Patient, is an ex-businessman, had history of hearing voices for 12 months, associated with loss of interest in his previous hobbies and disorganized behavior. 6 months prior to admission, he was presented with weird sustained posture, like in the above picture.
1. Name the posture in the picture above.
waxy flexibility/catalepsy
2. What is the most possible full diagnosis based on the history and finding.
schizophrenia with subtype catatonic
3. List the 5 criteria for the diagnosis from the question 2.
major symptom during 1month period,2 or more
i)delusion
ii)hallucination
iii)catatonic or disorganized behavior
iv)disorganized speech
v)negative symptoms
4. Give the medication you to prescribe on this patient.
atypical=clozapine,risperidone,olanzapine
typical =chlorpromazine,haloperidol,thioridazine,flupentixol
5. What is the difference between atypical and typical medication for the above diagnosis.
typical=better treating positive than negative symptom
s/e extrapyramidal symptoms,neuroleptic malignant syndrome,tardive dyskinesia
atypical=better at treating negative symptoms
=lower incidence of extrapyramidal symptom
5 comments:
schizo berlaku disebabkan excess dopamine in mesolimbic-mesocortical system.anti-psychotic drug act at D2-recepto(positive sym) and 5HT FOR negative symptoms.
SE of typical anti psychotic drug
-tardive dyskinesia
acute dystonia
0cculomotor crisis
akathisia
parkinsonism
can anyone just a little bit summarize about the clic osce ppsp did last sat... i just wan 2 know.. the scenario n example of chief complaintss that day...how long do we hav 2 ask Q?? how will the Q come out..is it in the form of chief complaint or we hav 2 ask the chief complaint ourself?? do we hav 2 summarized up?? tq 100x 4 ur kindness... :)
Actually answer for ques no. 1 is not accurate...
The accurate answer is Catalepsy
The definition is as below:-
Cataplexy: a transient attack of extreme generalized muscular weakness, often precipitated by an emotional state such as laughing, surprise, fear, or anger.
(This is one of the sleeping disorder usually a/w with narcolepsy)
Catalepsy: a morbid condition characterized by waxy rigidity of the limbs, lack of response to stimuli, mutism and inactivity; occurs with some psychoses, especially catatonic schizophrenia.
Waxy flexibility: psychomotor symptom of catatonic schizophrenia which leads to a decreased response to stimuli and a tendency to remain in an immobile posture.[1] For instance, if one were to move the arm of someone with waxy flexibility, they would keep their arm where you moved it until it was moved again, as if it were made from wax.
(Catalepsy is more to the fixed position of the patient while waxy flexibility is more to explaining how the patient allows others to move his limbs around and stay in that posture...)
Hope this info helps.. :)
Assalamualaikum..
still confuse.. can we diagnose him as catatonic subtype? dia pun ada hearing voices for 12 months long and disorganized behaviour kan? knp x diagnose him as paranoid subtype or disorganized subtype je? huhu~ boleh sesapa tlg ka?
Wassalam.
Subtype depends pada current complaint.. Sekarang chief complaint dia catatonic symptom.. So catatonic subtype la... Tp.. ak rasa kalo soalan exam takkan confusekan camni.. harap harap la..
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