Psychiatric disorders and Physical Health Flashcards

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1
Q

What is hemiparesis?

A

Cannot move one side of limbs

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2
Q

What is Emotional lability?

A

Switch in and out of crying excessively

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3
Q

What are delusions?

A

Fixed beliefs that you cannot be talked out of

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4
Q

What hallucinations?

A

Things that you believe you see

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5
Q

What is the ICD?

A

International Classification of Diseases

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6
Q

What is adjustment reaction?

A

Something derails you in life and interferes with social functioning and performance

Arises in the period of adaptation to a significant life change or stressful life event

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7
Q

What is organic delusional disorder?

A

disorder in which persistent or recurrent delusions dominate the clinical picture

The delusions may be accompanied by hallucinations.

Some features suggestive of schizophrenia, such as bizarre hallucinations or thought disorder, may be present.

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8
Q

What are the figures for post-stroke psychosis?

A

5% for delusions or hallucinations

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9
Q

What are common delusional themes for post-stroke psychosis?

A

Persecutory
Jealousy
Environment

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10
Q

What is the relationship between long term conditions and mental health issues?

A

cardiovascular diseases 3x risk of depression and anxiety

Diabetes 2x risk of depression

Chronic obstructive pulmonary disease 10x risk of panic disorder

Muscloskeletal disorders 2x risk of depression

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11
Q

Give some examples of physical illness causing discrete mental illness

A

Thyrotoxicosis: anxiety, mania

Thyroid deficiency: depression, dementia

Cushings disease: depression

Infections (syphilis, HIV): Psychosis

Cancer: depression

Parkinson’s disease: depression, anxiety, dementia

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12
Q

What are some reasons as to why chronic mental illness can lead to physical illness?

A

Diet and exercise
Smoking, alcohol and drugs
Medication

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13
Q

What might affect the timely diagnosis of physical health problems in those with mental health disorders?

A

Illness behaviour
Diagnostic overshadowing
Stigma
Lack of resources

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14
Q

What are some indicators of mental state?

A
Home tidiness 
State of dress 
Speech
Mood
Personality
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15
Q

What is the MOCA?

A

Montreal Cognitive Assessment

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16
Q

What comprises the MOCA?

A
30 point assessment
Visual spatial skills 
Subtraction
Repetition of sentences 
Delay recall
Orientation
17
Q

What is delirium?

A

organic cerebral syndrome characterized by concurrent disturbances of consciousness and attention, perception, thinking, memory, psychomotor behaviour, emotion, and the sleep-wake schedule.

The duration is variable and the degree of severity ranges from mild to very severe

18
Q

What is the prevalence of delirium?

A

20% acute hospital patients >65 on admission
20% more develop delirium after admission
Overall prevalence 30% on wards, 80% in intensive care

19
Q

What are the two types of delirium>

A

50% undetected

50% “hypoactive”

20
Q

What causes delirium?

A

Infection (Urine, pneumonia, cellulitis, wound etc)

Change in environment (ITU, HDU, ward)

Medication (opiates, anticholinergics, steroids)

Alcohol withdrawal

Surgery

Pain

21
Q

What conditions can cause delirium?

A
Liver/Renal impairment
Hypoxia
Hyponatraemia
Stroke
Encephalitis
Constipation
Urine Retention
Dehydration
22
Q

What are some predisposing factors for delirium?

A
Advanced age
Dementia (often undetected)
Impaired activities of daily living 
Immobility
Sensory impairment
Urinary catheterization
Malnutrition
Alcohol
Depression
23
Q

How do you manage delirium?

A
Anticipate
Modify risk factors if possible
Early diagnosis
Treat the causes
Good nursing
Single room, well lit, familiar staff/family (in an ideal world)
Medication
Wait!
24
Q

Think of some examples of stigma

A

Delay in diagnosing physical problems as they are not seen on every ward round

Interviewed by police

Detained under Mental Health Act

Reluctance of nursing homes to take Fred

25
Q

What is stigma?

A

Stigma refers to challenges faced by people with mental illness related to knowledge, attitudes, and behaviour of people they meet

26
Q

What can stigma present as?

A

Poor understanding of mental health
Negative attitude
Social exclusion

27
Q

What does stigma lead to?

A

Discrimination

28
Q

What is intrapersonal stigma?

A

Intrapersonal stigma
Direct effect on the individual
Internalised discrimination
Compounded by direct effects of illness

29
Q

What is interpersonal stigma?

A

Family
Friends
Colleague

30
Q

What is structural stigma?

A

Poor resources and funding

Access to physical health care