Psychosis Workup Flashcards

1
Q

Key differentials
-mental
-physical
-substances

A

Mental
-schizophrenia
-schizoaffective
-psychotic depression/mania

Physical
-thyroid
-encephalitis
-tumour/SOL
-epilepsy

Substances
-medication SE
-alcohol
-substance use

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2
Q

History
-what you aim to do

A

Establish timeline
-triggers
-duration
-pattern of symptoms

Systems review
-abdo, neuro, thyroid

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3
Q

Observations, examination

A

A-E exam, vital signs
Neuro
Thyroid focused
Abdo
-opiates - pinpoint pupils
-liver signs - alcohol misuse
-arms - IV drugs
MSE

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4
Q

Bloods
-what would you like to dop

A

FBC, CRP - infective
LFT
TFT
Urine + tox
EEG
Head CT/MRI
CSF LP

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5
Q

How to differential between schizophrenia, drug induced psychosis, psychotic depression, schizoaffective disorder
-schizophrenia

A

Prodrome
- increased social isolation
-low mood, increased anxiety
-difficulty focusing
-change in thinking or behaviour

Psychosis => low mood

Can be substance related but doesn’t resolve when stopped

Other symptoms of schizophrenia

Can last years if untreated

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6
Q

How to differential between schizophrenia, drug induced psychosis, psychotic depression, schizoaffective disorder
-drug induced psychosis

A

Acute

Duration of hours-days

Pattern with cannabis
-Resolves when cannabis stopped

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7
Q

How to differential between schizophrenia, drug induced psychosis, psychotic depression, schizoaffective disorder
-psychotic depression

A

Gradual onset

Can be concurrent substance use but doesn’t resolve

Last months if untreated

Mood congruent
-nihilistic delusions

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8
Q

How to differential between schizophrenia, drug induced psychosis, psychotic depression, schizoaffective disorder
-schizoaffective

A

Prodrome

Mood and psychosis at same time

Mood symptoms not as severe as psychotic depression

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