Psychoses 01
Topic: Anatomy
Created on Friday, December 29 2006 by
Last modified on Friday, December 29 2006.
A 36 year-old male kumquat taster is brought by ambulance to the emergency room.
He is uncooperative, disheveled, and insists that he is the head of Scotland Yard.
He complains of hearing voices telling him to feed the wombats.
He is accompanied by his caretaker, 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, nuchal rigidity, positive Kernig sign, and jolt accentuation of headache.
Of the following, which is the most appropriate diagnosis?
A) Schizoaffective disorder B) Schizophreniform disorder C) Psychotic disorder NOS D) Psychotic disorder due to a general medical condition E) Substance-induced psychotic disorder
This question was created on December 29, 2006 by .
This question was last modified on December 29, 2006.
ANSWERS AND EXPLANATIONS
A) schizoaffective disorder
This answer is incorrect.
Schizoaffective disorder is a manifestation of both psychotic symptoms and mood disorder. The diagnosis requires a period of at least 2 weeks during which the patient suffers from hallucinations or delusions in the absence of prominent mood symptoms. This patient's psychosis has an obvious organic cause. (
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B) 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. (
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C) psychotic disorder NOS
This answer is incorrect.
Psychotic disorder NOS is only made when a patient is psychotic, but does not meet the criteria for another diagnosis. This patient's psychosis has an obvious organic cause. (
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D) 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. (
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E) 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. (
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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) | Advertising:
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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