Mental health Flashcards
severity classification for anorexia nervosa
Mild: BMI ≥17 kg/m²
Moderate: BMI 16-16.99 kg/m²
Severe: BMI 15-15.99 kg/m²
Extreme: BMI <15 kg/m²
physical clinical features of anorexia nervosa
BMI< 85% predicted
amenorrhea
delayed puberty
fatigue, fainting, dizziness
intolerance to cold
GI- constipation, Abdo pain
appearance - wearing baggy clothes
Psychological features of anorexia nervosa
fear/ dread gaining weight
distorted body image
social withdrawal
denial of problem/ resistance to treatment
Examination findings in anorexia nervosa
gaunt, lanugo hair , acrocyanosis , restless
Maybe have postural hypotension
peripheral oedema
What 2 MSK test are done in anorexia nervosa
squat tests and sit up test
Management in ED for anorexia nervosa
weight restoration
OT, psychology, medical groups
Olanzapine and fluoxetine
what is a potential complication of weight restoration in anorexia nervosa patients
refeeding syndrome
what is a potential complication of weight restoration in anorexia nervosa patients
refeeding syndrome
what are the 4 things that becomes low in refeeding syndrome
potassium
phosphate
Magnesium
Thiamine
what risk assessment tool is used in anorexia patients
MEED traffic light system
clinical features of bulimia nervosa
weight fluctuation
low mood
low self esteem
body image concerns
dental erosion
parotid hypertrophy
russell’s signs
arrythmias
Investigation for bulimia nervosa
bloods
ECG
BMs
Treatments for bulimia nervosa
psychotherapeutic : CBT
Diet : meal planning
Medical: manage physical risk and consider SSRI or SNRI
What is diabulimia and who does it occur in
misusing insulin to control weight
Occurs in type 1 diabetes
What is the ICD 11 criteria for depression
fiver of ten everyday, most of the day for 2 weeks and must include 1 and 2
1. depressed mood
2.anhedonia
3.reduced concentration
4.low self worth, inappropriate guilt
5.sucidal ideation
6.hopelessness
7.too little/too much sleep
8.too little/too much appetite
9.low energy
10.psychomotor retardation/agitation.
What are the mental state examination items
use pneumonic: A Bee Stung My Arm Today Pretty Crap
Appearance
Behaviour
Speech
Mood
Affect
Thought
Perception
Cognition
Pharmacological treatment options for depression
SSRIs
Mirtazapine
Sertraline
what is bipolar 1 and what is needed for a diagnosis
Hypomanic, manic and depressive episodes can occur
At least one manic episode required for diagnosis (no depressive
episode required)
What is bipolar 2
Hypomanic and depressive episodes only
-At least 1 hypomanic episode and 1 depressive episode for
diagnosis
what is the DSM-5 criteria for Bipolar (Manic)
A manic episode includes at leats 1 week of persistently abnormally elevated or (irritable mood)
3-4 of :
Inflated self-esteem or grandiosity
Intensified speech
Decreased need for sleep
Rapid jumping around of ideas or
racing thought
Distractibility
Increase in goal directed
behaviour or psychomotor
agitation
Excessive involvement in
pleasurable but risky activities
symptoms of hypomania
must last for 4 days
- mild elevation of mood
- Symptoms of manic episode but less intense
-symptoms do not disrupt functioning
Symptoms of depressive episode
Low mood
anhedonia
loss of energy /fatigue
disturbed sleep, guilt,
decreased conc
thoughts of death or suicidal ideation
somatic syndrome:
- decreased interest
-diurnal variation
-Early morning variation or mood
-Decreased libido
-Decreased appetite or weight loss
what is cyclothymic disorder
people who experience hypomania, depressive symptoms but not enough t[ meet the threshold for the criteria
what is mixed affective disorder
Co-existance of depressive,
hypomanic and manic symptoms
what is rapid cycling in bipolar
> = 4 manic, hypomanic, depressive or mixed episodes occurring within 12 months
symptoms of catatonia
Motor disturbance
immobility
mutism
posturing/rigidity
waxy flexibility
stereotypy
echolalia
echopraxia
when should you refer for bipolar (new and existing)
New:
refer urgently if mania or severe depression is suspected or if there is a danger to them or other people
Existing :
refer urgently if there is an acute exacerbation of symptoms or an increase in risk
what are some non-pharmacological management for bipolar
inpatient admission or HTT
ECT
Psychological therapy and education
support with sleep hygiene, nutrition status
Managing co-morbidities
