First Aid for the Psychiatry Clerkship - "How to Succeed in the Psychiatry Clerkship" Flashcards
Address patients formally unless ____________.
otherwise told
Good advice for psychiatry (and all clerkships): __________________.
- Know as much about your patients as possible (psychiatric history, medical history, test results, past experience in the healthcare system, social history).
- Respect the patients at all times.
- Volunteer at every opportunity (to give a talk, to take on more patients, to stay late, etc.)
- Be a team player. Sense when you should defer to someone else and ask others for help.
All patients should be informed of their right to seek _______________ at the time of admission.
an advanced directive
Go through the brief update (for patients already hospitalized).
This is a [age]-year-old [gender] with a history of [major history such as bipolar disorder] who presented on [date] with [major symptoms, such as auditory hallucinations] and was found to have [working diagnosis]. [Tests done] showed [results]. Yesterday, the patient [state important changes, new plan, new tests, new medications]. This morning the patient feels [state the patient’s words], and the mental status and physical exams are significant for [state major findings]. Plan is [state plan].
List the things that should be included in a mental status exam.
•Appearance • Behavior • Speech • Mood (in patient's own words) •Affect •Thought process (linear?) •Thought content (suicidal/homicidal/grandiose/hyper-religious) •Perceptual disturbances •Cognition - Alert? - Oriented - Attention/concentration (serial 7s, months backward) •Memory (short and long) •Insight • Judgment •Abstract thought •Registration (three unassociated objects recalled at five minutes)
Go through the mnemonic DIGFAST for mania symptoms.
- Distractibility
- Irritability
- Grandiosity
- Flight of ideas
- Agitated
- Speech rapid
- Thoughtlessness
Go through the mnemonic SAD PERSONS for suicide risk.
- Sex - male
- Age greater than 60
- Depressed
- Prior attempt
- Ethanol use
- Rational thinking gone
- Suicide in family
- Organized plan
- No support
- Sickness
Go through the mnemonic SIGECAPS.
- Sleep (too much or too little)
- Interest
- Guilt
- Energy (decreased)
- Concentration problems
- Appetite
- Psychomotor changes (increased or decreased)
- Suicidal ideation
Also important: hopelessness, helplessness, worthlessness
What are symptoms of alcohol and benzodiazepine intoxication?
- Slurred speech
- Mood lability
- Disinhibition
- Ataxia
- Blackouts
- Respiratory depression
What are symptoms of alcohol and benzodiazepine withdrawal?
- Tremulousness
- Tachycardia
- Hypertension
- Seizures
- Nausea
- Hallucinations
- Anxiety
What is the only symptom of barbiturate intoxication that First Aid lists?
•Respiratory depression
What are symptoms of barbiturate withdrawal?
- Anxiety
- Seizures
- Delirium
- Life-threatening cardiovascular collapse
What are symptoms of opioid intoxication?
- CNS depression
- Nausea
- Vomiting
- Sedation
- Decreased pain perception
- Constipation
- Pupil constriction
- Respiratory suppression
What are symptoms of opioid withdrawal?
- Nausea
- Diarrhea
- Piloerection
- Yawning
- Cramps
- Restlessness
- Anxiety
- Anorexia
- Myalgias
- Rhinorrhea
- Diaphoresis
What are symptoms of amphetamine intoxication?
- Increased attention span
- Sympathetic activation: dilated pupils, tachycardia, hypertension, arrhythmias
- Euphoria
- Paranoia
- Formication (cocaine)
