PhysQuiz: A Focus on Tardive dyskinesia

1. According to an interview with Jonathan Meyer, MD, Clinical Professor of Psychiatry at UCSD, risk factors for developing tardive dyskinesia do NOT include which of the following?*
- a) Age older than 65
- b) Exposure to anti-epileptics.
- c) History of extrapyramidal symptoms during antipsychotic treatment.
- d) Exposure to antipsychotics.
2. Which of the following describes oral-buccal-lingual dyskinesia, according to an interview with Joseph McEvoy, MD, Professor Emeritus of Psychiatry and Behavioral Sciences, at Duke University School of Medicine?*
- a) Irregular facial movements (grimacing).
- b) Increased eye blinking.
- c) Blepharospasm.
- d) Repetitive, chewing movement of the mouth and/or jaw, often with tongue protrusion and lip pursing or smacking.
3. In discussing the American Psychiatric Association’s new recommendations on the treatment of schizophrenia, released in May 2021, take into account more recent data on antipsychotics, which of the following does Jonathan Meyer, MD, NOT say in regard to screening for tardive dyskinesia in high-risk patients?*
- a) Informal assessments could be based on a quick visual observation of the head/face and lower extremities.
- b) Informal assessments could be based on simple descriptors of severity (“none,” “some,” or “a lot”).
- c) Ideally, patients should be assessed prior to initiating or modifying an antipsychotic treatment to establish baseline “normal” movements and then screened regularly during treatment for any changes.
- d) Tardive dyskinesia assessments can be incorporated into routine protocols that are already in place in many clinical practices, which are used to monitor other antipsychotic-associated adverse events.
4. Which of the following does Chirag Shah, PharmD, RPh, NOT say in regard to why tardive dyskinesia (TD) is often underdiagnosed or misdiagnosed?*
- a) There are lot of drug-induced movement disorders that can be confused with TD, such as parkinsonism.
- b) Spontaneous dyskinesias are indistinguishable from TD and are found more commonly in older and/or edentulous patients.
- c) There is no truly effective way to treat TD.
- d) Since there is no “test” for TD, diagnosis depends on patient history and accurately identifying the types of abnormal movements that the patient is exhibiting; this can be especially challenging in patients who have more than one drug-induced movement disorders, which is not uncommon, and in virtual settings in which clinicians cannot observe the patient’s entire body or are hampered by poor video/camera quality.
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PhysQuiz: A Focus on Tardive dyskinesia

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