Mental Health

Question 1

What is the difference between a hallucination and an illusion?

Answer 1

Perceptual abnormalities
Hallucination - in absence of external stimuli
Illusion - misinterpreted external stimuli

Question 2

Bizarre vs non-bizarre delusions

Answer 2

Bizarre - cannot be true e.g. i can fly

Non-bizarre -can be true e..g i won the lottery

Question 3

What is classified as treatment resistant schizophrenia?

Answer 3

persistent +ve symptoms despite trials of ≥ 6 weeks of 2 diff antipsychotics at their maximum doses

Question 4

What is a confabulation?

Answer 4

Lying without intent to deceive - may genuinely believe they’re telling the truth

Question 5

What is the interaction between prolactin and some anti-psychotics?

Answer 5

Dopamine inhibitor of prolactin secretion

Blockage of D2 receptors by some anti-psychotics cause hyperprolactinaemia

Question 6

What is a Section 135?

Answer 6

Police + healthcare professionals enter home (need warrant from magistrate)
Take to place of safety - home/police station/hospital
Up to 36 hours

Question 7

What is a section 136?

Answer 7

Police can take you to place of safety from public place

Up to 24 hrs - can extend further 12 hrs

Question 8

What is a section 2?

Answer 8

Detainment when lack capacity
Up to 28 days for assessment + possible treatment
X be extended/reviewed, can section under section 3

Question 9

What is section 3?

Answer 9

Detainment if treatment can’t be given unless you’re in hospital
Up to 6 months, then 6 months, then 12 month periods

Question 10

How is assessment carried out in patients who are sectioned?

Answer 10

Approved Mental Health Professional (AMHP)
Registered Medical practitioner - usu pt GP
Section 12 approved doctor - usu psychiatrist
AMHP makes final decision

Question 11

What is the difference between atypical and typical antipsychotic medications?

Answer 11

Typical - D2 receptor blockade

Atypical - less D2, more 5-HT2 receptor

Question 12

What systems do atypical and typical anti-psychotics mainly target?

Answer 12

Atypical - tuberoinfundibular pathway

Typical - meso-limbic system

Question 13

What other pathways do typical antipsychotics target?

Answer 13

Serotonergic, Noradrenergic, Histaminic

Question 14

What are the main side effects of typical antipsychotics?

Answer 14

Extra pyramidal symptoms - Parkinsonism, Akathisia, Tardive dyskinesia, Dystonic reaction, long QTc

Question 15

What are the 3 main signs of Parkinsonism?

Answer 15

Bradykinesia, Rigidity, Tremors

Question 16

What are the main side effects of atypical antipsychotics?

Answer 16

Increased prolactin
Can get microadenomas in pit gland
↑ed risk metabolic syndrome - diabetes, ↑ BP, obesity

Question 17

What is the main antipsychotic used for treatment resistant schizophrenia?
What type of anti-psychotic is it?
What receptor does it have highest affinity for?

Answer 17

Clozapine, Atypical, D4 receptors

Question 18

What do you have to monitor in a pt taking clozapine?

Why?

Answer 18

Baseline FBC, continue monitoring as pt on it

Risk of agranular cytosis - bone marrow suppressed, x make WBC/RBC