Psych

Question 1

Neuroleptic malignant syndrome

Answer 1

Caused by use of antipsychotics (esp. typical). Hyperthermia, muscle rigidity, autonomic instability (hypertension/tachycardia), and mental status changes. Typically normal reflexes or hyporeflexia (as compared to serotonin syndrome with hyperreflexia). Treated with Dantrolene sodium (inhibits release of Ca from sarcoplasmic reticulum) or bromocriptine (D2 agonist).

Question 2

Serotonin syndrome

Answer 2

When using SSRI/SNRI/TCA and MAOi concomitantly or with any drug that increased 5-HT. Clonus, hyperreflexia, hypertonia, tremor, seizure, hyperthermia, diaphoresis, diarrhea, and agitation. Treat with cyproheptadine (5-HT2 receptor antagonist/antihistamine).

Question 3

Schizoid personality disorder

Answer 3

Characterized by indifference to social relationships. Group A (weird) personality disorder. Different from Avoidant (group C) in which the individual wants social contacts but feels inadequate.

Question 4

Acute dystonic reaction

Answer 4

Can occur due to typical antipsychotics (ex. haloperidol) which block D2 receptor leading to muscle spasm, stiffness, and/or oculogyric crisis within hours to days of starting medication. The symptoms are due to unopposed cholinergic activity without dopamine activity present.
Can be treated with the anticholinergic benztropine.