This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Psychiatry
[{'content': 'A 20 year old boy c/o hearing of voices, aggressive behavior for 2 days. He has a fever for 2 days. When asked to his family, they say that he has been muttering to self and gesticulating. There is no h/o of psychiatric illness. Likely diagnosis is- \nSelect and explain. \nA. Dementia, B. Acute psychosis, C. Delirium, D. Delusional disorder', 'role': 'user'}, {'content': 'Answer: B \nExplanation: This boy is having:-\n\nHallucination (hearing of voices)\nAggressive behavior\nAltered behavior (muttering to self and gesticulation)\nSymptoms for 2 days\n\n\nSo, the patient is having psychotic symptoms for 2 days (less than one month) → Diagnosis is an acute and transient psychotic disorder (brief psychotic disorder).\nHowever, there is one problem in diagnosing acute & transient psychotic disorder → This patient is having a fever. So, we can not exclude organic cause (e.g. CNS infection) as a cause of psychotic symptoms.\nWhile the diagnostic criteria for acute & transient psychotic disorder state that there should be the absence of organic cause.\nSo, the diagnosis of the acute & transient psychotic disorder cannot be made without addressing the organic basis of the disease.\nActually, the best answer here would have been organic psychosis, which is not provided in the options.\n\n\nAmongst the given options, Acute psychosis is the best answer because of two reasons:-\n\nOther three options can be excluded easily.\nSymptoms and duration of symptoms are meeting the criteria for acute & transient psychosis (except for the Presence of fever)\n\nAbout other options \n\nThe major symptoms in dementia are memory impairment and impairment of intellectual functions.\nFor Diagnosis of delirium, symptoms should be present in each one of the following areas:-\n\n\nImpairment of consciousness & attention.\nGlobal disturbance of cognition and perceptual disturbances.\nPsychomotor disturbances.\nDisturbance of sleep-wake cycle\nEmotional disturbances\n\nFor Delusional disorder, symptoms should be there for more than 3 months.', 'role': 'assistant'}]