ACT Psych Flashcards

1
Q

What are the basic conditions for detainment under the mental health act

A

Must be suffering from a mental disorder
Must be a risk to self/others
Must be unwilling to go to hospital voluntarily
All alternatives have been considered
Cannot be detained willingly if lack capacity

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2
Q

Describe Section 2 of the Mental Health act

A

ADMISSION FOR ASSESSMENT
Needs an AMHP and 2 Doctors (1 approved)
Up to 28 days, no renewal
Appeal within first 14 days

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3
Q

Describe Section 3 of the Mental Health act

A

ADMISSION FOR TREATMENT
Needs an AMHP and 2 Doctors (1 approved)
Up to 6 months, renewal available
Can be appealed twice in first 6 months and then yearly
For treatment of mental disorder, cause of disorder or consequence
NO OTHER TREATMENT

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4
Q

Describe Section 4 of the Mental Health act

A
URGENT ADMISSION
For urgent admission and unable to complete Section 2
Needs an AMHP and any registered doctor
Up to 72 hours
Convert to Section 2
No treating powers
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5
Q

Describe Section 5 (2) of the Mental Health act

A
DOCTOR’S HOLDING POWER
In-patients only - must be admitted to bed
Holding power for MHA assessment
Lasts up to 72 hours
No right to treat
Application by consultant or deputy
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6
Q

Describe Section 5 (4) of the Mental Health act

A

NURSE’S HOLDING POWER
In-patients only - must be admitted to bed
Holding power for MHA assessment
Lasts up to 6 hours

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7
Q

Describe Section 135 of the Mental Health act

A

SEARCH WARRANT
Warrant to search and remove patient from property
Police only

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8
Q

Describe Section 136 of the Mental Health act

A

PUBLIC SAFETY
If found in public place - take to a place of safety
Police only
Lasts 72 hours

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9
Q

Structure of a depression history

A
Low mood – Anhedonia – Low energy 
Concentration? Sex drive? Sleep? Appetite?
Explore Biopsychosocial causes
Assess RISK
PPHx, PMHx, DHx, FHx, SHx
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10
Q

Structure of suicide risk assessment

A

Do you ever feel hopeless?
Do you feel like life isn’t worth living?
Have you ever thought about ending your life?
- Have you made plans?
- Protective factors?
Have you thought about harming others?

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11
Q

Structure of Self harm history

A

Sequence of events: Before – During – After
Previous attempts - Asses RISK
PPHx, PMHx, DHx, FHx, SHx

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12
Q

Management of Suicide or Parasucide

A

Full history and examination
Medically treat poisoning or injuries - TOXBASE
Discuss confidentiality - ?speak to family/friends
Must have Psychiatric needs and risk assessment
Section 5 (2) can be used to detain if necessary
If discharging:
- Provide crisis team contact details
- Utilise protective factors eg. Family
- Arrange follow up

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13
Q

Describe Dementia, it subtypes and their aetiology

A

A progressive, degenerative disease of the brain resulting in difficulty with communication, memory and learning

Alzheimers - sporadic, genetic
Vascular - 15% Cardiovascular risk factors
Lewybody - 15% linked to Parkinsonism

5% Rare: HIV, Huntingtons, CJD,
Pick’s disease - atrophy of frontal and temporal lobes

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14
Q

Describe the pathophysiology of Alzheimer disease

A

Macroscopic: widespread cerebral atrophy

Microscopic: cortical plaques due to deposition of type A-Beta-amyloid protein and intraneuronal neurofibrillary tangles caused by abnormal aggregation of the tau protein

Biochemical: a deficiency of acetylcholine

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15
Q

Describe the pathophysiology of vascular dementia

A

Reduced blood supply to the brain caused by atherosclerosis and occlusion of blood vessels due to thrombus formation.
Further classified into: Stroke related and Subcortical

Associated with cardiovascular risk factors

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16
Q

Describe pathophysiology of Lewybody dementia

A

Misfolded alpha-synuclein proteins aggregate to form cytoplasmic inclusions (Lewy bodies) in the substantia nigra, paralimbic and neocortical areas

Early: Dementia symptoms + Hallucinations
Late: + mild Parkinson symptoms

Clinical diagnosis but if unclear - DaTscan
I‑FP‑CIT single-photon emission computed tomography