Neuropsychiatry

Question 1

What is the mnemonic for indicators of underlying organic pathology in psychiatry?

Answer 1

FLAVOUR

Question 2

What are the indicators of underlying organic pathology in psychiatry?

Answer 2

F - fluctuating Sx
L - localised (specific) cognitive defect
A - associated neurological signs
V - vague or transient paranoid delusions
O - olfactory or visual hallucinations
U - untypical Sx of a functional disorders
R - record of cognitive disorder pre-dating psychiatric Sx/admission

Question 3

What are the organic problems that might manifest in psychiatry?

Answer 3

1. TBI
2. CVA
3. Post-concussion
4. Epilepsy
5. Tumour
6. Acute confusional state/delirium
7. MS
8. Parkinson’s
9. SLE
10. Huntington’s
11. Wilson’s
12. Sleep disorders - narcolepsy, REM sleep behaviour disorder
13. Infection - HIV/AIDS, syphillis
14. Prion disease
15. Endocrine disorders
16. Nutritional disorders - B12 + thiamine deficiency

Question 4

What investigations should be ordered to exclude the possibility that manifestations in psychiatry are actually organic?

Answer 4

FBC - ?macrocytosis in alcoholism (B1/B2 deficiency) 
CRP/ESR - ?infection
U&E - ?delirium from dehydration/electrolyte imbalance
LFT - ?Wilson's/chronic alcoholism
TFT - ?thyroid dysfunction
Glucose - ?delirium due to DKA
Calcium
Folate
B12
B1
HIV/syphillis
MSU - ?infection
CXR - ?infection
CT/MRI - ?TBI or CVA