40yr old female with psychosis


A 40 yr old female was brought to the General medicine OPD by her husband with chief complaints of abnormal behavior since one week.

patient was admitted on 27/12/22

History of Presenting Illness
Patient was asymptomatic 2 weeks ago she then suddenly starting exhibiting abnormal behavior. She was shouting and was saying that she heard voices talking bad about her. 1 Male and and 2 female voices were heard. She also said that her husband was talking bad about her character. She was saying that her husband was spreading information that she didn’t tell him.
These small episodes occurred randomly throughout the day and had no pattern or any triggering factors. Patient was not able to do her normal work during such episodes. She was not aware of her abnormal behaviour.











                                                

Follow Up

3/1/23 -
Patient did not have any psychotic episodes. She ate well and also had  no sleep disturbances. Patient complaint of dizziness.

Past history 
No similar complaints in the past 
Not a known case of diabetes mellitus , hypertension, bronchial asthma, tuberculosis, epilepsy.
No previous surgical history 
No previous blood transfusion 

Personal history 
Mixed diet 
Normal appetite 
Inadequate sleep 
Normal bowel and micturiton 
No addictions 

Family history 
No similar complaints in family 
Insignifiant family history 

Drug history 
No drug history 

Allergies 
No known drug or food allergies 

General examination 
Patient was concious, coherent, and cooperative. She was lethargic and ortie ted to time, place and person.
No pallor
No icterus 
No cyanosis
No clubbing of fingers 
No generalised lymphadenopathy 

Vitals
Temperature - 98.7F
Pulse rate- 74beats/min
Respiratory rate - 14breaths/min
Blood pressure-120/90 mm of Hg
Oxygen saturation-98%

Systemic Examination 
Cardiovascular 
S1 and S2 sounds heard 
No thrills or murmurs 

Respiratory 
No wheezing or dyspnoea
Position of trachea- Central
Breaths sounds - vesicular 

Abdomen 
Shape- scaphoid 
No tenderness
No visible or palpable mass
No organomegaly 

CNS
Concious 
Speech normal 
No neck stiffness 
Reflexes present 
Finger nose test coordinated 
Knee heel test coordinated 

Investigations 
28/12/22








29/12/22










30/12/22                                                                                                                                        


31/12/22









Treatment                                                                                                                                                  
1. Tablet risperidone
2. tablet haloperidol
3. tablet lorazepam
4. syrup ascoril

Diagnosis-
Acute transient psychotic disorder 




























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