Psychiatric Emergencies

Question 1

Involuntary hospitalization may be indicated in these 3 situations:

Answer 1

1. Threat to self
2. Threat to others
3. Inability to care for self

Question 2

The most deadly mental health disorder is:

Answer 2

Anorexia Nervosa (loss of 25% of body weight of the norm for age and sex)

Question 3

This movement disorder is characterized by intense involuntary spasm of muscles of neck, face, jaw, eyes or trunk

Answer 3

Acute Dystonia

Question 4

This movement disorder can be treated by decreasing dosage of antipsychotic, benztropine or diphehydramine

Answer 4

Acute Dystonia

Question 5

This movement disorder is characterized by abnormal movement of mouth, tongue, face, neck and trunk.

Answer 5

Tardive Dyskinesia

Question 6

Aside from decreasing or discontinuing the drug, these are the only 2 drugs used to treat tardive dyskinesia:

Answer 6

valbenazine (Ingrezzo)
deutetrabenazine (Austedo)
VMAT 2 inhibitors

Question 7

This movement disorder is characterized by agitation, restlessness, muscle discomfort or dysphoria.

Answer 7

Akathisias

Question 8

Reducing antipsychotic drug, propanolol, or benzodiazepines can be used to treat this movement disorder

Answer 8

Akathisias

Question 9

Describe the symptoms of NMS (use mneumonic):

Answer 9

Fever
Encephalopathy
Vitals instability
Elevated CPK
Rigidity of muscles

Question 10

Discontinuing the antipsychotic, IV Dantrolene (muscle relaxant) and oral bromocriptine (dopamine agonist), hydrating and cooling is used to treat this psychiatric emergency

Answer 10

NMS

Question 11

Intracorporeal _______ or mechanical or surgical drainage is used to treat this psychiatric emergency

Answer 11

phenylephrine (common decongestant ingredient, a vasoconstrictor)
Priapism (TrazoBONE)

Question 12

Describe the symptoms of serotonin syndrome (use mneumonic)

Answer 12

Shivering
Hyperreflexia and myoclonus (sudden muscle spasms)
Increased temp
Vitals instability
Encephalopathy
Restlessness
Sweating

Question 13

Comprehensive supportive care with nitroglycerin, cyproheptadine (Periactin), cooling blankets, chlorpromazine (Thorazine), dantrolene (Dantrium), benzodiazepines, anticonvulsants, mechanical ventilation and paralyzing agents are used to treat this psychiatric emergency

Answer 13

Serotonin Syndrome

Question 14

Steven’s Johnson syndrome can be related to titrating this drug too quickly

Answer 14

lamotrigine (Lamictal)

Question 15

These symptoms describe which MEDICAL emergency that may present with psychiatric symptoms?
Tachycardia, GI dysfunction, hyperthermia, panic/anxiety, agitation, MANIA, dementia, psychosis

Answer 15

Thyrotoxicosis

Question 16

These symptoms describe which psychiatric emergency? Vomiting, abd pain, profuse diarrhea, severe TREMOR, ataxia (impaired coordination), coma, seizures, confusion, dysarthria (difficulty speaking), focal neurological signs

Answer 16

Lithium toxicity

Question 17

Lavage (saline irrigation and suction of gastric contents), osmotic diuresis, medical consultation or ICU tx are used to treat this psychiatric emergency

Answer 17

Lithium toxicity

Question 18

Elevated liver enzymes, nausea/vomiting, abd pain/heartburn, tremor, hair loss are symptoms of this psychiatric emergency

Answer 18

Valproate Toxicity

Question 19

Overdose effects of this mood stabilizer may include: restlessness, hallucinations, SEDATION, coma or death

Answer 19

Valproate

Question 20

These presentations would all require what intervention?
Panic disorder
Dissociative episodes
Catatonia
Mania and psychosis
Tactile or olfactory hallucinations

Answer 20

Medical evaluation

Question 21

These presentations would all require this type of intervention:
Assaultive, aggressive or violent behavior
Schizophrenia
Bipolar Disorder
Substance Intoxication and withdrawal (across all ages)
Dementia and delirium

Answer 21

Pharmacological Intervention

Question 22

Medications such as ______ may be helpful after behavioral interventions have failed to treat urgent (non-life threatening) situations in children (ex: bedwetting, hyperactivity and behavioral issues).

Answer 22

imipramine (Tofranil), a TCA

Question 23

This disorder is defined as inflicted injury or illness onto a child or faking the illness of a child by caregiver

Answer 23

Munchausen Syndrome by Proxy/Shared Factitious Disorder