Psychiatry

Question 1

Define psychiatry

Answer 1

Medical speciality concerned with the recognition and tx of disorders of the mind
Impacts 1 in 4

Question 2

When do we feel anxiety? What is it’s function?

Answer 2

When a perceived threat of danger

Serves to mobilise energy reserves for action and enhances performance by increasing arousal

Question 3

When does anxiety become pathological?

Answer 3

When too intense, frequent or persistent = interferes with functioning of an individual

Question 4

Symptoms of anxiety disorders? (psychological and physical)

Answer 4

Psychological:

• Sense of dread
• Irritability
• Fear of loss of control
• Avoidance
• Panic

Physical:

• Palpitations
• SOB
• Chest pains
• Butterflies
• Sweating
• Dry mouth
• Nausea

Question 5

What is a generalised anxiety disorder?

Answer 5

Anxiety is not confined to a specific situation but is pervasive
Experienced more days than not
Anxiety raises in stressful situations
May result in panic attacks

Question 6

Features of phobic disorders?

Answer 6

Situational, predictable, with anticipatory anxiety and avoidance

Question 7

Types of phobic disorders?

Answer 7

Simple phobias - specific animal phobias
Social phobia
Agoraphobia

Question 8

What is the name of dental phobia?

Answer 8

Odontophobia

Question 9

Possible presentations of odontophoia?

Answer 9

Delayed presentations
Looking anxious
Cancel appointments at short notice/fails to attend

Question 10

Possible reasons of odontophobia?

Answer 10

Specific phobia (drills, needles, sounds)
Anxiety about somatic rxns (gagging, injection)
Generalised anxiety disorder
Social phobia

Question 11

How to prevent dental anxiety?

Answer 11

Dental health education
Calm approach
Honest and tactful explanation of procedures
Relaxed atmosphere
Confident and professional manner

Question 12

Treatment of dental anxiety?

Answer 12

Education regarding anxiety
Relaxation techniques
Desensitisation
Short term pharmacological anxiolytics (diazepam)
Long term pharmacological antidepressants

Question 13

What is body dysmorphic disorder?

Answer 13

Excessively concerned about perceived defect in physical features

Question 14

What is hypochondriasis?

Answer 14

Abnormal preoccupation about the presence of an underlying serious physical disease
Pt can place an abnormal interpretation upon a normal sensation

Question 15

What is somatoform pain?

Answer 15

Cause is psychological rather than physical
Absence of organic pathology
Evidence of psychological cause

Question 16

Characteristics of somatoform pain?

Answer 16

Inconsistent with anatomical landmarks
Continuous or bilateral
May prevent sleep but does not wake pt
Analgesia ineffective

Question 17

What are affective disorders?

Answer 17

Alterations of mood are a normal part of life
Extremes of mood with associated symptoms and impaired func can be delineated into illnesses
Mood can go up as well as down - unipolar affective disorder, bipolar affective disorder

Question 18

Prevalence of depression in men and women?

Answer 18

10% men, 20% women

Question 19

Symptoms of depression?

Answer 19

Depressed mood 2 weeks or more
Lacking energy and enjoyment
Poor appetite/weightloss
Sleep disturbance
Poor concentration
Guilt/hopelessness
Delusions/hallucinations

Question 20

Bipolar affective disorder features and prevalence?

Answer 20

Elevated mood = normal experience
Likely to have mania
Men and women at equal risk - 1% population

Question 21

What is mania?

Answer 21

Elated or irritable mood for more than 1 week or resulting in admission

Question 22

Mania symptoms?

Answer 22

Over activity
Disinhibition
Risk taking activity
Distractibility
Reduced need for sleep
Inflated self esteem
Rapid, loud speech
Delusions/hallucinations

Question 23

What is schizophrenia?

Answer 23

Abnormal thoughts and experiences

Reduction in drive, social function and alteration in personality and emotion

Question 24

When is the age of onset of schizophrenia?

Answer 24

Early/mid adulthood

Question 25

Positive symptoms of schizophrenia?

Answer 25

Delusions
Hallucinations
Passively phenomena
Thought disorder

Question 26

Negative symptoms of schizophrenia?

Answer 26

Social withdrawal
Emotional blunting
Apathy: lack of drive, motivation

Question 27

Features of anorexia nervosa?

Answer 27

Body weight <15% expected
BMI <17.5
Self induced weight loss
Body image distortion
Widespread endocrine disorder
Arrest of puberty

Question 28

What is bulimia nervosa?

Answer 28

Pervasive preoccupation with eating
Attempts to counteract the fattening effects of foods
Morbid dread of fatness

Question 29

Eating disorders and dental problems?

Answer 29

Erosion of dental enamel
Thermal hypersensitivity 
Salivary gland enlargement
Dry mouth
Redness of throat and palate
Reddened, dry and cracked lips

Question 30

How to screen for alcohol misuse?

Answer 30

Felt you should cut down?
Annoyed if people comment on your drinking?
Feel guilty about the amount you drink?
Drunk early in the morning as an eye opener?

Question 31

What is a personality disorder?

Answer 31

Severe disturbance in the characterological constitution and behavioural tendencies of the individual
Appears in late childhood/adolescence
Persists into adulthood

Question 32

What is dementia?

Answer 32

Acquired impairment of global cognitive function which is progressive and irreversible

Question 33

Types of dementia?

Answer 33

Alzheimer’s dementia
Vascular dementia
Frontotemporal dementia

Question 34

What characterises delirium?

Answer 34

Impairment of consciousness
Disturbed attention
Perceptual abnormalities
Emotional disturbances
Disturbed sleep wake cycle
Fast onset

Question 35

Causes of delirium?

Answer 35

Infec
Drugs
Systemic illness