GP - mental health & dementia Flashcards
What are the categories of symptoms of depression?
emotional cognitive sleep eating energy and motivation psychosomatic suicide
What are the screening tools for anxiety and depression for GPs?
PHQ-9 for depression
GAD-7 for anxiety
What is treatment for depression?
CBT/counselling
SSRI e.g. sertraline
Tricyclic e.g. amytripyline
ECT
duloxetine, mirtazapine
What are the treatments for dementia?
acetylcholinestarase inhibitors - donepezil, rivastigmine, galantamine
Memantine
Name 3 symptoms of dementia
memory loss visuo-spatial problems emotional disturbance loss of normal social behaviour hallucinations
What are the two screening tests used in primary care to assess possible dementia?
GPCOG
6-CIT - year? month? address and name? time? 20-1, months in reverse, repeat an address
What are the official types of eating disorder?
anorexia nervosa
bulimia nervosa
binge eating disorders
other specified feeding or eating disorder (OSFED)
What is the definition of malnutrition?
deficiences, excessess or imbalance in a person’s intake of energy and/or nutritients
Who can assess capacity? Which form would you use?
Doctors and nurses
Anyone specially trained e.g. social workers
COP3 form
What is a DoLS?
deprivation of liberty safeguards
- procedure prescribed in law when it is necessary to deprive a person of their liberty when they lack capacity to consent to their care and treatment in order to keep them safe from harm
Which act is the principle of best interests in?
Mental Capacity Act 2005
What is an IMCA?
Independant mental capacity advocate
What is the different between advanced directives and advanced decisions?
Advanced directives are legally binding, advanced decisions are not
What is lasting power of attorney?
A person nominated by an individual whilst they still have capacity but a loss of capacity is imminent to represent their interests
- one for properly and finances
one for health and welfare
How long does someone need to continue with CBT to see an impact?
At least 3 months
Give examples of SSRIs and explain how they work
Give two side effects
sertraline, fluoxetine, citalopram
inhibits neuronal uptake of serotonin from synaptic cleft increasing its availability
SE - dry mouth, constipation, diarrhoea, weight disturbance, erectile dysfunction
Give examples of TCAs and explain how they work
amitriptyline, nortriptyline, imipramine
inhibit neuronal uptake of serotonin and noradrenaline from synaptic cleft
SE - dry mouth, constipation, urinary retention, blurred vision, breast changes
What scores for MMSE are significant?
<27 = mild <24 = significant
What scores for GPCOG are signficant?
5-8 mild
0-4 significant
What is the definition of dementia?
Syndrome defined by acquired loss of higher mental function affecting two or more congnitive domains, of sufficient severity to cause significant social or occupational impairment and occurring in clear consciousness
What is distal preservation?
Remembering things far in the past but not recent events
What are the 6 congnitive domains?
Episodic memory Language function Visuospatial function Frontal executive function Agnosia (recognition) Apraxia (purposeful movement)
What is it?
memory loss, distal preservation, cognitive dysfunction, visuospatial problems
Alzheimer’s
What is it?
Memory loss, visual hallucinations, Parkinsonism
Lewy body
