Physical Examination

Question 1

What physical causes can cause:

Mood changes:

• Neuro - 3
• Endocrine - 2

Insomnia:

• something affecting sleep
• endocrine - 1
• GI - 1
• obvious cause

Confusion/disorientation:

• Kidneys - 1
• Infectious - emergency - 1

Answer 1

MS
Stroke
DM
Brain tumour 
Hypothyroidism 

Sleep apnoea
Hyperthyroidism
GORD
Pain

Renal failure
Sepsis

Question 2

What physical causes can cause:

Personality changes:
- Neuro - 1

Hallucinations:

• Type of headache
• Brain - 2

Psychosis - list some

Irritability:

• What vitamin deficiency?
• Others?

Answer 2

MS

Migraine
Encephalitis
Seizures

Sensory loss
Syphilis
Dementia

Vitamin B12 deficiency
Drug withdrawal
Substance misuse

Question 3

Physical signs in psychiatric illness and possible cause:

What may cause:

• Parkinsonian facies
• Abnormal pupil size
• Argyll-Robertson pupil
• Enlarged parotids (‘hamster face’)
• Hypersalivation
• Goitre
• Multiple forearm scars
• Needle tracks/phlebitis
• Gynaecomastia
• Russel’s sign (knuckle callus)
• Lanugo hair
• Polierection (‘goose flesh’)
• Excessive thinness

Answer 3

APs
Depression

Opiate use

Neurosyphilis

Bulimia nervosa (secondary to vomiting)

Clozapine treatment

Thyroid disease

Borderline PD

IV drug use

APs Rx
ALD

Bulimia

Anorexia

Opiate withdrawal

Anorexia

Question 4

CV signs in psychiatric illness and possible cause:

Rapid/irregular pulse

Slow pulse

Answer 4

Anxiety disorder
Drug/alcohol withdrawal
Hyperthyroidism

Hypothyroidism
Anorexia nervosa

Question 5

Abdominal signs in psychiatric illness and possible cause:

Enlarged liver

Multiple surgical scars

Multiple self-inflicted scars

Answer 5

ALD
Hepatitis

Somatization disorder

Borderline PD