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First Aid: Step 2 CS > Differential & Work-up: Depressed Mood, Psychosis > Flashcards

Differential & Work-up: Depressed Mood, Psychosis Flashcards

1
Q

68 yo M presents with a 2-month history of crying spells, excessive sleep, poor hygiene, and a 15 lb (6.8 kg) weight loss, all following his wife’s death. He cannot enjoy time with his grandchildren and admits to thinking he has seen his dead wife in line at the supermarket or standing in the kitchen making dinner.

A
  1. Normal bereavement
  2. Adjustment disorder with depressed mood
  3. Major depressive disorder
  4. Schizoaffective disorder
  5. Depressive disorder not otherwise specified
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2
Q

WORK UP FOR:

  1. Normal bereavement
  2. Adjustment disorder with depressed mood
  3. Major depressive disorder
  4. Schizoaffective disorder
  5. Depressive disorder not otherwise specified
A
  1. TSH
  2. CBC
  3. Urine toxicology
  4. Beck Depression Inventory
  5. PHQ–9
  6. QIDS-SR16
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3
Q

42 yo F presents with a 4 week history of excessive fatigue, insomnia, and anhedonia. She states that she thinks constantly about death. She has suffered five similar episodes in the past, the first in her 20s, and has made two previous suicide attempts. She further admits to increased alcohol use in the past month.

A
  1. Major depressive disorder
  2. Substance induced mood disorder
  3. Persistent depressive disorder (dysthymia)
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4
Q

WORK UP FOR:

  1. Major depressive disorder
  2. Substance induced mood disorder
  3. Persistent depressive disorder (dysthymia)
A
  1. Beck Depression Inventory
  2. PHQ-9
  3. QIDS-SR16
  4. Blood alcohol level
  5. TSH
  6. CBC
  7. Urine toxicology
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5
Q

26 yo F presents with a 6.5lb (2.9kg) weight loss in the past 2 months, accompanied by early morning awakening, excessive guilt, and psychomotor retardation. She does not identify a trigger for the depressive episode but reports several weeks of increased energy, sexual promiscuity, irresponsible spending, and racing thoughts approximately 6 months before her presentation.

A
  1. Bipolar I disorder
  2. Bipolar II disorder
  3. Cyclothymic disorder
  4. Major depressive disorder
  5. Schizoaffective disorder
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6
Q

WORK UP FOR:

  1. Bipolar I disorder
  2. Bipolar II disorder
  3. Cyclothymic disorder
  4. Major depressive disorder
  5. Schizoaffective disorder
A
  1. Mood Disorder Questionnaire
  2. Urine toxicology
  3. TSH
  4. CBC
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7
Q

19 yo M c/o receiving messages from his television set. He reports that he did not have many friends in high school. In college, he started to suspect his roommate of bugging the phone. He stopped going to classes because he felt that his professors were saying horrible things about him that no one else noticed. He rarely showered or left his room and has recently been hearing a voice from his television set telling him to “guard against the evil empire”.

A
  1. Schizophrenia
  2. Schizoid or schizotypal personality disorder
  3. Schizophreniform disorder
  4. Psychotic disorder due to a general medical condition
  5. Substance-induced psychosis
  6. Depression with psychotic features
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8
Q

WORK UP FOR:

  1. Schizophrenia
  2. Schizoid or schizotypal personality disorder
  3. Schizophreniform disorder
  4. Psychotic disorder due to a general medical condition
  5. Substance-induced psychosis
  6. Depression with psychotic features
A
  1. Mental status exam
  2. Urine toxicology
  3. TSH
  4. CBC
  5. Electrolytes
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9
Q

28 yo F c/o seeing bugs crawling on her bed for the past 2 days and hearing loud voices when she is alone in her room. She has never experienced anything similar in the past. She recently ingested an unknown substance.

A
  1. Substance induced psychosis
  2. Brief psychotic disorder
  3. Schizophrenifonn disorder
  4. Schizophrenia
  5. Psychotic disorder due to a general medical condition
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10
Q

WORK UP FOR:

  1. Substance induced psychosis
  2. Brief psychotic disorder
  3. Schizophrenifonn disorder
  4. Schizophrenia
  5. Psychotic disorder due to a general medical condition
A
  1. Urine toxicology
  2. Mental status exam
  3. TSH
  4. CBC
  5. Electrolytes, BUN/Cr
  6. AST/ALT
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11
Q

48 yo F presents with a 1-week history of auditory hallucinations that state, “I am worthless” and “I should kill myself”. She also reports a 2-week history of weight loss, early morning awakening, decreased motivation, and overwhelming feelings of guilt.

A
  1. Schizoffective disorder
  2. Mood disorder with psychotic features
  3. Schizophrenia
  4. Schizophreniform disorder
  5. Psychotic disorder due to a general medical condition
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12
Q

WORK UP FOR:

  1. Schizoffective disorder
  2. Mood disorder with psychotic features
  3. Schizophrenia
  4. Schizophreniform disorder
  5. Psychotic disorder due to a general medical condition
A
  1. Mental status exam
  2. Beck Depression Inventory
  3. Urine toxicology
  4. TSH
  5. CBC
  6. Electrolytes
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First Aid: Step 2 CS (23 decks)

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