Addiction
An 18 y/o patient presents to the ER with a clouded sensorium, agitation, hyperactivity, mild paranoia, pressured speech and euphoric though labile mood. Physical exam notable for HTN, tachycardia and vertical nystagmus. What substance did he likely ingest?
PCP
This is the most common psychiatric presentation following a stroke
Depression
This is the metabolic abnormality commonly found with anorexia nervosa, purging subtype.
Hypokalemia**
Picture perfect, you don't need no filter
Intentions - Justin Bieber
Treatment of acetaminophen overdose
N-acetylcysteine **
23 y/o patient presents to the ER after a party. Found to have dehydration, dilated pupils, HTN, hyponatremia, and elevated CPK. What substance did he likely ingest?
MDMA *
EEG findings in delirium
Diffuse slowing of background rhythm
What mood stabilizer should be held before ECT, as it associated with prolonged seizures?
Lithium
On a dark desert highway, cool wind in my hair
Hotel California - The Eagles
40 y/o pt presents with delirium, tremor, diaphoresis, rigidity, hyperpyrexia, and myoclonus in making the transition from the use of clomipramine to phenelzine. Pt is most likely experiencing?
Serotonin syndrome
A heroin dependent female discovers she is pregnant and wants to detox. What is the recommended treatment plan?
Methadone maintenance until delivery then detox *
A 67-year-old patient was started on fluoxetine and a week later presents to the ER with mild confusion, lethargy, and polydipsia. What electrolyte abnormality is likely?
Hyponatremia
A 40 y/o M developed gradually progressive dementia and abnormal involuntary movements. Older brother and father have similar illness. DNA analysis will likely show?
Excess CAG triplets (Huntington’s disease)
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Bodak Yellow - Cardi B
35 y/o pt presents to the ER with severe depression and episodes of anxiety for 9 months that have become so bad he can no longer leave the house, has severe weight loss, hyperpigmentation of exposed skin, and vomiting. What is the diagnosis?
Addison’s disease (adrenal insufficiency)
Alcohol use is associated with what changes in sleep?
Decreased sleep latency, decreased REM
A 79-year-old patient presents with personality changes, cognitive difficulties, affective lability, and olfactory and gustatory hallucinations. MRI reveals hyperintensities in the temporal lobes. What is the diagnosis?
HSV encephalitis
Transcranial Magnetic Stimulation for treatment of depression targets this brain region.
Prefrontal Cortex
I feel stupid and contagious. Here we are now, entertain us.
Smells Like Teen Spirit - Nirvana
A 40 year old with AIDS presents with symptoms of progressive hemiparesis and a R homonymous visual field deficit. There are patchy white matter lesions on MRI and LP is normal. What is the diagnosis?
Progressive Multifocal Leukoencephalopathy *
This is the molecular mechanism of ketamine
NMDA receptor antagonist
This is the most common manifestation of acute neurosyphilis.
Stroke
C/L is consulted on a 28y/o with emotional lability and impulsivity. LFT’s are elevated. A close relative had similar sx and died at 30y/o from hepatic failure. Which blood level would be diagnostic?
Ceruloplasmin (Wilson’s disease) *
you may find yourself in a beautiful house with a beautiful wife. and you may ask yourself, well
How did I get here?
Once in a Lifetime - Talking Heads
A patient with schizophrenia presents to the ER after a recent medication adjustment with fever, diaphoresis, stiffness, tachycardia, confusion. Name the diagnosis, most typical lab finding, and treatment.
Neuroleptic malignant syndrome, elevated creatine kinase, and dantrolene (skeletal muscle relaxant) along with hydration and cooling.