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Neuro III > Laboratory Tests in Psychiatry > Flashcards

Laboratory Tests in Psychiatry Flashcards

1
Q

What are the 5 basic reasons to assess lab values?

A
  1. Rule out an underlying physiologic/metabolic cause of the presenting psychiatrcic symptoms
  2. Rule out the use of illicit substances as the cause of the presentign psychiatric symptoms
  3. Establish a baseline of physiologic function before initiating a medication
  4. Assess the safety and possible resultant side effect(s) of the medication(s) prescribed
  5. Assess the therapeutic range of the medication prescribed
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2
Q

Why would you order an EKG?

A

cardiac irregularity(s) either causing disrutbance or side-effect from medication

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3
Q

Why would you order an EEG?

A

assess brainwave activity – ruling out seizure disorder; assessing for cognitive disorder(s)

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4
Q

Why would you order an CXR?

A

rulign out TB, histoplasmosis

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5
Q

Why would you order an MRI?

A

ruling out space occupying lesion

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6
Q

Why would you do genetic testing?

A

ruling out “syndromes” ie (turner syndrome, prader-willi)

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7
Q

Patients who present with depression could have what underlying physiological problems?

A

disturbance in Thyroid gland

Syphilis or HIV

tumor of head of tha pancreas

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8
Q

Other than depression, disturbance in the thyroid gland can present in what psychiologic manifestation?

A

hypomania / mania

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9
Q

Patients who present with anxiety or panic disorder could have what underlying physiological problems?

A

pheochromocytoma

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10
Q

A patient with syphilis or HIV may present with what psychiatic presenting problems?

A

confusion

hallucinations

mood lavility

depression

dementia

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11
Q

Patients who present with thought disorder or mood disorder may have what physiological causes?

A

seizure disorder

liver dysfunction

infection

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12
Q

A patient with a seizure disorder may present with what psychiatric symptoms?

A

hallucinations

thought disorder

mood disorder

confusion/dementia

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13
Q

A patient with liver dysfunction may present with what psychiatric symptoms?

A

thought disorder

confusion

mood disorder [hepatic encephalopathy]

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14
Q

What is important to remember if a patient presents to you with delirium?

A

discover underlying physiologic cause & treat it

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15
Q

What baseline laboratory tests should you order prior to initiating medication in psychiatry?

A
  • baseline CBC
    • with reticulocyte & platelet count
  • baseline CMP
  • baseline Kidney Function: BUN/Cr
  • baseline Liver Function [LFT’s]
  • baseline Thyroid Function: TSH
  • Icon/serum pregnancy test
  • option
    • urine drug screen
    • baseline EKG/ECG
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16
Q

What lab should you order if you suspect a pheochromocytoma?

A

catecholamine levels

17
Q

What are “labs to consider”?

A
  • Hormone levels
    • estrogen / testosterone
  • Vitamin D (25-hydroxy)
  • Folate /B12
  • Lead levels/Heavy metals
18
Q

You should order a sleep study to rule out what conditions?

A
  • obstructive sleep apnea
  • narcolepsy
  • restless leg syndrome
  • periodic limb movement disorder
19
Q

vitamin B12 deficiency can cause what type of psychatric manifestations?

A

depression, apathy, irritability, dementia, catatonia, delerium, and hallucinations

20
Q

What can be the first presenting symptoms of pancratic cancer?

What are the techniques used to diagnose pancreatic cancer?

A

depression

  • ultrasound
  • CT scan
  • MRI
  • PET
  • Ca 19-9 Blood test
21
Q

What tests can you order to screen for syphilis?

A

RPR

VDRL

22
Q

Antipsychotics can cause weight gain, lipid disturbance & glucose dysregulation which can contribue to the development of what condition?

A

metabolic syndrome

23
Q

What is the diagnostic criteria for metabolic syndrome?

A

3+ of the following:

  • waistline 40 inches or more (male) 35 inches or more (female)
  • BP 130/85 or higher
  • triglyceride level > 150 mg/dl
  • fasting blood glucose level >100 or are taking glucose-lowering medications
  • High density lipprotein level (HDL) <40 mg/dl (male) or <50 mg/dl (female)
24
Q

What symptom could be an early indicator of long-term weight gain when taking antipsychotics?

A

early weight gain

(significant weight gain can occur within 6-8 weeks)

25
Q

What antipsychotic drugs are associated with a low risk of developing metabolic syndrome?

A
  • Asenapine
  • Aripiprazole
  • Lurasidone
  • Ziprasidone
  • Haloperidol
  • Cariprazine
  • Brexpiprazole
  • Lumateperone
26
Q

What antipsychotics are associated with a medium risk of developing metabolic syndrome?

A

quetiapine

risperidone

paliperidone

Iloperidone

27
Q

What antipsychotics are associated with a medium to high risk of developing metabolic syndrome?

A

chlorpromazine

28
Q

What antipsychotics are associated with a high risk of developing metabolic syndrome?

A

clozapine

olanzapine

Neuro III (14 decks)

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