Group E: Med causes of psychiatric symptoms (incl HIV/AIDS)

Question 1

Why is it important to include vital signs (Pulse, Respiratory Rate, Blood Pressure, and Temperature) in the assessment of psychiatric patients? 2marks

Answer 1

Including vital signs is important because they can reveal underlying physical conditions that might contribute to psychiatric symptoms, such as infection, metabolic disturbances, or cardiovascular issues. This helps in the comprehensive assessment and management of the patient

Question 2

In what situations would a psychiatrist consider performing a brain imaging study like a CT or MRI? 2marks

Answer 2

A psychiatrist would consider performing brain imaging in situations where there are localising signs on a neurological exam, new-onset seizures, excessive or atypical cognitive impairment, suspected encephalitis, recent head injury, or when risk factors like anticoagulation or alcoholism are present.

Question 3

Identify and briefly describe three medical conditions that could lead to a neurocognitive disorder. 6marks

Answer 3

Three medical conditions that could lead to a neurocognitive disorder include:

• Alzheimer’s disease: A degenerative brain disease that leads to progressive cognitive decline, memory loss, and behavioural changes.
• HIV infection: Can cause HIV-associated neurocognitive disorder (HAND), leading to cognitive impairment and potentially HIV-associated dementia.
• Traumatic brain injury: Can result in cognitive decline, memory issues, and changes in personality and behaviour due to damage to the brain

Question 4

List 4 key features of psychotic disorders [4 marks]

Answer 4

*Delusions
*Hallucinations
*Disorganised thinking (speech)
*Grossly disorganised or abnormal motor behaviour (including catatonia)
*Negative symptoms

Question 5

What is the pharmacological management of the four major psychiatric symptoms: psychosis, neurocognitive disorder, BPMD (incase of a manic episode) and anxiety (acute setting)? (4 marks)

Answer 5

• Psychosis: antipsychotics (risperidone an atypical antipsychotic)
• NCD: anticholinesterase (Rivastigmine)
• Anxiety : Benzodiazepine(Midazolam/lorazepam)
• BPMD (Manic- lithium/valproate)

Question 6

When should brain imaging , such as CT scan or MRI , be considered in the investigation of psychiatric patients ?(6)

Answer 6

Localising signs on neurological exam
New onset
Excessive cognitive impairment
Encephalitis
Head injury
Patients with vulnerability factors like anti coagulation or alcoholism