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brs (phase 1b) > (psych) psychiatry through the lifecourse > Flashcards

(psych) psychiatry through the lifecourse Flashcards

1
Q

in terms of child and adolescent health, what are the 4 Ps?

A

predisposing, precipitating, perpetuating and protective factors

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2
Q

by what age do most mental health conditions start?

A

approx 14 years (but often most cases are undetected and untreated)

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3
Q

what must be considered when a child’s mental health is being assessed?

A

important to consider developmental age

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4
Q

how is a child’s developmental age assessed?

A

using Erikson’s stages of psychosocial development

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5
Q

what are Erikson’s stages of psychosocial development?

A

the theory that personality develops in eight stages through a predetermined order, from infancy to adulthood

the idea that we encounter various crises and by resolving them, we contribute to our psychosocial development

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6
Q

how does the brain develop through childhood and adolesence?

A

cortex reaches its maximal volume soon after birth

but structural maturation continues through adolesence as grey and white matter have different maturation times

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7
Q

why does maturation continue after the maximum volume is reached by the cortex?

A

while maximal volume is reached, the structures are not sufficiently developed

structural maturation takes place through adolesence as grey and white matter have different maturation rates

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8
Q

how does grey matter mature?

A

maximum density of gray matter is reached first in the primary sensorimotor cortex and last in higher association areas such as the prefrontal cortex

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9
Q

how does white matter mature?

A

volume of white matter increases continually from childhood into early adulthood

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10
Q

how does the prefrontal cortex develop compared to the subcortical areas?

A

the prefrontal cortex matures later (maxium density reached later) than the cortical areas associated with sensory and motor task

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11
Q

why is adolescence a period of neural imbalance?

A

due to the early maturation of the sensorimotor cortical areas and the delayed maturation of the prefrontal control areas

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12
Q

how does the neural imbalance affect behaviour during adolesence?

A

during highly emotional situations, the developed sensorimotor cortical regions (limbic and reward systems) will affect behaviour more than the relatively immature prefrontal control system

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13
Q

what is the age of onset for attention deficit hyperactivity disorder (ADHD)?

A

approx 9.5 years

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14
Q

what is the age of onset for autism spectrum disorder?

A

approx 5.5 years

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15
Q

what is the age of onset for autism spectrum disorder (ASD)?

A

approx 5.5 years

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16
Q

what is the age of onset for depression?

A

approx 19.5

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17
Q

what is the age of onset for anxiety?

A

approx 5.5

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18
Q

what is the age of onset for obsessive compulsive disorder?

A

approx 14.5

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19
Q

what is the age of onset for substance misuse?

A

approx 19.5

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20
Q

a 10 year old girl, doesn’t want to sleep in the room alone, gets raised heart rate, sweating and difficulty breathing in crowded places, and does not like doing presentations in class

what is her diagnosis?

A

anxiety

due to raised heart rate, tachypnoea in crowded situations

21
Q

a 10-year-old boy, several attendances to GP and Emergency Department with recurrent abdominal pain, no physical cause found so far

what is his diagnosis?

A

somatisation disorder

pain but no cause found, could be due to psychological concerns

22
Q

a 15-year-old young woman with tiredness, sleeping 12 hours/day, irritability, and reduced enjoyment from her hobbies

what is her diagnosis?

A

depression

due to anhedonia and irritability

23
Q

a 4-year-old boy whose language is behind peers in class, doesn’t interact much with others, prefers watching buses/trains to playing in the playground

what is his diagnosis?

A

autism spectrum disorder

lack of interaction w peers and behind in class

24
Q

an 8-year-old boy who has been fidgeting in lessons, speaking out of turn, and struggling to stay focused on homework tasks

what is his diagnosis?

A

attention deficit hyperactivity disorder (ADHD)

due to fidgeting and struggle to focus

25
Q

an 8-year-old boy who has been fidgeting in lessons, speaking out of turn, and struggling to stay focused on homework tasks

what is his diagnosis?

A

attention deficit hyperactivity disorder (ADHD)

due to fidgeting and struggle to focus

26
Q

a 9-year-old boy has been using increasing amounts of alcohol hand gel, wearing rubber gloves when going outdoors, and lining up the toys in his room before going to sleep

what is his diagnosis?

A

obsessive compulsive disorder

due to increased hygiene and need for conformity

27
Q

a 10-year-old boy with involuntary movements in the face, neck, and arms as well as making sounds that are not context-appropriate

what is his diagnosis?

A

Tic disorder/Tourette syndrome

due to involuntary movements and unexplained sounds

28
Q

a 15-year-old young man with conduct disorder has been truanting from school and stealing his mother’s credit cards; he was found smelling of cannabis, and more recently has been smoking it in his bedroom

what is his diagnosis?

A

substance misuse

29
Q

a 16-year-old young woman has been cutting herself with a razor when feeling distressed and recently has bought several packets of paracetamol

what is her diagnosis?

A

self-harm and possible suicide risk

30
Q

a 14-year-old girl who has been spending a lot of time thinking about food, has cut out carbohydrates from her diet, has been skipping breakfast and using grandfather’s laxatives to lose weight

what is her diagnosis?

A

eating disorders

31
Q

what are the core features of ADHD?

A

persistent pattern ofinattention,hyperactivity and impulsivity

inappropriate for their
developmental level

interferes with functioning or development

32
Q

what is required to diagnose ADHD?

A

six or more symptoms of either inattention/hyperactivity-impulsivity for children up to age 16 years

OR five or more for adolescents age 17 years and older and adults

symptoms have been present for at least 6 months + to an extent that is disruptive and inappropriate for the person’s developmental level

33
Q

what are the risk factors for ADHD?

A

genetic:

  • no isolated gene for ADHD, several genes contribute to vulnerability for developing it
  • significant heritabilIty at 76%
  • first degree relatives of children w ADHD have a diagnostic probability approx x4-5 higher

environmental:

  • premature birth
  • low birth weight
  • prenatal tobacco exposure
34
Q

what are the genetic factors for ADHD?

A
  • no isolated gene for ADHD, several genes contribute to vulnerability for developing it
  • significant heritabilIty at 76%
  • first degree relatives of children w ADHD have a diagnostic probability approx x4-5 higher
35
Q

what are the environmental factors for ADHD?

A

premature birth

low birth weight

prenatal tobacco exposure

36
Q

what is the prognosis for ADHD patients?

A

approx 70% of children who have this disorder will have the disorder as teenagers, and approx 40%-60% will still have it as adults

37
Q

what is dementia?

A

degenerative disease of the brain with cognitive and behavioural impairment
that is sufficiently severe to interfere significantly with social and occupational function

38
Q

what is the epidemiology of dementia?

A

worldwide, 47.5 million people have dementia +
expected to reach 75.5 million by 2030 and 135.5 million by 2050

in UK, dementia is leading cause of death in women and is second to heart disease for men

39
Q

what is the most common cause of dementia?

A

Alzheimer’s disease (causes approx 70% of cases)

40
Q

what are the early symptoms of dementia?

A

absent-mindedness

difficulty recalling names and words

difficulty learning new information

disorientation in unfamiliar surroundings

reduced social engagement

41
Q

what are the early symptoms of dementia?

A

absent-mindedness

difficulty recalling names and words

difficulty learning new information

disorientation in unfamiliar surroundings

reduced social engagement

42
Q

what are the progressive symptoms of dementia?

A

marked memory impairment

reduced vocabulary

loss of less complex speech patterns

mood swings and/or apathy

decline in ADLs & social skills

emergence of psychotic phenomena

43
Q

what are the symptoms of advanced Alzheimer’s disease?

A

monosyllabic speech

psychotic symptoms

behavioural disturbance

loss of bladder and bowel control

reduced mobility

44
Q

what are the psychiatric symptoms of dementia?

A

delusions (usually of a paranoid nature)

auditory and/or visual hallucinations (can be a simple misidentification + indicate rapid cognitive decline)

depression

45
Q

what are the behavioural disturbances seen in dementia?

A

aggression, explosive temper

wandering

sexual disinhibition

incontinence

excessive eating

searching behaviour

46
Q

what personality changes are seen in dementia?

A

an exaggeration of premorbid traits

coarsening of affect (visible reaction a person displays) and egocentricity

47
Q

what can be used to test for dementia and Alzheimer’s?

A

an MMSE (mini-mental state examination)

48
Q

what is an MMSE?

A

mini-mental state examination

set of 30 questions that doctors and other healthcare professionals commonly use to check for and monitor the progression of cognitive impairment

49
Q

how can the scores of an MMSE be interpreted?

A 
25-30 = normal
21-24 = mild impairment
10-20 = moderate impairment
<10 = severe impairment

brs (phase 1b) (71 decks)

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