Question

Upon making rounds at the end of your shift on a busy medical-surgical unit, Sam Gregory is lying in bed and does not acknowledge your presence when you enter his room. He does not respond to your verbal questioning, has a flat affect, and mumbles back your words to him. Sam was fine earlier in the shift, and this is a sudden change. When his arm is lifted, it remains elevated. What is the most likely diagnosis for Sam's condition?

1) Catatonia
2) Delirium
3) Depression
4) Anxiety

Answer 1

The symptoms described suggest that Sam Gregory is most likely experiencing catatonia, a condition characterized by motor immobility and behavioral abnormality.

Step-by-step explanation:

The most likely diagnosis for Sam's condition, considering his lack of response, flat affect, parrot-like mumbling, and his arm remaining elevated when lifted, is catatonia. Catatonia is associated with a variety of psychiatric and medical conditions and is characterized by motor immobility, behavioral abnormality, and mimicking of speech (echolalia) or movements (echopraxia).

Given the acute onset of symptoms, a medical evaluation is imperative to rule out any neurological events, such as stroke, infections, or metabolic disturbances, which can sometimes present with catatonic features. Early identification and treatment of the underlying cause are crucial for a better prognosis.