Psychiatry Flashcards
What is GAD?
Generalised anxiety disorder
Define GAD
at least 6 months of excessive worry about everyday issues that is disproportionate to any inherent risk, causing distress or impairment
How is GAD diagnosed?
AT least three of the following: Restlessness or nervousness Easily fatigued Poor concentration Irritability Muscle tension Sleep disturbance
What physical complaints are seen in GAD?
Sweating Lightheadedness Palpitations Dizziness Epigastric discomfort
What is the management for GAD?
CBT Applied relaxation Mindfulness or meditation Sleep hygiene Exercise
SSRIs e.g. sertraline
Benefit should be seen at 12 weeks
What is wernicke’s encephalopathy?
Neuropsychiatric disorder
Caused by thiamine deficiency
Usually alcoholics
What are features of encephalopathy?
nystagmus (the most common ocular sign) ophthalmoplegia ataxia confusion, altered GCS peripheral sensory neuropathy
What are the investigations for wernicke’s encephalopathy?
Therapeutic trial of parenteral thiamine
MRI?
What is the management of wernicke’s?
Urgent thiamine replacement
What are differentials for loss of libido?
Stress/Anxiety Depression Erectile dysfunction Dysparaenia Age Medicine side effects Diabetes Hypothyroidism Cancer Hyperprolactinaemia
What are RFs for insomnia?
Female gender Increased age Lower educational attainment Unemployment Economic inactivity Widowed, divorced, or separated status
What investigations are done for sleep disorders?
Patient interview
Sleep diaries
Polysomnography but rare
What is the short term management for sleep disorders?
Address health issues
Advice not drive
Good sleep hygiene
Hypnotics only if SEVERE e.g. zopiclone (benzodiazepine)
