscle wasting, myalgias
- other: hot flashes, increased sensitivity to heat

Front 13

SLE sx

Back 13

- psychiatric: "lupus psychosis," schizophrenia-like syndromes, affective disorders, psychotic symptoms, delirium, personality changes, anxiety, emotional lability
- cognitive impairment
- only last hours to days associated with flares of the illness
- neurologic: seizures, stroke, cranial nerve abnormalities, HA

Front 14

sx of delirium due to hypoglycemia

Back 14

- acute confusional state (e.g. refusal to give blood)

Front 15

signs of hypoglycemia

Back 15

- tachycardia, tremor, hypertension, seizures

Front 16

Beck's triad

Back 16

- used to dx MDD
- includes: feeling ineffectual, believing the world is always hostile, knowing that things will never change

Front 17

drug property associated with greater withdrawal sx

Back 17

shorter half life

Front 18

drug property associated with greater addiction potential

Back 18

shorter the half life, the quicker the high, and the quicker the addiction potential

Front 19

types of delusions:
1. mood congruent
2. mood-incongruent
3. bizarre delusions
4. somatic delusions
5. ego-syntonic delusions
6. ego-dystonic delusions

Back 19

1. delusions compatible with state of mind e.g. pt feels guilty and he has delusions of punishment
2. delusions are not compatible with mood, e.g. pt has delusions of grandeur
3. no way the delusions can be true
4. related to bodily functions
5.delusions are acceptable and pleasant to the pt; e.g. king of the world
6. delusions are unacceptable and unpleasant

Front 20

narcolepsy vs idiopathic hypersomnolence

Back 20

multiple naps in narcolepsy are much refreshing, versus idiopathic hypersomnolence in which naps are long and unrefreshing

Front 21

hypnagogic hallucinations

Back 21

hallucinations when going to sleep