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PACES management > Psych > Flashcards

Psych Flashcards

1
Q

Acute stress reaction definition

A

transient disorder
develops in an individual without any other apparent mental disorder
in response to exceptional physical and mental stress
usually subsides within hours or days

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2
Q

key features of acute stress reaction

A
  • initial state of daze
  • constriction of field of consciousness
  • narrowing of attention
  • inability to comprehend stimuli
  • disorientation
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3
Q

what other things can be noted with an acute stress reaction?

A
  • severe withdrawal from surrounding situation could manifest as stupor
  • may cause agitation and over reactivity
  • autonomic signs of panic (tachycardia, sweating): occur within mins of a stimulus and disappear within hours/days
  • partial or complete amnesia
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4
Q

what is the duration of an acute stress reaction?

A
  • at least 3 days

- if symptoms persist >1 month consider diagnosis of PTSD

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5
Q

define adjustment disorder

A
  • states of subjective distress and emotional disturbance
  • usually interferes with social functioning and performance
  • arises in period of adaption to a significant life change or stressful life event
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6
Q

manifestations of adjustment disorder

A
  • depressed mood
  • anxiety
  • worry
  • feeling of inability to cope, plan ahead or continue with present situation
  • disability in performance of daily routine
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7
Q

what can be an associated feature in adjustment disorder?

A

conduct disorder (mainly in adolescents)

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8
Q

What is generalised anxiety disorder?

A
  • anxiety that is generalised and persistent

- but not restricted to any particular environment (is free floating)

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9
Q

duration of GAD

A

at least 6 months with prominent tension, worry and feelings of apprehension about everyday events and problems

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10
Q

symptoms of GAD and how many do you need?

A

at least 4 of following including at least 1 autonomic

  • Autonomic: palpitations, sweating, trembling, dry mouth
  • Chest/Abdo: difficulty breathing, feeling of choking, chest pain, nausea/abdo distress
  • Brain/mind: dizziness, light headedness, derealisation/depersonalisation, fear of losing control, fear of dying
  • General: hot flushes/ cold chills, numbess or tingling sensation
  • Tension: muscle tension/ aches/pains, restlessness, mental tension, lump in throat
  • Other: exaggerated startle response, difficult concentrating, persistant irritbaility, difficulty sleeping
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11
Q

common fear in GAD

A

that they themselves or a relative will shortle become ill or have an accident

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12
Q

key things to remember about GAD classification

A

does not meet criteria for panic disorder, phobic anxiety disorder, OCD or hypochondriacal disorder
not caused by organic health problem or substance misuse

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13
Q

Define OCD

A

recurrent obsessional thoughts or compulsive acts

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14
Q

what are the obsessional thoughts in OCD?

A
  • obsessional thoughts can be: ideas, imaged, impulses
  • they are distressing
  • patient often tries to resist them
  • recognised as their own thoughts
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15
Q

what are the compulsive acts in OCD?

A
  • compulsive acts/rituals repeated again and again
  • they are NOT enjoyable/ don’t result in completion of an inherently useful task
  • are thought to prevent some unlikely event
  • behaviour recognised as pointless
  • attempts made to resist
  • anxiety present which gets worse if compulsive acts resisted
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16
Q

what is body dysmorphic disorder characterised by?

A
  • appearance preoccupations (preoccupied with slight defects of flaws in physical appearance)
  • repetitive behaviours (repetitive, compulsive behaviours in response to appearance concerns)
  • clinical significance (causes distress or impairment of functioning)
  • specifiers
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17
Q

specifiers in BDD

A
  • muscle dysmorphia: preoccupised with idea that his or her build is too small/ too muscular
  • insight specifier
18
Q

define panic disorder

A

recurrent attacks of severe anxiety (panic) which are not restricted to any particular situation or set of circumstances
therefore unpredictable

19
Q

symptoms of panic disorder

A
  • sudden onset palpitations
  • chest pain
  • choking sensations
  • dizziness
  • feelings of unreality (depersonalisation/derealisation)
  • fear of dying, losing control or going mad
20
Q

what is social phobia?

A

fear of scrunity by other people leading to avoidance of social situations

21
Q

what might social phobia be associated with?

A
  • low self esteem

- fear of criticism

22
Q

what may people with social phobia present with?

A
  • complaints of blushing, hand tremor, nausea or urinary urgency in social situations
  • symptoms can progress to panic attacks
23
Q

what is a specific phobia?

A

phobias restricted to highly specific situations e.g. proximity to slugs
contact can evoke panic

24
Q

what is agoraphobia?

A
  • cluster of phobias embracing fears of leaving home, crowds/public places, travelling alone
25
Q

how may agoraphobia present? what associated features?

A
  • may manifest with panic attacks
  • associated features: depressive, obsessional symptoms, social phobias
  • avoidance of phobic situation
26
Q

what is PTSD?

A
  • delayed or protracted response to a stressful event of an exceptionally threatening/ catastrophic nature
  • likely to cause distress in almost anyone
27
Q

duration of PTSD

A

> 1 month

28
Q

predisposing factors of PTSD

A
  • history of neurotic illness

- certain personality traits (e.g. compulsive)

29
Q

key features of PTSD

A
  • re-experiencing: flashbacks, dreams, nightmares
  • avoidance of activities reminiscent of trauma
  • autonomic hyperarousal (hypervigilance, insomnia)
  • sense of numbness
  • detachment from other people
  • unresponsiveness to surroundings
  • anhedonia
30
Q

prognosis of PTSD

A
  • recovery expected in most

- small proportion may become chronic = enduring personality change

31
Q

3 subtypes of ADHD

A
  1. ADHD predominantly inattentive: easily distracted, forgetful, daydreaming, disorganisation, poor concentration, difficulty completing tasks
  2. ADHD predominantly hyperactive-impulsive: excessive fidgetiness/ restlessness, hyperactivity, immature behaviour, difficulty washing and remaining seated, destructive behaviours
  3. ADHD: combination of above
32
Q

how is ADHD subdivided?

A
  • based on presence of at least 6 out of 9 symptoms (inattention/ hyperactivity-impulsivity) of inattention, hyperactivity or both lasting for at least 6 months
33
Q

inattention symptoms

A
  • difficulty paying close attention to details
  • trouble holding attention on tasks
  • trouble organising tasks and activities
  • loses things necessary for tasks
  • appears forgetful in daily activites
  • shorter attention span
  • easily distracted
  • difficulty with structured schoolwork
  • difficulty completing tasks that are tedious/ time consuming
34
Q

hyperactivity-impulsivity symptoms

A
  • unable to sit still
  • fidgets, squirms in seat
  • leaves seat in inappropriate situations
  • takes risk with little thought for dangers
  • talking more than others
  • often answers quickly
  • has trouble waiting their turn
  • interrupts or intrudes on conversations
35
Q

duration of symptoms

A
  • must have appeared by age of 6-12 years
  • occurring in >1 environment (e.g. home and school)
  • clear evidence of causing social, school or work-related problems
  • last >6 months
36
Q

what is autism spectrum disorder?

A

persuasive development disorder that is defined by:

  • presence of abnormal or impaired development that is manifest before the age of 3 years
  • characteristic type of abnormal functioning in all 3 areas of psychopathology: reciprocal social interaction, communication, restricted/stereotypes, repetitive behaviour
37
Q

what other non-specific problems are common with autism spectrum disorder?

A
  • phobias
  • sleeping/ eating disturbances
  • temper tantrums
  • self directed aggression
38
Q

what is asperger’s syndrome?

A
  • disorder of uncertain nosological validity
    characterised by:
  • abnormalities of reciprocal social interaction that typify autism
  • restricted, stereotypes, repetitive repertoire of interests and activities
  • no general delay in language or retardation in language or in cognitive development
39
Q

what is Asperger’s syndrome associated with?

A
  • marked clumsiness
  • strong tendency for abnormalities to persist into adolescence and adult life
  • psychotic episode occasionally occur in adult life
40
Q

what are the baby blues?

A
  • tearfulness, irritability and low mood
  • occuring a few days of childbirth
  • lasts for few days
  • mood may be labile
  • spontaneously resolves after few days
41
Q

what is postnatal depression?

A
  • depressive disorder with peripartum onset (from anytime during pregnancy to 1 year after delivery)
  • criteria is same as non-childbirth depression
  • most patients recover within a month
42
Q

what is puerperal psychosis?

A
  • not defined by DSM5 or ICD-10
  • onset of psychotic symptoms after childbirth (usually around 2 weeks)
  • tends to follow 3 patterns: delirium, affective (like psychotic depression or mania), schizophreniform
  • symptoms deteriorate and fluctate rapidly
  • most patients recovery within 6-12 weeks

PACES management (7 decks)

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