dreamer
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ans plz
A 23 yo M is brought to the physician by his mom because he has head a voice over the past month telling him to hurt himself. his mother says that her son has no freinds and is a lifelong loner. since graduating from high school , he has been unable to hold a job. he admits to smoking marijuana occasionally and drinking six beers weekly. examination shows a poorly groomed man with poor eye contact. he has a flat affect and limited facial expression. he says he has no intention of harming himself or others. which of the following is the most appropriate next step in management?
A schedule a follow up visit in 4 weeks
B prescribe oral risperidone and schedule a follow up visit in 2 wks
C admit him to the partial hospital program and prescribe oral lithium carbonate
D admit him to the psychiatric unit for detoxification
E admit him to the psychiatric unit and prescribe oral imipramine
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| lakshya_0_7
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B
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| Drtweetie
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B
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| MAGY17
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WHAT THE DX?
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| dreamer
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Dx: brief psychotic disorder , because he has hallucinations, grossly disorganize(poorly groomed man with poor eye contact. he has a flat affect and limited facial expression),Sx is more than 1 day but less than 30 days,
he seems has preexisting PD which is a risk factor.
so the Rx is antipsychotic
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| radonc
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But the psychosis is substance-induced. Don't you need to detox him first>? Answer D
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| Kamsi
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B
Marijuana intoxication rarely produces hallucinations,No symptons like red conjuctivae,dry mouth,tachycardia,increased appetite and so on,There is no medication specifically used for detoxification.It's generally eased by reassurance in aquiet setting though serotonin antagonist may decrease the craving for thr drug
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| elitoki
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B
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| dr in trouble
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I dont think that this is a brief psychotic disorder, it looks like Schizophrenia .
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| njcjzy
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Schizophrenia should have symptoms for over 6 months.
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| Ivonne
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(B)
i don't agree that this is a case of brief psychotic disorder. the pt is having auditory hallucinations over the past month however he is having impaired social function for a long time(since graduation who knows when, we don't have that info)
1.-Brief psychotic........sudden onset.....last<1 month.......possibly stress related
2.-Schizophreniform.....last<6 months
3.-Schizophrenia......2 or more symptoms plus impaired social function>6 months
the question is about next step which i think the answer B. About the diagnosis which is not the purpose of the question I think it can be 3 or 2 but i need more specific time info.
-hallucinations over the past month
-Social withdrawal and impaired social function after highschool
-flat affect how long?
-limited facial expression how long?
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