Medical Conditions Presenting as Psychiatric Symptoms Lecture Powerpoint

Question 1

3 criteria that must be met to diagnose a mental disorder being caused by a general medical condition and 2 types of conditions it does NOT include

Answer 1

• Evidence the disturbance is a direct consequence of the condition
• Disturbance is not better accounted for by a mental disorder
• Disturbance does not occur exclusively during course of delirium

-Neurocognitive disorders or substance intoxication

Question 2

DTAMC abbreviation

Answer 2

Due to another medical condition

Question 3

ANotherMEDICalCONDITion acronym for remembering the categories of DTAMC causes

Answer 3

-Autoimmune
Nutritional deficit
-Metabolic encephalopathy
-Endocrine disorders
-Demyelination
-Immune
-Convulsions
-Cerebrovascular disease
-Offensive toxins
-Neoplasm
-Degeneration
-Infection
-Trauma

Question 4

Herpes simplex virus (1 and 2) common mental associated symptoms

Answer 4

• Most common non neonatal encephalitis

- Most commonly aseptic meningitis

Question 5

HIV common mental associated symptoms (3)

Answer 5

• HIV associated dementia
• HIV neurocognitive impairment
• Some retroviral drugs may cause symptoms

Question 6

Rabies common mental associated symptoms (3)

Answer 6

• 4-8 week incubation followed by nonspecific symptoms
• paresthesias/fasciculations at the bite site
• episodic confusion/psychosis/combativeness

Question 7

Lyme common mental associated symptoms (4)

Answer 7

• Ticks must stay attached over 36 hours to transmit
• Flulike symptoms after laying dormant for months to years
• erythema chronicum migrans rash
• Diagnosed via ELISA

Question 8

Neurosyphilis common mental associated symptoms (3)

Answer 8

• Argyll robertson pupils (bilateral asymmetrical small irregular pupils hard to dilate
• Personality and neurological changes
• Hyperactive reflexes

Question 9

Chronic meningitis common mental associated symptoms (3)

Answer 9

• 2-10 years after infection
• behavioral problems
• ocular changes

Question 10

Creutzfeldt Jacob disease common mental associated symptoms (2)

Answer 10

• 10-15 year delay in onset of symptoms most often 55-75 year olds
• perception/vertigo/psychosis

Question 11

Seizure disorders common mental associated symptoms (2)

Answer 11

• Often absent on EEG

- Experienced by 60% of individuals with epilepsy

Question 12

Metabolic encephalopathy (hepatic or renal) common mental associated symptoms (3)

Answer 12

• Asterixis
• Jaundice
• Porphyria (build up of natural chemicals in the body causing nonspecific/cognitive syndromes often genetic in origin)

Question 13

Triad of porphyria

Answer 13

• Episodic acute colicky abdominal pain
• motor polyneuropathy
• psychosis

Question 14

Sheehan’s common mental associated symptoms (1)

Answer 14

-Necrosis (often from post partum hemorrhage) of part of the pituitary that can cause post partum depression with every pregnancy, and in severe cases psychosis following any pregnancy as well

Question 15

Flat affect is often seen in patients with….

Answer 15

….Parkinson’s disease

Question 16

Important to always ___ dosages when patients are having response mentally to excessive drug intake or polypharmacy

Answer 16

Taper off

Question 17

THINC MED acronym for medical conditions that mimic psychiatric conditions

Answer 17

Tumor
Hormonal
Infectious
Nutritional
CNS

Miscellaneous (MI, wilson’s disease, etc)
Electrolytes
Drugs

Question 18

Hypercalcemia 4 common presenting symptoms

Answer 18

• Stones (urinary ca2+)
• Bones (osteoporosis)
• Groans (fatigue, peptic ulcer, constipation)
• Psychiatric overtones

Question 19

3 P’s of diabetes mellitus

Answer 19

Polyuria
Polyphagia
Polydipsia