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FCM Y1 SGUL > MENTAL HEALTH > Flashcards

MENTAL HEALTH Flashcards

1
Q

recurrent episodes of binge eating
lack of control during an eating episode
recurrent inappropriate compensatory behaviour to prevent weight gain

binge eating with purgative behaviour at least once a week for 3 months

A

bulimia nervosa

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2
Q

restriction of energy intake relative to requirements
intense fear of gaining weight. becoming fat
disturbance to one’s body weight/shape is experiences

A

anorexia nervosa

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3
Q

bulimia nervosa management

A

refer to specialist care

bulimia-nervosa guided self-help for adults - or CBT-ED
children should be offered focused family therapy (FT-BN)

pharmacological tx = trial of high dose SSRI (fluoxetine)

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4
Q

anorexia nervosa management

A

individual eating disorder CBT - CBT-ED

MANTRA

specialist support clinical management (SSCM)

young people - focus family therapy (first line)

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5
Q 
low mood 
lack of interest in activities 
significant changes to weight/appetite
changes to amount of sleep 
inappropriate feeling of guilt 
indecisive/inability to concentrate/think
recurrent suicidal ideation
A

mild to moderate depression = sleep hygiene, low intensity psychosocial interventions, computerised CBT and group physical activity programmes

moderate-severe depression = SSRI initiation, high intensity psychosocial interventions, individual CBT

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6
Q

chronic depressive state more than 2 years duration

doesn’t meet the full criteria for depression

A

dysthymia

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7
Q

management of dysthymia

A

antidepressants first line

psychotherapy

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8
Q

elevated mood, irritable, agitated or aggressive
high levels of energy and very little sleep
pressure of speech or incomprehensible speech
racing thoughts
distracted
poor concentration
increased libido
extravagant/improactile plans

A

bipolar disorder

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9
Q

management of bipolar disorder

A

antipsychotics = olanzapine, haloperidol, quetiapine or risperidone

lithium may be added, or if unsuitable valproate is added
psychological interventions

in depressive period = SSRI/fluoxetine

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10
Q

auditory hallucinations - voices, thought echo
though disorders = insertion, withdrawal or broadcasting
delusions
disorganised speech, behaviour and thoughts
loss of motivation
social withdrawal
self neglect

A

schizophrenia

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11
Q

management of schizophrenia

A

oral antipsychotics - clozapine (titrate up from low dose)
CBT offered to all patients

associated with CVD - pay close attention to this

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12
Q

impaired social interaction/communication
playing alone
unable to regulate interactions with non-verbal cues
unable to form and maintain appropriate relationships
Problems in obtaining or sustaining employment or education.
A history of a neurodevelopmental/mental condition

A

autistic spectrum disorder

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13
Q

management of autistic spectrum disorder

A

early educational/behavioral interventions

pharmacological - SSRIs, antipsychotics, methylphenidate for ADHD
family support and counselling
parent education on how to interact with the child

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14
Q

cannot follow instructions
reluctant to engage, distracted
forgetful/loses things
difficulty organising and sustaining tasks
talks excessively, plays noisily
interruptive/intrusive
run and climbs in inappropriate situations

A

attention deficit disorder

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15
Q

attention deficit disorder

A

10 week wait and watch, refer to 2° care

first line = methylphenidate - alternative, lisdexamfetamine
do baseline ECG

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16
Q 
intrusive thoughts (flashbacks and nightmares)
dissociation 
negative mood 
avoidance 
arousal 
<4weeks
A

acute stress disorder

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17
Q

management of acute stress disorder

A
  1. trauma focused CBT

2. benzodiazepines for agitation/sleep disturbance

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18
Q

usually occurs over 5 stages
initially denial = feeling numb, pseudohallucinations of the deceased
anger = against family/medical professionals
bargaining
depression
acceptance

not same for all

A

uncomplicated bereavement

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19
Q 
use of OTC drugs (overdose)
use of illicit drugs 
ingesting household substances and plant material 
or 
episodes of cutting
A

deliberate self harm

20
Q

management of deliberate self harm

A

assess for ant physical, psychological or safeguarding risks/concerns

if at physical/psychological risk = emergency referral
minor self-injury = primary care

referral to CAHMs if within that age group

21
Q

symptoms start at 6-12 hours: tremor, sweating, tachycardia, anxiety
peak incidence of seizures at 36 hours
peak incidence of delirium tremens is at 48-72 hours: coarse tremor, confusion, delusions, auditory and visual hallucinations, fever, tachycardia

A

alcohol withdrawal

22
Q

alcohol withdrawal management

A

admit and monitor till the patient stabilises

first-line = long-acting benzo such as diazepam
if hepatic failure lorazepam is preferred

chronic alcoholics may need thiamine to prevent wernicke’s encephalopathy
rehydration important

23
Q 
6months of excessive uncontrollable worry about everyday issues 
restlessness/nervousness 
poor concentration, sleep disturbance 
easily fatigued irritable 
muscle tension 
can experience abdo discomfort
A

generalised anxiety disorder

24
Q

management of GAD

A
  1. education and active monitoring
  2. low intensity psychological interventions
  3. high intensity psychological interventions + drug Tx firstline = sertraline
    or duloxetine/venlafaxine), pregabalin last

under 30yrs = weekly follow up for the first month
benzodiazepines in acute crises

25
Q 
frequently complain of pain 
sleep disturbance 
chest pain & SOB 
tachycardia
hypertension 
tremors 
sweating
A

panic disorder

26
Q

management of panic disorder

A

CBT or drug treatment - SSRI first line

if unresponsive after 12 weeks = imipramine or clomipramine offered

27
Q

feared situation makes patient anxious and distressed
tachycardia
sweaty
tremor/trembling

response is usually out of proportion to the reality of the situation

A

phobia

28
Q

management of social phobia

A

CBT + medication (SSRI)

29
Q

management of agoraphobia

A

psychological therapy (systemic desensitisation) & SSRIs

30
Q

management of simple phobias

A

systematic desensitisation

31
Q

re-experiencing through nightmares, flashbacks
avoidance of people/places/things which resemble the traumatic event
hyperarousal/vigilance and exaggerated startle response
emotional numbing/feeling detached

A

post-traumatic stress disorder

32
Q

management of post-traumatic stress disorder

A

mild cases = watchful waiting for 4 weeks

severe cases = trauma-focused CBT, eye movement desensitisation and reprocessing

drugs Tx not routinely used but usually venlafaxine pr SSRI
severe cases = risperidone

33
Q

unwanted intrusive thoughts, urges or images that com repeated to mind
repetitive behaviours or mental acts that a person feels driven to perform - either overtly or covertly

A

obsessive-compulsive disorder

34
Q

management of OCD

A

mild cases = CBT or ERP
(can offer SSRI course if insufficient)

moderate cases = offer SSRI/intensive CBT

severe functional impairment - combined SSRI + CBT
if SSRI effective = continue use for 12months

35
Q 
unstable mood or emotional dysregulation 
- daily or hourly mood changes 
may present with overdose/self-harm 
pseudohallucinations 
angry outbursts
chronic feeling of emptiness 
dissociation 
impulsivity
A

Borderline/emotionally unstable PD

36
Q

management of borderline PD

A

psychotherapy

antipsychotic can be given - usually quetiapine

37
Q

deception, repeatedly lying
impulsiveness, failure to plan ahead
irritable, aggressive
reckless, disregard of personal and other’s safety
consistent irresponsibility and lack of remorse

men>women

A

antisocial PD

38
Q

unwarranted tendency to question the loyalty of friends
reluctance to confide in others
preoccupation with conspirationa beliefs/hidden meanings
unwarranted tendency to perceive attacks on their character

A

paranoid PD

39
Q

inappropriate sexual seductiveness
needs to be centre of attention
rapidly shifting & shallow expressions of emotion
self dramatisation
relationships considered more intimate than reality

A

histrionic PD

40
Q 
gardoise sense of self importance 
preoccupied in fantasies - unlimited power, success or beauty 
sense of entitlement 
lack of empathy 
chronic envy 
arrogant, hauty attitude
excessive need for admiration
A

narcissistic PD

41
Q 
indifference to praise or criticism 
prefers solitary activities
lack of interest in sexual relations/interactions 
lack of desire for companionship
emotional coldness 
few friends/confidants
A

schizoid PD

42
Q 
Odd beliefs, magical thinking 
unusual perceptual disturbance 
paranoid ideation, suspiciousness 
lack of close friends 
odd but clear speech 
eccentric behaviours
A

schizotypal PD

43
Q

mental health condition that causes an individual to experience physical bodily symptoms in response to psychological distress.

these could include pain, weakness, dizziness, fainting and digestive symptoms also

A

somatoform disorder

44
Q

somatoform disorder management

A

CBT and SSRI

45
Q

somnolence
pupillary constriction/pin-point pupils
decreased repsiration
track marks on the arms

A

opiate intoxication/overdose

46
Q

treatment for opiate intoxication/overdose

A

naloxone injection
(opiate reversal agent)

may get aggressive/vomit
substance abuse counselling needed

FCM Y1 SGUL (15 decks)

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