Curriculum Flashcards
Describe the aetiology and epidemiology of psychiatric illness, and how these differ with age, gender and culture.
Moderate Depression Severe Depression Depression with psychosis Hypomania Mania Cyclothymic Dysthymic Generalised Anxiety Disorder Panic Attack Post Traumatic Stress Disorder Social Anxiety Disorder Type 1 Bipolar Type 2 Bipolar Rapid Cycling Bipolar Simple Scizophrenia Hebrephrenic Scizophrenia Catatonic Schizophrenia Paranoid Schizophrenia Amphetamine Abuse Cannabis Abuse Cocaine Abuse Alcohol Dependence Korsakoff Syndrome Wernicke Encephalopathy Delirium Alzheimers Lewy Body Frontotemporal Vascular Parkinsonism Somatoform Disorder Factitious Malingering Conversion Borderline Personality Disorder Emotional Personality Disorder
Describe the current, common psychological, physical and social treatments for psychiatric conditions, including the indications for their use, their method of action and any unwanted effects. This includes ECT.
Psychological Therapy CBT CAT PPT FBT
SSRI (Anxiolytics)
Tricyclic antidepressants
Atypical Antipsychotics
Typical Antipsychotics
ECT
Understand that stepped care is often appropriate. Understand that good treatment should lead to improved well-being and growth for an individual, not just reduced symptoms.
Start on a low dose and gradually increase
State the doctor’s duties and the patient’s rights under the appropriate mental health legislation and mental capacity legislation.
Sectioning under the Mental Health Act
Section 2 Section 3 Section 37 Section 45A Section 47 Section 48 Section 117 Section 136 Community Treatment Order
Section 2 Up to 28 days can be appealed against Section 3 Treatment Order up to 6 months Section 37 Section 45A Section 47 Section 48 Section 117
Describe what may
constitute risk to self
Describe what may
constitute risk
to and from others
Understand how such abuse (of adults and children) increases the risk of psychiatric and personality disorders.
suicide self harm neglect, engaging in high risk behaviour
child abuse,
domestic violence
protection of vulnerable adults
Summarise the major categories of psychiatric disorders, for example using ICD-10.
ICD 10 Chapter 5
1 F00–F99 – Mental and behavioural disorders
- 1 (F00–F09) Organic, including symptomatic, mental disorders
- 2 (F10–F19) Mental and behavioural disorders due to psychoactive substance use
- 3 (F20–F29) Schizophrenia, schizotypal and delusional disorders
- 4 (F30–F39) Mood (affective) disorders
- 5 (F40–F48) Neurotic, stress-related and somatoform disorders
- 6 (F50–F59) Behavioural syndromes associated with physiological disturbances and physical factors
- 7 (F60–F69) Disorders of adult personality and behaviour
- 8 (F70–F79) Mental retardation
- 9 (F80–F89) Disorders of psychological development
- 10 (F90–F98) Behavioural and emotional disorders with onset usually occurring in childhood and adolescence
- 11 (F99) Unspecified mental disorder
Take a full psychiatric history, carry out a mental state examination (including a cognitive assessment) and write up a case (as would be found in medical records). This includes being able to describe symptoms and mental state features, aetiological factors, differential diagnoses, a plan of management and assessment of prognosis.
PC HxPC PMH PPH FHx mental illness DHx + illicit + over counter SHx part 1 FODSACHAM SHx part 2 PEFFP
ABSMTPCI
Differential
Mgx + Prognosis
Prescribe psychotropic medication (if appropriate) safely, effectively and economically.
Antipsychotics
Antidepressant
Anxiolytics
Provide immediate care in psychiatric emergencies, which may occur in psychiatric, general medical or other settings. In particular be able to conduct a risk assessment (risk to self and others, including from abuse), act appropriately based on this risk assessment; and to be competent in the management of acute behavioural disturbance.
Catatonia Suicide Attempt Acute psychotic episode Substance Abuse Depression Violence Rapid Change in Behaviour Hazardous Drug Interactions Anxiety Abuse Natural Disasters
Mgx
Suicidal Ideation Self Destructive Behaviours Previous Suicide Attempts Haloperidol 10mg IM (Rapid Tranq) or Lorazepam 2mg Exits Delirium Haloperidol 0.5 mg Delirium Tremens ICU use BDZ thiamine and fluids Oculogyric Crisis Promethazine Seratonin Syndrome PC hyperthermia
Plan which physical and psychosocial investigations should be carried out when patients present with psychiatric symptoms and when starting psychotropic medication.
Cognitive Assessment as part of MSE
Full Examination to rule out organic causes
FBC U&E and LFT to establish baseline renal and liver function
Evaluate information about family relationships and other relevant social factors (including work, education and finances) and their impact on an individual patient, This may involve gaining information from other sources.
Taken as part of Social History
Evaluate the impact of mental illness on the individual, their family and those around them.
Taken as part of Social History and or Risk Assessment
Recognise that illnesses of the brain/mind are of equal importance as illnesses of other parts of the body.
Yes
Demonstrate understanding of how patients’ opportunities may be affected by stigmatisation of mental illness and show sensitivity to the concerns of patients and their families about such stigmatisation.
Yes
Recognise the importance of multidisciplinary teamwork in the field of mental illness in psychiatric, community, general medical, primary care and non-medical settings.
Nurses
Receptionists
Reflect on how working in health settings may impact upon their own health (including mental health) and that of colleagues. Understand the importance of seeking professional help if they themselves develop mental health problems. Know how/where to access this help.
May be applicable in SJT