Mental health core conditions Flashcards

Question

What are the withdrawal symptoms? When is the onset? And how long does it normally last?

Answer 1

``` tremor nausea vomiting sweating generalised convulsions Delrium tremens ``` 3-6 hours after last drink lasts 5-7 days

Answer 2

``` Occur in 3% of alcohol withdrawals rapid onset of confusion Complications: seizures hyperthermia dehydration electrolyte imbalance shock chest infection ```

Answer 3

``` confusion ataxia opthalmoplegia nystagmus memory disturbances hypothermia hypotension coma ``` Treat urgently with parenteral thiamine

Answer 4

F: 15-19 | M;20-24

Answer 5

They should be referred to A&E and be admitted to a paediatric ward over night

Answer 6

Referred to A&E and presumed to have suicidal thoughts until proven otherwise

Answer 7

IBS and chronic pain PTSD antisocial personality disorder history of sexual or physical abuse

Answer 8

Multiple symptoms, often occurring in different organ systems symptoms that are vague or exceed objective findings chronic course presence of psychiatric disorder history of extensive diagnostic testing rejection of previous physicians

Answer 9

Infection- e.g. UTI Metabolic disturbances- e.g. hypoglycaemia, electrolytes, dehydration CV disorder- e.g. MI respiratory disorder- e.g. PE or COPD exacerbation Neurological disorders- e.g. stroke, enecephalitis, SAH Endocrine disorders- e.g. thyroid or Cushing's Urinary retention GI disorders- e.g. hepatic failure, constipation, malnutrition Severe uncontrolled pain ``` Depression sleep deprivation visual or hearing impairment emotional stress change in environment ``` alcohol intoxication Medication

Answer 10

``` opioids benzodiazepines amoldipine antihistamines anti-parkisonian meds tricyclic antidepressants lithium antipsychotics anticonvulsants antiarrhythmics antihypertensives corticosteroids NSAIDs ```

Answer 11

``` >65 cognitive impairment e.g. dementia Multiple co-morbidities significant injuries catherisation polypharmacy surgery alcohol excess sensory impairment poor nutrition lack of stimulation terminal phase of illness ```

Answer 12

hours to days | They tend to fluctuate

Answer 13

falling and loss of appetite

Answer 14

inappropriate behaviour hallucinations restlessness wandering

Answer 15

lethargy reduced concentration reduced appetite may appear quiet and withdrawn

Answer 16

Confusion that has developed suddenly and fluctuates Inattention disorganised thinking altered level of consciousness

Answer 17

``` urinalysis- hyperglycaemia sputum culture- chest infection FBC- infection or anaemia Folate and B12 Urea and electrolytes- AKI, hyponatremia/kalaemia HbA1c Ca LFTs ESR CRP drug levels TFTs CXR ECG ```

Answer 18

Alzheimer's (50-75%) Vascular dementia (20%) Dementia with Lewy bodies (5%) Frontotemperal dementia (2%) ``` rarer: Parkinson's disease dementia progressive supranuclear palsy Huntington's CJD Normal pressure hydrocephalus chronic subdural haematoma benign tumours Hypocalcaemia recurrent hypoglycaemia Vitamin B12 and thiamine def HIV Syphillis ```

Answer 19

``` Age mild cognitive impairment Learning difficulties esp. Down's Genetics CV risk factors for vascular dementia- DM, smoking, HTN low physical activity stroke depression alcohol low educational attainment low social engagement and support ```

Answer 20

mutation in the amyloid precursos protein (APP) | or presebillin genes: PSEN1, PSEN2

Answer 21

Impairment of at least 2 cognitive domains (see below) leading to significant functional decline that cannot be explained by another disorder or medication memory language behaviour visuspatial or executive function

Answer 22

``` agitation/ emotional labillity depression apathy repetitive questioning psychosis aggression sleep problems wandering ```

Answer 23

memory problems receptive or expressive dysphagia difficulty carrying out coordinated movements e.g. dressing Disorientation and unawareness of time and place impairment of executive function e.g. planning or problem solving

Answer 24

early impairment of episodic memory- loss of memory of recent events, repeated questioning, difficulty learning new info

Answer 25

stepwise increase in severity of symptoms | focal neurological signs e.g. hemiparesis or visual field defects may be present

Answer 26

``` repeated falls syncope severe sensitivity to antipsychotics delusions hallucinations Memory impairment may not be apparent in early sarges Parkinsonian motor features ```

Answer 27

Personality changes and behavioural disturbances e.g. apathy, sexual disinhibition Other cognitive functions e.g. memory and perception may be preserved

Answer 28

Acetylcholinesterase inhibitors- donepezil, galantamine and rivastigmine Memantidine