QM/BM 3

Question 1

What is the Capgras delusion?

Answer 1

Capgras delusion is a misidentification syndrome in which the patient believes that someone close to them has been replaced by a clone.

Question 2

What is a Fregoli delusion?

Answer 2

Fregoli delusion describes where a patient believes that everyone they meet is the same person but with different disguises. It can be associated with injury to the right frontal area, left temporoparietal areas and the fusiform gyrus.

Question 3

What is a Cotard delusion?

Answer 3

Cotard delusion is a rare psychiatric delusion in which the patient believes they are dead or have had organs removed. It is associated with schizophrenia but can be found in patients with depression, brain tumours and migraine headaches.

Question 4

How do we treat Conn’s syndrome?

Answer 4

There is no evidence of adrenal adenoma on CT, and with bilateral aldosterone production on adrenal vein sampling, bilateral adrenal hyperplasia is the most likely diagnosis. The first line in management for this is aldosterone inhibition with spironolactone or eplerenone, and then review whether this helps to reduce blood pressure.

Question 5

What is early dumping syndrome?

Answer 5

Early dumping syndrome occurs 10–30 minutes after food and is caused by the passage of hypertonic gastric contents into the small bowel, which causes intestinal distension owing to the rapid fluid shift. This can lead to symptoms of vomiting and hypovolaemia (leading to faints), which triggers a sympathetic response, causing sweating and tachycardia. This can be managed by advising the patient to have smaller and more frequent meals.

Late = 1-3hrs