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year 3 OSCE > Mental health > Flashcards

Mental health Flashcards

1
Q

What is the Mnemonic for mental health evaluation?

A

All Sane Men Think That Pizza Is Italian

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2
Q

What does A stand for in mental health evaluation?

A

Appearance and behaviour

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3
Q

What are you looking for in appearance and behaviour in MHE?

A 
Appearance = age, sex, how they are dressed, if they are kept, signs of self harm
Behaviour= Calm/Fitting, alert/confused, eye contact
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4
Q

What does S stand for in MHE?

A

Speech

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5
Q

What are you looking for in “speech” part in MHE?

A

Quality = how clear and volume
Rate
Quantity= Too much or too little talking

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6
Q

What does M stand for in MHE?

A

Mood

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7
Q

What are you looking for in the “mood” part in MHE?

A

Are they angry, anxious, low, agitated etc

Do they have any suicidal thoughts

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8
Q

What does first T stand for in MHE?

A

Thought form/process

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9
Q

What are you looking for in “thought form” part in MHE?

A

The speed of thought formation
Is it fluently being produced
Is the thoughts random or make sense

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10
Q

What does the second T stand for in MHE?

A

Thought content

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11
Q

What are you looking for in “thought content” part of MHE?

A

Do they have any delusional thoughts that other people in their culture/community do not hold
Overvalued thoughts–> such as being anorexic
Obsessive thoughts

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12
Q

What does P stand for in MHE?

A

Perception

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13
Q

What are you looking for in “perception” part of MHE?

A

Hallucinations –> a experience without any stimuli

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14
Q

What does the first I stand for in MHE?

A

Insight

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15
Q

What are you looking for in “insight” in MHE?

A

Does the patient know they have a problem?
What does the patient think the cause of the problem is?
Does the patient want help?

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16
Q

What does the last I stand for in MHE?

A

IQ

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17
Q

What are you looking for in IQ part of MHE?

A

Cognitive function

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18
Q

What questions do you ask to assess cognitive function?

A

Orientation –> time, place ,person
Attention and concentration = 20 to 1
Short term memory= remember address or some words

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19
Q

Name a Screening test for MHE?

A

AMTS

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20
Q

What are the 10 questions in AMTS?

A

1) How old are you?
2) What year where you born?
3) What time is it?
4) What is the year?
tell them address to remember
5) Where are we?
6) Who is the monarch/prime minister
7) What was the date of twin tower attack
8)Can you count back from 20 to 1
9)Who are these two people?
10)Can you remember that address?

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21
Q

What is depression?

A

Persistent low mood or sadness and/or
Loss of interest or pleasure +/or
Fatigue or low energy

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22
Q

How long does symptoms have to last for to be diagnosed as depression?

A

2 weeks

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23
Q

What other symptoms should you ask about in depression?

A 
Sleep
Concentration
Low confidence
Agitation
Apeptite 
Guilt
Suicidal thoughts
Slow movement
24
Q

How many symptoms to be

a) not depressed
b) mild
c) moderate
d) severe/physchosis

A

a) <4
b) 4
c) 5-6
d) 7 or more

25
Q

What open question should you ask before taking history?

A

Just generally how they are feeling recently

26
Q

What questions should you ask to identify the main 3 symptoms of depression?

A

Have you recently felt down or low for long periods of time
Have you recently found they you are not finding pleasure or interest from life?
Have you recently found that you are feeling overally tired?

27
Q

What are the two broad groups of symptoms you need to assess for depression?

A

Biological symptoms and Cognitive symptoms

28
Q

What are the biological symptoms?

A

Mood
Appetite
Sleep
Libido

29
Q

What questions would you ask for sleep symptoms?

A

How has your sleep pattern been recently?

Do you find it difficult to go to sleep or wake up early and can’t get back to sleep?

30
Q

What questions would you ask for appetite symptoms?

A

How has your diet been recently?
Has their been any changes to your diet?
What do you eat on a typical day?

31
Q

What questions would you ask for mood symptoms?

A

Does your mood change throughout the day?

Is your mood worse at any time throughout the day?

32
Q

What questions would you ask for in libido symptoms?

A

Have you seen any changes in your libido?

Has your sexual drive reduced?

33
Q

What are the cognitive symptoms you want to asses?

A

Concentration
Perception of current/future situation
Perception of them selves

34
Q

What questions would you ask for in concentration symptoms?

A

How has your concentration been?

Been able to follow tv?

35
Q

What questions would you ask for in “perception of current/future situation” symptoms?

A

How do you feel about your current situation?

How do you feel about the future?

36
Q

What questions would you ask for in “perception of themselves” symptoms?

A

How do you feel about your self?

Do you ever feel guilty or blame your self?

37
Q

How do you differentiate from bipolar disorder?

A

Ever had period of feeling particular high and happy then low

38
Q

How to elicit any symptoms of physchosis?

A

Have you ever heard voices speaking when there seems to be no-one around?”
Do you ever feel people are out to get you?

39
Q

What questions would you ask to open a assess suicidal risk?

A

When people feel down and depressed they sometimes feel like it is not worth living. Have you ever felt like this?

40
Q

How do you further investigate suicidal risk?

A

How often have you felt like this?
Have you ever planned how you would do it?
Have you ever done it?
What has stopped you from doing it?

41
Q

What should you ask in past medical history in depression history?

A

Have you ever felt like this before?

Have you ever gone to the GP for feelings similar to this?

42
Q

What social history questions should you ask in a depression history?

A

How has your mood affected:
a)your work
b) relationship with friends and family
c) hobbies
d) have you told anyone about how you are feeling
Ask about if they smoke, take drugs or alcohol

43
Q

What is the screening done for alcohol history at the start?

A

CAGE

44
Q

What does CAGE stand for ?

A

C: Have you ever thought about Cutting down on your drinking
A: Do you get Annoyed by people commenting on how much you drink
G: Have you ever felt guilty about your drinking
E: Have you ever had a eye opener?

45
Q

What does eye opener mean?

A

Drink in the morning, to stop the shakes/nerves

46
Q

What score suggest problematic drinking?

A

2/4 score

47
Q

What things do you need to ask in a detailed alcoholic intake?

A

When did you start drinking?
When did they notice their alcohol intake increase?
Current drinking pattern ( days and time)
How much do you drink on average day?

48
Q

What are the two types of dependancy you need to identify in how alcohol affects a patients life?

A

Biological dependency

Physical dependency

49
Q

What are the biological dependency?

A

If you stop drinking do you ever get sweats, shake or abnormal changes?
Do you think your tolerance has increased?

50
Q

What are the physical dependency?

A

How important is drinking to you?

Do you feel like you nee to drink?

51
Q

What factors do you want to find out about their life that alcohol could be affecting?

A 
Diet
Occupation
Relationship
Alcohol related crime
Any attempted to stopping
Living situation
52
Q

What is important to ask in alcohol related PMH?

A

Any liver problems/ going into hospital relating to alcohol

53
Q

Do you do a physiological assessment in alcohol history?

A

Yes you are assessing risk

54
Q

What do you ask ion PMH in alcohol history taking?

A 
General PMH
alcohol related
Any medication
Allergies 
Family history
55
Q

What do you ask in physiological assessment?

A

“How has your mood been?”
“How is your appetite?”
“What is your sleeping pattern like?”
“Are there things you enjoy in life? What?”
“How is your concentration?”
“Have you had any thoughts of hurting yourself?”
“Have you ever thought of ending it all?” (If so, any plans)
Do you ever have thoughts of harming others?”

year 3 OSCE (14 decks)

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