Psych- Psychotic disorders

Question 1

Acute intermittent porphyria

Answer 1

Autosomal dominant disorder involving alterations in the enzymes involved in heme biosynthesis. Presents with neurovisceral attacks.

Question 2

Signs an symptoms of acute intermittent porphyria

Answer 2

-New onset Psychiatric symptoms
-New onset neuropathy (motor or sensory)
abnormalities
-Acute abdominal pain
-No abdominal tenderness
-FHx

Following fasting, medications, alcohol, tobacco.

Question 3

Diagnostic test for acute intermittent porphyria

Answer 3

Elevated urinary prophobilinogen during a neurovisceral attack

Question 4

Brief psychotic disorder

Answer 4

Characterized by psychotic symptoms lasting between 1 day and 1 month. Often triggered by traumatic or stressful event (such a loss of loved one)

Question 5

Distinguish between brief psychotic and normal grief

Answer 5

While normal grief may have hallucinations they are centered on maintaining connection. Behavior and speech is normal and they can relate to others

Question 6

Management of tardive dyskinesia

Answer 6

Reducing dose
Vesicular monoamine transport 2 (VMAT2) inhibitor
-valbenazine or deutertrabenzine
Switching antipsychotic

(anticholinergics worsen TD)

Question 7

Which antipsychotic should be used to cross-taper in tardive dyskinesia

Answer 7

Quetipine or clozapine

Question 8

Treatment of acute dystonia

Answer 8

Anticholinergics (benztropine)
Antihistamines (diphenhydramine)
Switching antipsychotic