Mental Health

Question 1

PTSD

- definition

Answer 1

Death, serious injury or sexual violence

• direct experience
• witness to the event
• close family member
• repeated exposure (first responders)

Question 2

PTSD

• 3 x clusters of sx
• persist > 1 month after exposure

Answer 2

1. Re-experiencing symptoms
2. Hyper-arousal
3. Avoidance / numbing

Question 3

Adjustment disorder

Answer 3

• Can be AD with depressed mood or anxious mood
• onset within 3 months of an identifiable stressor
• persists for less than 6 months

Question 4

Conversion disorder

Answer 4

• blindness, paralysis or other neurological sx that cannot be medically explained
• sx usually begin after a stressful experience

Question 5

Schizophrenia

Answer 5

Delusions, hallucinations, disorganised speech / behaviour +/- negative symptoms & social / occupational dysfunction

At least 6 months

Question 6

Hx questions to explore risk of suicide

Answer 6

1. Access to means of suicide
2. Past suicide attempts
3. Social isolation
4. Adverse life events
5. FMHx suicide
6. Recent suicide of someone known to patient
7. Substance abuse
8. Hx impulsive behaviour
9. Given away possessions or written goodbye note

Question 7

Hypomania

- hx questions to ask

Answer 7

• increased energy
• decreased need for sleep
• increased libido
• grandiosity
• distractibility
• increased harmful activities - excessive spending
• psychotic features such as hallucinations
• hospitalisation
• drug use

Question 8

Invx required for lithium monitoring (4)

Answer 8

1. UEC (3-6 monthly)
2. Ca (6-12 monthly)
3. TFTs (6-12 monthly)
4. Li level (3-6 monthly until stabilised)