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C21 Phase 1 > Case 10 - Mental Health > Flashcards

Case 10 - Mental Health Flashcards

1
Q

Role of astrocytes in the brain

A

star-shaped cells that provide the scaffolding to the brain

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2
Q

Role of pericytes in the brain

A

induce the ‘tightness’ of the junctions maintaining the blood brain barrier

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3
Q

Causes of pathology in the blood brain barrier

A

meningitis
stroke
traumatic brain injury
haemorrhage

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4
Q

What is the monoamine theory of depression

A

too little serotonin

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5
Q

Role of the following neurotransmitters:

  • dopamine
  • noradrenaline
  • serotonin
  • acetylcholine
  • gamma amino-butyric acid
  • glutamate
  • glycine
A 
dopamine = pleasure
noradrenaline = fight/flight
serotonin = mood
acetylcholine = muscle
gamma amino-butyric acid = major inhibitory
glutamate = major excitory
glycine = spinal cord inhibitory
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6
Q

Explain neurotransmitter termination

A

Diffusion out at synaptic cleft
Reuptake to synaptic membrane
degradation by enzymes

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7
Q

Mechanism of action of reuptake inhibitors

A

Neurotransmitter spends more time in the synaptic cleft by inhibiting the enzyme that breaks them down

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8
Q

Side of effects of eating foods containing tyramine on MAOs

A

Cannot be broken down, side effects include flushing, headaches and hypertension

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9
Q

What is serotonin syndrome

A

Too much serotonin causes anxiety, agitation, disorientation, and D&V

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10
Q

What is the purpose of sleep

A 
restoration
hormone production
waste clearance
memory
mental health + behaviour
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11
Q

What is the circadian pacemaker

A

The suprachiasmatic nucleus

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12
Q

Sleep related neurotransmitters

A

Orexin
Melatonin
GABA
Adenosine

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13
Q

Stages of sleep

A 
Wakefulness
N1
N2
N3
REM
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14
Q

Approximately how long does a sleep cycle take

A

90 minutes

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15
Q

Role of melatonin in regulating sleep

A

Builds throughout the day to make you feel sleepy

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16
Q

Role of adenosine in regulating sleep

A

Increases sleep pressure

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17
Q

Role of GABA in regulating sleep

A

Increases sleep pressure

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18
Q

Role of caffeine in regulating sleep

A

Blocks adenosine receptors

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19
Q

What are zeitgebers

A

Environmental stimuli that regulate the circadian rhythm

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20
Q

Examples of good sleep hygiene

A 
Going to bed and waking at the same time
Relaxing routine
No big meals before bed
Exercise in the day not at bed time
Bed is for sleep only
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21
Q

What is insomnia and how is it treated

A

Decreased sleep quality/quantity for 3x per week over 3 months causing deficits

Treatment = sleep hygiene, medication, CBT

22
Q

What is obstructive sleep apnoea and how is it treated

A

Upper airway either completely or partially occluded while sleeping, may cut off air supply several times in a night

Treatment = CPAP

23
Q

Examples of hypersomnia conditions

A

Narcolepsy

Kleine-Levin Syndrome

24
Q

What is REM sleep behaviour disorder

A

People act out their dreams as they are not paralysed properly

25
Q

What’s the difference between nightmares and night terrors

A

Nightmares occur in the REM stage and can be remembered, night terrors do not and will not be remembered

26
Q

Examples of NREM sleep disorders

A

Sleep walking
Sleep eating/drinking
Sleep talking
Night terrors

27
Q

What is the onset and endpoint of adolescence

A 
Onset = puberty
Endpoint = socially gaining independence
28
Q

What is adrenarche

A

activation of hypothalamic-pituitary-adrenal axis, secondary sexual characteristics begin to develop

29
Q

What is gonadarche

A

activation of the hypothalamic-pituitary-gonadal axis

30
Q

how is the growth axis activated

A

Growth hormone secreted causing growth spurt

31
Q

What is the impact of prolonged hypothalamic-pituitary-adrenal axis activation on growth

A

prolonged hypothalamic-pituitary-adrenal axis activation decreases growth hormone secretion. Children who experience ACEs are more likely to have prolonged HPA axis activation and so may be physically different to their peers

32
Q

White matter changes in the adolescent brain

A

increase in white matter particularly in males

33
Q

Grey matter changes in the adolescent brain

A

Region-specific, non-linear pattern of development

Pre-pubertal increase followed by post-pubertal decrease due to synaptic pruning

Motor and sensory systems mature before primary function systems

34
Q

What does synaptic overpruning increase the risk of

A

Schizophrenia

35
Q

Psychological symptoms of depression

A
  • continuous low mood or sadness
  • feeling hopeless and helpless
  • having low self-esteem
  • feeling tearful
  • feeling guilt-ridden
  • feeling irritable and intolerant of others
  • having no motivation or interest in things
  • finding it difficult to make decisions
  • not getting any enjoyment out of life
  • feeling anxious or worried
  • having suicidal thoughts or thoughts of harming yourself
36
Q

Physical symptoms of depression

A
  • moving or speaking more slowly than usual
  • changes in appetite or weight (usually decreased, but sometimes increased)
  • constipation
  • unexplained aches and pains
  • lack of energy
  • low sex drive (loss of libido)
  • changes to your menstrual cycle
  • disturbed sleep – for example, finding it difficult to fall asleep at night or waking up very early in the morning
37
Q

Social symptoms of depression

A
  • avoiding contact with friends and taking part in fewer social activities
  • neglecting your hobbies and interests
  • having difficulties in your home, work or family life
38
Q

Examples of SSRIs

A

citalopram
fluoxetine
sertraline

39
Q

Examples of SNRIs

A

duloxetine

40
Q

Triggers/causes of mental illness

A
  • childhood abuse, trauma, or neglect
  • social isolation or loneliness
  • experiencing discrimination and stigma
  • social disadvantage, poverty or debt
  • bereavement (losing someone close to you)
  • severe or long-term stress
  • having a long-term physical health condition
  • unemployment or losing your job
  • homelessness or poor housing
  • being a long-term carer for someone
  • drug and alcohol misuse
  • domestic violence, bullying or other abuse as an adult
  • significant trauma as an adult, such as military combat, being involved in a serious incident in which you feared for your life, or being the victim of a violent crime
  • physical causes – for example, a head injury or a neurological condition such as epilepsy can have an impact on your behaviour and mood. (It’s important to rule out potential physical causes before seeking further treatment for a mental health problem).
41
Q

Differential diagnoses for mental health disorders

A 
lead poisoning
malingering
hyperthyroidism
mental retardation
understimulation for intelligent children
seizures
chronic illness
drug side effects
42
Q

Stages of a mental state examination

A 
Appearance and behaviour
Speech
Mood
Thoughts
Perception
Cognition
Insight
43
Q

Types of auditory hallucination

A

2nd person - ‘you are’, ‘you should’
3rd person - ‘they are’, ‘they should’
Thought echo - thoughts repeated back to them

44
Q

What is a delusion

A

A fixed, false belief that cannot be changed by logic and are not consistent with culture or education

45
Q

What is a hallucination

A

A false sensory perception without an external stimulus

46
Q

What is an illusion

A

A misinterpretation of an existing stimulus

47
Q

Examples of antipsychotics and side effects

A

Seroquel, Zyprexa

Sedation, weight gain, involuntary movement, diabetes

48
Q

Examples of antidepressants and side effects

A

Fluoxetine
Citalopram

Suicidal behaviours, weight loss, abnormal bleeding

49
Q

Examples of mood stabilisers and side effects

A

Lithium

Weight gain, nausea, diarrhoea, tremors

50
Q

Examples of anti-ADHD medications and side effects

A

Adderall, Ritalin

Growth delays, tics, insomnia, decreased appetite

51
Q

Examples of anti-anxiety medications and side effects

A

Hydroxyzine

Sedation, dizziness, dry mouth

52
Q

Reasons to be sectioned

A
  • you need to be assessed or treated for your mental health problem
  • your health would be at risk of getting worse if you did not get treatment
  • your safety or someone else’s safety would be at risk if you did not get treatment
  • your doctor thinks you need to be assessed or treated in hospital, for example if you need to be monitored very regularly because you have to take new or very powerful medication. Otherwise, you may be asked to attend a hospital out-patient clinic.

C21 Phase 1 (45 decks)

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