PSYCH 5

Question 1

delirium is the most common what
lasts what
symptoms
cause

Answer 1

health problem in over 65s

1-4 weeks. rapid onset

impairment of conscious, cognition disturbance, hypoactive/hyperactive psychomotor disturbance, affective disturbance

MI, PE, RF, hypoxia, UTI, drugs, alcohol, infections, neuro, vascular, withdrawal

Question 2

risk factors for dementia
ix
treatment

Answer 2

age, dementia, blind/deaf, prev, periop, hypo/hyperthermia, immobility, social isolation, new environment, stress

MMSE/CAM, MOCA, urinalysis, FBC, U&Es, EEG, LFTs, TFTs, BG, CRP, B12 and folate, CXR, MRI/CT

haloperidol 0.5-5mg PO then IM up to 10mg/24h
Parkinsons, LBD, neuropathic sensitivity - Lorazepam 0.5-2mg up to twi times in 24 hour
In alcohol/sedative withdrawal BZDs after

Question 3

what is dementia

Answer 3

memory impairment from 6 months - progressive

Question 4

alzheimer’s symptoms

Answer 4

gradual and slowly progressive

short term memory impairment + expressive language impairment. visual spatial impairment eventually

Question 5

vascular dementia symptoms

Answer 5

history of stroke/TIA

frontal: apathy, no longer socially/personally aware
temporal: memory
occipital: blindenes

Question 6

lewy body dementia

Answer 6

dementia symptoms and fluctuations in lucidity, level of alertness/awareness. features of parkinson’s. visual hallucinations

Question 7

alcohol dementia is what

wernickes

Answer 7

long history of alcohol abuse
only short term memory goes
wernickes encephalopathy: opthalmeplegia, ataxia, confusion
thiamine parental

Question 8

frontotemperal dementia

Answer 8

semantic - progressive loss of semantic memory

progressive non fluent aphasia - difficulties in speech, understanding complex sentences

Question 9

younger onset dementia cause

Answer 9

1. alzheimers
2. frontotemp
   huntingtons, wilsons, downs

Question 10

expressive brocca’s aphasia

Answer 10

expressive

inferior frontal gyrus

Question 11

wernickes aphasia

Answer 11

receptive

superior temporal gyrus

Question 12

acute dystonic reaction symp and treatment

Answer 12

when drug started. involuntary muscle spasms - neck, eyes, back
anti cholingerics

Question 13

drug induced parkinsons

Answer 13

typical

Question 14

akathisia

Answer 14

restlessness esp in legs. develops over days-weeks. staying still - uncomfortable
reduce drug

Question 15

tardive dyskinesia is a what kind of side effect
symp
rx

Answer 15

long term years SE
abnormal involuntary movement of lips and tongue
hard to treat. can stay or get worse if antipsychotics are stopped

Question 16

consent in >16s
<12s
12-16

Answer 16

presumed to have capacity
not
depends on undertsanding

Question 17

aggressive behaviour in history of known cardiac disease, history of atypical antipsychotics, current illicit drug use
if unsuccessful of effect required within 30 mins
wait 30 more mins then

Answer 17

Lorazepam 1-2mg PO

Loarazepam 1-2mg IM. mixed 1:1 in water or saline

inject again if necessary

Question 18

confirmed history of significant typical antipsychotics
unsuccessful or effect required within 30 mins
wait 30 mins

Answer 18

Lorozapema 1-2mg and / or Haloperidol 5mg

Loarzepam 1-2mg IM in water/saline. In extreme - Lorzaepam and Haloperidol 5mg IM. monster RR, BP, PR every 5-10 min for 1 hour

inject again if necessary

Question 19

emergency detention

Answer 19

lasts for 72 hours
can’t give treatment
medical practitioner

Question 20

short term detention

Answer 20

authorises treatment
lasts 28 days
requires MHO consent

Question 21

compulsory treatment order

Answer 21

lasts up to 6 months
in community or hospital
2 medical reports one from AMP

Question 22

who can have ECT

Answer 22

severe depression, catatonic, severe mania

Question 23

how is ECT given

how often

Answer 23

no eating/drinking 6 hour before
bilateral
unilateral - requires higher dose said to decrease memory issues - given in those with cognitive difficulties or S/E
twice a week over 6 week period

Question 24

short term side effects for ECT

Answer 24

headache
jaw/muscle pain 
distressed 
short term memory loss
risk of GA
nausea

Question 25

long term side effects for ECT

Answer 25

memory problems 10%

Question 26

driving to ECT

Answer 26

advised not to till resolved

ECT can lead to disorientation and impair visual functioning