Psychiatric Emergencies

Question 1

Psychiatric side effects of interferon alpha

Answer 1

SI;
Anhedonia
Fatigue
(Anorexia)

Question 2

Pathophysiology of acute dystonia

Answer 2

dopamine blockade, which results in a relative excess stimulation of acetylcholine receptors (as dopamine and acetylcholine are in balance)

Question 3

What is the treatment of sustained restlessness in a patient on antipsychotics?

Answer 3

Benztropine, beta-blockers, and benzodiazepines can be used in the treatment of akathisia

Question 4

What is the antidote of choice in a depressed patient with a suicide attempt who demonstrates QRS widening on ECG?

Answer 4

Sodium bicarbonate for tricyclic antidepressant overdose

Question 5

What medication can be used to treat serotonin syndrome?

Answer 5

Cyproheptadine

Question 6

Causes of NMS

Answer 6

Haloperidol and fluphenazine are the medications most commonly associated with NMS. Risk factors include higher doses of neuroleptic agents, recent or rapid dose escalation, a switch from one agent to another, and parenteral administration. While NMS typically develops in the first two weeks of therapy, this syndrome can occur after a single dose or after years of treatment

Question 7

altered mental status, autonomic instability, hyperthermia, and classic “lead pipe” rigidity, dx?

Answer 7

NMS