Hospital psychiatry Flashcards
What does liaison psychiatry refer to?
Diagnosis and management of psychiatric and psychological illness in general medical populations
Capacity, discharge planning, existing and new conditions, diagnosis and management, complications, education and training
History taking in deliberate self harm?
Perceived lethality
Planning for how long
Future plans - suicidal thoughts
Did they take precautions not to be found
Previous history of self harm
Triggers
Mental state - how are they now? thoughts on actions? substance misuse? risk assess
personal and psychiatric history - life situations, health issues, drug abuse, child care
Collateral history
If someone presents with ongoing suicidal intent how are they best managed?
Admission to ward or home treatment team follow up
Risk factors for patient suicide?
Contact with services in last 12 months Non-compliance with treatment Not showing up to appointments and follow ups Alcohol abuse - 45% of cases Male, middle aged/elderly, single/divorced/widowed, job loss, living alone, low socioeconomic class Recent bereavement Previous attempts Drug abuse
When does delirium tremens develop? risk factors?
1-7 days after not consuming alcohol, usually peaking at 48 hours
Severe dependance, ongoing infection, liver disease
Symptoms of delirium tremens?
Agitation Drop in consiousness Hallucinations Sweating and tachycardia disorientated Worse at night
How do you assess for delirium tremens?
GMAWs assessment tool (glasgow modified alcohol withdrawal scale)
What do you give to treat delirium tremens?
Long acting benzo like chlordiazepoxide
Why does Wernickes encephalopathy occur?
B1 depletion
What is Korsakoffs psychosis? what can cause its development? 3 symptoms?
Amnesia, disorientation and confabulation (gaps in memory consciously filled in with lies)
Caused by alcohol related damage, recent stomach cancer removal, post anaesthesia, CO poisoning, basal temporal lobe epilepsy
How do you manage Korsakoffs psychosis?
IV thiamine then oral for 2 years
Wilsons disease? psychiatric effects the illness can have?
Abnormal accumulation of copper in the blood and deposits in organs
Can cause personality changes, early onset dementia, aggression, depression, irritable, extrapyramidal signs, Bulbar signs, Kayser fleischers rings
Autoimmune cause of hyperthyroidism?
Graves disease
Symptoms of hyperthyroidism?
Weight loss Prefer cold - removing layers Decreased sleep Agitated Poor concentration Anxiety
Symptoms of hypothyroidism?
Lethargic Weight gain Always cold - many layers on Slow thoughts Irritable and aggressive
