Other Psychiatric Problems Flashcards

1
Q

What cardiovascular disorders can cause delirium?

A

Intracranial/Subdural bleed
MI
PE
CCF

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2
Q

What GI disorders can cause delirium?

A

Liver failure

Pancreatitis

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3
Q

What endocrine disorders can cause delirium?

A

Diabetic complications

Thyroid disorders

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4
Q

What GU disorders can cause delirium?

A

UTI

Renal failure

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5
Q

What neurlogical disorders can cause delirium?

A
Head injury
Meningitis
Encephalitis
Tumours
Epilepsy
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6
Q

What is the NHS Tayside Protocol for pharmacological management of delirium?

A

Haloperidol 0.5-5mg PO then IM:

- Up to 10mg in 24 hours

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7
Q

What drug, in the NHS Tayside Protocol for pharmacological management of delirium, is used in Parkinson’s, Lewy Body Dementia and Neuroleptic sensitivity?

A

Lorazepam 0.5-2mg, up to 2 times in 24 hours

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8
Q

What is the mean duration of delirium?

A

1-4 weeks:

  • Often longer in elderly
  • Some can become chronic
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9
Q

What is the most common neuropsychiatric complication of a stroke?

A

Post-Stroke depression

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10
Q

How many patients have depressive symptoms following an MRI?

A

65%

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11
Q

What is anterograde amnesia?

A

Difficulty in acquiring new material

Difficulty in remembering events since illness/injury onset

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12
Q

What is retrograde amnesia?

A

Difficulty remembering info prior to illness/injury onset

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13
Q

What is it important to assess in cognition of memory problems?

A
Memory
Attention and concentration
Executive functioning
Visuospatial functioning
Language
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14
Q

In individuals with suspected cognitive impairment, what should be carried out?

A

MMSE

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15
Q

What examination approves initial testing?

A

Addenbrookes Cognitive Examination

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16
Q

What is MMSE scored out of?

A

30

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17
Q

What is the cut off for MMSE?

A

> 27 vs <24

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18
Q

What are the 4 criteria assessed in an MMSE?

A

Orientation
Memory
Visuospatial
Language

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19
Q

What are the advantages of MMSE?

A

Quick

Different languages

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20
Q

What are the disadvantages of MMSE?

A
Not adjusted for age
Poor for executive functioning
Poor in severe cases -> 'Floor effect'
Poor in high premorbid functioning
Not sensitive in early stages
Exclusion of non-verbal skills
21
Q

What domains are assessed in the Addenbrookes Cognitive Examination III?

A
Orientation
Attention
Memory
Executive functioning
Language
Visuospatial functioning
22
Q

How long does the Addenbrookes Cognitive Examination III take?

A

~15 minutes

23
Q

What domains are assessed in Neuropsychological Assessments?

A
Pre-morbid functioning
Orientation and attention
Memory and new learning
Visuospatial and constructional functioning
Language
Executive functioning
Emotional status
24
Q

What is the diagnostic triad in ADHD?

A

Inattention
Hyperactivity
Impulsivity

25
Q

What do the triad of features in the diagnosis if ADHD have to be to diagnose ‘combined-type’ ADHD (aka Hyperkinetic Disorder)?

A

Developmentally inappropriate
Impairing
Pervasive
Longstanding

26
Q

What structured diagnostic questionnaires can be used in the diagnosis of ADHD?

A

Conners Rating Scale

ADHD Rating Scale

27
Q

What are some risk factors for ADHD?

A

Family history
Male gender
Socioeconomic status

28
Q

What are the first line psychological therapies for ADHD?

A
Parent training (New Forest parenting programme)
Classroom strategies
29
Q

What are the second line psychological therapies for ADHD?

A

Social skills

Sleep and diet

30
Q

When might psychological therapies be useful and not sufficient?

A

Useful for secondary difficulties at home

Not sufficient in most cases

31
Q

What are the first line pharmacological treatments for ADHD?

A

Methylphenidate (‘Ritalin’)
Dexamfetamine
Lisdexamfetamine

32
Q

How do the first line pharmacological treatments for ADHD work?

A

‘Stimulants’

  • Increase DA transmission in executive functioning networks to prefrontal cortex
  • Directly improve symptoms
33
Q

What are the side effects of the first line pharmacological treatments for ADHD?

A
Reduced appetite
Reduced sleep
Dysphoria
Anxiety
Tics
34
Q

What is the second line pharmacological treatment for ADHD?

A

Atomoxetine

35
Q

What are the third line pharmacological treatments for ADHD?

A

Antidepressants
Antihypertensives
Antipsychotics

36
Q

What weeks of the New Forest Parenting Programme are parent only?

A

Week 1
Week 2
Week 5
Week 8

37
Q

What weeks of the New Forest Parenting Programme are parent and child?

A

Week 3
Week 4
Week 6
Week 7

38
Q

What techniques do parents learn during week 2 of the New Forest Parenting Programme?

A

Routines
Clear communication
Limit setting
Ability to avoid confrontation

39
Q

How can a parent learn to manage a child’s temper during week 3 of the New Forest Parenting Programme?

A

Firm limits

Distraction strategies

40
Q

What do parents learn to use during week 4 of the New Forest Parenting Programme?

A

Time out

Quiet time

41
Q

During weeks 6 and 7, how long does the practitioner of the New Forest Parenting Programme observe the parent and child alone for?

A

15 minutes

42
Q

How common is Autism Spectrum Disorder?

A

1/68

43
Q

Is Autism Spectrum Disorder more common males or females?

A

Males

44
Q

What are the triad of impairments in Autism Spectrum Disorder?

A
  1. Qualitative impairments in reciprocal social interaction
  2. Language impairment
  3. Thought and behaviour
45
Q

How is Autism Spectrum Disorder defined in DSM-IV-TR?

A

> =6 symptoms including:

  • > =2 of qualitative impairment in social interaction
  • > =1 of qualitative impairment in communication
  • > =1 symptoms of restricted/repetitive behaviour
46
Q

When is Risperidone used in Autism Spectrum Disorder?

A

Short-term for:

  • Aggression
  • Tantrums
  • Self-injury
47
Q

If there are ADHD symptoms in Autism Spectrum Disorder, what drug can be used?

A

Methylphenidate

48
Q

If there are sleep problems in Autism Spectrum Disorder, what drug can be used?

A

Melatonin