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Question 1

If there is a hemidisection of the spinal cord (most likely from penterating injury) - you get Brown Sequard syndrome. Explain the symptoms

Answer 1

Ipsilateral - already crossed at medulla

Loss of proprioception and fine touch - dorsal
Loss of motor - corticospinal

Contralateral - crosses at spinal level

contralateral loss of pain and temperature - spinothalamic

Question 2

What medication can help women with hot flushes if they are reluctant to go on HRT?

Answer 2

FLUshes = FLUoxteine

Question 3

What are the 3 major symptoms of depression?

Answer 3

MEE

2 weeks of depressed Mood
reduced Energy
loss of interest/Enjoyment

Question 4

Go over the headings that must be hit when taking a psych history

Answer 4

PC - in patients own words

Question 5

What questions are important to ask in a depression history/when screening for depression?

Answer 5

SOCRATES IT

S -
O - when did it start, any triggers
C - any voices in head? any periods of extreme joy in past?
R -
A - fatigue? lack of enjoyment? loss of appetite? poor sleep? poor concentration?
T - any time when it isn’t as bad/gets worse?
E - any thing that makes it better or worse and how have you been managing it so far?
S - if you have had something this before, how does it compare

how is it affecting your day to day life and interactions with others

SUICIDE RISK
- important we ask this question and everything confidental - sometimes when people feel this way they have thoughts about ending their life - you ever felt this way?

Rest as normal

Social
- ask about gambling/finances/debt
- drug and alcohol abuse
- social support network

Question 6

How regularly do those who take lithium have their levels checked?

Name some of the common side effects of lithium

Answer 6

Weekly after a dose change until levels are in range

3 monthly after that

N+V, diarrhoea
tremor
Hyperparathyroidism -> hypercalceamia