PASTest Flashcards
what is EUPD typified by?
explosive interpersonal relationships
lack of identity
unstable moods
impulsiveness
splitting defence mechanism?
immature defence mechanism
unable to reconcile both good/bad traits in a given person
dissociation
immature ego defence where one person’s identity is temporarily and drastically modified to avoid distress
Deprivation of liberty
how long can it apply?
7 days
care home / hospital
what is an AMHP and what role do they play in section 2
approved mental health professional
> Can decide whether a person can be detained under mental health act (section 2)
medication for PTSD
paroxetine / sertraline
only if not having trauma focused psychological treatment
venlafaxine can be given
12 months > gradually withdrawn over 4 weeks
what therapy for combat focused PTSD?
trauma based CBT
psychoeducation, dealing with hyperarousal and flashbacks and processing trauma related emotions
postpartum blues
50% of females experience it
fatigue
tearful
depressed affect
resolves 10-14 days following birth
postpartum depression
2 weeks of depressed mood
begins 4 weeks of delivery
5 symptoms:
change in sleep
guilt
loss of interest
decreased energy
diff concentrating
sluggishness
suicidal ideation
how many women get postpartum depression?
10%
how many women get postpartum psychosis?
0.1%
hallucinations and delusions present
what is regression?
immature ego defence where you act like a child / revert to childish behaviour
in setting of stress
regressed to toddler
flooding refers to?
term in behavioural therapy
exposed to worse fear aims to trigger desensitisation
how long does a 5(2) last?
needs a dr to do it
72 hours
what are scheider’s frist rank symptoms?
Auditory hallucinations
>3rd person commentary
>thought echo
>running commentary
Thought disorder
>Broadcast
>Withdrawal
>insertion
passivity phenomena
delusional perception
2 stage
normal object percieved then delusional insight into object
Poor prognostic indicator for Schizophrenia?
strong family history
gradual onset
low IQ
prodrome of social withdrawa;
lack of obvious precipitant
section 136 can be used to?
detain from a public place - shopping centre etc
by police
for mental health concern
coping mechanism: Avoidance
just avoiding the problem pretending it does not exist
continue their behaviour as if the stressor is not present
hypofunction of ___ is associated with schizophrenia
_____ cerebral ventricles are also present
prefrontal cortex
enlarged
Korsakoff’s amnesia
severe deficiency in thiamine vitb1
= bilateral loss of mammilary bodies in the brain
what is beri beri?
b1 defiency
polyneuritis
muscle waste
dilated cardiomyopathy
Niacin Vit b3
can lead to pellagra
how to report on speech? in MSE
rate
rhythm
volume
how to treat folie a deux
shared delusional disorder
1st step is to separate patients
acute schizophrenia how to manage?
commence an atypical antipsychotic
olanzapine
but this takes 10 days to work
so sedative might be needed - short acting benzodiazepine -Lorazepam
procyclidine can help with acute dystonia
social learning?
modelling behaviour pattern acquired by watching other people
then assimilating their actions
diagnostic criterion for anorexia nervosa?
an intesne fear of gaining weight
becoming fat
violence and schizophrenia?
people with schizophrenia are responsible for 20th of homicides
5% compared to general popupulation 1%
alcohol abuse what kind of therapy is best?
group self help
interpersonal therapy is best for?
depression - prolonged grief
when would psychoanalytic psychotherapy be best
deep rooted problems that did not respond to interpersonal therapy
neuroleptic malignant syndrome
antipsychotic extreme side effect
fever
muscular rigidity
delirium
hypertensions
schizophrenia stats
20 million people worldwide have it
1%
46% in monozygotic
14% in dizygotic
indications for ECT
severe catattonic stupor
high risk of suicide
psychotic features
food refusal
refractory to antidepressants
previous response to ECT
how long is a full course of ECT?
12 sessions
you can
what is displacement?
displacing your feelings on people not involved
so if you are angry with partner but shout at cyclist on your way to work
projection is?
when you assume someone is in the wrong when you actually are
motivation interview: RULE
resist to employ a firm course of action
understand reason for change in behaviour
listen to ICE
empower the patient that they can change their behaviour
Indications for Clozapine?
more effective than conventional antipsychotic for resistant psychosis
not used first line
30% of patients improve after 6 weeks of treatment
60% respond after a year
hypersalivation - sialorrhoea
how to treat?
common s/e of clozapine
hyoscine - anticholinergic
procyclidine is a?
anticholinergic
helps with acute dystonia as a s/e of antipsychotic - more with typical
evaluating a patients suicide risk
assess static and dynamic factors
static: age, sex, previous history of self harm
dynamic: drug use, self harm, employment status
reward system hormone
dopamine
anhedonia is when dopamine in the brian must be affected
IQ - normal range
70-130
100 is average
severe LD?
20-34 IQ
moderate LD
35-49
<20 IQ
profound LD
diagnosing dependence - alcohol
strong sense / compulsion
difficult in controlling how substance behvaiour happens so like how long you take it for/ when / where/ not being able to say no if you had planned to but now someone is offering it to you
evidence of tolerance
neglect of other interests
persisting with substance despite clear evidence of harm
what can make lewy body dementia worse?
haloperidol - first gen antipsychotics
what can be used to treat lewy body dementia?
clonazepam - sleep
donepezil - acth inhibitor to help with hallucinations
memantine - if can’t take donepezil
rivastigmine - increases acetylcholine in brain
acetylcholnesterase inhibitors
memantine
donepezil
rivastigmine
increase levels of acetylcholine in brain
Cocaine-induced delusional disorder
what are the findings in Nephrogenic DI?
low urine osmolality but high serum osmolality
DI associated with signs of dehydration because you are not able to retain/ reabsorb water
postural drop in bp
sodium - hypernatraemia
Bipolar patient presenting with mania
acutely unwell
check lithium levels
consider adding an antipsychotic
Dementia vs delirum how to differentiate in a&e
fluctuating consciousness indicates delirum
when is paroxetine > citalopram
paroxetine is for a major depressive disorder
