There are 486 questions on various topics in Neurology in the FrontalCortex neurology question bank.

Psychoses 01

Topic: Anatomy

Created on Friday, December 29 2006 by

Last modified on Friday, December 29 2006.

A 37 year-old male police officer is brought by ambulance to the emergency room.
He is uncooperative, disheveled, and insists that an evil hamster is trying to kill him.
He complains of hearing voices telling him to feed the deer.
He is accompanied by his nephew, who states that he was lucid and rational until 5 days ago, when he also began to complain of nausea and headache.
Physical exam is significant for repeated vomiting, jolt accentuation of headache, photophobia, and high fever.

Of the following, which is the most appropriate diagnosis?

A) Psychotic disorder due to a general medical condition

B) Substance-induced psychotic disorder

C) Schizophreniform disorder

D) Mood disorder with psychotic features

E) Schizophrenia

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This question was created on December 29, 2006 by .
This question was last modified on December 29, 2006.

ANSWERS AND EXPLANATIONS

A) psychotic disorder due to a general medical condition

This answer is correct.

The diagnosis of psychotic disorder due to a general medical condition is made when findings of delusions, hallucinations, disorganized speech, or grossly disorganized behavior are attributable to the direct physiological effects of a general medical condition. This patient has exam findings suggestive of meningitis, which can explain the psychotic symptoms. (See References)


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B) substance-induced psychotic disorder

This answer is incorrect.

The diagnosis of substance-induced psychotic disorder is made when findings of delusions, hallucinations, disorganized speech, or grossly disorganized behavior are attributable to the direct physiological effects of a medication, drug of abuse, toxin, or other substance. This patient has no known substance exposures. (See References)


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C) schizophreniform disorder

This answer is incorrect.

The diagnosis of schizophreniform disorder is made when psychotic symptoms last more than 1 month, but less than 6 months. After 6 months, a diagnosis of schizophrenia can be made. Prior to 1 month, a diagnosis of brief psychotic disorder should be considered. This patient's psychosis has an obvious organic cause. (See References)


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D) mood disorder with psychotic features

This answer is incorrect.

Like schizoaffective disorder, the diagnosis of mood disorder with psychotic features requires both psychotic and mood symptoms. However, in mood disorder with psychotic features, the psychotic features are never present without the mood symptoms. When patient mood normalizes, the psychotic features resolve. This patient's psychosis has an obvious organic cause. (See References)


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E) schizophrenia

This answer is incorrect.

The diagnosis of schizophrenia requires at least 6 months of continuous signs of psychological disturbance. This 6-month period must include at least 1 month of "active-phase" symptoms: delusions, halucinations, disorganized speech, grossly disorganized or catatonic behavior, or negative symptoms (affective flattening, alogia, or avolition). This patient's psychosis has an obvious organic cause. (See References)


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References:

1. American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders Fourth Edition, Text Revision. American Pyschiatric Association, Washington, DC. (ISBN:0890420254)

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anatomy
Psychoses 01
Question ID: 12290600
Question written by . (C) FrontalCortex.com 2006-2009, all rights reserved. Created: 12/29/2006
Modified: 12/29/2006
Estimated Permutations: 0