PSYCH 5 Flashcards
delirium is the most common what
lasts what
symptoms
cause
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
risk factors for dementia
ix
treatment
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
what is dementia
memory impairment from 6 months - progressive
alzheimer’s symptoms
gradual and slowly progressive
short term memory impairment + expressive language impairment. visual spatial impairment eventually
vascular dementia symptoms
history of stroke/TIA
frontal: apathy, no longer socially/personally aware
temporal: memory
occipital: blindenes
lewy body dementia
dementia symptoms and fluctuations in lucidity, level of alertness/awareness. features of parkinson’s. visual hallucinations
alcohol dementia is what
wernickes
long history of alcohol abuse
only short term memory goes
wernickes encephalopathy: opthalmeplegia, ataxia, confusion
thiamine parental
frontotemperal dementia
semantic - progressive loss of semantic memory
progressive non fluent aphasia - difficulties in speech, understanding complex sentences
younger onset dementia cause
- alzheimers
- frontotemp
huntingtons, wilsons, downs
expressive brocca’s aphasia
expressive
inferior frontal gyrus
wernickes aphasia
receptive
superior temporal gyrus
acute dystonic reaction symp and treatment
when drug started. involuntary muscle spasms - neck, eyes, back
anti cholingerics
drug induced parkinsons
typical
akathisia
restlessness esp in legs. develops over days-weeks. staying still - uncomfortable
reduce drug
tardive dyskinesia is a what kind of side effect
symp
rx
long term years SE
abnormal involuntary movement of lips and tongue
hard to treat. can stay or get worse if antipsychotics are stopped
consent in >16s
<12s
12-16
presumed to have capacity
not
depends on undertsanding
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
Lorazepam 1-2mg PO
Loarazepam 1-2mg IM. mixed 1:1 in water or saline
inject again if necessary
confirmed history of significant typical antipsychotics
unsuccessful or effect required within 30 mins
wait 30 mins
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
emergency detention
lasts for 72 hours
can’t give treatment
medical practitioner
short term detention
authorises treatment
lasts 28 days
requires MHO consent
compulsory treatment order
lasts up to 6 months
in community or hospital
2 medical reports one from AMP
who can have ECT
severe depression, catatonic, severe mania
how is ECT given
how often
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
short term side effects for ECT
headache jaw/muscle pain distressed short term memory loss risk of GA nausea
long term side effects for ECT
memory problems 10%
driving to ECT
advised not to till resolved
ECT can lead to disorientation and impair visual functioning
