general hospital psychiatry

Question 1

common mental health problems

Answer 1

self-harm

affective and adjustment disorders (depression, anxiety)

organic brain syndromes (delirium, dementia, amnesic syndromes)

personality disorders

psychiatric disorders associated with substance misuse

eating disorders

functional disorders

Question 2

less common mental health problems

Answer 2

schizophrenia

bipolar affective disorder

melancholia (Severe depression)

Question 3

reasons for increased prevalence of mental health problems

Answer 3

challenges of physical illness

functional disorders (somatoform, dissociative)

increased physical morbidity in patients with mental health problems

Question 4

what is the commonest reason for admission in females < 65?

Answer 4

self harm

Question 5

what is self harm often associated with?

Answer 5

significant mental illness and / or personality disorder
substance misuse (alcohol, drugs)
multiple social problems

Question 6

delirium

Answer 6

acute organic confusional state

global cognitive impairment

disorientation in time and place

Question 7

delirium tremens

Answer 7

manifestation of alcohol withdrawal

Question 8

management of delirium

Answer 8

correct contributing factors

sleep hygiene
hydration and nutrition
orientation
pain control
early mobilisation
regulation of bowel and bladder function

medications: avoid sedation, benzodiazepines, antipsychotics, promethazine

Question 9

substance misuse / dependence presents as

Answer 9

physical complications

intoxication

withdrawal (inc delirium, ARBD)

trauma / accident

drug induced psychosis (e.g. legal highs)

feigned illness in order to obtain drugs

Question 10

functional disorders

Answer 10

medically unexplained symptoms

• dissociative disorders
• somatoform disorders

Question 11

mental health provisions in hospitals

Answer 11

liaison psychiatry services

psychology

alcohol liaison nursing team

unscheduled care team

no specific counselling service

pastoral care