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Psychiatry > Primary Care and Learning Disability > Flashcards

Primary Care and Learning Disability Flashcards

1
Q

Key symptoms of Depression

A

Persistent sadness/low mood
Anhedonia
Fatigue/low energy

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2
Q

Associated symptoms of depression

A 
Disturbed sleep 
Poor concentration 
Low self-confidence 
Poor or increased appetite 
Suicidal thoughts or acts 
Agitation or slowing of movements 
Guild or self-blame
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3
Q

Which criteria is required for mild depression

A

4 symptoms

Least 2 key

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4
Q

Which criteria is required for moderate depression Dx

A

5-6 symptoms

least 2 key

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5
Q

Which criteria is required for severe depression dx

A

Seven or more (all 3 key)

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6
Q

What must you ALWAYS ask a patient in a psychiatric history

A

suicidal thoughts

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7
Q

What should you ask regarding suicide in a history

A

How far have they gone to plan it?
Previous attempts
Homicidal risk

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8
Q

if patient presents with considerable immediate risk to themselves or other what is the management

A

Refer urgently to specialise mental health services

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9
Q

Which criteria is often used by GPs to diagnose depression

A

DSM

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10
Q

Which is the 1st line anti-depressant

A

SSRI

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11
Q

Which psychological therapy should you use for depression

A

CBT

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12
Q

Rules for switching anti-depressant

A 
initially switch to a different SSRI 
or SNRI 
Subsequently to another class which may be less well tolerated
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13
Q

Who should prescribe MAOI

A

Specialist care only

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14
Q

Define prolonged grief disorder

A

Marked distress and disability caused by the grief reaction.
AND the persistence of this distress and disability more than 6m after a bereavement.

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15
Q

What are the treatment options for prolonged grief disorder

A

Counselling
Antidepressant for co-morbid depression
Behavioural/cognitive/exposure Refer if significant impairment in functioning

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16
Q

1st line Rx for OCD

A

CBT including exposure and response prevention

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17
Q

2nd line Rx for OCD

A

SSRI

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18
Q

3r line Rx for OCD

A

Clomipramine

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19
Q

Examples of SSRIs

A

Sertraline
Citalopram
Fluoxetine
Paroxetine

20
Q

2ndry causes of insomnia

A 
Anxiety/depression 
Physical health problem 
Obstructive sleep apnoea 
Excess alcohol or illicit drugs 
Parasomnias 
Circadian rhythm
21
Q

Primary care for eating diroders

A

Recognise and refer to 2ndry care

22
Q

Expected SE of lithium treatment

A 
Fine tremor 
Dry mouth 
Altered taste sensation 
Increased thirst 
Urinary frequency 
Mild nausea 
Weight gain
23
Q

Toxicity symptoms of lithium

A 
Vomiting and Diarrhoea 
Coarse tremor 
Muscle weakness
 Lack of co-ordination including ataxia 
Slurred speech 
Blurred vision 
Lethargy 
Confusion 
Seizures
24
Q

How often do lithium levels need to be checked

A

3/12

25
Q

What should you not start Rx in the depressed phase

A

Refer/discussed with 2yr care

26
Q

What is GAD?

A

Generalised Anxiety Disorder (GAD)

Excessive worry about a number of different events

27
Q

What is panic disorder

A

Recurrent panic attacks
Persistent worry about
further attacks

28
Q

What is social anxiety disorders

A

persistent fear of, or anxiety about one or more social or performance situations that is out of proportion to the actual health posed by the situation

29
Q

ICD 10 definition of learning disability

A

• ‘A condition of arrested or incomplete development of the mind, which is especially characterised by impairment of skills manifested during the developmental period, which contribute to the overall level of intelligence i.e. cognitive, language, motor and social abilities’

30
Q

Criteria for LD

A

1.Intellectual impairment (IQ < 70) (Wechsler)

2.Social or adaptive dysfunction (Vineland Scale)
a. Deficits/Impairments in 2 or more of following adaptive skills: communication,
self-care,
home living,
social skills,
community use,
self direction,
health and safety, functional academics,
leisure & work

3.Onset in the developmental period (age 18)

31
Q

IQ of mid learning disability

A

50-59

32
Q

IQ of moderate LD

A

35-49

33
Q

IQ of severe learning disability

A

20-34

34
Q

IQ of profound LD

A

<20

35
Q

Genetic aetiology of LD

A

Single gene: Fragile X, PKU, Retts Syndrome

Microdeletion/duplication: DiGeorge Syndrome, Prader-Willi, Angelman syndrome

Chromosomal abnormality: Down Syndrome

36
Q

Infective aetiology of LD

A

Ante-natal e.g rubella, Zika virus

Post-natal e.g meningitis, encephalitis

37
Q

Toxic aetiology of LD

A

Fetal alcohol syndrome

38
Q

What is the main aetiology of LD

A

unknown for most individuals

39
Q

Trauma aetiology of LD

A

Birth asphyxia

Head injury

40
Q

Which neuro condition is more common in LD

A

Epilepsy

41
Q

Which sensory impairments are more common in LD

A

Hearing

Vision

42
Q

Which GI problems are more common in LD

A

Swallowing problems Reflux oesophagitis Helicobacter pylorii

Constipation

43
Q

Which respiratory problems are more common in LD

A

Chest infections
Aspiration
Pneumonia

44
Q

Is cerebral palsy more or less common in LD

A

more common

45
Q

Which orthopaedic problems are more common in LD

A

Joint contractures

Osteopororsis

46
Q

How many of those with LD have autism

A

2/3

47
Q

Is ADHD higher or lower incidence in LD

A

Much higher

Psychiatry (15 decks)

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