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Psychoses 01

Topic: Anatomy

Created on Friday, December 29 2006 by

Last modified on Friday, December 29 2006.

A 28 year-old male gerbil biologist is brought by ambulance to the emergency room.
He is uncooperative, disheveled, and insists that Krisna wants him to convert Interpol to Sikhism.
He complains of hearing voices telling him to feed the silverfish.
He is accompanied by his niece, who states that he was lucid and rational until 2 days ago, when he also began to complain of nausea and headache.
Physical exam is significant for opisthotonus, positive Kernig sign, nuchal rigidity, and jolt accentuation of headache.

Of the following, which is the most appropriate diagnosis?

A) Psychotic disorder due to a general medical condition

B) Schizoaffective disorder

C) Mood disorder with psychotic features

D) Substance-induced psychotic disorder

E) Psychotic disorder NOS

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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) 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. (See References)


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C) 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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D) 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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E) 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. (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