Medical Assessment and Laboratory Testing in Psychiatry

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What is the main goal of physical health monitoring in psychiatry?

To provide appropriate care for existing illnesses and protect current health from future impairment.

What critical issues necessitate medical assessment in psychiatric patients?

Pervasive metabolic syndrome and shorter life expectancy of psychiatric patients.

List one component of medical history collection relevant to psychiatric patients.

Prior injuries, especially head injuries, or a history of unconsciousness.

What role does collateral information play in medical history collection?

It assists in obtaining detailed information from family members or prior clinicians when patients are unable to provide sufficient details.

What type of imaging is crucial for diagnosing dementia?

Magnetic Resonance Imaging (MRI) and Computed Tomography (CT).

What does a Complete Blood Count (CBC) measure in dementia patients?

It helps assess overall health and detect a variety of disorders, such as anemia.

What is the purpose of the Venereal Disease Research Laboratory (VDRL) test?

To screen for syphilis infection.

What are structural imaging methods used in neurology?

X-ray, CT, and MRI.

Define functional imaging in psychiatry.

It provides a visualization of specific biochemical processes and is used for assessing brain function.

What is Positron Emission Tomography (PET) primarily used for in psychiatry?

To measure regional brain glucose metabolism and assist in dementia diagnosis.

What can high blood alcohol levels indicate?

Impairment of judgment and coordination, especially levels above 100 mg/dL.

What does chronic alcohol use commonly lead to in terms of hematologic effects?

Macrocytic anemia, often due to nutritional deficiencies.

What renally related condition can be a result of long-term lithium use?

Nephrogenic diabetes insipidus (DI).

When is a Dexamethasone-Suppression Test relevant in psychiatric evaluation?

It is a research tool and not used in routine clinical care.

What is the primary laboratory test to evaluate liver function?

Liver Function Tests (LFTs) including AST and ALT.

Identify a common substance associated with substance use disorder.

Alcohol.

What is the typical duration of detection for amphetamines in urine?

48–72 hours.

What is required before initiating therapy with antidepressants during pregnancy?

A pretreatment urine hCG test.

What are the common symptoms of lead intoxication?

Behavioral abnormalities and potential neurological changes.

What types of conditions does the assessment of urine and blood assist in evaluating?

Conditions causing hyponatremia, including SIADH.

What laboratory finding is often elevated in patients with hepatic encephalopathy?

Serum ammonia.

What psychiatric symptoms can elevated thyroid hormones cause?

Depression, anxiety, mania, and psychosis.

How can metabolic syndrome affect psychiatric patients?

It can contribute to physical health issues like obesity and diabetes.

What is the function of a Holter monitor?

To continuously record a patient’s ECG for a prolonged period.

What potential side effect is associated with the use of clozapine?

Leukopenia.

What type of testing is performed for chronic heavy alcohol use?

Carbohydrate-deficient transferrin (CDT) testing.

What role does polysomnography play in psychiatry?

It assesses sleep disorders and is used in the evaluation of psychiatric symptoms.

In what cases would intravenous drug use (IVDU) screening be particularly relevant?

When a patient has a history of drug abuse or presents with unexplained behavioral symptoms.

What symptoms are indicative of neuroleptic malignant syndrome (NMS)?

Hyperpyrexia, rigidity, autonomic instability, and altered mental status.

What are common risk factors for developing substance use disorders?

History of criminal behavior, adolescent age, and high-risk behaviors.

Which component of medical history may indicate the risk for personality disorders?

Legal history and past relationships.

What type of behavior is associated with hypokalemia in patients?

Anorexia and bulimia, particularly from purging.

Why is serum salicylate monitoring important?

To avoid severe toxicity and determine treatment effectiveness.

What does an ECG monitor in regards to neuroleptic treatment?

It checks for QTc prolongation and cardiac arrhythmias.

Which psychiatric medications may lead to hyperprolactinemia?

Antipsychotics such as clozapine and risperidone.

What is a common clinical finding in patients with Wilson's disease?

Movement disorders and changes in personality.

How is serum ceruloplasmin significant in diagnosing copper metabolism disorders?

Low levels indicate Wilson's disease.

What type of history is crucial for evaluating psychiatric disorders related to thyroid dysfunction?

Family history of thyroid disease or psychiatric symptoms.

What is a hallmark sign of chronic substance use in physical examination?

Changes in vital signs, such as hypertension or tremors.

What common psychiatric manifestation is associated with systemic lupus erythematosus (SLE)?

Depression and psychosis.

Environmental toxins can lead to which kinds of psychiatric manifestations?

Cognitive impairment and panic disorders.

What is the common laboratory approach for diagnosing infectious diseases in psychiatry?

Blood cultures, CBC, and serologic testing.

Melatonin levels can provide insight into which condition in psychiatric patients?

Sleep disorders.

What does the presence of U waves in an ECG indicate?

Potential hypokalemia, often associated with eating disorders.

What cognitive and emotional symptoms can hypercalcemia produce?

Confusion, weakness, and neuropsychiatric changes such as depression.

Which parameter of liver function tests is typically higher in alcohol-induced liver disease?

AST compared to ALT.

What general approach is taken when evaluating metabolic abnormalities in patients with psychiatric conditions?

A comprehensive review of electrolytes, liver function, and nutritional status.