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Core Conditions > Mental Health Conditions > Flashcards

Mental Health Conditions Flashcards

1
Q

Who is typically affected by alcohol dependence?

A

More common in MEN
LOW SOCIO ECONOMIC
LOW EDUCATION LEVELS

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2
Q

What is the cause for alcohol dependence?

A 
It is defined as a:
CRAVING
TOLERANCE 
PREOCCUPATION
- social factors
- genetic factors
- environmental factors
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3
Q

What are the risk factors associated with alcohol dependence?

A

NON-MODIFIABLE- age, family history, social/cultural factors
MODIFIABLE- steady drinking over time
PMH- depression/mental health problems

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4
Q

What are some of the symptoms of alcohol dependence?

A 
Inability to limit alcohol consumption
Trying to cut down
Craving alcohol
Failing to fulfill major obligations
Giving up other activities
Using alcohol in unsafe situations
Developing tolerance to alcohol
Experiencing withdrawal symptoms
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5
Q

What are the clinical signs of alcohol dependence?

A

More than a score of 2 on the CAGE test

Stigmata of liver disease

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6
Q

What comprises the CAGE test?

A

Cutting down?
Annoyed by criticism?
Guilty about drinking?
Eye-opener (ever needed a drink in the morning/steady nerves/cure hangover?)

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7
Q

What other investigations are needed in suspected alcoholism?

A

BLOODS: GGT (raised in alcohol dependence), MCV (raised in alcohol dependence but also many other things), CDT
CAGE
AUDIT-C
AUDIT QUESTIONNAIRE

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8
Q

What is the best management for alcohol dependence?

A 
Determine the severity of the dependence
Admit/refer for specialist treatment
Individual treatment plan
Assisted alcohol withdrawal
Extended brief intervention
Advice (harm, barriers to change, practical strategies)
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9
Q

Who is most commonly affected by anxiety?

A

WOMEN

ELDERLY

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10
Q

What are some of the risk factors for anxiety?

A

Age 35-54
Divorce/separation
living alone/lone parent

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11
Q

What are the key symptoms experienced in anxiety?

A

Autonomic arousal symptoms- palpitations, tachycardia, sweating, shaking, dry mouth

Chest/Abdo. symptoms- difficulty breathing, chest pain, choking sensation, nausea/abdo. distress

Mental symptoms- dizziness, fear of death, loss of control, derealisation

General symptoms- restlessness, hot flushes/cold chills, muscle tension

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12
Q

What are the differential diagnoses associated with anxiety?

A 
Panic disorder
PTSD
OCD
Social phobia
Schizophrenia
Dementia
Alcoholism
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13
Q

What investigations can be done in suspected anxiety?

A

Mostly history- but ICD-10

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14
Q

What is the treatment for anxiety?

A

Graded care plan

  • low intensity psychological support/self-guided help
  • cognitive behavioural therapy, drug treatment
  • specialist drug/psychological treatment
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15
Q

Who is typically affected by delirium?

A

ELDERLY

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16
Q

What is delirium?

A

ACUTE, fluctuating syndrome of disturbed consciousness, attention, cognition and perception

  • HYPERACTIVE
  • HYPOACTIVE
  • MIXED

Can also be MULTIFACTORIAL

  • infective
  • metabolic
  • intracranial
  • endocrine
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17
Q

What are the key risk factors in delirium?

A

NON-MODIFIABLE- old age

MODIFIABLE- poor nutrition, excessive alcohol, lack of stimulation

PMH- cognitive impairment (dementia), frailty/multiple comorbidities, significant injuries, functional impairment, metabolic disturbance, any other systemic disorder.

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18
Q

What are the notifiable symptoms in delirium?

A

Acute behaviour changes
Altered cognitive function
Inattention
Disorganised thinking
Altered perception
Increased sensitivity to immediate surroundings
Agitation, restlessness, sleep disturbance
Lethargy, reduced mobility, lack of interest in ADLs, reduced appetite, withdrawn.

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19
Q

What are some differentials associated with delirium?

A

Mood disorder
Psychotic illness
Dementia

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20
Q

What investigations are carried out in suspected delirium?

A

AMTS

21
Q

What comprises the AMTS?

A 
Name
DOB, Age
Address- 42 West Street
Current location
Current time
Current year
Current Monarch/ Prime minister
Year of WW2 (start/end)
Recognition of people
Counting backwards 20-1
Repeat address
22
Q

What is the treatment for delirium?

A

Identify and treat the underlying cause
Provide environmental and supportive measures
Avoid sedation
Regular clinical review

23
Q

Who is typically affected by dementia?

A

ELDERLY

24
Q

What are the primary causes of dementia?

A

Alzheimer’s disease
Vascular dementia
Dementia with Lewy bodies
Frontotemporal dementia

25
Q

What are the risk factors associated with dementia?

A

NON-MODIFIABLE- old age, genetics, low socioeconomic status

MODIFIABLE- smoking, excessive alcohol

PMH- mild cognitive impairment, learning difficulties, diabetes, hypercholesterolaemia, hypertension, Parkinson’s, stroke, depression

26
Q

What are the symptoms associated with dementia?

A 
Memory problems
Repetitive and expressive dysphagia
Difficulty in carrying out coordinated movements
Disorientation
Psychosis
Agitation, emotional liability
Depression and anxiety
Withdrawals
Difficulties with ADLs
27
Q

What are the differentials of dementia?

A 
Age related memory changes
Mild cognitive impairment
Depression
Delirium
Vitamin deficiency
Hypothyroidism
28
Q

What investigations should be carried out in suspected dementia?

A

MMSE
6-CIT
IMAGING: MRI, CT

29
Q

What is the management for dementia?

A

Identify the type

Care plans- care givers, dossett boxes

30
Q

Who is most commonly affected by depression?

A

WOMEN

31
Q

What are the risk factors for depression?

A

NON-MODIFIABLE- genetic factors, personality, failure of adaptive mechanisms to stressors
SOCIAL- psychosocial issues
PMH- chronic comorbidities, past head injury

32
Q

What are the symptoms associated with depression?

A 
Low mood, hopelessness
Little interest/pleasure in doing things
Fatigue
Worthlessness/ excessive guilt
Recurrent thought about death/suicide
Diminished ability to think
Psychomotor agitation or retardation
Insomnia/hypersomnia
Significant appetite/weight loss
33
Q

What are the clinical signs associated with depression?

A

Hypersomnia
Neglectful appearance/hygiene
Obviously low mood

34
Q

What are the differentials for depression?

A 
Grief reaction
Dementia
Substance abuse
Adverse drug effects
Hypothyroidism
35
Q

What investigations should be carried out in depression?

A

QUESTIONNAIRES- PHQ-9. HADS. BDI-II
Assess suicide risk
Look out for co-morbid conditions
Biochem and Haematology to rule out other causes.

36
Q

What is the appropriate management for depression?

A

Watchful waiting
Source support
low and high psychological interventions
counselling and short term psychodynamic

Antidepressants
- generic SSRI (citalopram, fluoxetine, paroxetine, sertraline)

37
Q

Who is most likely to be affected by self harm?

A

ADOLESCENTS and YOUNG ADULTS

slightly more prevalent in FEMALES

38
Q

What are the risk factors associated with self-harm?

A 
Socio-economic disadvantage
Social isolation
Mental health problems
Chronic physical health problems
Alcohol/drug misuse
Child maltreatment/domestic violence
39
Q

What are the symptoms of self harm?

A

Depressive symptoms

40
Q

What clinical signs of self harm can be manifest?

A

Marks on the skin
Neglectful appearance/hygiene
Extreme weight loss

41
Q

What is the management for self-harm?

A

Manage any sustained injuries
Manage psychosocial needs
Remove access to means of self-harm if possible
CAMHS

42
Q

What is somatisation?

A

The manifestation of physical symptoms without physical cause/stimulus

43
Q

Who is most likely to be affected by somatisation?

A

WOMEN

before the age of 30

44
Q

What are the risk factors for somatisation?

A 
IBS
Chronic pain
PTSD
Antisocial personality disorder
Sexual/Physical abuse
45
Q

What are the symptoms of somatisation?

A

CARDIAC- sob, palpitations, chest pain
GI- vomiting, pain, dysphagia, nausea, bloating, diarrhoea
MSK- pain in joints and limbs
NEURO- headaches, dizziness, amnesia, visual changes, paralysis/parasthesia
UROGENITAL- pain on urination, low libido, impotence, dyspareunia, dysmenorrhea

46
Q

What are the differentials for somatisation?

A

Bipolar disorder
Schizophrenic disorder
Panic disorder
Anxiety

47
Q

What investigations are carried out for somatisation?

A

Structured history/interview

48
Q

What is the management for somatisation?

A 
BATHE
Background
Affect
Trouble
Handle
Empathy

Take seriously and treat with empathy

Core Conditions (11 decks)

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