Terminology

Question 1

What’s another term for slowed thought process

Answer 1

Bradypsychia

Question 2

Describing catatonia to pts/family

Answer 2

stuck

In either constant non-motion or in motion

Question 3

Mitgehen

Answer 3

Light touch—>large movements

Question 4

Gagenhalten

Answer 4

Resistance with equal and opposite of that’s applied by the examiner

https://www.mdedge.com/psychiatry/article/189753/schizophrenia-other-psychotic-disorders/catatonia-recognition-management

Question 5

Catatonia treatment

Answer 5

Lorazepam 1-2 mg q4h-q8h IV
Escalate until sx disappear or they’re too sedated
6-24 mg/day usually
24-48 hrs on IV after improve then convert to oral (some sx can return as PO Ativan is less effective)

For malignant catatonia, ECT

Question 6

Risks/CI for ECT 3

Answer 6

Increased risk of arrhythmia (K displaced)
Within 3 months of MI
Space-occupying lesion

Question 7

Second line tx for catatonia

Answer 7

Zolpidem (gaba-A agonist)

NMDA antagonists (amantadine, memantine)
Memantine preferred over amantadine (can lower seizure threshold and can worsen psychosis if that’s underlying because amantadine is dopamenergic)

Question 8

Delirium

Answer 8

A reversible, acute confusional state that involves a reduced/fluctuating level of consciousness and attention with difficulties in memory and thought processes.

Question 9

Așa toxicity vs Meniere’s disease

Answer 9

No unilateral hearing loss with Asa toxicity