KW PSYCHOSOCIAL

Question 1

This eating disorder’s lab abnormalities: serum electrolyte studies typically reveal hypokalemia, hypomagnesemia and hypochloremic alkalosis

Answer 1

chronic binging and purging behaviors

Question 2

behavioral syndrome with the following principal motor signs: rigid posture, mutism, fixed staring, stereotypic movements, apparently purposeful hyperkinetic movements, stupor, and negativism (resistance to instructions).

Answer 2

Catatonia

Question 3

refers to verbal unresponsiveness and reduced or altered arousal; when severe, the patient is mute, immobile and does not withdraw from painful stimuli

Answer 3

stupor

Question 4

what is cataplexy

Answer 4

, is a sudden loss of muscle tone that occurs in narcolepsy

Question 5

While alcohol ________lowers the seizure threshold, _________ is actually protective against seizures.

Answer 5

withdrawal

intoxication

Question 6

what is the effect of Psilocybin (“magic mushrooms”) ?

Think M.A.N.

Answer 6

prolonged serotonergic symptoms of mental status change, autonomic hyperactivity, and neuromuscular abnormalities.

Question 7

What are the Cardiac complications of eating disorders (restricting)

Answer 7

bradycardia, hypotension, prolongation of the QT interval, dysrhythmias (atrial & ventricular premature contractions, ventricular tachycardia), and even sudden death.

Question 8

NMS management

Answer 8

stop offending agent, IV fluids, bromocriptine +dantrolene
*don’t use dantrolene if LFTs are high

Question 9

Agitation, has flushed skin, ridged upper extremities, and tremulous lower extremities. Her T is 38.8°C, HR 110, R 24, and BP 138/91. Physical exam findings include dilated pupils, bilateral 6-8 beat ankle clonus, and 3+ anterior tibial deep tendon reflexes.
How do you treat this?

Answer 9

loraz cyproheptadine

Question 10

Agitation, has flushed skin, ridged upper extremities, and tremulous lower extremities. Her T is 38.8°C, HR 110, R 24, and BP 138/91. Physical exam findings include dilated pupils, bilateral 6-8 beat ankle clonus, and 3+ anterior tibial deep tendon reflexes. What is this?

CLONUS=serotonin

Answer 10

Serotonin Synd

Question 11

Agitation, has flushed skin, ridged upper extremities, and tremulous lower extremities. Her T is 38.8°C, HR 110, R 24, and BP 138/91. Physical exam findings include dilated pupils, bilateral 6-8 beat ankle clonus, and 3+ anterior tibial deep tendon reflexes. Under what circumstances does this occur?

Answer 11

usually occurs within the first 24 hours of a dosage change or exposure to a serotonergic medication or product, such as a selective serotonin reuptake inhibitor (SSRI) commonly used to treat depression, as well as potent serotonergic drugs of abuse such as MDMA and similar amphetamines

Question 12

Mental status changes can include restlessness, agitation, and frank delirium. Autonomic hyperactivity may manifest as hyperthermia, hypertension, tachycardia, diaphoresis, vomiting, and diarrhea. Common neuromuscular abnormalities, more readily apparent in the lower extremities, are clonus, hyperreflexia, shivering, and rigidity. The interesting finding of ocular clonus, slow repetitive horizontal eye movements, may be seen in

Answer 12

Serotinin Syndro,me

Question 13

In _________ Syndrome, Antipyretics will not have any effect since the hyperthermia is due to muscle over-activity rather than temperature regulation by the hypothalamus

Answer 13

Serotonin Syndrome

Question 14

why cant you use bromocriptine in Serotonin synd?

Answer 14

bromocriptine is a serotonin agonist, which would aggravate the symptoms of serotonin syndrome

Question 15

How do you distinguish NMS from serotonin synd?

Answer 15

Serotonin syndrome can be distinguished from neuroleptic malignant syndrome by its relative rapid progression (hours vs. days to weeks), and hyperreflexia as opposed to the bradyreflexia of neuroleptic malignant syndrome.

Question 16

________ medications and _____ can cause dystonic movements that can look similar to tics

Answer 16

antipsychotics and metoclopramide

Question 17

What OTC meds reduce lithium clearance?

Answer 17

NSAIDs, such as naproxen and ibuprofen, can reduce lithium clearance and raise lithium levels. Thiazide diuretics and ACE inhibitors can also raise lithium levels.

Question 18

What must a pt avoid when on lithium and taking OTC meds (nsaids)?

Answer 18

dehydration

Question 19

What are the early signs of lithium tox

Answer 19

Early signs of lithium toxicity include coarse tremor, ataxia, dysarthria, vomiting, diarrhea, cardiovascular changes and renal dysfunction.

Question 20

What are the late signs of lithium tox

Answer 20

Later signs of lithium toxicity include impaired consciousness, muscle fasciculations, myoclonus, seizures, coma and death.

Question 21

A lithium level of ________ is toxic.

Answer 21

> 1.5 meq/L

Question 22

lithium toxicity management includes

Answer 22

reatment of lithium toxicity involves discontinuing lithium, hydrating the patient, and maintaining electrolyte balance. Hemodialysis should be considered in any individual with symptoms of a life-threatening ingestion, renal insufficiency, neurological effects and levels that continue to rise despite other aggressive therapies.

Question 23

The parents of a 13 yo male with autism spectrum disorder bring him to the ED because they had difficulty waking him from sleep this afternoon. They also report that since waking, he has been “chasing after things that aren’t there.” He has had cold symptoms for the past week for which he has been taking an over-the-counter cold preparation. His T is 38.8ºC, HR 140, RR 28, and BP 125/78. His cheeks are erythematous. He frequently stares before moving about the exam room, grasping at the floors and walls. In the course of your evaluation the patient’s urine drug screen is reported positive for opioids

Name this condition

Answer 23

anticholinergic tox