Clinical medicine Flashcards
What is mood?
The patient tells the doctor about their mood
What is affect?
The doctor observes the patient’s emotions
What is anhedonia?
Loss of positive pleasure
Does a diurinal depression or reactive mood suggest depression is more severe?
Diurinal depression
What is blunting?
Total absence of emtion, seen most commonly in chronic schizophrenia
What is incongrous mood?
Where emotion fails to match thoughts and actions
For example- Patient laughing when describing the death of a close relaive
What is presure of speech and when does it mainly occur?
Mainluy occurs in mania and can be recognised by loudness, rapidability and difficult to interrupt
What is poverty of speech?
Appears to be an absence of any thoughts and patients report their minds to be empty
Occurs in depressive illness
What is Thought block?
Occurs in schizophrenia
Abrupt and complete interruption of the stream of thought. Mind goes blank
What us flight of ideas?
Patient’s thoughts rapidly jump from one topic to another.
What is perseveration?
Persistent and inappropriate repetition of the same thoughts and ideas
What is thought broadcast?
When the patient experiences their thoughts as being understood by others without talking, as though their thoughts are being broadcasted to others
What is thoguht insertion?
Occurs when a patient’s thought is percieved as being planted in their mind by someone else
What is thought withdrawl?
When a patient experiences their thoughts being taken away without their control
What is an obsession rumination?
Recurrent, persisten thought, impulse or image or musical theme that occurs despite the patient’s efforts to resist
Recognises the obsessional thoughts is their own, but it os usually unpleasant and often out of character
What is a compulsion?
Repetitive and seemingly purposeful action performed in a steyotypical way
Accompanied in a subjective sense that they must be carried out by an urge to resist
What is insight?
The degree to which a person recognises that they are unwell
What is illness beliefs?
Patient’s own exxplanation of their ill health
What are primary delusion?
Rare and appear suddenly and with full conviction but without any preceding events
What are secndary delusion?
Derived from a preceding morbid experience, such as auditory hallucinations
What are overvalued ideas?
Deeply held personaly convictions that are understandable when the individuals background is known
What are ideas of self reference?
Fall short of delusions
Held by people who are particularly self conscious
Cannot help feeling that people take notice of them in public places
What are illusions?
Misperceptions of external stimuli and are most likely to occur when the general level of sensory stimulation is reduced
What are hallucinaions?
Hallucinations may affect any of the following perceptions- auditory, visual, tactice, gustatory, olfactory or deep sensation
What are pseudohallucinations?
Usually auditory
True externally sited hallucinations
Insight into their imaginary nature or are sited within internal spaces
What are depersonalisation?
Change in self awareness such that the person feels unreal or detached from their bod
What is derealisation?
Unpleasant feeling
The external environment has become unreal and/or remote.
Dream like state
What are exampples of increased sensitivity of perceptions? What do these occur in?
Photosensitivity and phonosensitivty
Occurs in anxiety disorders as well as migrane
What is sublimation?
Unconcious diversion of unaccepatble bejaviours into acceptable ones
What is neuroses?
Illnesses in which symptoms vary only in severity from normal experiences such as depressive illness
What is psychoses?
Illnes in which symptomas are quantitively different from normal experiences
What are predisposing factors?
Stem from early life
Genetic
Pregnanyc and delivery
Personallity factors
What are precipitating factors?
Physical, psychological or social in nature
What are perpetutating factors?
Prolong the course of a disorder after it has occured
What are mood disorders divided into?
Bipolar and unipolar
What is bipolar I
Depressoon alterniating with mania
What is bipolar II
Depression alternating with hypomania
How are depressive disorders classified?
ICD-10
What is dysthymia
Mild to moderate depressive illness that lasts intermittently for 2 years or more and is characterised by tiredness and low mood, lack of pleasure, loss self esteem and feeling of discourage,emt
What is postpartum psychosis?
Occurs in every 500-1000 births
Classical features of affective psychosis, disorientation and confusion are also there
Response to treatment is good
What are some possible aetiology of unipolar depressive disorders
Genetic Biochemical Hormonal Neural changes Sleep Child trauma Social
What is involved in the treatment of depressive illnesses?
Exercise
Drugs- SSRIs, TCA, SNRIs, MAOIs and RIMAs
Electroconvulsive therapy
Psychologicla treatments- CBT, interpersonal therapy, other therpies
What should the doses of antidepresseants be in elderly people?
Halfed.Same in renal and hepatic failure
What is CBT?
Helps reverse the negative cognitive triad in which patients regarded themselves
ID of the negative automatic thoughts that maintain the negative perceptions that feed depression
What is interpersonal therapy?
Therapist focuses on a patient’s interpersonal relationships involved in or affected by their illness using problem solving techniques to help patients to find solutions
What is cyclothymia?
Personality treait with spontaneous swings in mood not sufficiently severe or persistent to warrant another diagnosis
What is the epidimologyh of bipolar?
1% lifetime prevalance
Equal among men and women
Mean age of osnet is 21
What is the biochemical link in bipolar?
Brain monoamines seem to be increased in mania
