Module Quiz Week 10: Case Study Psychosis    
They are putting poison in my water supply and my phone istapped.
MG is a 23 year old male who is brought to your emergencydepartment by the police.  He was foundwandering around outside, naked, in below freezing temperatures.  He explains that he needs to find the man whostole all of his money and then asks you repeatedly to turn off the radio (itsnot on) and shut the voices up.  Itappears that he has not eaten or bathed in several days. 

Current Meds:
None reported

Past Medications:
None reported

Past PsychHistory:
None reported
Past MedicalHistory:
None reported
No known current Primary Care Provider
Family Medical andPsych History
Father: Schizophrenia stabilized on clozapine
Mother: Cancer and DM
Siblings: none
Social History:
Smokes PPD.  Workedat Jiffy Lube, but has not shown up for work in the past week, and has sincebeen fired.
Mental Status Exam
Appearance: unkempt, hasnt showered in days.  Appears extremely nervous and fearful, attimes gets agitated at internal stimuli. 
Eye Contact: poor. Eyes are shifty and darting.
Affect:  Blunted
Speech and language: illogical and disorganized
Thought Content:  Paranoidand delusional.  (+) visual/auditoryhallucinations.  Visual hallucinationsconsist of shadowy figures.  Auditoryhallucinations consistent of a running commentary between 2 voices that arecritiquing all of MGs words and actions. There is a 3rd voice that is warning MG about the poison inhis water supply and that people are out to get him.  (-) suicidal ideation or homicidal ideation.
Abstract reasoning: Poor to non-existent
Orientation: not oriented to place or time
Judgment:  very poorinsight
Given all of theinformation you know about the treatment of psychosis, please provide atreatment recommendation for MG.  There may be more than one correct answerfor the questions below, as long as the justification provided is correct,rational, and sound. Cite your sources.

Is there anything else you would like to know about this client?


What is your primary diagnosis according to DSM V criteria?


Will you treat this patient on an in-patient or out-patient basis and why?

4.     Whichspecific medication would be best to initiate in MG?   Please list one.
5.     Whydid you select the above option over all of the other available first lineoptions?  Please list two reasons. 
6.     Whatis your initiation dosing regimen, titration plan, and your goal dose of themedication selected for MG?  Be veryspecific here. 
7.     Arethere any labs to be ordered prior to starting the selected medication?
8.     Arethere any labs to be ordered to monitor this medication? (levels or adverseeffects)
9.     Whatshould you tell MG regarding the timing of onset of effect?  (ex. how long until effect may be seen?)
10.  Howshould therapeutic response be evaluated?
11.  Whichpotential side effects should be monitored in MG?
12.  Whatare 2 common and 1 severe side effects associated with the selected medicationthat MG should be educated about?    
Dont forget to cite your sources using APA format. 

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