Psychiatry & Communication

 Common presentations of dissociative (conversion) disorder
 Gait disturbance  Loss of function in limbs  Aphonia
 Non-epileptic seizures  Sensory loss  Blindness

Reference: Davidson 23rd , Page : 1184
Explanation : Nihilistic delusion- My head is missing , I have no body or I am dead

Reference: Davidson 23rd; P-137
সলভ ক্লাসের জন্য আলোচনা পোস্ট দেখুন - [আলোচনা পোস্টের লিঙ্ক]

Explanation: A delusion is a false belief, Illusions are misperceptions of real stimuli. Hallucinations are sensory perceptions that occur in the absence of external stimuli

Mood disorders Mood or affective disorders include:
 unipolar depression: one or more episodes of low mood and associated symptoms
 bipolar disorder: episodes of elevated mood interspersed with episodes of depression
 dysthymia: chronic low-grade depressed mood without sufcient other symptoms to count as ‘clinically signicant’ or ‘major’ depression.

Explanation: history remains the most important part of the clinical decision-making process. Studies show that physicians make a diagnosis in 70–90% of cases from the history alone

Explanation: Lithium, Valproate, Lamotrigine are mood-stabilising drgus

Explanation: Organic mental disorders: Dementias, Delirium Other mental disorders due to brain damage or disease

Explanation: Antidepressants are the drugs of first choice. The therapeutic dose is usually higher for anxiety disorders than for depression

Explanation: The specific benzodiazepine antagonist flumazenil (0.5 mg IV, repeated if needed) increases conscious level in patients with benzodiazepine overdose

Reference: Davidson 23rd; P-8(Fig-1.7).

Extreme cachexia in young female with history of diet control, heavy exercise and amenorrhea – anorexia nervosa.

Multiple doses of activated charcoal is effective against other substances.

Reference: Davidson 23rd; P-440

About one-third of those who develop an acute schizophrenic episode have a good outcome. One-third develop chronic, incapacitating schizophrenia, and the remainder largely recover after each episode but suffer relapses. Most affected patients cannot work or live independently. Schizophrenia is associated with suicide and up to 10% of patients take their own lives

Reference: Davidson 23rd , Page : 1200
Explanation : Lithium carbonate is the drug of first choice for bipolar disorder.

Bulimia nervosa
 Recurrent bouts of binge eating 
Lack of self-control over eating during binges 
Self-induced vomiting, purgation or dieting after binges 
Weight maintained within normal limits

In the immediate aftermath of a significant trauma, the main aim is to provide support, direct advice and the opportunity for emotional catharsis (routine debriefing may actually be harmful).
In established PTSD, structured psychological approaches (CBT, eye movement desensitisation and reprocessing (EMDR) and stress management) are effective. Antidepressant drugs are moderately effective.

Reference: Davidson 23rd; P-133

Reference: Davidson 23rd; P-133

Reference: Davidson 23rd; P-133

Reference: Davidson 23rd; P-137

Illusion is a false interpretation.

Cardiac arrhythmias
Antipsychotic medications cause prolongation of the QTc interval, which may be associated with ventricular tachycardia, torsades de pointes and sudden death. If this occurs, treatment should be reviewed, with careful electrocardiographic monitoring and treatment of serious arrhythmias if necessary.