Psychiatry

Question 1

Causes of psychosis?

Answer 1

1) Drugs - withdrawal or ingestion
2) psychiatric - schizoaffective disorder, schizophrenia, low mood, bipolar
3) Organic - delirium, dementia, SLE, Huntington’s, syphilis

Question 2

Types of hallucinations that indicate cause of psychosis?

Answer 2

1) Auditory - schizophrenia
2) visual - drug induced or delirium
3) olfactory or gustatory - seizure
4) tactile - delirium or alcohol withdrawal

Question 3

Drug induced causes of psychosis?

Answer 3

1) Withdrawal - Benzos or alcohol
2) prescription - antidepressant, antipsychotics, anticonvulsants, antimalaria , levodopa, steroids
3) illicit - amphetamine, cannabis, legal highs

Question 4

reasons to get Ain someone under MHA?

Answer 4

1) mental disorder (not substance misuse, paedophilia is because no treatment for this you can detain)
2) risk to themselves
3) risk to others and risk to their own welfare
4) SIDMA (decision making) due to MH (must have this)
5) necessity (can be treated in hospital)

Question 5

adults with incapacity act

Answer 5

1) weigh the problems
2) make decision
3) act on that decision
4) communicate
5) retain info

Question 6

presentation of depression

Answer 6

1) core symptoms
- low mood (particularly in the morning)
- anhedonia
- anergia

2) biological
- poor concentration
- anxiety
- irritability
- loss of libido
- reduced attention
- DSH or suicidal ideation
- weight loss

3) somatic
- fatigue
- amenorrhoea
- abdominal pain, constipation or indigestion

4) physiological (becks triad)
- hopelessness
- worthlessness
- excessive guilt

Question 7

what other diagnosis should you consider when looking into someone with depression?

Answer 7

1) Medical - hypothyroidism, Cushing’s, syphilis, SLE
2) Drugs - steroids, isotretinoin (Roaccutane), B-blockers
3) psychiatric - schizophrenia (voices?), anxiety (worry), bipolar (elation), dysthymia (2 years of depressive symptoms, but not enough to meet criteria)

Question 8

effects of discontinuing antidepressants?

Answer 8

F - Flu-like symptoms
I - insomnia 
N - Nausea
I - imbalance 
S - sensory disturbance 
H - hyperarousal (pressure speech)

Question 9

what is serration syndrome and what are the symptoms?

Answer 9

too much serotonin in your body, often when yo use a lot of antidepressants at once. can cause ANM -

A - autonomic symptoms (dizziness, hypertension, tachycardia, sweating)
N - neuromuscular symptoms (tremor, clonus, hypertonicity)
M - mental state change (confusion, agitation, pressure speech)

can be confused with neuroleptic malignant syndrome and catatonia (skitzophrenia and mania)