Psychiatry

Question 1

Psychiatric patient is found with febrile, hypertensive (SBP 160), unresponsive and with muscular rigidity. What condition might the patient have?

Answer 1

Neuroleptic malignant syndrome:

• Fever
• Autonomic dysfunction
• Altered mental state
• Muscular rigidity

Question 2

True/False: Lithium causes diabetes mellitus

Answer 2

False.

Lithium can cause nephrogenic diabetes insipidus

Question 3

What is Somatisation disorder?

Answer 3

MULTIPLE physical symptoms and the patient refuses to accept reassurance or negative test results.

Question 4

What is Factitious syndrome (AKA Munchausen’s syndrome)?

Answer 4

Psychiatric disorder with ‘Fake’ symptoms with personal gain (e.g. patient gets attention)

Question 5

What is Conversion disorder?

Answer 5

‘Real’ symptoms (typically MOTOR or SENSORY) with NO personal gain.

Question 6

What is Dissociative disorder?

Answer 6

• Psychiatric symptoms (amnesia, fugue or stupor) in the act of SEPERATING off memories from normal consciousness
• Dissociative identity disorder is the most severe form (previously known as ‘multiple personality’ disorder)

Question 7

What is Malingering?

Answer 7

Non-psychiatric disorder with ‘Fake’ symptoms with personal external gain (e.g. money, drugs)

Question 8

Why are factiitious and conversion disorders essentially the converse of one another?

Answer 8

Factitious = FAKE symptoms / Personal Gain
Conversion = REAL symptoms / NO Gain