Laboratory Tests in Psychiatry Flashcards
(28 cards)
What are the 5 basic reasons to assess lab values?
- Rule out an underlying physiologic/metabolic cause of the presenting psychiatrcic symptoms
- Rule out the use of illicit substances as the cause of the presentign psychiatric symptoms
- Establish a baseline of physiologic function before initiating a medication
- Assess the safety and possible resultant side effect(s) of the medication(s) prescribed
- Assess the therapeutic range of the medication prescribed
Why would you order an EKG?
cardiac irregularity(s) either causing disrutbance or side-effect from medication
Why would you order an EEG?
assess brainwave activity – ruling out seizure disorder; assessing for cognitive disorder(s)
Why would you order an CXR?
rulign out TB, histoplasmosis
Why would you order an MRI?
ruling out space occupying lesion
Why would you do genetic testing?
ruling out “syndromes” ie (turner syndrome, prader-willi)
Patients who present with depression could have what underlying physiological problems?
disturbance in Thyroid gland
Syphilis or HIV
tumor of head of tha pancreas
Other than depression, disturbance in the thyroid gland can present in what psychiologic manifestation?
hypomania / mania
Patients who present with anxiety or panic disorder could have what underlying physiological problems?
pheochromocytoma
A patient with syphilis or HIV may present with what psychiatic presenting problems?
confusion
hallucinations
mood lavility
depression
dementia
Patients who present with thought disorder or mood disorder may have what physiological causes?
seizure disorder
liver dysfunction
infection
A patient with a seizure disorder may present with what psychiatric symptoms?
hallucinations
thought disorder
mood disorder
confusion/dementia
A patient with liver dysfunction may present with what psychiatric symptoms?
thought disorder
confusion
mood disorder [hepatic encephalopathy]
What is important to remember if a patient presents to you with delirium?
discover underlying physiologic cause & treat it
What baseline laboratory tests should you order prior to initiating medication in psychiatry?
- baseline CBC
- with reticulocyte & platelet count
- baseline CMP
- baseline Kidney Function: BUN/Cr
- baseline Liver Function [LFT’s]
- baseline Thyroid Function: TSH
- Icon/serum pregnancy test
- option
- urine drug screen
- baseline EKG/ECG
What lab should you order if you suspect a pheochromocytoma?
catecholamine levels
What are “labs to consider”?
- Hormone levels
- estrogen / testosterone
- Vitamin D (25-hydroxy)
- Folate /B12
- Lead levels/Heavy metals
You should order a sleep study to rule out what conditions?
- obstructive sleep apnea
- narcolepsy
- restless leg syndrome
- periodic limb movement disorder
vitamin B12 deficiency can cause what type of psychatric manifestations?
depression, apathy, irritability, dementia, catatonia, delerium, and hallucinations
What can be the first presenting symptoms of pancratic cancer?
What are the techniques used to diagnose pancreatic cancer?
depression
- ultrasound
- CT scan
- MRI
- PET
- Ca 19-9 Blood test
What tests can you order to screen for syphilis?
RPR
VDRL
Antipsychotics can cause weight gain, lipid disturbance & glucose dysregulation which can contribue to the development of what condition?
metabolic syndrome
What is the diagnostic criteria for metabolic syndrome?
3+ of the following:
- waistline 40 inches or more (male) 35 inches or more (female)
- BP 130/85 or higher
- triglyceride level > 150 mg/dl
- fasting blood glucose level >100 or are taking glucose-lowering medications
- High density lipprotein level (HDL) <40 mg/dl (male) or <50 mg/dl (female)
What symptom could be an early indicator of long-term weight gain when taking antipsychotics?
early weight gain
(significant weight gain can occur within 6-8 weeks)
