Skip to main content


Showing posts with the label Psychiatry

Alcoholic liver disease

 INTRODUCTION  Chronic and excessive use of alcohol is one of the major causes of liver disease. 90% of daily heavy drinkers (>60 g alcohol/day) as well as binge drinkers have fatty liver but a smaller percentage (10-35%) of drinkers progress to alcoholic hepatitis which is a precursor for cirrhosis. The long-term risk is 9 times higher in patients with alcoholic hepatitis compared to those with fatty liver alone. Some population-based surveys have documented that men must drink 40 to 80 g of alcohol daily and women must drink 20 to 40 g daily for 10 to 12 years to achieve a significant risk of liver disease. Liver pathology consists of  3 major lesions  that are progressive and rarely exist in a pure form: 1) fatty liver (usually reverses quickly with abstinence), 2) alcoholic hepatitis and 3) cirrhosis. Prognosis of severe alcoholic liver disease (ALD) is bad. Mortality of patients with alcoholic hepatitis concurrent with cirrhosis id nearly 60% at 4 years. Alt

Delirium - definition, common causes, physical examination

Definition: Delirium is defined by the acute onset of fluctuating cognitive impairment and a disturbance of consciousness. Cognition includes memory, language, orientation, judgement, conducting interpersonal relationships, performing actions (praxis), and problem solving. Delirium is thus marked by short-term confusion and changes in cognition. There is also rapid improvement in most cases when the causative factor is identified and eliminated. Abnormalities of mood, perception, and behavior are common psychiatric symptoms. Tremor, asterixis, nystagmus, incoordination, and urinary incontinence are common neurological symptoms. Common causes of delirium: 1) Central nervous system disorder Seizure (postictal, nonconvulsive status, status) Migraine Head trauma, brain tumor, subarachnoid hemorrhage, subdural, epidural hematoma, abscess, intracerebral hemorrhage, cerebellar hemorrhage, nonhemorrhagic stroke, transient ischemia 2) Metabolic disor

Difference between factitious disorder and malingering

Persons with factitious disorder fake illness. They simulate, induce, or aggravate illness. They also often inflict painful and even life-threatening injury on themselves or those under their care. Unlike malingerers who have material goals, such as monetary gain or avoidance of duties, patients with factitious disorder bear the sufferings primarily to gain the emotional care and attention that comes with playing the role of the patient. The disorders have a compulsive quality, but the behaviors are considered voluntary in that they are deliberate and purposeful, even if they cannot be controlled.

Depression - cause, signs and symptoms

Depression is a mood disorder whereby mood is sad. About 30% of psychiatric cases deal with depression. Both males and females are affected but females are slightly more prone to be depressed. Cause: The biological cause is that there is a decrease in the serotonin neurotransmitter. Signs and symptoms: A simple mnemonic to remember is SIPS CAGE. 1) Sleep - There is late onset of sleep, intermittent awakening and early morning awakening i.e. around 2 hours before the normal waking up time. Rarely, the patient may over sleep. 2) Interest - Patient will have a decrease interest in the daily activities. This can result in social withdrawal, decreased ability to function in occupational and interpersonal areas. At times there is the inability to experience pleasure aka anhedonia . 3) Psychomotor activity - In younger patients, there is slowness in the thinking process and activities also are carried out at a slow pace. In elderly on the other hand, there is restlessness and inc