Mental health

Question 1

What does drawing a clock test for

Answer 1

Executive functions

Question 2

What is meant by executive functions

Answer 2

Verbal reasoning

Problem solving

Planning

Maintaining sustained attention

Multitasking

Cognitive flexibility

Question 3

What is cognitive impairment

Answer 3

Disturbance of higher cortical functions including memory, thinking, judgement, language, perception, awareness

Question 4

Give an overview of dementia

Answer 4

Decline in both memory and thinking sufficient to impair personal activities of daily living

Problem with processing incoming information

Problem with maintaining and directing attention

Present for > 6 months

Question 5

Which cognitive assessments may be used for dementia

Answer 5

AMT

6-CIT

GP-COG

MMSE

MoCA

ACEiii

Question 6

Give an overview of Alzheimer’s dementia

Answer 6

Gradual onset

Slow progression

Early memory impairment

Volume loss in brain on imaging

Question 7

Give an overview of vascular dementia

Answer 7

Gradual or sudden onset

Erratic course

Depression common

Evidence of infarcts, bleeds, or white matter ischaemia on imaging

Question 8

Give an overview of frontotemporal dementia

Answer 8

Gradual onset

Quick progression

Early loss of executive abilities

Impaired social behaviour

Apathy

Disinhibition

Frontotemporal atrophy on imaging

Question 9

Give an overview of Lewy body dementia

Answer 9

Fluctuating course

Often initially mistaken for delirium

Hallucinations

Parkinsonism

May have psychotic symptoms

Question 10

What are the potential drug treatments for dementia

Answer 10

Donepezil, rivastigmine, galantamine (cholinesterase inhibitors)

Memantine (NMDA receptor antagonist)

Question 11

What are the side effects of cholinesterase inhibitors for dementia

Answer 11

Worsen pulmonary disease

Increase risk of peptic ulcers

Syncope

Bradycardia

Seizures

Question 12

What is the side effect of memantine in dementia treatment

Answer 12

Seizures

Question 13

Which medications should be avoided in dementia

Answer 13

Anticholinergics (cognitive deterioration, hallucinations)

Benzodiazepines (risk of falls, cognitive decline)

Antipsychotics (risk of falls, movement disorders, cognitive deterioration)

Question 14

Give an overview of delirium

Answer 14

Most common complication of hospitalisation in the elderly

Impairment of cognition

Disturbance of attention and conscious levels

Abnormal psychomotor behaviour and affect

Disturbed sleep-wake cycle

Can be hyperactive or hypoactive

May have delusions or hallucinations

Question 15

What are the possible causes of delirium

Answer 15

Hypoxia

Constipation/urinary retention

Malnutrition

Drugs

Alcohol

Endocrine issues

Electrolyte disturbance

Hepatic impairment

Renal impairment

Intracranial events

Post-op period

Pain

Question 16

Which questionnaires can be used to assess for delirium

Answer 16

CAM (confusion assessment method)

AMT

MMSE

Question 17

What are the steps of a mental state examination

Answer 17

Appearance and behaviour

Speech

Emotion

Perception

Thought

Insight

Cognition

Question 18

What are people with learning disabilities more likely to have

Answer 18

Language difficulties

Sensory impairment

Epilepsy

Mobility issues

Physical ill health

Limited coping strategies

Limited choices and opportunities

Limited social network

Limited or adverse life experiences

Question 19

What are the core features of autism

Answer 19

Difficulties in social interaction and communication

Rigid and repetitive behaviours

Restricted interests