Assessment and rating scales Flashcards
cut off for ace score
88
what are the five components for ACE
visualspatial
attention
fluency
memory
language
what is audit screen tool
score of 20 plus is deemed sinificant
10 items recommended by NICE for harmful, hazardous or dependence drinking alcohol
what is the fast screening tool
3 or more hazardous
16 max
4 questions
- more than 8 or 6 (m , f) on one ocasison
- how often last year unable to remember night out
- how often failred to what expected
- relative or friend or doctor concerned about it and aske du to cut down
CAGE
4 questions
cut down
angry
guilty
eye opener
what is SASQ
when was last time you had 8 or 6 drinks (m,f) in one day
if within 3 months -hazardous drinking
PAT
PADDINGTON
used bt A&E to assess for hazardous drinking
MAST
michagan alcoholism
PAPS4
FOR dependence
RAPS
Remorse
amnesia
perfromance
starts early AM drinking
what is argyl robertson pupil associated with
teritary syphillis
the pupil responds poorly to light
small and irregular
accomodation retained
in diabetes soemtimes
what is telopsia and pelopsia
object appears closer -pelopsia
telopsia - appears smaller /further
Pareidolia.
detailed omage form shapes
hypnopompic
WAKING from sleep
HYPNAgognic
falling asleep
5 components to personality
OCEAN
openness
conscientiousness
extravasion
agreeable
neurotism
what is stupor
mutism and immobility
what is wavey flexibility
in an uncomfortable position for a long time
negavitism
gegenhatten
resistents attempt of examiner to move hand/arm etc
resistance strengthens
what is automatic obedience
exagerrated cooperation
an example is mitmachen
what is mitgehen
An extreme form of mitmachen in which the examiner is able to move the patient’s body with the slightest touch (anglepoise lamp sign), like in mitmachen, the body part returns to the original position once the force is removed.
The examiner lightly touches the patient’s arm, and the arm follows the movement with minimal resistance. Once the touch is removed, the arm returns to its initial position.
mitmachen
A form of automatic obedience whereby the body of the patient can be put into any posture, even if the patient is given instructions to resist. The body part immediately returns to the original position once the force is removed (unlike in waxy flexibility). The examiner lifts the patient’s arm, which then falls back to its original position as soon as the examiner releases it.
what is ambitendency
The patient alternates between resistance to and cooperation with the examiner’s instructions; for example, when asked to shake hands, the patient repeatedly extends and withdraws the hand. The patient extends their hand to shake the examiner’s hand but then quickly pulls it back, repeating this action sever
who discovered term catatonia
kahlbaum
what is psyhological pillow
invisible pillow
echopraxia
imitaties action of examiner
motor perservation
persistent action e.g. picking up pen action even when has done it
echopraxia
echolaiaia
involuntary repetition of someone elses action
involuntary repetition of someone elses words
logorrhoea
logoclonia
increased talkativeness
repetition of words
verbigeration
meaningless repetition of words
what is the clitfton assessment procedure
The CAPE evaluates the presence and severity of impairment in mental and behavioural functioning. It was intended for elderly long-term psychiatric patients.
quality of life
cognitive deficits
physical dependence -unmet needs?
behavioru rating
cognitivie
cognitive dysfucnction can be screened by
clock drawing testing
permorbid inteligence
50 irregularly spelt words
national adult ereading test -NART
The Wechsler Adult Intelligence Scale (WAIS)
The Wechsler Adult Intelligence Scale (WAIS) is an IQ test designed to measure intelligence and cognitive ability in adults and older adolescents.
stroop test
incongruencies like red written in purpple
rey osrettich complex figure
visual memory
copy item
immediate recall
delayed recall (20-30mins later)
testing for language
boston naming
naming objects or pictures
frontal lobe dysfunction
winsconsin card sorting
sort a card based on a specific rule
copropraxia
coproalalia
involuntary exhibition of socially inappropriate/obscene actions e.g. tics
involuntary exhibition of socially inappropriate language
what is amok
found in malaysia
males aggressive dissociative state rush in a frenzy
what is brain fag
west africa
identified in nigerian
seen in students reduced concenre`tion and poor concentration
ataque de nervios
attack of nurves
seen in latino community
itense emtoional upset, shaking, shouting, out of control
post stress
which condition is seen in cambodia
khyal attack
similar to panic attack
wnd attack
seen in refugee with ptsd
dhat
south asia
yoiung male
semen loss
what is koro seen in
chinese /south east asia
males
penis withdrawing inside abdomen
and think with die
often tie it with strings
what is kufungisia
shona of zinbabwe
thinking too miuch
latah
malaysia
females
sudden fright, starticle,
echopraxia,lalaia
hyperensisivty
what about phiblokto
eskimo comunity
extreme excitiment –> seizure –> death/coama
what is seen in haitian comunity
maladi moun
snet sickness
belief sent from others who are envious/see to cause malice
nevra
greek
loss of control/nerves
boil over
shouting, throwing screaming
wendigo
north america
scaricity of food in winters
cannabislistic urges
susto
fright
latino
frightful event–> soul leaves body –> unhappiness
difference between taijin kyofusho and shenjing
shuairo
japanese
anaxiety and avoidance of a situation,
fear that one body parts of function is embarassing or offensive to others
chinese
rriggered by stress fatigur, headache, cocnentraiton difficulty, sleep disturbance, memory loss
chinese medicine
four components of ego
Conscience
Emotion
reality
relationships
what are the three aspects of psychotic defense mechanisms
deliusional projection
Distortion - grossly reshaping external reality to suit their inner needs
Denial -refusal to accept
Three Ds
what is megalomanical belief
denial personal responsibility
belief that others is at faul
tcant do it
obessessed with power
cant see their fault
what are the 8 immature defenses
- splitting (seen in BPD)
- projection
- projective identification
- schizoid fantasy
- hypodchondriasis
- passive aggresisce
- acting out
- rwgression
at are
what is splitting
emotional conflict
positive and negative qualities of one/other
goes from black and qhite
opposite affect and failing to integrate
what is projection
attributing your own unacceptable and unacknowledged feeling onto another person
how does that differ from projective identification
ego projected onto another
it takes impact onto recipient who feels what is projected into them
sense of feeling of being controlled or manipulated
schizoid fantasy
tendency to use fantastic
and indjuge in autistic retreat for purpose of conflict resolution
define
hypodhcondriasis
transformation of reroach towards tohers arising from lonliness bearevament
worrying about serious illness
passive aggressive
indirect ineffective passively or directly against the self
acting out and regression
acting out -impulsive action to avoid dealing with distressing impulse/anxiety e.g. tempers
regression- going back to erlierstage of development when faced with an unpleasant emotion
what are the four mature mechanisms
alturism - service to others
humour -expression of ideas/feelings without discomfort to self or others
suppression - (sub)concious decision to proposone paying attention to the conscious impulse/conflict
sublimation - indrection or attenuated expression of instinct without consequences into a healthier i.e. playing a sport
what is valliant level
classifies the above levels of defences
level 1
- psychotic <5
- level 2 -immature 3-15
- level 3- neurotic 3-90
-c
level IV - mature 12-90
what is DMSR
perry defensve mechanism trating scale
30 processes of defence into 7 catgeories
what are the six neurotic ones
dissocation - block in that feeling
displacement -reidrecting pulse to another
undoing - as below
interlectulisation - excessively analytical or abstract thought patterns
reaction formation -reacting opposite way
repression
what is ungeschehenmachen
to supress
aim to make an attempt to cause past thoguts/words to not have occured
what are the breakdown of delusional structure
polarised - delusional and fact mingled
juzrapsposed - both delusion and fact exist but ar enot interacting
autistic - reality is not taken into accoutn and patient lives in delusinal woard
monothematic -single theme
polythematic -multiple themes
fragmented - unorganised, disconnected delusions
what is the difference between a primary and seconary delusion
primary -arises spontenaousely from normal psychological meaning
seocndayr -conseuqnce of morbid experience
what is fregoli
people are the same in diguse
capgras
someone they know has been replaced by an imposter
subjective double
dopplerganger
delusional companion
non living objects have consciousness
think, feel, independently
what is intermetamorhosis
swapped identified but same apperance e.g. brother is your father
folie deux
shared delusion between two people
ekbom syndrome
infested with insects
otheollo
partner is cheating
pseudocyesis
belief woman is pregnant
declarembount
lots of lovers
lycanthropy
have transformed into an animal
what is digit span
examiner reads numbers
patients recalls forwardas and backwards
longer sequece incrwasingly
when patient fails both f AND Backward-digit span value
normal 7 plus/minus 2
what are dissociative seizures
non epileptical seizures
F>M
teens /late adolececes
differs from epileptic
dissociative seizures
duration >2 minutes
gradual onset
eyes closed
more violence
incontinence not common
biting mouth uncommon
can recall
whereas epileptic <2 mins , less violnt, incotinence common, biting common, recall rare
what did an RCT show aboiut dissoaitive seizure
improvement with cbt
what is the difference betweeN ICD and dsm1
ICD -PARIS
ALL healthcar practioners
diagnostic and guidances and world clasisification
no operational criteria
under diagnoses
whereas DSM1 - USA
psuchaitrist
usa CLASSIFICATO
INCREASE diagnoses with each revision
depedent on operational criteria
what is EPDS
edinburgh post natal depression scale
10 item self reported questionnaire
over 7 days
selection 1of. 4 responses with rating of 0-3
0-9 low 10-12 moderate 13 plus high
what defines epilepsy
2 unprovoked seizure over 24 hours apart
first rank syymptoms
running commentary
thought echo
voices hearding arguijng
thought insertion
thought withdrawal
thought broadcast
delusional perception
somatic passivity
flynn effect
arise over time in standardised intelligence test
hayling brixton test
2 sets of 14 sentences each with rising last words
meassure response initation speed
to test frontal lobe
what is kraepelin mixed state
most mood states tend to be mixed with pure maria and pure depression being less common
how many types of kraepelin mixed states were there
6 but has now been reduced to 2
- dysphoric manaia - mania plus some depression
- depressivex mixed state -full depression with some mania
what codnition is associated with lambert eaton syndrome
small cell lung cancer
(breast and ovarian soemtimes)
antibody is directed against presysnamic voltage dated claicum channel in PNS
muscle contractions to increase strength
limbe girdle weakness
resused reflxe
sdry mouth
micturation
opthalmolegia
repetitive electrical stimulation
mx cancer, redpnsiolone, azithroprine
four types of doctor patient relationship
- paternalisitc
- informative
- intepretivie
- deliberative
define each type of dr patient relationship
- paternalisitc: dr knows best
- informative: provides info to pt, pt decides
- intepretative - dr helps patient, knows patients alues but lets them decide
- deliberative- acts as a guide but gives perefences
akinesia va akasthisa
aknesina - loss of muscle movement
akathesia - restlessness
what is athoesis
worm like movement involutnarry
seen in cerebral palsy, stroke
slow withering
hemiballismus
damage to subthalamic nucelus
large involuntarry limb movement
usually lower limb and unilateral
what is myahtesia gravis
autoimmune disorder
insufficiency of acetylcholine receptors
antibiodies and aceptchline recipe to NMJ
diplopia
weakness in face, neck, limbs
ptosis
dysphagia
how is M.G diagnosed
CT thorax
electromyogram
CK normal
antibiodies
Mx with pyridostigamine (anticholsteramise)
prednisolone,
IV IG
what can aggrevate m.G
TCA
Haloperidol
so use SSRI
what is PANSS
positive and negative syndrome scale
for schzioprhenia
what is phaeochromtcytoma associated with
MEN TYPE 10% familal
Neurofibromosis -VHL syndrome
bilateral 10%
malignant 10%
extradrenal 10%
where are they found phaemcchromcytoma out of adrenal gland
zuckernkendall burification of aorta
how to test for phachromotyctoma
24 hour metanephrine urinary collection of catecalomines
definitive management with surgery but can use alpha and beta blockers to manage symptoms
who discovered paramnesia
emil kraepelin
what is prosody
emotional tone of lanfguaage
inflections and melodious quality
what is bodily diistress disorder
multiple body symptoms which vary over time
focus is to a single symptom e.g. pain/fatigue
- persistent coupational negative consequences
- rpeeated consequences with healthcare
- focus on those symptoms
- more days for several months
bodily integrity disorder
intense persistent desire to become disabled e.g. blind, paraplegic
attempts to harm self, imapired feeling not within another medical disorder
factitious dx
factitious - attenpton
malingering - internatl benefits
how does OCD differ
ocd - thoughts, images, urges
compulsions -acts
what is a trance dx
marked alternative in individuals consciosuness state or a loss of identity
narrowed awareness of surroundings
what is SUDEP
sudden unexpected death of epilepsy patient
20-30% of deaths in these patients
diffrisk factors for SUDEP
male
lamotrigine
intellectual disability
noctural seizure
no meidications
difference in lithium long term use and toxicity
coarse temor in toxicity
fine tremor in long term (physiological)
what are the hz of tremors
intentional -2hz
parkinson -5hz
essential 7hz
physiological 10hz
psychogenic variable
what is psychogenic polydipsia
thirst regulation
water balance in body controlled by plasma osmbaility
release of ADH from piturary gland
hypothalamus has osmoreceptors
whatwhat does ADH do
promote water retention
therefore hypohatramic
increase instake, reduce Na, as excreeds excretion
20% schizophrenia drink 5-15L a day
wont say they are thirsty but have a delusional explanation
which depresson anxiety screening ar eself rated
becks
gd
UZG
EDINRBURGH -POSTNATAL
which are clinical rating scales
madrs
hamilton
BASREC
hama
correll dementia
which scale used in ocd
y bocs s scale
sf36
26 item survey
8 scales
function and wealking
general health
what is WHO DAS
what
dusability assessement schedule
previous 30 datys
mobility
self care
connection with people
social/society
what does deficiency in following vitamins cause:
A - night blindness
D rikets, osteomalacia
E- ataxia,
k coagulaiton
B1 -thamine - wernkeries, beri beri
b2 -rivoflacvin - goltittiis
b3 -niacin -pellgara
b6 -poly
b7 bitoin - alopecia, paresjhaia
b12 -anesia neuro depementia
c -scuvrvy
b9 folic acid - NTD, anacrotic anaemia
what is prosody
emoitonal tone of language
meladious
quality
inflection poijnt
divided into execuetive and receptive ( expressive and undderstadning)
pre motor cortex and temporal lobe
frontal -non dominant
what is the hayling test used to test for
sentence completion 2 sets of 15 questions
with last work missing
second part has an unrelated word and looks for response initation
what is brixton test used for
rule detection and following
whcih scale is heriachial
gutman scale
what is bleuler coin?
schizophrenia term but also acessory vs basic
what are the four 4
who is associated
bleuler
affectivie
autism
ambuvilence
loose of associations
what does the tower of london test look at
executive function
sf36
8 scales looks as
social and physical functioning
bodily pain
vitality - fatifue
emotion
MH
General health
korean cultural bound ilnness
fire
supressed anger
hwa byong
what scale is used for OCD
what does it measure
y bocs
severity and response to Rx
what scale is used for antidepressant s
DESS
dicontinuation emergency signs symptoms
43 items
scale associated with neuroleptic induced parkinsoms
item 10
simpson angus
gait, rigidity (6), tap,tremor, salivation 3items
LUNSER is
antipsychoetic medication
neuroleptic s/e
AIMS
tardive dyskinesia
with >2 or moew signfiicant
12 items
cornell scale
depression in dementia
madras
change with antidperessant medixcation
