Psychiatry

Question 1

Panic Disorder

Answer 1

Tx

- Unique among anxiety spectrum disorder bc CBT + pharmacotherapy have a synergistic effect

Question 2

Delirium (Confusion)

Answer 2

Dx

1) Acute + fluctuating mental status
2) Attention deficit
3) Disorganized thinking
4) Hyper or hypoalert

Be careful with dehydration and malnourishment

Don’t Miss

• Alcohol + drugs (illicit or rx)
• Meningitis
• Metabolic (ex hypoglycemia)
• Stroke

Imaging
- Rarely indicated if typical presentation

Tx

1) Underlying cause
2) Consider supportive tx
a) Agitated: stop catheters if possible, trazodone (anti-depressant but also cautiously used for delirium sometimes), lorazepam (alch withdrawal), haloperidol (antipsychotic for aggression)
b) Lethargic: dec hypnotic + psych meds
* Make sure you check renal + liver fncn first