Mental Health Flashcards
PTSD vs acute stress reaction +mx
PTSD >1m = Trauma focused CBT + EMDR +/- venlafaxine or sertraline
Acute stress reaction = <4 weeks, CBT
OCD mx
SSRI + CBT
GAD mx
> 6m
CBT +/-
(1) Sertraline
(2) SSRI/SNRI (dulox)
(3) Pregabalin
Wait until 12m after it as resolved
Mania vs hypomania
Mania >7d. Impairs functioning
Psychotic symptoms (auditory hallucination)
Increased mood
Hypomania <7d (3-4)
Can be high functioning
No psychotic symptoms
Increased mood
ROutine referral
Baby blues vs post natal depression vs postpartum psychosis
Baby blues 3-7d
Post-natal depression within 1m usually. Peaks 3m. Sertraline
Postpartum psychosis 2-3 weeks
Depression 1st line medication
Sertraline
Depression vs dementia
Depresion is shorter history, rapid onset, bio symptoms (sleep disturbance), pt is worried about poor memory, reluctant to take tests (disappointed with results), global memory loss (dementia is more recent memory loss)
Brief psychotic disorder, timeframe
<1m, return to baseline
Circumstantiality vs tangentiality
Circumstantiality - excessive detail, return to original point
Tangentiality - wanders from topic, without returning to original point
strongest RF of schizophrenia
FH
Atypical vs typical antipsychotics and S.E
1.Atypical antipsychotics for schizophrenia - EPSE + hyperprolactinaemia less common
Antipsychotics ↑ risk VTE + stroke in elderly
EPSE:
Dystonia = muscle contractions - torticollis, oculogyric crisis
Akathesia = restless
Tardive dyskinesia = chewing, pointing
MX personality disorders
PS therapy, Dialectical behaviour therapy
Schizoid personality describe
lack interest in sex/relationships, few interests
Schizotypal personality describe
Odd beliefs
ADHD mx (when initiate meds) and monitoring of the mx
Inattention, hyperactivity, impulsivity
10 week watch and wait
Methylphenidate 6 week trial - monitor weight + height
Alcohol withdrawal - what meds can help:
Craving, sobriety, withdrawal
Alcohol withdrawal
Chlordiazepoxide (benzo)
Aftercare:
Disulfiram - reaction with alcohol
Acamprosate - craving
Naltrexone - sobriety
What to use for alcohol overdose
activated charcoal, benzos, pabrinex
What to give for benzo overdose
Flumazenil
What to use for TCA overdose
Sodium bicarb
Opioid overdose - what to use
Naloxone
Paracetamol overdose mx
<1hr activated charcoal
<8hrs NAC IV -> methionine pO
Correct hypoglycaemia
Wernickes triad
Ophthalmoplegia (nystagmus)
Ataxia
Confusion
Korsakoffs triad + mx
Amnesia - anterograde + retrograde
Confabulation
Need pabrinex Vit B1
S2
28d, non renewable, AMHP + 2 Drs
S3
6m, renew, AMHP + 2 Drs
S4
72 hrs in emergency
S5
(2) vol pt in hospital detained by Dr 72hrs
(4) Vol pt in hospital detained by nurses 6hrs
s17
CTO, can recall back to hospital
S 135
Police court order, private
(136 is public)
ad + LBD mx
AceE inhibitors +/- memantine
Fronto temporal dementia symptoms
Personality, social conduct problems
Parkinsons disease triad
Tremor, rigidity, bradykinesia
Parkinson disease plus syndromes
PSP = vertical gaz palsy, falls, Hummingbird on MRI
MSA = postural hypotension, ANS, hot cross bun sign
Corticobasal degeneration - unilateral, alien limb
Bulimia meds
FLuox
Somatisation
Multiple physical symptoms >/2 year,s refuse to accept reassure
Meds insomnia
Bezos or non-benzos (z drugs) 2 weeks
Sleep paralysis meds
Clonazepam
Charles bonnet syndrome
Complex hallucinations in clear consciousness. Usually visual impaired
cotard syndrome
Believes dead/ non existant
De Clerambaults
Believe someone famous in love with her
Orthellos
Jealousy
Converison disorder
Conversion disorder
Loss motor/sensory function - Hoovers sign
Catatonia
Stopping vol movement or staying still in unusual position
Vovlulus on XR and mX
