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Author15 Posts
  #1

21 yo man presents wih 4-week hx of paranoid delusions and auditory hallucinations that comment his appearance. You ds scizophrenia, paranoid type and Rx Haldol 5mg bid. One week later-pt returns, says that the symptoms are improved but also new ones appeared-stiffnes of neck and arms. You give Rx benztropine(Cogentin)1mg bid. One week later- pt's mother calls and says that the condition is worse-son is agitated, confused, ,tachycardic, with dilated pupils, flushed skin. Next appropriate step:
a. DC cogentin and Rx amantadine(SYmmeterl)
b. increase haldol5mg tid
c. increase cogentin 2mg bid
d. DC haldol, prescribe Risperdal
e. Rx Ativan 1mg tid




  #2

a. it is an anticholinergic crisis, right??


  #3

Yep!


  #4

good question rasul !!


  #5

With a 4wk H/O psychotic symptoms the Dx would be Brief Psychotic Disorder..right?


  #6

The q did not ask you about the dx, ask you side-effects of cogentin, cogentin, cogentin !


  #7

A 25 y/o man is very upset with his co-workers and describes fantasies of driving to work and "beat them up".

Which of the following is the most ominous sign that he may take action?

a. a lack of anxiety

b. the presence of temporal lobe epilepsy

c. a history of alcohol abuse

d. the presence of persecutory delusions

e. a history of violence

Thanks



  #8

c?


  #9

d.


  #10

E. a history of violence


  #11

d for AAAAA's question


  #12

A person who describes "fantasies" will only act out with persecutory delusion. Persecutory delusion=perceive being persecuted and harrassed by someone at one but indeed is either paranoid schizophrenia with persecutory delusion (delusion is very important feature)

Terry Yates from Texas killed all her five children, one at a time by drowning , secondary to post-partum psychosis (probably schizophrenia with predominent persecutory delusion and paranoid ideation.

A person with antisocial personality disorder will "commit" the act of violence with a history of violence.



  #13

A person with anti-social personality disorder with features of failure to understand the consequence of his act. The person does NOT has fantasies and go ahead to beat people up . A history of previous violent offence is a very high predictive value of anti-social personality disroder to commit violent acts.

Think, think,think here :

Many cults around the world believe in spreading the messages to their members that they are being persecuted by the authorities, by the Government and act out in fantasies to commit horrible murders to their own members by massive murders and suicide ! (history proved a perceived persecutory delusions in a crazy person or crazy group will commit those violence against their family, friends and to their OWN members !! (church members)



  #14

thanks AAAAA.


  #15

my answer is e too





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