smitha
Forum Elite
Topics: 53
Posts: 236
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MATCH THE CASE HISTORIES WITH DIAGNOSIS.....
1.Acute PCP intoxication
2.Alcohol hallucinosis
3.Schizophrenia
4.Bipolar disorder.manic
5.Paranoid disorder
A. A successful 52 yo business man admitted to an ortho pedic ward with a severely #d femur,in a skiing accident.After 2 days, he becomes agitated,complaining that people r making derogatory comments abt. him from the hallway, despite the fact that no one is there. Within 1 wk, he
has returned to normal.
B. A 30 yo woman who has not slept in 3 days following her delivery of her 1st child, speaks continuously in a pressured , intrusive fashion of needing to prepare the world for the son of god.She has no previous h/o any psychiatric illness ,but her father, who becomes quite agitated & pressured when given anti depressants ,has a h/o recurrent depressions.
C.A 19 yo woman, who had dropped out of college to join religious commune, is brought to the ER for bizarre behaviour.During the 18 months that she has lived in the commune,she has been frequently observed talking to herself & she often speaks of the devil trying to enter her head thru her left ear. She has become uncontrollably agitated following an acute ingestion of an unknown substance.she is visibly responding to threatening voices.These symptoms continue for several weeks.Physical & neuro exam. r unremarkable.
D.A 32 yo man with 3 previous psychi hospitalizations is admitted to the hospital for harassing 2 young boys in front of a store. He insists that he's a spl. agent for the FBI & wants to report their misbahaviour to the police.
He live salone in acheap hotel room & speds his days talking to people on TV. He's isolated & shows little affective response,regardless of the situation.
E. A 48yo machanical engg. is referred for evaluation by his attorney coz of his insistance that his employers request to change his jobis part of a communist conspiracy against him.He has no previous h/o psychi illness and appears to be nomal xcept when talking abt. his employer & communists.
F.A 20 yo man without a previous h/o psychi illness is brought in for evaluation after violently attacking his best friend. He has auditory & visual hallucinations & screams abt. being attacked when anyone approaches him.He has slurred speech & moves in an unsteady fashion.He is noted to have vertical & horizontal nystagmus.
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| no more a loser
Forum Guru
Topics: 140
Posts: 580
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1) F
2) A
3) C, D
4) B
5) E
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| smitha
Forum Elite
Topics: 53
Posts: 236
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 That's peeeeeeeeerfect matching u did losergirl.......
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| Delusional
Forum Elite
Topics: 41
Posts: 226
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Okay now....let me ask some question........
How could an alcoholic......be successful? hehehe
Anyways briefly some points i wanted to share
1.Acute PCP intoxication: young patient with features of what seems to be alcohol intoxication (slurred speech,unsteady gait, nystagmus) but also what seems to be cocaine intoxication (agitation, hallucinations and paranoia) but when both these co-exist then it is likely to be PCP and unlikely to be alcohol with cocaine ... :P
2.Alcohol hallucinosis ....it is one of the forms of alcohol withdrawls ( look at the end of this discussions for the different forms of alcholo withdrawls)... it is characterized by auditory hallucinations that begin usually 2 days from withdrawl...
3.Paranoid disorder: this is a delusional disorder
it has to be non-bizzare.....
an example of a bizzare delusion is the nihilistic delusion in pts with Depression....that they don't exist.....definitely too bizzare....and if seen then the patient is liely to have Depression ...
Alcohol Withdrawl....
I....Minor:
Alcoholic shakes that begin within 1st day of withdrawl and characterized by tremor, GIT upset, and tachycardia
Treatment ------> chlordiazepoxide or Oxazepam
II...Major:
1....Alcoholic Seizures: that begin within 1st day and may last for 2 days
Gen Tonic Clonic Seizures
Treatment-------- >IV BDZ
2...Alcocholic Hallucinosis: Begin within 2 days and may last for 1 week
Auditory hallucinations with intact mental status
Treatment-------->Antipsychotics
3...Delirium Tremens: (most serious) begins within 2-3 days and usually last for 3 days
Delirium ( altered mental status, agitation, hallucinations)+ autonomic instability
Treatment---------> Intensive care with IV BDZ and supportive Treatment (BP)
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