- Medical Causes of Psychiatric Symptoms

Question 1

Name 3 levels of impairment due to HIV Associated Dementia

Answer 1

• Asymptomatic Neurocognitive Impairment
• Mild Neurocognitive Disorder
• HIV Associated Dementia

Question 2

What are two drugs commonly indicated in the development of mania, psychosis and depression?

Answer 2

• Methamphetamine
• cocaine

Question 3

HIV Associated Dementia

Answer 3

• Most severe form (1)
• Inability to independently complete daily tasks (1)

Question 4

Mild Neurocognitive Disorder

Answer 4

• Mild form (1)
• Interferes with everyday function

Question 5

Asymptomatic Neurocognitive Impairment

Answer 5

• Mild form of HAND with impaired performance on neuropsychological tests (1)
• Affected individuals report independence in performing everyday functions (1

Question 6

Name 2 of the stress hormones that precipitate anxiety and the hormone that reduces stress

Answer 6

Stress hormones – noradrenaline and cortisol
Hormone that reduces – oxytocin

Question 7

What is the name of the antiretroviral that is known to induce psychosis and why is there a risk of psychosis with this drug?

Answer 7

Efavirenz (1 mark)
It is neurotoxic (1 mark)

Question 8

Outline two psychiatric symptoms/conditions that are indicated in syphilis infection?

Answer 8

Mania (1 mark)
And Dementia (1 mark)
Due to tertiary syphilis/neurosyphilis/invasion of the brain and/or spinal cord (1 mark for any)

Question 9

Name and explain 1 infectious factor that can lead to confusional states

Answer 9

• UTI: usually when it leads to sepsis and metabolic disturbances/when there is already an underlying condition such as diabetes
• Pneumonia: hypoxia (leads to declining cognitive function)
• Meningitis: increased ICP and compression impairs cerebral blood flow/there is toxic metabolites from the microbe/cerebral oedema can further increase ICP.
• Sepsis: systemic hypotension leads to (hypoperfusion and) organ dysfunction (esp. the brain)

Question 10

Name and explain 1 metabolic factor that can lead to confusional states

Answer 10

• Hypoglycaemia: inadequate glucose supply to the brain causes impaired (brain) function.
• Liver failure: accumulation of metabolized toxins (such as ammonia) leading to hepatic encephalopathy.
• Kidney failure: accumulation of uric acid in the body, electrolyte imbalance and/or metabolic acidosis.