A.) Anxiety disorder
B.) Bipolar disorder
C.) Conversion disorder
D.) Obsessive-Compulsive disorder
F.) Major depression
G.) Munchausen’s by proxy
H.) Panic disorder
I.) Post-traumatic stress disorder
J.) Somatisation disorder
For each presentation select the most likely psychiatric diagnosis.
- A 21 year old intellectually impaired woman is brought in by ambulance accompanied by her carers. They report sudden episodes of paralysis which have occurred multiple times in the last 4 months. On exam she is breathing spontaneously with normal effort and able to converse but has no movement of her limbs. Previously she has been admitted with all investigations negative and the paralysis has spontaneously resolved within 24 hours.
- A 15 year old girl is brought in by her parents. They describe her fear of making a mistake which has become much worse in the last few months. They state she continually asks for reassurance and that things are checked multiple times for accuracy. It has started to interfere with her schoolwork and her marks have declined due to her inability to complete tasks.
- A 42 year old man is brought in by her partner who states that he has been behaving abnormally for the last 10 days. He has been sleeping for only 1-2 hours a night, has been painting obsessively for the remainder of the day and is convinced that he will win the Archibald this year despite no previous artistic inclination. On exam he is talking very fast and easily moves from one subject to the next.
- A 28 year old soldier who returned home from service in Afghanistan 3 months ago presents with agitation. She describes intrusive thoughts and recollections of an even that occurred in combat. She is unable to sleep and has become withdrawn from her family.
Author: J Haire
Ref: Dunn 4th Ed p. 723-35
A.) Acute Dystonia
D.) Cerebrovascular accident
E.) Neuroleptic malignant syndrome
F.) Orthostatic hypotension
H.) QT prolongation
I.) Tardive dyskinesia
For each presentation of a select the most appropriate antipsychotic side effect.
- A 23 year old man presents with fever, shortness of breath and hypotension. CXR shows multilobar pneumonia and FBC shows a neutrophil count of 0.46 x 109.
- A 40 year old man who has just had his dose of Fluphenazine increased presents with sudden onset of neck extension, jaw clamping shut and eyes forced upwards.
- A 75 year old man who was started on Thioridazine for hallucinations 3 weeks ago presents with tremor, slow, shuffling gait and drooling.
- A 40 year old man who has just been started on Haloperidol 3 weeks ago presents with restlessness. On exam you note constant moving of his torso and limbs.
Author: J Haire
Ref: Tintinalli p. 1953-55