Trieu ctlthng ndo sau dfry thuQc ,6i logn tw duy: S-rZ'.. Ptttit bi€u ndo sau tIiry phit hqp vti cftm xrtc ciln Q?th,Ui" f*ilinoi, nQi dung kh6ng phong phu c Ao tucmg Y i;A >ttar, "i..
Trang 1TN'J'.-TiIO DIl Y D^UQC CAN THO
iil;,.i v:- eQ iraox'rAu rHAN
N.av thi:10/6/2014'
rn \,
v/
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'
-)ro,"
,-, ^ Bi ttri mdn: !T Tim Thin 't'r-'-'^$J- LAn thi: 1 DOi tugng: Y K25
': -+hbi gian lirm bai: B phtt/ I tr?m' DA: 100
MA DE: ': ?!'-/
,\'1 Trieu ctlthng ndo sau dfry thuQc ,6i logn tw duy: S-r(Z' Wl.Yti,bflh qu:: hiit stg vipc dd xiv ra vd thay
"i 1.a* u't '(u
ou' 6*! "'*vv
';;"fXl::['r'iri;f,';:;if,:;;:l;:r':r::t nstdi b) Tucrng nham
Y.;;;;;'uo rou ddv tluqc sft dvng ai *nAmi'thirc: @niu chuvQn
b) Hdi f .tuang hoang tu&ng, em anh ,t-agg BQnh nhftn trong trgng thtii,trdm cdm vdi ! tu'ottg A,HAi .,,4 *,,no ouanh t,{,ty, clro yin.l phdm chdt xdu, nhi'r'r kltuv€t
' ddy ld triQu chirng gi:
X; ttoi vA ao giac
^3 Ptttit bi€u ndo sau tIiry phit hqp vti cftm xrtc ciln Q?th,Ui"
f*ilinoi, nQi dung kh6ng phong phu c) Ao tucmg
Y) i;A >ttar, "i icictritrictr x,.jng quanh d) Hoang tuctng
c) Hnnh vi di tsi iui nhiAu t tf; B€ni
ry:A" vdi, bi6u hiQn kdm tri nhd vd nh$n
,r) Hrmg ph6n, vui vd hsn binh thucm g , -th1t1' to.:f :ifS 9', nghbo,ndn vA crt'm gidc' nhitt
4, Hitnlz vi xufrt ltign dQt ngQt kttbng c6 stg it6u tranh cdch c6 lrtc biin aai- ta bidu hiprt cfia r6i lottn gi:
b€n trong ad *im'cltd lgi, n6 xdv io ua id' vO nghia l) ItAT tT":}tl v*
vd mdnlt iitt, ci xu hwong gAv isi ddn b&e'' tk6n hav Olli,t-tl't311'$i',
ntbi trwdng xung quanh,"nhi n iripu ch*ng gi? QTam thin phdn liQt
).
flb;j ;;;;i"-,.e oO'e @c[am ph6t trien tlm thin
(B fianl vi xurrg d'ng, kich dQng -|L'-T'ong md ICD'10 v6i ki hiQu Fab't, clt'7n pl:'at
Y,i*?irig?i3?i*sia; 'Jf'{{!tr;,in,so.*an,k1^nh (s* {d\
5 Tripu clt*ng nd'o satt ddy tituQc ItQi chrirng I u
ie ihe !e$ 't.[*'* l'[*u'
ts Korsakoff: @,o 1? 1",1!'*"
b) Ting nho Larls
n.di phil bi6u niro sau day KFhNG yhit hzp klzi nai
':?"1""F
ric,tinh do thuic antlfia kinh:
g vit;"d aavitril"tir}, =-A^,n ., 4, ,_^: a) LamOt cdp cuu noikhoa
a TriQu cltftng ndo sau dAy KIIANG thupc hQi Ul p1C" hiei1t{ ddi thAn kintr co' t[ng men
CPK-"",tri,nili^'ga*, c) DiQu tr! chu yeu 1?r nAng dd
ffi\ ciam tii nhs YZ' fn'o nghia g6c cila th.uQt.ngir Hi' lgp trottg
-t-ir
t?Yl1Tll:'^i"^: u, ,{^1 schizophreiia,';phrenia" (optiv, Qpsv) cd nghin [i:
Allil|;*
\4 -: ,
c) Kol loa.n
d) Phdn IY
./
9 c\,,, uc ' c[';r, "2"tL
Trang 2tte: lUu
ls ram thin phdn IiQt khin.phdt wj+q"mdi ndo: W.*ot loq'n d4ng phan ller :q." Tl h4A uts:
a)25 "'";'.d
b) 35 'n6' *A t$,f ":,?5 70 iii"ii"t, iao cia tdm thin phdn
b) 35 'n6' n d t# ra - 53 io ini bQnh iito crta fim ftdn phdn li€j cd citc
@_0.t Tr \ l rlan1 'sfi''j f€.r trd
Toong tuhttg vd do gidc rd rQt, hdnh vi v6 tit cltric: vd l'olt
^n,
biEu nito sau itfty KHilNI.phiyhrp fhi ndi \!':it^!::*::::iwsc, vlt kh6'i bQnh muQn hott'
,i nWrcrynaoiJt ,,iT.s.tdm thin phdn^ tiQt: ,a) ThA thanh xuln
'tr '" a) Th€ tram cd.m sau phin liQt ,.'-''-' qll]? 1=Ti:-1^ l" ,lot, i,4.Q+
:iffll{*trfrTixf:;,1;,Sxu6n ffiili?iiltlijft^"'.'-'{"f", fi nai logn ndo vdi tinh ch'dt c'fia'cdc hoang Jk;1.#7""''tw6'ng
@-o:.h5s-sau phdn liet'
ir;;;";oi;r'i;;aia npi dung kh6ng kr qu-di tro!_s
, 75 Logi hoang'twhng hav gdo nhdt trong tftm thfrn
r,,t *fi",i;i;;;-t
twons nw s*Pry uur&6 1r"" "'a'- ',!;#r;J;:r;#rc!I.f,iuiulf,,,Y;X'i;;,'f;',iii,
E; i-ienlQ , rd"rpt'ho(c idng inmrg iqtc ciing nhw crlc tri(tt
cl lic!_nnoi cttirns amfinh
-d)Tgcao i+cc''it''t;a-rrPL :- ;ffi;iffi;"iran'et
1'6 Phtit u,i
"a') '"'iu, phil hsp khi ndi vi ao BfiH;Hf.lilt;Lti
40
'!J'{!ifJu;ui dusc benh nhan.nghy thay tu m6i rrucrng "dfrat loan tim tlqtt t+ :
b€n ngoiri co thA cua bQnh nhan 1; [""-(+''at t llR-t-:t:?i.tT thAn thuc the
b) Tiene noi nay rafro rang md bgnh nrrar, .b tha phan zlz, n r n6i vi ltguyun'tilc diiu tr! tdm thin phin ftat'
biQt dusc d6 Ia giqng din 6ng hay din bir'"' ) ngchpn-'!" Y.ONG phil hgp: !
,oc) Ao thanh that c6 d giai ao* gioo cua tim ,i,an'- rj'frruv th'oc ptrii xac-ai*r vi di€u tri cic trit:'t
"Biiu1*iJ**t**rei;.;ir
do iro gi6c vir
$,}3;jit"ng
c6c thu6c khac so v6i nhrng rin iie;
17 Phdt Uiei nAo sau ttdy td pttit hgp khi ndi vt
^L nguy,Ennnan'r'io-rinqtr,iorls,ti,'qt'^.urt i,*-
mOtthu6cli4dan6tuin'
a) R6i rop c,m xirc co yeuto rganthL e4?^q tdi ;i;G" ;i1a a*ng phr; cua thu6c ch6ng loan tb2 b) R6i loan ;5-d6ng do su dUrffiffic tfiuE.rnhcim bing trihexyphenidvl'
benzodiazepin 'u
tn*l :"0' 'u'u" n*rr.-Khi oti ,i ti'ua, ch6ng loq'n thftn thi hg c*' c) R6i lo.an hirnh vi cuongchO trong 6m anh sg' -
'
t'u 'l'gn cfru phit ht' p: t*-^ dofa4r'r'r"'
(Elrcac t.n thuong thgc th nao nhiiu nio, viam nio ^ gil;il Jo ta a*g a6i van s'er\ine - dopamir''*
y cni cdn I tri(u ctu*ng tnia,c tiau_cfujy I aa ffira au"g tr.n cac trieu chtmg driong tinh cua'ogn-h cttdn dorttt t6m tttdn pttdn^Ugiiiro DSM-IV n,u , Y"t thin phdn liQt
I
cltgn triQu cltdrng ndo KHING pltit hqp: c) it tic dung tren trieu chtmg im tinh
a) Hoang tu6mg c.6 nOi dung ki.quai' d]19:I tf dilnc phr; ngoqi th6p
b) Ao thanh ralieng n6i binir oohli'i,u,, qrc vi hdnh vi zt xni ndi vi ;t;i;
'itaig losn thdn
c'5 di\n' choi't
, L.-L -LA6
'Dcdupltit hgn: , i a t - rL.' *ul
6i:*H*1t
'o'de
dsa, gi6t.hav gav hai ue"r'*al, t-i::,":;ltr::' vin chu vAu tran ciic thu ih€
X eo thanh edm 2 hay nhi€u ft,it'z gtn-g n6i tro ifuq$lt f,401"***)
"
^.,.-
\ ;:td;;'irirln, hsp duqc chdn docin Id tdm.thdn iinh
pttdn ti(t theo ICD - I0 ntrnns ,;-,i.U Siian b!.rdi ff*-.tnu6t dai diQn; oianzapin' risperi'Jcn
,'*Ml,Tt'{,;:f;hdng sd itusc chdn
d$tfil!;*a*tdc dung ngoqithap nhibu hun
a) ROi loan tAm thAn cdP
Trang 3?- Ei,: ltltl
25, Thu6c ch6ng logn tltdn sau it6y ituqc chi.dinh bidu hiQn thu rit,.-xa l6nh' vQ sinh th6n thi kdm'
iriiu tr! cho cd,c ie'ni nnan tam *dn pii'n- uryl*nang ;;;"s- A!:JaY yielr" Chdn dodn tric ndv m *e si
tr!, nhrns bft"':;';"";'"i"i iia d gay iiary tqch cfia tfr.m thfrn phdn IiQt?
-[- , -r
'rt*rts t'tt rt n ut:
z:"-et" b) Th€ cang trucrng lgc
:-raDUlozaplne
\K ni.".riaon @ vdt ritq di.chung
rne trAm cirm sau Phdn ligt
_,sau 5 ndm bpntt
?r:y;f;;f#'ftoono orrit hqp voi ti6n rwqng xiiu nhr,n td tsi tdi *ndTn',a-i; ;;d, wn tinh.tiqne,
it' d b€nh nhdnffi;;;dtiia, ier, ryie's t:.',ni: cftn.g nhai nhw tttd kh6ng kiam ctft
: ff,[ff,':;;;;;{n .*df r aisi chdn dodn th€m ndo Id phit h.op d th6'i di6m
$Co tiAn su gla dinh lo4n thin 1 ,ndY?
c) Kh6ng c6 yeu *,i"a" iqi '' @ R6i lo4n vin dQng musn
d) Bat thrro'g ul i* * nao 5 UOi chrmg Parkinsondo thu6c
zl in-iffie ;;; ;iils;rsc c) Loan trucrnq ru9
9o.caq , MOt benh ** ,Llilrai, prral bqnh kholng horr.l al HQi chtmg dctinh do thu.c
thang nay voi ;il
"gt , ngt, ti6ng-noi trong:tai xui SZ' knAi nifm "dimg nhiiu rugu.Igp !t' Iftn lgi
'lLa gisc, bdt benh nhnnti ru duong,';; dil;rui ttai' ngiry din nai gay fic hgi tdn thd chit' tinh thfrtt"' BQnh nhnn cim thAy c6 ai do ludn theo d6i minh; gpild:- T{53
bQnh nhdn f.frOng .ftir lim vigc nhu trudc, c6 nhimg a) Nhi6m dQc rugu
1ic lim nhim i-,qt '*inh,
dinh nguoi than v6 cd' AP:lg l?p ruqu
Tham kh6rn khac khdng phdt hien benh 19 noi ngo4i ql9 thuQc rugu
khoaquantrong,kh6ngti€nsusfrdpngchttmaniy'd)Lamoungrugu
I; TiruOc chong trim cirm *R;:? ::: l:?
fi}l?TiF"tgH;Y^ys4r{c Ii* :oy ,!u6., r'a rynq-:!^:t:j thuvEn,hda rrou, ,,ru e1161 ttito
) , :do sau itfty;uIY;r;;{; i#.',ri iiie aai cho rdi sau itfrv rythNc iluqc chuv*n hda sd gdv ra hiprt,
f) rcqn nsy:
tr trwung uur' u'Ee L" "wt'6 fuwg-buin non, non 6i, nhthc cldu, nrtng ltttt c6 tha
"
Gt Haroperidol q dy ia"g, &o gidrc vd caii cimg gfty ch6.t do do Iifi ha
Ir ru &zusperidone hftt:'
T) oranzapine @+':l:i*l* b) Acettc acto rt
d) Chlorpromazine
)ls Ti'ioN-c- iiqp LAM sriNc sau z ngdy diiu- c) Aldehvde dehvdrogenase
tri, dQt nnrci Wh- nhfrn.cuttg hitm, trgn *i7' y^o '.6 llAl::1"\dehvdrogenase
vd cltdy nw6c cldi Tltudc oao tt,ict iW Ai diiu tri 3'5, Ndit'i sry phdn chia theo nhintg r,i logn fiAn ,Aitog" mi phdt ndy: lr{ quan yn a'1y1t' chqn c.fru drtng:
,
a) piracetam " u; Nitqlg toito+n su dgng rugu gom: lam dgng ruo-ti
{d ;#.i]ri -hn\'tx., ['p l'-"'*[ (u)*t*g r6i loan gay ra do rusu gdm: nhiem'ruo-Lt r a
Yl ci*g.biioba "' ' -' -i'r
.t_ s _ _r c,ai ruou n: cai ruou i,a i3
30 TRUN;^rq, tApf SiryC Do tdc rtsng phtl S\O*t r6i ioan su dirng ruou gdr
,a ,il-riiyiriiii,ri, bQnh nhdn u6ng thu6c kh6ng, thuQc rueu
diu, ty jt b6 trtu6c, Trong trtdi gian nnia1s + nam id d) Nhrnig r6i 1o4n gay ra do rusu g6m: 1€ thuoc ruo-r-'
;i;,;{ri, nttd.n tdi pttdt b(nit nhiiu tiii, aan ain vd nhi6m ddc rusu dac uttg
Trang 4Tr4rn:4 Eb: 108
36 Di AE hon trong viQc ddnh gid nhitng rdi togn sir d) Lo?n khi s6c chu ki
ctvng rwou, tac gii niing^(l9ia1 lwa ra chwvidt tit 42 Ti tp luu hdnh cfia trilm crtm chil ydu 0 ngu'iti c.eEt, insn j, ighia xn-hNc p.hil hqp: trwdng thdnh Id:
a) c6 fuo'gid anh (chi) carn !b"v miott nOn oit giirm
R?; t?'1:,
fl-f4
(but downfviQc u6ng rus,r ctrult q i9 '!2v: '
fl C6 bao gid an[ (chi) cim thAv pi phiin ha ! ts - zox
(Annoyed) boi mQt ai vi chi trich viQc udng nrEr cua q>24%
bnn chua?
ra co bao sio anh (chi) cam th6y tg cao (Grandiose) trdm cdm chrtyau:
"c ) vspLl\
d) C6 bao g'iA th (chi) u6ng rusu vdo bu6i sang simr 9:i ll chung,.nam = nt T
Z4
(iv op.nrt) chua? @luoi thi€u ni€n, nam < nt
;;
; :i*i:';,!l"i!,ifil !! f iTi {; ::;;: ;#;!,1;ffi ffi ,:
iy ^" u,,, r, i,,, d u 6 r ri c
ildm b6a chfrc ndng sinh tin, cdn bii sung vitamin, nh6m nh6n cdclt trong co ch| bQnh sinh, clipn plzrit dpc bipt Id vitamin ind* ndo sau ddy: r.i{ A6-yl!t" lryt ^ -,i,*j.c ;^d#*n ,
\X; u/ \- c) Nhdn cdch 6m,anh > nh&n cdch ranh gioi
|s| luat vd cdc giai dogn cai rugu, giai ilogn *do^n,,i7 Rii logn gi6c ngrt diin hinh trong trdm cdm chti q16)thwdng tdt eii1Sfrl -co silt: 'yo'("-t!i*np lieu hipn:
;) ; lf gi" NLi vL- tLau,r 4(ii D Kl6ng duy tri dusc giAc ngu
6i;rz - zi g\d ^ , , &l'i4, "gY lan t6a.
Vl;; -1fii, nri ,ulnt Jrr c',ri r tl-u @4ingu cudi dern
39 Ktti ndi vi c,ic chin dodn phdn bit.lt voi sgng tlo V ne"i nhdn vdi biiu ttign cdng thdng nbi tfrn, cai rwqu d nh6m bQ-nh c6 td"g h;;;;iirg ttriin"ktot ltil n.ip, itdnh tring ngtrc,.iych nianh, cdn cdo h;to
^ , ^ thwc v1t vd thay dii trgng thtii tdm thin, chpn cdu tir, , p6y li tri(u chtittg gi crta ffftm cdrn:
r' 0+ "xiOie'ini nw, g.lv{it sinh iuc,-,_,
d";#['#*u' GDtq* f'-7)
5 lteO dqc thudc klt6ng cholinergic l) ROi loan hoat dQng co th€
c) Su dgng c6c thu6c nf,u amph.Lmine, cocain d) MAt hrmg thri
d)Tangrroatao.rqt"yC"giap 47 DA chin tlodn trdm cdm (theo DSM-IV), Isanlt
40 Trong cdc r6i logn khi sdc, r6i logn,dqc trwny nhdn phdi itdp ftng it nhdt'| trong 2 triQu ch*ng
^ n nhirni giai itogn trffi ca^-Ati hinh, dwqc ch6'n,.oul
Si sic trdm vir giAm sp rp trong
{ a'r docin Id: 4x:6) V tuong buQc tQi va nhin tucrng lai bi quan
fry-;i'ioun lu6'g csc I @yt rc tri*vi mAt,moi quan tdm thich thir
H,pA; lnen luemg cuc Z T) Y tucmg.tg s{tvi mAt.sinh lgc
ffiil'" ;';;;r" - f trl:-!' !! 'if' f:(' 'shie.' ,'.!:dt,*n,tnv ftheo
DSt't-di Loqn khi sic V-TR), chn thdi gian tii thiAu bao lftu:
4tr Trong cdc rii togn khf sdc,,,6i loqh dqc trwng a)01 thang
bhi milt ltay nhiiu g:ioi dogt,t trdm cd'm,l' khbng tnQt R 9! tl:"g
-, ^n giai itogn hwng cdm, lu.rng cdm nhg ho(c hin hap, $) IZ thang
nN Vno, citin dodn !d: d)24 th6ng
a) Roi lo4n lucmg cr,rc 1
b) ROi loqn lu&ng cuc 2
6),Tram cAm chu y6u
\/
Trang 5nnA od: ,iLy(i Dii: 1oo
4e Pttcit biiu ndo sau itdv xn.fuxe pnt'-!{l:16:1i.au @.or':::0.:l
cttudn chdn itotin Ig thuQc,chAt (the; DSil-tVrry1t Ti' Xni lqtJns.amphetamin.sau mQt thdi gim sir a) Giirm hen hiQu quA n6u
"t',i ,o d\r;g mqt luqng d,ng,seti7.:uitp",innyiiuvim$tfrmthi'nndo:
tusng tg sau *Ot titOi gian diing' , r , r a) Hrmg cim'
b) St dqng cirng ch6t hoac chit tuong t'u de trdnh 51Tta'* tt;' Tr 0)
hoac lirm gilm hOi chimg cai' -: ; - , YLo4n than'
^
rt fic) MAt nhigu tl,oi gi*.tt:ong hoqt dQng 9\ th'i6t dA co d) Roi 1o4n nhan cdch'
duqcchat,rr] j;d;atdoioacph dikhoic6ct6c s6 sft d4ng methadon trong itiiu tri cni ngliQn dgngphgcuachAt.'; !!,nhdmchdtmufiyndosaudfry:
dfi genh nrran ,,i|eu lirc phiri ngung chAt vi mic cAc @ S: thu6c phiqn'
va",'a* ly, sric khoe xiy ra do su dung chat (xio x5o b]
lg ampnelamrn.
gir dil,;t'a* cim hay tlet aa div,';)' -,-A,.^ c) Cin sa'
5i, Trong nhirng chdt sau dfry, chfu ndo KHONG cd <i) Cocain'
nguin g6c tir tltikc Pttign:
rj:::::
r',uuc Pr"er"
X'Jfrfr" f,ffi '.chsn
cfttt KHaNG phil hsp:
' b) Heroln
d$H:iil" ,? -i ^ ,,.i,.,:'@\ulio,*ol6ltri6ntutt'
s j Khi n6i vi cdc bi6u lti(n tttay ddi *an co.thd eirt Y) c6 bang-chrmg ch3
PAv r6i loan do h4u quir truc sir dgng moiph,in tr6n ng*di iA qurn thh6c, chgn ti6p cua *0t lAt co th
cfru KH1NG pltit ttgp: '
Ltuer' "wvv' v'qv"
, sa ri E sa srtt tdmthiin 0 ngwdiffan 85 tuitt lir:
a) Khoan w,o[i aE ciriu tim dim .* ,f I a) 10% +r-ttt
r ( ]( g
c)Nhip tho chim, nhiqt d9 gidm nhg c) 30% {tr , o/L .
@Ut iieu chay, san xuAt ACTH tang'
iz xt i nai r'i'iiiu tri-nso io, iiit" cdpi chpn cdu
1)n:1f silt tdm thiin KEloNG-do cric ttsuy€tz nirlitr
*''qiflfiffiEft**.f
:t*#r
.j aiai ddc bing nuio*on duong tinh m4ch @ Hunetilt:l
d-) Ddm bao th6ng khi cho bqnh nhdn b) creutzfeldt-Jakob
S'3 Chdt rldn tiuyin thdn kinh ndo sau dfty li€n @Ahheimer.
quan trryc tidp ddn "vbng trbn khen thwhng": $ parkinson
q a; ecetycttotin
60 Khi ndi vA tilu chutn 42 crta ti€u chudn chiin
?ooi*t" dodn sa srt fm thin Iogi Alzheimer (DSM-IV'TR1,
:ii'i:j:il:tt" , ,.- chen tripu ch*n!"phil hqp:
"\'r'\0\
54 Chdt ,rf,o"roo dav Kn1lrc eav hrii, chimg cai qffi?:l::ftt At
)
tLL uu r'6ILL'tL'
.i l,lA, uin aoig () /,,
b) Heroin d) Rdi lo4n chuc ndng thi henh' .J
c) Cannabis a LAi wLj^'{nl
P
I ram: ]