Psychiatric Emergencies

Question 1

Psychiatric review of systems

Answer 1

MOAPS

Mood 
organic 
Anxiety 
Psychosis 
Safety 
Intoxication

Question 2

Acute psychosis ddx

Answer 2

• primary psychotic disorder (e.g. schizophrenia)
• secondary to medical condition (e.g. delirium)
• drugs: substance intoxication or withdrawal, medications (e.g. steroids, anticholinergics)
• infectious (CNS)
• metabolic (hypoglycemic, hepatic, renal, thyroid)
• structural (hemorrhage, neoplasm

Question 3

Medications for agitation

Answer 3

■ benzodiazepines: lorazepam 2 mg PO/IM/SL

■ antipsychotics: olanzapine 5 mg PO, haloperidol 5 mg PO/IM

Question 4

High risk patients for suicide

Answer 4

SAD PERSONS

Sex = male
Age >45 yr old
Depression

Previous attempts 
Ethanol use 
Rational thinking loss 
Suicide in family 
Organized plan 
No spouse, no support system 
Serious illness