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mental health > Exam > Flashcards

Exam Flashcards

1
Q

Core principles/objectives of mental health act

A
  1. Least intrusive/restrictive methods of assessment and treatment
  2. People should get to make decisions about their care
  3. Rights, dignity and autonomy
  4. Holistic care
  5. Children and young people prioritised
  6. Caters recognised and supported
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2
Q

Authorised persons

A

Police
Paramedics
Medical practitioners (in mental health services)
Mental health practitioners

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3
Q

The act permits authorised persons to…

A
  1. Enter premises
  2. Apprehend
  3. Restrain
  4. Transport
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4
Q

Mental health and well-being definition components

A
  1. Realises potential
  2. Cope with normal stressors
  3. Work productively
  4. Make a contribution to community
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5
Q

Medical definition mental illness

A

Clinically significant disturbance in
1. Cognition
2. Emotion regulation
3. Behaviour

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6
Q

Legal definition mental illness

A

Significant disturbance in
1. Thought
2. Mood
3. Perception
4. Memory

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7
Q

How many Australians have a mental or behavioural condition?

A

5.0 million / one in five

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8
Q

Competency components

A
  1. Communicate decision
  2. Understand information
  3. Appreciate consequences
  4. Manipulate information in a reasonable fashion
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9
Q

Organic causes that can mimic mental health

A
  1. Alcohol/drugs
  2. Medications
  3. Infection
  4. BGL
  5. Hypoxia
  6. Brain injury
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10
Q

Crisis management plan

A
  1. Identify history/problem
  2. Identify pt and carer’s intended outcome
  3. What do you think needs to happen?
  4. Give pt/carer options and engage in planning
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11
Q

High risk symptoms

A
  1. Attempted suicide/self harm (current)
  2. Intentional overdose/poisoning
  3. Severe intoxication where you can’t do MSA
  4. Section 351
  5. Requires sedation
  6. Dangerous social situation
  7. Acute psychosis, mania or delirium
  8. Any red flags
    Transport to hospital
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12
Q

Types of delusions

A

Persecution/paranoia (“they” are out to get me)
Reference (special meaning in neutral things)
Grandeur (famous/important/unusual powers)
Control (thoughts or actions controlled)

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13
Q

5 domains of psychopathology for schizophrenia spectrum/psychotic disorders

A
  1. Delusions
  2. Hallucinations
  3. Disorganised thinking
  4. Disorganised/catatonic behaviour
  5. Negative symptoms
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14
Q

Schizophrenia positive symptoms cause

A

Increased dopamine in mesolimbic DA neurons

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15
Q

Schizophrenia negative symptoms cause

A

Decreased dopamine activity in mesocortical and nigro-striatal systems

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16
Q

Acute behavioural disturbance AV CPG care objectives

A
  1. Maintain safe environment
  2. Use least restrictive measures/deescalation
  3. Consider clinical causes
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17
Q

5 key features of delirium

A
  1. Disturbance in attention
  2. Short period of time
  3. Disturbance in cognition
  4. Not caused by neurocognitive disorder
  5. Is caused by a medical condition, substance intoxication/withdrawal, toxin exposure or multiple aetiologies
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18
Q

SAT +3

A

Combative, violent, out of control
Continual loud outbursts
Manage with ketamine

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19
Q

SAT +2

A

Very anxious and agitated
Loud outbursts
Manage with droperidol (or midazolam)

20
Q

SAT +1

A

Anxious/restless
Normal or talkative
Manage with olanzapine

21
Q

SAT -1

A

Asleep but rouses if name is called
Slurring or prominent slowing
(Aim for this when sedating)

22
Q

SAT -2

A

Responds to physical stimulation
Few recognisable words

23
Q

SAT -3

A

No response
No speech

24
Q

Olanzapine dose/route

A

10mg oral ODT (5mg for elderly/frail/<60kg/sedation from alcohol/drugs)
Repeat once only after 20 min

25
Q

Olanzapine onset/duration

A

Onset: 15min
Duration: 12-24 hours

26
Q

Olanzapine precautions

A
  1. Less effective for drug intoxication and alcohol withdrawal - use benzodiazepines first
  2. Elderly/frail and children more susceptible to adverse effects
27
Q

Droperidol dose/route

A

5-10mg IM or IV (5mg for elderly/frail/<60kg/sedation from alcohol/drugs)
Repeat after 15min once only
If ineffective after 2 doses use midazolam

28
Q

Droperidol precautions

A
  1. Elderly/frail more susceptible to adverse effects
  2. Parkinson’s disease
  3. Lewy body dementia
  4. Can cause QT prolongation rarely
29
Q

Droperidol onset/peak/duration

A

Onset: 3-10 min
Peak: 20-30 min
Duration: 2-4 hours

30
Q

Midazolam dose/route

A

5-10mg IM (2.5-5mg for elderly/frail/<60kg/sedation from alcohol/drugs)
Repeat after 10 min once only

2.5-5mg IV (1-2mg elderly/frail/<60kg/sedation from alcohol/drugs)
Repeat at 5 min intervals

Max dose 20mg for both

31
Q

Midazolam precautions

A
  1. Reduce doses for elderly/frail/renal failure/CCF/shock
  2. Enhanced effects with narcotics and alcohol
  3. Respiratory depression in COPD pt
  4. Myasthenia gravis
32
Q

Midazolam onset/peak/duration

A

IM
Onset: 3-5 min
Peak: 15 min
Duration: 30 min

IV
Onset: 1-3 min
Peak: 10 min
Duration: 20 min

33
Q

Ketamine dose/route

A

IM
<60 kg: 200mg
60-90 kg: 300mg
>90 kg: 400mg

IV: 50-100mg (dilute 200mg/2mL with 18mL saline)

Request MICA

34
Q

Ketamine onset/duration

A

IM
Onset: 3-4 min
Duration: 12-25 min

IV
Onset: 30 sec
Duration: 5-10 min

35
Q

Post sedation care

A
  1. Airway management
  2. Supplemental O2 (routine with ketamine)
  3. Capnography
  4. Perfusion management
  5. Temperature management (administer midazolam for hyperthermia)
  6. Reassessment and management of clinical causes
  7. IV insertion
  8. Management of hypersalivation (ketamine)
36
Q

Mood disorders

A

Persistent depressive disorder
Major depressive disorder
Disruptive mood dysregulation disorder
Premenstrual dysphoric disorder
Antenatal and postnatal depression
Psychotic depression
Bipolar I disorder
Bipolar II disorder
Cyclothymic disorder
Seasonal affective disorder

37
Q

First line antidepressants

A

SSRI, NASSA, melatonergic agonist, NDRI, SNRI

38
Q

Second line antidepressants

A

NARI, TCA, MAOI

39
Q

Signs of TCA toxicity ECG

A

QTC prolongation
QRS widening
Right axis deviation (late sign)
Right bundle branch block
Tachycardia

40
Q

Cluster A personality disorders

A

Odd, bizarre, eccentric
Paranoid, schizoid, schizotypal

41
Q

Cluster B personality disorders

A

Dramatic, erratic
Antisocial, borderline, histrionic, narcissistic

42
Q

Cluster C personality disorders

A

Anxious fearful
Avoidant, dependent, obsessive-compulsive

43
Q

Asylum seeker definition

A

Fled their own country and applies for protection as refugee

44
Q

Refugee definition

A

Outside own country and can’t return due to well founded fear of persecution

45
Q

Displaced person

A

Forced to flee home because of violence, human rights violation or natural/man-made disasters

46
Q

5 key concepts of MHiMA framework

A
  1. Cultural responsiveness
  2. Risk and protective factors
  3. Culturally responsive practice
    Consumer and cater participation
  4. Recovery and cultural diversity

mental health (2 decks)

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