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4 Finals > Psychiatry > Flashcards

Psychiatry Flashcards

1
Q

In an MSE what is assessed for in appearance?

A 
age
physique/build
dress/evidence of self neglect
effort with appearance
tattoos
signs of physical ill health
posture
physical expression
physical features of alcoholism or drug abuse
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2
Q

In an MSE what is assessed for in behaviour?

A

what is the pt doing and is it appropriate
psychomotor agitation/retardation
eye contact
attitude/rapport

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3
Q

In an MSE what is assessed for in speech?

A 
form of speech
pressure or poverty of speech
spontaneous speech
latency
rate
volume
tone
articulation
sudden silences
accent
vocabulary
abnormalities of articulation
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4
Q

In an MSE what is assessed for in mood?

A

objective and subjective description of mood
neutral, euthymic, dysphoric, euphoric, anxious, angry, apathetic, irritable
rating of mood on a scale

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5
Q

In an MSE what is assessed for in affect?

A

congruent/incongruent
intensity - normal, blunted, exaggerated, flat, heightened
extent to which affect changes

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6
Q

In an MSE what is assessed for in suicidality?

A

suicidal ideation
thoughts of life not worth living
thoughts of wanting to self-harm, methods, plans

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7
Q

In an MSE what is assessed for in thought?

A 
form
tempo
flight of ideas
poverty of thought
formal thought disorder
thought blocking
loosening of associations
knights move thinking
tangential thinking
circumstantiality
neologisms
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8
Q

What is knights move thinking?

A

Jumping from topic to topic with no connections between them

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9
Q

What is a formal thought disorder?

A

a disturbance in organisation, control and processing of thoughts

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10
Q

What is tangential thinking?

A

Wandering from the topic and never providing the information asked for

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11
Q

What is Circumstantiality?

A

Inability to answer a question without providing an excessive amount of detail.

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12
Q

In an MSE what is assessed for in thought content?

A

preoccupations
overvalued idea
delusional ideation
delusions

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13
Q

In an MSE what is assessed for in perception?

A

derealisation/depersonalisation
illusions
hallucinations

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14
Q

What should be assessed for in auditory hallucinations?

A 
Interna; vs external space
open to conscious manipulation
2nd or 3rd person
number of voices
gender
content
running commentary
thoughts spoken 
commanding voices
compelled to act on them
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15
Q

In an MSE what is assessed for in cognition?

A 
attention and concentration
orientation
memory
calculation
language
visuospatial functioning
executive functioning
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16
Q

In an MSE what is assessed for in insight?

A

Awareness of symptoms
Attribution of symptoms to a mental disorder
Appraisal and analysis of consequences of such symptoms
Acceptance of treatment

17
Q

In depression what can the MSE show about a persons’ appearance and behaviour?

A 
reduced facial expression
brow classically 'furrowed'
reduced eye contact
limited gesturing
rapport often difficult to establish
18
Q

In depression what can the MSE show about a persons’ speech?

A

reduced rate, volume and innotation
lowered pitch
increased speech latencies
limited content

19
Q

In depression what can the MSE show about a persons’ mood?

A

low, miserable, unhappy, sad
can be described as flat
often empty

20
Q

In depression what can the MSE show about a persons’ affect?

A

depressed
reduced range
limited reactivity

21
Q

In depression what can the MSE show about a persons’ thought?

A

form typically normal
flow - slow, pondering, can almost be absent
content - negative, self-accusatory, failure, guilt, low self-esteem, pessimism
delusions can occur
paranoia - increased sensitivity to the criticisms of others

22
Q

In depression what can the MSE show about a persons’ perception?

A

hallucinations - almost always auditory, 2nd person and derogatory, typically reflecting negative and depressive themes

23
Q

In depression what can the MSE show about a persons’ cognition?

A

slow - poor memory
‘psuedo-dementia’
typical deficits in working memory, attention and planning

24
Q

In depression what can the MSE show about a persons’ insight?

A

typically preserved

attribution however can often be affected

25
Q

How is depression diagnosed?

A 
last at least 2 weeks
no hypomanic or manic symptoms
2 of 
- depressed mood
- loss of pleasure or interest
- decreased energy
26
Q

What are the additional symptoms (non core) in depression?

A 
loss of confidence
unreasonable feelings of guilt
any suicidal thoughts/behaviour
diminished ability to think/concentrate
any agitation or retardation
sleep disturbance
change in appetite
27
Q

What is mild depression?

A

2/3 main symptoms + additional symptoms to make 4

28
Q

What is moderate depression?

A

2/3 main symptoms + additional symptoms to make 6

29
Q

What is severe depression?

A

3/3 main symptoms + additional symptoms to make 8

30
Q

What is somatic syndrome?

A

4 of the following:

  • loss of interest or pleasure
  • lack of emotional reactions
  • early waking
  • psychomotor retardation/agitation
  • loss of appetite
  • weight loss
  • marked loss of libido
31
Q

What is atypical depression?

A 
Mood is reactive
2 or more of:
- weight gain or increased appetite
- hypersomnia
- leaden paralysis
- longstanding personal rejection
32
Q

What is psychotic depression?

A

Occasional paranois, typically mood-congruent or hypochondrial
Cotard’s syndrome with nihilistic delusions

33
Q

What is a hypomanic episode?

A

Mood elevated or irritable more than normal for individual for at least 4 days and 3 of the following must be present:

  • increased activity/restlessness
  • increased talkativeness
  • difficulty concentration/distractability
  • decreased need for sleep
  • increased sexual energy
  • mild spending sprees or other types of reckless or irresponsible behaviour
34
Q

What is a manic episode?

A

Mood predominantly elevated, expansive or irritable
Mood sustained for at least 1 week
At least 3 of following:
- increased activity or physical restlessness
- increased talkativeness
- flight of ideas
- loss of normal social inhibitions
- decreased need for sleep
- distractability or constant changes in activity or plans
- foolhardy or reckless behaviour
- marked sexual energy

35
Q

What is mania with psychotic symptoms?

A

Mania with delusions or hallucinations are present - grandiose, self-referential, erotic or persecutory.

36
Q

What is the lifetime prevalence of BPD?

A

1-4%

4 Finals (20 decks)

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