Classification and Assessment pyschmentor Flashcards
ALCOHOL SCREENING
AUDIT
10 items cover the 3 domains of harmful use, hazardous use, and dependence superior to biochemical markers score 0-40 harmful: >8,/7 dependance >15/13 AUDIT C = 3qs
FAST 4 qs, score 0-16 >3 hazardous drinking 1. 8/6 drinks (SASQ only asks this question- in 3m = +ve) 2. remember night before 3. failed normal activities 4. others concerned about drinking
PAT (Paddington Alcohol Test), was developed for use in a busy A&E department to detect hazardous drinking.
MAST (Michigan Alcoholism Screening Test) for detecting dependent drinkers.
Rapid Alcohol Problem Screen 4 (RAPS4) Consists of four questions highly effective in detecting alcohol dependence. A 'yes' answer to at least ONE of the four questions suggests that your drinking is harmful. R (remorse) A (amnesia) P (performance) S (starter drinker behaviour)
Palinopsia
Allesthesia
Teleopsia
Chromatopsia
Synaesthesia
gedankenlautwerden
Brodnignagian
DYSMEGALOPSIA
cant appreciate size of objects
Palinopsia
persistence of image after stimulus removed, usually organic pathology
Allesthesia
stimulus percieved at a remote point in body away from stimulus point
Teleopsia
objects appear to be farther away than they actually are.
Pelopsia is the opp
Chromatopsia
colourless objects appear coloured
Synaesthesia
sensation in one modality produces a sensation in another modality
can be called ‘union of the senses’ occurs in 1% normal
Echo de la pense
ALSO thought echo and gedankenlautwerden
Brodnignagian
large people
Alzheimer’s (SPECT Imaging)
DaT-SCAN refers to the isotope ‘Ioflupane’ which is used to produce a SPECT image
temporal and parietal hypoperfusion
ANOREXIA DSM DIAGNOSIS
The DSM-IV provides the best guide to the diagnosis of anorexia nervosa.
Diagnostic features include:-
REFUSAL to maintain body weight above 85% of what is expected
Intense FEAR of becoming fat despite being thin
Disturbed BODY IMAGE and DENIAL of seriousness of there low body weight
Amenorrhea
ATYPICAL IF NOT MEETING DIAGNOSTIC CRITERIA
APRAXIAS
Limb kinetic apraxia - fine/ delicate movements
Ideomotor apraxia - learned tasks when given the necessary objects
Constructional apraxia - copy a picture or combine parts of something to form a whole
Ideational apraxia - follow a sequence of actions in the correct order e.g. Take a match out a box and strike it with your left hand
Oculomotor - an inability to control eye movements
RAPID CYCLING
BIPOLAR
prev- 10-20% of all patients with bipolar disorder
more common in women
earlier age
more related to external factors
develops late in course and lasts 2 yrs in 50%
medical disorders: Hypothyroidism, Grave's disease Subarachnoid haemorrhage, Stroke, Head injury Multiple sclerosis propranolol, levodopa, cyproheptadine
MANAGE
NICE Guidelines: lithium and valproate as first line
adding: APs, or mood stabilisers
BPRS
BPRS
24 items
7 point scale
based on observation** and via short interview
CAMBERWELL FAMILY INTERVIEW
expressed emotions
Copropraxia
palilialia
coprophagia
Eating faeces = coprophagia
Repeating one’s own sounds = palilialia
use of obscene gestures = Copropraxia
COTARDS
Delusion that one does not exist OR has lost his or her blood, internal organs, or soul, or that one is dead seen in: dep, trauma, schizo, bipolar 90% females and elderly
CULTURE BOUND:
KORO
LATAH
BRAIN FAG
AMOK
DHAT
WINDIGO
PIBLOKTO
Koro (Genital retraction syndrome)
Origins: China, Malaysia, Indonesia
penis is shrinking and that eventually it will be absorbed into their body. ‘FATAL’
Latah
Origins: Malaysia and Indonesia
middle aged women. 30 min outbursts of screaming, hysterical laughing and obscenities.
Brain fag, or brain fog
Origin: West Africa
stressed out West African students. poor concentration, and unusual somatic sensations such as burning skin.
Amok
Origin: Malaysia
suddenly overcome with a violent outburst
continues until they are overpowered at which point they fall into a deep sleep and upon waking have no recall of the event.
almost always affects males.
Dhat
Origin: India
Men believe passing semen in their urine which leads to a loss of physical and mental energy.
Windigo
Origin: Native North America
intense desire for human flesh and a strong believe that one is turning into a cannibal.
Piblokto
Origin: Eskimo societies
hysteria and behave oddly for instance by rolling around in snow naked while muttering to themselves.
CLASSIFY DEFENCE MECHANISMS:
- PSYCHOTIC
- IMMATURE
- NEUTROTIC
Psychotic defenses (Level 1)- distort experiences in such a way that they eliminate the need to deal with reality. They include:-
Distortion
Denial
Delusional projection
Splitting *
Immature defenses (Level 2). These include:-
Schizoid Fantasy Projection Acting out Hypochondriasis Passive aggression Idealization * Projective identification *
Neurotic defenses (Level 3). short term advantages.They include:-
Displacement Reaction formation Repression Intellectualization Dissociation Isolation * Regression * Rationalization * Controlling * Externalization * Undoing *
FEATURES OF
PICKS
PSP
Picks’s disease (aka fronto temporal dementia)
speech and language dysfunction including poverty of speech and echolalia
PSP
Shares many features of Parkinson’s disease apart from TREMOR
Presents with loss of balance and falls
voluntary eye movements PROBLEMS
Use of SPECT IN DEMENTIA (GUIDELINES)
DEMENTIAS AND USE OF EEG
Perfusion hexamethylpropyleneamine oxime (HMPAO) single-photon emission computed tomography (SPECT) should be used to help differentiate Alzheimer’s disease, vascular dementia and frontotemporal dementia
People with Down’s syndrome may show SPECT abnormalities
HMPAO SPECT is unavailable, 2-[18F]fluoro-2-deoxy-d-glucose positron emission tomography (FDGPET) can be used
Dopaminergic iodine-123-radiolabelled 2-carbomethoxy-3-(4-iodophenyl)-N-(3-fluoropropyl) nortropane (FP-CIT) SPECT should be used to help establish the diagnosis in those with suspected dementia with Lewy bodies (DLB)
EEG if: If delirium, frontotemporal dementia or CreutzfeldtJakob suspected
DEPRESSION (BROWN AND HARRIS)
Depression (Brown and Harris)
In 1978, 58 women in the inner London area of Camberwell
four ‘vulnerability factors’
no. of children UNDER 14 (3+), relationship, loss of mother
Down’s syndrome (assessment of dementia)
DMR (Dementia Questionnaire for Persons with Mental Retardation)
DSDS (Dementia Scale for Down Syndrome)
