Mental Health Flashcards

Question

What is section 2 of MHA?

Answer 1

Person can be detained under section two if suffering from mental health condition which warrants their detention in hospital with a view to the protection of themselves or others Under section two if not assessed in hospital before or have not been assessed for a while Lasts 28 days

Answer 2

Detained in hospital for treatment Can follow a section two Up to 6 months Force treatment for first three months but needs reassessing after 3 months

Answer 3

72 hour emergency hold for treatment

Answer 4

Delusions | Hallucinations

Answer 5

Blunted mood Reduced speech Poor self care Loss of volition

Answer 6

Disorders of speech Tangential Knights move Neologisms

Answer 7

Birth asphyxia, childhood encephalitis, sexual abuse, cannabis, separation from parent, born in city Increased risk in Afro Caribbean and south Asian patients Poor prognosis gradual onset, strong family history, low IQ, premorbid hisorur of social withdrawal and lack of obvious precipitation

Answer 8

Paranoid- commonest subtype, hallucinations and delusions Hebephrenic- age of onset 15-25, poor organisms, flu testin affect prominent with fleeting fragmented delusions and hallucinations Catatonic- characterised by stupor, posturing, waxy flexibility, negativity Simple and residual- negative symptoms predominant

Answer 9

``` CHIMPS PHONED Constipation Hypoxia Metabolic disturbance Pain Sleepnlessness Prescriptions Hypothermia or Pyrexia Organ dysfunction eg hepatic or renal failure Nutrition Environmental changes Drugs ```

Answer 10

History of dementia or depression Look for infection Medications- opiates or calcium supplements Vascular problems-previous MI, limb ischaemia (vascular dementia RF) Other presenting complaints History of recurrent admissions

Answer 11

Early warning score BP and pulse (check for sepsis, dehydration, hypotension) Obs CT head- bleeds, strokes, SOL Bloods- FBC (anaemia, WCC, MCV), U&Es (electrolyte imbalance high calcium, dehydration), LFT (alcohol intake, liver failure), TFTs, calcium, b12, glucose, CXR, blood cultures upfield query sepsis, urine dip for UTI

Answer 12

``` Alzheimer’s Vascular dementia Dementia with Lewy Bodies Traumatic brain injury Frontotemporal dementia Semantic dementia Creutzfeldt Jakob disease Normal pressure hydrocephalus Wernicke Korsakoff Pseudo dementia secondary to depression Confusion secondary to infection ```

Answer 13

Addenbrookes cognitive assessment Montreal cognitive assessment- MoCA Mini mental state exam Hospital anxiety and depression scale

Answer 14

Usually caused by an acute, such as stroke or TIA Can also develop over time from small blockages or slowing of blood Risk factors- diabetes, hypertension, high cholesterol, CHD, peripheral artery disease Step like decline in memory or cognition Lower the vascular risk- aspirin and statins

Answer 15

Most common form of dementia Usually Begins in 60s Risk factors- age, genetics Gradual downward slope decline, starting from memory, thought and language,

Answer 16

Involvement in cortical function eg aphasia, agnosia, apraxia Decrease of motivation and drive Slow rate of progression CT and MRI show cerebral atrophy Hallucinations, delusions, anxiety, marked agitation, aggression, agitation, wandering, hoarding, sexual inhibition

Answer 17

Early onset is autosomal dominant so 50% chance of getting it. 50% of those with Down’s syndrome who live to 60 will get AD Late onset genetics- apolipoprotein E (E4 increases risk, E3 normal risk, E2 reduced risk)

Answer 18

Cholinesterase inhibitors - donepezil Rivastigmine Memantine- NMDA receptor blockers Meds slow down progress of the disease Delays worsening of dementia for 6-12 months

Answer 19

``` CBT reminiscence therapy Aromatherapy Sensory stimulation Music therapy ```

Answer 20

``` Decline in memory, decline in emotional control or motivation Apathy Coarsening of social behaviour Must not have delirium Must be present for at least 6 months Should be irreversible ```

Answer 21

Memory impairment Sleep disturbances- nightmares, aggressive movements, disturbed sleep cycle Autonomic dysregulation Variable cognition Urinary incontinence Visual spatial difficulties, language impairment, dyspraxia Memory, motor and psychosis Deposits of alpha synuclein Memory difficulties and problems develop at least one year before motor Give rivastigmine and maybe memantine

Answer 22

One third with PD develop dementia Memory and psychotic symptoms develop one year after motor difficulties Also alpha synuclein deposits

Answer 23

Frontal lobe- behaviour, problem solving, executive function (planning) Temporal lobe- language, recognising objects and people Lost inhibitions, lose empathy, apathy, change in eating habits

Answer 24

Impulsive aggression, affective lability, self injury and identity diffusion Unstable self image, fears of abandonment, transient psychotic symptoms, Maladaptive patterns of thought and behaviour Treatment- co morbidities such as anxiety and depression, CBT, DBT,

Answer 25

Appearance- overall impression, physical conditions suitability of dress, cleanliness Behaviour- appropriateness of behaviour, distractibility, eye contact, rapport Speech- rate, rhythm, volume, tone, coherence, relevance, quantity and fluency, abnormal associations, flight of ideas Mood Perception- delusional perception, illusion, hallucination Thought- form- linear, tangential, circumferential, derailment Content- suicidal or violent thoughts, delusions, overvalued ideas Cognition- alert, attention concentration, orientation to time and place, short term memory Insight- recognition of illness and need for treatment