psychiatric disorders across the lifespan

Question 1

what is dementia

Answer 1

Degenerative disease of the brain with:
cognitive and behavioural impairment
must be severe enough to impact social and occupational functon

Question 2

pathophysiology of Alzheimers

Answer 2

Amyloid plaques
Neurofibrillary tangles (NFTs)
loss of neurons and synapses in the cortex and hippocampus

Question 3

example of an acetylcholinesterase inhibitor

Answer 3

Donepezil

Question 4

example of a NMDA receptor antagonist

Answer 4

Memantine

Question 5

early symptoms of Alzheimers

Answer 5

Absent-mindedness
Difficulty recalling names and words
Difficulty learning new information
Disorientation in unfamiliar surroundings
Reduced social engagement

Question 6

features of progressive alzheimers

Answer 6

Marked memory impairment
Reduced vocabulary
Loss of less complex speech patterns.
Mood swings and/or apathy
Decline in ADL’s & social skills
Emergence of psychotic phenomena

Question 7

advanced alzheimers symptoms

Answer 7

Monosyllabic speech
Psychotic symptoms
Behavioural disturbance
Loss of bladder and bowel control
Reduced mobility

Question 8

psychiatry involved in alzheimers

Answer 8

delusions - paranoid
auditory/visual hallucinations
depression

Question 9

catastrophic reactions in alzheimers

Answer 9

the patient becomes very frustrated and angry with their inability to understand and lash out

Question 10

tool used to assess alzheimers

Answer 10

MMSE

Question 11

delirium vs dementia vs depression

Answer 11

delirium - acute, fluctuating, hours/weeks, altered consciousness, impaired attention, psychomotor agitation/depression, reversible
dementia - insidious, progressive, months/years, irreversible
depression - acute or insidious, chronic, months/years, psychomotor depression, reversible

Question 12

importance of adolescent brain

Answer 12

vulnerable to influence by peers

reward system develops faster than [refrontal cortex )risky behaviours therefore)

Question 13

diagnosis of ADHD

Answer 13

at least 6 months of 
persistent pattern of inattention/hyperactivity
inappropriate to developmental level
interferes with functioning
seveal symptoms before 12
symptoms in two or more settings
not explained by another disorder

Question 14

risk factors of ADHD

Answer 14

boys
1st degree relatives
premature birth
low birth weight
prenatal tobacco

Question 15

prognosis of ADHD

Answer 15

70% still have it as teenager

40-60% as adults

Question 16

stages of psychosocial development

Answer 16

infant - hope
18mth-3yr - will
3-5 - purpose
6-13 - competency
14-21 - fidelity
22-39 - love
40-65 - care
65+ - wisdom

Question 17

somatisation disorder

Answer 17

symptoms/pain with no physical cause found

Question 18

autism spectrum disorder

Answer 18

not interacting with others, behind peers in class, prefers to sit back and observe

Question 19

OCD

Answer 19

compulsions and obsessive thoughts manifesting as repeated actions + perfectionism

Question 20

tourettes syndrome

Answer 20

involuntary movements of body, not context-appropriate sounds/actions

Question 21

What is the epidemiology of dementia?

Answer 21

UK, dementia is leading cause of death in women and is second to heart disease for men.
Most common cause of dementia is Alzheimer’s disease (AD), 70% of cases.
Risk of AD increases with age:
1% at age 60yrs;
doubles every 5yrs;
40% of those aged 85yrs.

Question 22

What are behavioral disturbances associated with dementia?

Answer 22

aggression, wandering, explosive temper, sexual disinhibition, incontinence, excessive eating, and searching behaviour.

Question 23

What are features of personality disorders in dementia?

Answer 23

often reflects an exaggeration of premorbid traits with coarsening of affect and egocentricity.

Question 24

What are the 4 P’s regarding factors which impact mental disorders?

Answer 24

Predisposing, precipitating, perpetuating and protective factors

Question 25

What is the global impact of mental health disorders?

Answer 25

Mental health conditions account for 16% of the global burden of disease and injury in people aged 10-19 years
Half of all mental health conditions start by 14 years of age but most cases are undetected and untreated

Question 26

How does the adolescent brain develop?

Answer 26

The prefrontal cortex matures later than the cortical areas associated with sensory and motor tasks.

Adolescence is a period of neural imbalance caused by early maturation of subcortical brain areas and delayed maturation of prefrontal control areas.

Question 27

What is somatisation disorder?

Answer 27

Extreme stress or emotional reaction to symptoms which may not have any physical cause

Question 28

Is ADHD genetic?

Answer 28

No isolated gene for ADHD, there may be several genes contributing to the vulnerability for developing it
Twin studies have shown a significant heritability for ADHD - as high as 76%
First degree relatives of children with ADHD have an ADHD diagnostic probability 4-5 times higher than the general population
Boys are more vulnerable than girls