Management Flashcards by Thomas Dauncey

Anorexia nervosa (Mx + prognosis)

Psych - CBT/supportive

Social - support groups (BEAT)

Bio - raise calorie intake

Hospital admission >35% weight loss
50% recover
5% mortality

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Bulimia nervosa (Mx + prognosis)

Bio - SSRI

Psych -

Social - support group (BEAT)

70% recover within 5 years
No increased mortality

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Mania (Mx)

Acute - neurolytics (olanzapine, haloperidol)

Prophylaxis - mood stabilisers (lithium, sodium valproate, carbamazepine)

ECT

Psychological therapies - improve concordance with therapies

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Severe depression (Mx)

Bio -

Psycho -

Social - Mind website/depression alliance

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Moderate depression (Mx)

Bio -

Psycho -

Social - Mind website/depression alliance

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Mild depression (Mx)

Bio -

Psycho -

Social - Mind website/depression alliance

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Psychosis (Mx)

Bio -

Psycho -

Social -

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OCD (Mx)

Bio - SSRI (if moderate)

Psycho - Exposure and response prevention

Social -

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PTSD (Mx)

Bio -

Psycho - trauma focused CBT
Eye movement desensitisation and reprocessing

Social -

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Social Phobia (Mx)

Bio - SSRI, benzodiazepines ONLY for specific situations

Psycho - CBT, graded exposure

Social -

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Agoraphobia (Mx)

Bio - SSRI if moderate

Psycho - systematic desensitisation (graded exposure to feared scenario)

Social -

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Acute alcohol withdrawal(Mx)

Admit to hospital if:
- high risk of seizures/DT
-

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Opiate abuse/withdrawal (Mx)

Bio -

Psycho -

Social - AA meetings

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Alzhiemers disease (Mx)

MDT

Bio - Donepezil, rivastigmine, galantamine (mild-moderate), memantine (moderate-severe)

Psycho - structured group cognitive stimulation programme, co-morbid depression/anxiety - CBT, tailored interventions

Social - Alzhiemer’s society, support for carers (psychotherapy, peer-support groups, educational support), financial support, housing - environmental modification, inpatient care

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Dementia (Mx)

Bio -

Psycho -

Social - Dementia UK

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Parkinson’s Disease (Mx)

Bio -
Early PD - Levodopa, non-ergot dopamine agonist, MAO-B inhibitors, specialist referral

Late PC - modified release levodopa, dopamine agonist, MAO-B

Psycho - depression treatment (CBT etc.), psychosis management (avoid drugs that effect motor function)

Social - Parkinsons UK

Post-partum psychosis (Mx)

Bio -

Psycho -

Social - admit to mother and Baby care unit

Post-partum depression (Mx)

Bio - SSRI, TCA, SNRI

Psycho - CBT

Social - admit to mother and Baby care unit, Action on Posttpartum psychosis network

ADHD (Mx)

Bio -

Psycho -

Social -

Conduct disorder (Mx)

Bio -

Psycho -

Social -

Personality disorders (Mx)

Bio -

Psycho -

Social -

Autism (Mx)

Bio -

Psycho -

Social -

Lewy-body dementia (Mx)

Bio -

Psycho -

Social -

Cyclothymia (Mx)

Bio -

Psycho -

Social -

Learning disabilities (Mx)

Bio - Psycho - Social -

Vascular dementia (Mx)

Bio - Psycho - Social -

Alcohol withdrawal seizures

Short acting benzodiazepine (eg. lorazepam) NOT phenytoin

Delirium Tremens

1st Oral lorazepam 2nd parenteral lorazepam, haloperidol or olanzapine Review any medication

Alcohol dependence Mx

Specialist alcohol services Bio - thiamine (oral/ parenteral if necessary) - Nalmefene (if not detox) Psycho: - CBT (alcohol focus), - behavioural therapies - Social network - environmental therapies - couples therapy Social - AA

Wernicke-Korsakoff Syndrome

Supported independent living if mild cognitive impairment Supported 24 hour care for moderate/severe cognitive impairment

Assisted alcohol withdrawal | Inpatient criteria

(>15 units/day or >20 AUDIT) drink over 30 units of alcohol per day • have a score of more than 30 on the SADQ • have a history of epilepsy, or experience of withdrawal-related seizures or delirium tremens during previous assisted withdrawal programmes • need concurrent withdrawal from alcohol and benzodiazepines • regularly drink between 15 and 30 units of alcohol per day and have: • significant psychiatric or physical comorbidities (for example, chronic severe depression, psychosis, malnutrition, congestive cardiac failure, unstable angina, chronic liver disease) or • Significant learning disability or cognitive impairment.

Alcohol dependence drugs

Acamprosate Naltrexone Disulfiram - worse hangover