Psychiatry

Question 1

what are the clinical features of mania?

Answer 1

more talkative
decreased sleep
flight of ideas
distractability
risky behaviour
goal directed behaviour

Question 2

What are the legislitative measure for keeping people against their will and their conditions?

Answer 2

Duty of care
* have a physical condition causing physical harm
* be danger to themselves

Mental Health Act
* Suspected mental health disorder
* no less restrictive options available

Question 3

What are the steps in escalating aggressive patients?

Answer 3

Verbal deescalation
oral sedation eg 10mg diaz
Show of force
Physical restraint
IV sedation eg drop/midaz

Question 4

A 36 year old man with a history of heavy alcohol use is brought in to your department
by ambulance with general malaise.
On examination he is drowsy but rousable to voice, with slurred speech and
disorientation.
Temp 37.6
HR 95
BP 100/60
SpO2 97% RA

List 8 causes of confusion here

Answer 4

• Acute alcohol intoxication
• Alcohol withdrawal
• Post-ictal state (numerous causes)
• Head trauma – SDH/EDH/ICH
• Hepatic encephalopathy
• Infection – meningitis, encephalitis
• Korsakoff’s syndrome – from severe vitamin deficiency
• Wernicke’s encephalopathy
• Co-ingestion of other drugs of abuse, eg: opiates
• Thrombotic stroke,