Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Medicine Finals 2020 > Mental Health > Flashcards

Mental Health Flashcards

1
Q

Section 2

A

Allows for admission to hospital for ASSESSMENT within 28 days.
Non-renewable.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Section 3

A

Allows for admission to hospital for treatment FOR UP TO 6 months.
Renewable.
Doctor has to see patients in the past 24 hours.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Section 4

A

Allows for admission to hospital for ASSESSMENT within 72 hours due to EMERGENCIES (as section 2 might be too delayed)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Section 5(2)

A

Allows for a DOCTOR to legally DETAIN a patient who is ALREADY a VOLUNTARY patient in a hospital for up to 72 HOURS.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Section 5(3)

A

Allows for a NURSE to legally DETAIN a patient who is already a VOLUNTRAY patient in a hopsital for up to 6 HOURS.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Section 135

A

Allows for the police to BREAK INTO A PROPERTY to REMOVE A PATIENT to a PLACE OF SAFETY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Section 136

A

Allows for the police to REMOVE a person who APPEARS TO HAVE A MENTAL DISORDER (AT RISK TO SELF OR OTHERS) from a PUBLIC PLACE to a PLACE OF SAFETY.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Main 3 symptoms of depression with other symptoms?

How long should they be present for?

A

More than 1 month of:

a) Persistent depression/low mood
b) loss of interest/pleasure in hobbies
c) low energy/fatigue

Biological: sleep (insomnia or early morning waking), weight & appetite changes, sex drive/libido

Cognitive: loss of concentration, poor memory, lousy perception of self or the future

Mood: Excessive guilt, psychomotor agitation/retardation

Risk: Harm to self, harm to others, thoughts about suicide.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Suspicious of others & extreme vigilance.
Distrustful: Perceives neutral/friendly comments as hostile + questions people all the time/counter-attack.

Sensitive to criticism.
Bears grudges.
Conspiratorial

Self-importance (excessive)

A

Paranoid Personality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Isolated
Aloof

Emotionally cold & detached, flattened affect
Indifferent to praise or criticism

Lack of enjoyment in life

A

Schizoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Cold and aloof
Odd, eccentric and perculiar

Poor rapport & socially withdrawn

Odd beliefs of magical thinking which is inconsistent with social norms.
Intense illusions, auditory hallucinations and delusions

A

Schizotypal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

A young man with:

Callous: insensitive disregard of others

Low frustration threshold
Irritable & impulsive
Unstable relationships: can establish but cant maintain

Failure to learn from past experiences or accept responsibility
Lack of guilt

Drawn to criminality

A

Dissocial/Anti-social

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Emotional instability
Lack of impulse control

Prone to outbursts of VIOLENCE or THREATENING behaviour in response to criticism

A

Emotionally unstable (IMPULSIVE)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Instability of mood (rapid mood shifts), self-image and unstable relationships

Associated with excessive efforts to avoid abandonment such as blackmails with self-harm (I’LL KILL MYSELF) or suicides (self-damaging behaviour)

A

Emotionally unstable (borderline)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Self-dramatization, theatrical, exaggerated expressions of emotions.

Seeks excitement

Attention seeking
Wants appreciation by others
Wants to be the centre of attention

Vain (physical looks) + Shallow
Inappropriate seductiveness

Easily influenced - suggestible

A

Histrionic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Excessive orderliness
Preoccupied with details, rules and order
Perfectionism that interferes with task completion
Inflexible & dogmatic
Stubborn
Cautious & doubt

Humorless

A

ANANKASTIC (Obsessive Compulsive)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Believe that they are unlikable. Wish to be accepted but already expect others to reject them.

Persistent, tense and apprehensive feelings
Worry
Inferiority Complex: socially inept and personally unappealing
Fear of criticism or rejection

Avoids interpersonal contact
Avoids social or occupational activities (general unwillingness to get involved with others) –> socially inept UNLESS THEY KNOW THEY ARE CERTAIN OF BEING LIKED

A

ANXIOUS AVOIDANT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Passive
Encourages others to make important/life decisions for them.
Excessive need to be taken care of.
Feels helpless when alone.

Fears abandonment and thus:

  • Compliant with other people’s wishes
  • Unwilling to make demands (on others they depend on)
  • puts others need before their own in order to maintain the relationship
A

DEPENDENT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Management for personality disorders?

A

Psychotherapy (possibly in a group setting).

Long consistent relationship with the GP.

Be careful of prescribing benzodiazepines due to risk of over-dependence (OD)

For poor impulse, you can consider tranquilisers or SSRI.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Features of Lewy Body Dementia?

A
  • Progressive cognitive impairment (fluctuates)
  • Affects attention (poor) and executive function more than memory (unlike Alzheimer’s)
  • Visual hallucinations
  • REM sleep
  • Usually develops before Parkinsonism
  • Eventually develops shuffling gait, rigidity, slow movement [bradykinesia], and loss of spontaneous movement) and autonomic dysfunction (such as postural hypotension, difficulty in swallowing, and incontinence or constipation) may be present.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What can you give and not give in patients with Lewy Body Dementia?

A

Give:

  • Acetylcholinesterase inhibitors (Donepezil and Rivastigmine)
  • Memantine

Avoid anti-psychotics/neuroleptics (like haloperidol, clozapine, olanzapine) as they can trigger worsening of parkinsonism.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Clinical features of Vascular Dementia?

A

Step-wise progression of symptoms worsening.

  • early gait disturbances
  • personality changes
  • might have focal neurological deficits
  • early urinary problems

History if vascular disease elsewhere like hypertension, previous MI, PVD, renovascular and retinopathy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Features of Parkinson’s Dementia?

A

Starts with Parkinsonism.
Has dementia after more than 12 months.

Behavioral problems, mood problems (apathy, depression, anxiety) and sleep disturbances.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

After reaching 35 years old, a man started developing:
- chorea = irregular, involuntary (dance-like) motion
- personality changes (e.g. irritability, apathy, depression) and intellectual impairment
dystonia
- saccadic eye movements

A) What is it
B) What happens patho-wise
C) What is the gene-inheritance like?

A

Huntington’s Disease:

  • Problem at Chromosome 4: Trinucleotide repeat disorder (so gets worse & presents earlier after each subsequent generation).
  • Results in the decrease in cholinergic and GABAnergic neurons in the striatum of the basal ganglia
  • Autosomal Dominant (AD)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Features of Frontotemporal Dementia?
When does it happen?
How does it come?

A

Onset before 65 usually and comes insidiously.

  • Personality change
  • Behavioural disturbance (such as apathy or social/sexual dis-inhibition)
  • Memory and visuo-spatial perception may be relatively preserved
26
Q

What is Pick’s Disease?

Features?

A

Fronto-temporal Dementia

  • Personality changes and social conduct (sexual dis-inhibition)
  • Hyperorality and increased appetite.
27
Q

What is the investigational characteristic of Pick’s?

A

Focal gyral atrophy with a knife-blade appearance.

Macroscopic changes seen in Pick’s disease include:-
- Atrophy of the frontal and temporal lobes

Microscopic changes include:-

  • Pick bodies - spherical aggregations of tau protein (silver-staining)
  • Gliosis
  • Neurofibrillary tangles
  • Senile plaques
28
Q

What is the triad for Normal Pressure Hydrocephalus?

A
  • ataxic gait
  • urinary incontinence
  • Cognitive impairment
29
Q

What do you see in the CT/MRI head of someone presenting with ataxic gait, urinary incontinence and cognitive impairment?

What can you do to treat it?

A

Disproportionate ventricular enlargement.

Ventricular shunting.

30
Q

What is pseudo-dementia?

A

poor memory and poor concentration due to depression

31
Q

Management for Alzheimer’s Dementia?

A

Acetylcholinesterase inhibitors: Donepezil & Rivastigmine

NMDA Glutamate R antagonists: Memantine

32
Q

Management for Vascular Dementia?

A

Control cerebrovascular risk factors via ASPIRIN & SMOKING CESSATION.

Possible anti-cholinergics.

33
Q

Management for Lewy Body?

A

Cholinesterase inhibitors: rivastigmine or donepezil

DONT GIVE ANTI-PSYCHOTICS LIKE HALOPERIDOL AS IT WORSENS PARKINSONISM

34
Q

Pharmacological treatment for Generalised Anxiety Disorder?

A

1) SSRI like escitalopram, sertraline, paroxetine
If not then SNRIs like duloxetine or venlafaxine. If both contraindicated then pregabalin.

Warn that it can cause anxiety, agitation, and sleeping problems and even increase thoughts of suicide initially.

Normal: Thus monitor every 2-4 weeks in first 3 months, then 3 monthly.
Suicide: weekly for 1 month

35
Q

Conservative management for GAD?

A

Sleep hygiene

Regular exercise

36
Q

What is a panic disorder?

Management?

A

Sudden onset, randon/unpredictable attacks of panic that is recurrent.
Severe anxiety attack accompanied by physical symptoms like tachycardia, palpitation, hyperventilation, sweating & tremor.
Fear of going mad/dying.

Affected individuals are SYMPTOM FREE in between panic episodes.

MX = CBT

37
Q

What is Acute Stress Disorder?
Who?
When does it happen? How long can it last max?

Typical features?

A

Secondary to physical or mental trauma in people WITHOUT pre-existing mental health problems.

Happens within minutes after the triggering event and resolves rapidly.
If removed from the stressor, complete resolution within hours. Max = 3 days

Daze followed by disorientation & inability to process external stimuli. Might have amnesia of the event later on.

38
Q

What are the characteristic features of Hebephrenic Schizophrenia?

Hint: think Hebe the mandarin singer

A
  • Disorganised speech + behaviour and flattened/inappropriate affect.
  • Earlier age of onset.
  • Worse prognosis than paranoid.
39
Q

What type of schizophrenia is this?

  • Best prognosis
  • Mainly hallucinations or delusions (positive symptoms)
  • Increased suicide risk
A

Paranoid Schizophrenia

40
Q

What schizophrenia is this?

  • A gradual decline in functioning
  • Only negative symptoms WITHOUT ANY POSITIVE SYMPTOMS
A

Simple Schizophrenia

41
Q

What is the feature of Chronic Schizophrenia?

A

Negative symptoms happen after 1 year of positive symptoms.

42
Q

What is the feature of Delusional Schizophrenia?

A

Delusions alone make up the diagnosis.

43
Q

What is the feature of Transient Schizophrenia?

A
  • A crescendo of symptoms within two weeks and complete resolution within 3 months.
  • Precipitated by a stressful event.
44
Q

What is the feature of Catatonic Schizophrenia? [8]

A
  • Mutism + preservation of words
  • Stupor, excitement, negativism
  • Rigidity, waxy flexibility
  • Posturing
45
Q
  • Fear of LEAVING HOME

- Fear of being in public or crowded places, travelling or public transport (places that are difficult to leave)

A

Agoraphobia

46
Q

Diffuse fear of SOCIAL INTERACTION such as talking to others, drinking and speaking in public.

A

Social Phobia

47
Q

Management of phobic disorders?

A

Behavioral therapy based around graded exposure or desensitisation to the fear-stimulus.

Anxiety management and also CBT.

SSRI as adjuvant.

48
Q

What is Adjustment Reaction?

A

Symptoms occur within 1 month, tends not to persist past 6 months.

Depression, anxiety, irritability and feeling of being unable to cope.

49
Q

What is PTSD?
When and how long?
What is the feature? [3]

A

Delayed weeks to months from a stressor that is of exceptionally threatening or catastrophic nature that is likely to cause pervasive stress to ANYONE. Can persist for years.

CF = nightmares & flashbacks.
Avoidance
Autonomic hyper-arousal such as hypervigilance, insonmia, anxiety, depression, guilt

50
Q

What is this?

Female w real disease. Presents with pain and fatique but seems really disproportionate to the disease. u get the feeling that it isnt fake (patient doesnt want it)

A

Somatisation Disorder

51
Q

What is this?

Feamle with no illness but during history, it seems like she has a preoccupation with acquiring an illness despite reassurance. She doesnt want the illness, but wants to check via investigations.

A

Hypochondriac

52
Q

what is this?

After witnessing some conflict/stressful event, a person presents with neuro complaints such as motor (paralysis) and sensory (blindness). Though they have these symptoms, it doesnt seem to lead them to hurt themselves i.e. not walking to wall or falling.

There is no preoccupation and the defect seems disproportionate to what the stressor was.

A

Conversion disorder.

53
Q

What is delirium tremens?

A

Acute CONFUSIONAL state characterised by:

  • disorientation
  • visual hallucination (snakes in bed)
  • fearfulness + agitation
  • sweating + tremors

Usually occurs about 3 days after alcohol withdrawal

54
Q

What is the triad and other symptoms of Wernicke’s encephalopathy? What causes it? Management?

A
  • Confusion
  • Ataxic Gait
  • Ophthalmoplegia
    Thiamine deficiency –> haemorrhage
  • Might also have peripheral sensory neuropathy or nystagmus

Mx: give thiamine

55
Q

What is Korsakoff’s Syndrome?

A

Anterograde (new) & retrograde (old) amnesia
the gaps are filled with CONFABULATIONS

preserved long term memory and social skills

56
Q

What is hypomania?

A

milder episodes of elevated mood (relative to mania) with no hallucination

57
Q

Bipolar management:

1) Mania?
2) Agitation?
3) long-term prophylaxis

A

Mania: Neuroleptics i.e. haloperidol or olanzapine
Agitation: benzodiazepines i.e. diazepam

Long term: Lithium (mood stabiliser) –> sodium valproate or carbamazepine.

58
Q

What are the indications for electroconvulsive therapy?

A

Refractory depression i.e. catatonic
Prolonged or severe manic episode
Life-threatening severe depression

59
Q

What are some symptoms of both mania and hypomania?

  • Mood
  • Speech and thought
  • Behaviour
A

Mood is predominantly elevated + irritable.

Pressured speech & flight of ideas & inattention.

Lack of inhibition, insomnia, increased appetite.

60
Q

Signs of delirium tremens?

A

Symptoms start 6-12hrs: Tremor, tachycardia, sweating, anxiety
Seizures - peak 36hrs
Delirium tremens peak at 2-3 days: coarse tremor, confusion, delusions, auditory and visual hallucinations, fever, tachycardia.

61
Q

Management for delirium tremens? If hepatic failure?

A

Tapering (decreasing dose) of benzodiazepines i.e. chlordiazepoxide. If there is hepatic failure, then lorazepam instead.

Medicine Finals 2020 (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions