Consultation-Liaison Psychiatry
What is the mechanism of menopause?
It is the progressive insensitivity of the ovary to the effect of follicle-stimulating hormone (FSH).
What type of somatoform disorder has the best prognosis?
Conversion disorder.
What is a possible psychiatric comorbidity with a left prefrontal cerebrovascular accident patient?
Depression.
What is risk factor for the development of postpartum psychosis?
Maternal history of puerperal psychiatric illness.
A 23-year-old woman was referred to a psychiatrist by a plastic surgeon. She constantly complains that part of her face is swollen; however, the surgeon could not document her claim. What is the most likely diagnosis?
Body dysmorphic disorder.
What conditions may cause catatonia?
Conditions that may cause catatonia are:
Mania.
Neurologic disorders (e.g., encephalitis).
Depression.
Schizophrenia.
Ingestion of phencyclidine.
Other psychiatric conditions.
Electrolyte imbalances, such as hypocalcemia, do not cause catatonia.
What is the drug of choice for rapid tranquilization?
Haloperidol given intramuscularly.
If the patient is willing and able to take an oral drug, the choice would be equivocal. Recent research shows risperidone to be as effective as haloperidol and to have a comparably rapid onset of action and a better side-effect profile. Intramuscular ziprasidone and olanzepine are emerging new treatments.
What is the major concern in acetaminophen overdose?
Hepatotoxicity.
What are some important factors in evaluating chronic pain?
The patient’s ethnic background may influence the symptoms.
Depression may present as chronic pain.
One third of patients respond to a placebo.
What medical conditions should be ruled out in patients with acute extreme anxiety?
Alcohol withdrawal.
Pulmonary embolism.
Use of sympathomimetic agents.
What is the most useful diagnostic tool for patients with suspected delirium?
The Mini-Mental Status Examination (MMSE).
What is the role of benzodiazepines in controlling delirium?
As a general rule, benzodiazepines should be avoided in cases of delirium. Benzodiazepines may cause increased confusion, disinhibition, falling, and behavioral problems.
What is the best agent for managing steroid-induced mania?
Usually, a low-dose antipsychotic agent, because of these drugs’ rapid effect.
Benzodiazepines may cause more confusion.
Antidepressants and mood-stabilizing drugs take weeks to produce effects, and are therefore not used.
What characteristics are more likely in elderly than in young patients with medical surgical conditions?
Delirium.
Adverse reactions to anticholinergic drugs.
What is the most important risk factor for postpartum psychosis?
A history of puerperal psychiatric illness.
Age, complications of delivery, and multiparity are not risk factors for postpartum psychosis.
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