Phsycial / Metabolic & Endocrine / infectious Flashcards
What is somatisation disorder? Commonly seen in? Usual places? What do you need to do?
2 years of multiple physical sx with no physical explanation
Social + family functioning impairment
GI/skin
Rule out physical illness
How does anxiety play a role in somatisation disorder
-> misinterpret bodily sensations -> increased anxiety -> worsens
What is hypochondrial disorder? Management?
Fear of having serious illness
CBT
What is dysmophobia ? Management?
Excessive preoccupation with imagined / barely noticeable physical defects
CBT
SSRIs
What is dissociative disorder also called? What is it?
Conversion disorder
Physical / neuro sx occur in ABSENCE OF PATHOLOGY & have clear relationships with stressful events / disturbed relationships
Egs of sx of conversion disorder
Motor / sensory - weakness, numbness, blindness
Convulsions (non epileptic) - up to 10% of people in epilepsy clinics
Dissociative fugue / amnesia - usually personal information forgotten (eg identity / memories and personality) -> upsetting
Dissociative vs somatisation disorder ?
D - More signs
S - presents with Sx
Who often has repeated requests for testing of HIV
Depression, anxiety, hypochondrial disorder, schitz
What kind of psychological reactions do people tend to exhibit to a diagnosis /failing treatment for HIV
Acute stress reactions
Adjustment disorders
Anxiety / depression -> self harm / suicide
How can mental illness increase risk of hiv
Impulsivity
How does mental illness affect a diagnosis of HIV? What might you need to do?
Less likely to adhere to complicated antiretroviral treatment
May need to breach confidentiality
Depression is common at all stages of HIV, what are the DDs of depression in HIV ? Risk with depression?
Decreased CD4 count + viral load -> fatigue / weight loss
Lack of adherence / self harm
What is AIDS dementia complex also known as? What is it?
HAND - HIV Associated Neurocognitive Disorder
Due to direct HIV infection in brain
Opportunistic infections can also cause Eg syphilis, parvovirus, toxoplasmosis
Usual cause of viral encephalitis ? Sx?
Herpes simplex
Severe headache, vomiting, reduced consciousness
What is general paralysis of the insane? Which disease does it occur in? What are the features? How do you test for it? What’s the treatment?
Tertiary syphilis - occurs many years after initial infection
Cognitive - poor concentration
Dementia 30%
Depression 25%
Grandiosity - can rarely occur with mania / other psychoses
Test - VDRL (venereal disease research laboratory test)
Treat - IM penicillin
What transmission is acute intermittent porphyria? what does it affect? Sx?
AD - affects heme production
ABDO PAIN, constipation, vomiting, peripheral neuropathy, epilepsy
Psych - Delirium (50%), depression, emotional liability and schitz like psychoses
Hypothyroidism
Depression/Anxiety?
Behavioural disturbance?
Psychosis?
Both
Irritability, occasional apathy and poor appetite
Psychotic depression
Hypothyroidism / hyperparathyroidism Depression/Anxiety? Behavioural disturbance? Psychosis? Cognitive change?
Both
Acute agitation, apathy and emotional liability
Some hallucinations post parathyroidectomy
DELIRIUM, dementia, poor concentration, cognitive impairment
Usual cause of hypercorticoidaemia ? Psych sx?
Iatrogenic
Mania
What is hypocorticoidaemia ? Behavioural change?
Addison’s
Apathy
Usual cause of Addison’s? Common Sx? What is an adrenal crisis and sx?
Primary adrenal insufficiency - Autoimmune usually (often TB in developing world)
Abdo pain, weakness, weight loss, darkening of areas of skin
Low BP, lower back pain, vomiting, loss of consciousness
Management of Addison’s
Corticosteroids
Eg hydrocortisone
Hypopituitarism
Depression/Anxiety?
Behavioural disturbance?
Cognitive change?
Depression
Irritability
Impaired memory
How does vitamin b12 deficiency lead to psych symptoms? What are they?
-> pernicious anaemia + subacute degeneration of the spinal cord
-> neuropathy and spinal cord signs
Psych - mental slowing, confusion, memory problems, intellectual impairment
