Psychiatry and the G.I tract Flashcards
Globus sensation
a sensation of a lump in the throat
Causes of globes sensation
foreign bodies
cancers
neurological conditions
Management for globus
Reassurance anti-reflux treatment stopping smoking referral to SALT Treatment for stress - antidepressants, CBT
Functional dysphagia
Bizarre symptoms
Causes of psychosis
Mood disorders -depression -mania -bipolar Schizophrenia Drug induces Organic causes -dementia -delirium -brain tumours
What does the mental health act do
Takes patients rights away as patient cannot determine what is best for them
What is ECT
Electroconvolusive therapy
Electrical signals sent through the brain
How is IBS related to psychiatry
Link to trauma - especially physical or sexual abuse in childhood
Stress, and anxiety
How to manage IBS
Dietary advice
Watch out for red flags
Psychological treatments
MUS accounts for what percent of GP appointments
20%
factitious disorder
Patients not honest about symptoms
Many reasons for this
Diagnosis is based on the intent behind the deceit
To occupy ‘sick role’ and not for external gain
Malingering disorders
Making up or exaggerating symptoms for external gain eg. influencing upcoming court case, avoid work, increase benefits, access to drugs
Anorexia nervosa
Due to psychological distress Significant weight loss Weight loss is self induced Feels that obesity represents failure and chaos whereas being skinny is successful and controlled Widespread endocrine abnormality
What are the endocrine abnormalities are caused by anorexia nervosa
Decreased Na, K, Mg, PO4, insulin, glusoucse, thyroid
increased cortisol
Bulimia nervosa
Attempts to restrict intake fails, leading to bungee
low, normal or increased weight
No endocrine abnormalities
30% past history of anorexia
Signs of bulimia
Russels sign - calluses on nuckles from inducing vomiting
Teeth eroded by acidic vomiting
OCD symptoms
Ritualised behaviour
-food related (eating behaviour)
-non-food related (obsessional cleaning ect)
May resolve with weight gain
Female OCD patients - 30% history of anorexia
Personality disorders
Borderline traits
Anakastic - OCD personality disorder
Avoidant/anxious - hide at the end of the day
Causes of eating disorders
Socio-cultural pressures Family dysfunctions Personal vulnerability factors Conflicts relating to sexual maturity Biological vulnerability
Treatment for eating disorders
Weight gain is essential Psychological interventions -CBT -psychoanalytic psychotherapy -family therapy Drugs -antidepressants -antipsychotics -no impact
What is the mortality for eating disorders
20% motility after 20 years illness
Suicide amounts for 50% of all deaths
Onset before puberty - poorer outcome
