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Human Disease > Psycho-Social Disorders > Flashcards

Psycho-Social Disorders Flashcards

1
Q

Generalised Anxiety Disorder clinical features and examples of certain ones

A
  • Long-term condition with feeling of anxiousness about a wide range of situations
  • People with GAD feel anxious most days
Clinical Features:
Physical
-Nausea
-Dizziness
-Tachycardia 
-Palpatations 
-Dry mouth 
-Headaches
-Insomnia

Psychological

  • Aggression
  • Lack of concentration
  • Poor memory
  • Irritability
  • Worries
  • On edge
Phobias 
Panic disorders
OCD
PTSD
Social Anxiety disorder
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2
Q

Phobia def

A

Type of generalised anxiety disorder
Associated with an irrational feat of an object or a situation
Often triggers severe anciety

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3
Q

Panic disorder

A

Type of GAD

Associated with episodes of intense anxiety or panic

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4
Q

OCD def

A

Type of GAD

Associated with recurring thoughts leading to need to repeatedly perform certain acts

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5
Q

PTSD

A

Anxiety caused by stressful, frightening or distressing events
GAD disorder

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6
Q

Social Anxiety Disorder

A

Fear of social situations

Type of GAD

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7
Q

Depression definition and clinical features

A
  • Sustained depression of mood
  • More females than men
  • Lowering of mood
  • Loss of appetite
  • Lack of energy
  • Reduced libido
  • Difficulty concentrating
  • Early morning waking
  • Sustained lowering of mood
  • Inability to experience pleasure
  • Suicidal thoughts
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8
Q

Bipolar disorder

A
  • Alternating episodes of depression and euphoria
  • Onset 20-40
  • Episodes of elevation of mood associated with mental and physical overactivity
  • Bright clothes, over familiar, pressure of speech, flight of ideas, grandidose ideas and risk taking
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9
Q

Schizophrenia definition and clinical features

Treatment

A
  • Mental illness associated with relapsing episodes of psychosis
  • Psychosis is a loss of contact with reality

Clinical Features:
-Hallucinations (perception in absence of reality)
Auditory, visual, tactile, gustatory

-Delusions (belief in something untrue)
Persecutory, grandiose, delusions of reference

-Thought disorders
Insertion, broadcasting, withdrawal

  • Paranoid beliefs
  • Social withdrawal
  • Tx is anti-psychotic meds and therapy (Cognitive behavioural therapy)
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10
Q

Anorexia Nervosa definition

A
  • More females than men
  • Voluntary reduction in oral intake to reduce body weight
  • Increase in exercise, laxative abuse, vomiting
  • Anxiety about body shape and weight
  • Fear of obesity
  • Low self esteem, depression, anxiety
  • Light headed, dizziness amenorrhoea
  • May take several years to fully recover
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11
Q

Bulimia nervosa definiton

A
  • attempt to control weight by restricting amount that they eat, then binge eating and then self inducing vomiting or laxative abuse
  • Associated with abnormal attitude towards food or body image
  • Normal body weight or some weight loss
  • More common than anorexia
  • Low self esteem, depression, anxiety, self harm
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12
Q

Dental relevance of common psychiatric disorders

A
  • Poor dental attenders
  • Mood on clinics
  • Poor oral hygiene
  • Increased risk of smoking, alcohol abuse, illegal drug abuse
  • Anti-depressants, and anti psychotics may lead to a dry mouth
  • Dental phobias
  • Increased risk of dental and maxillofacial trauma
  • TMJ disorders and chronic orofacial pain
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13
Q

Dental relevance of common eating disorders

A

Dental Erosion especially on palatal surfaces of the upper incisors
Salivary gland enlargement
Need to take low body weight into account when calculating drug dosages
Increased risk of fainting/postural hypotension

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14
Q

Dementia causes, clinical features, treatment and dental relevance

A

-Gradual deterioration of intellect, memory and cognitive function in the absence of a disturbance of consciousness

Caused by:

  • Degenerative disease (Alzheimer’s)
  • Genetic (Huntington’s chorea)
  • Metabolic (Wilson’s disease)
  • Toxic (alcohol)
  • Brain lesion (tumour, infection and inflammation)

Clinical features:

  • Impaired intellect
  • Memory
  • Concentration
  • Diffculty reading, writing and speaking
  • Personality changes

Treatment:
-Social support

Dental Relevance

  • Poor OH
  • Poor attenders
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15
Q

Alzheimers Disease causes, association and tx

A
  • 70% of dementia are due to Alzheimers
  • Parts of brain atrophy
  • Unknown cause
  • Increased risk w fam history, smokign obesity

Depression
Aggressive behaviour
Uncoorpoeration

Tx

  • Drugs (donepezil, acetyl choline esterase inhibitors)
  • Social Support
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16
Q

Parkinsons Disease

Clinical features, definition, tx and dental relevance

A

Degeneration nerve cells in substantia nigra with loss of dopamine (vital role in regulating the movement of body)

Tremor- at rest, may affect the tongue and jaw
Rigidity- resistance to passive movements
Hypokinesia- slowness of movement
Postural changes
Loss of facial expression
Weak voice

Social support (dressing, cooking, cleaning), physiotherapy, drugs- levodopa, dopamine agonists

Poor OH
increased risk of aspiration
Difficulty tolerating tx eg sitting in chair
Drooling

17
Q

Psychological dependence definition

A

Condition in which the drug promotes a feeling of satisfaction and a drive to repeat the consumption of the drug in order to induce pleasure or avoid discomfort

18
Q

Physical Dependence

A
  • Physical disturbances occur when the amount of drug in the body is markedly reduced
  • Disturbances form a withdrawal or abstinence syndrome composed of somatic and mental symptoms and signs which are characteristic of each drug type
19
Q

Tolerance

A

-Increased amount of a substance are required to achieve the desired effect

20
Q

Class’s of Drugs

A

-Broadly graded according to harm attributable to a drug when it is misused

Class A drugs: Ecstasy, heroin, cocaine, LSD, class B drugs when prepared for injection

Class B: Cannabis, amphetamines, codeine

Class C: Benzodiazepines

21
Q

Typical examples of drugs

A
  • Alcohol
  • Tobacco
  • Marijuana
  • Opoids
  • CNS depressants (Barbiturates, Benzodiazepines)
  • CNS stimulants (cocaine, amphetamines, ecstasy)
  • Hallucinogens (LSD)
22
Q

Aetiology of drug dependency

A

Environmental:

  • Acceptability (Social attitude)
  • Availability (over perscription, illegal acquisition)

Constitution:
-Genetic, personality, psychiatric illness, education, experience

Drug/substance:
-Pharmacological effect leading to abuse, tolerance, physical dependance

23
Q

Cannabis effects, oral manifestations and complications

A
  • Euphoria, sociability, carelessness, tachycardia, hypotension, impairment of memory and judgement
  • Chronic use associated with apathy, withdrawal, depression and lack of motivation
  • Oral manifestations include dry mouth, oral ulceration with chronic use
  • Respiratory complications such as lung cancer
  • Gateway drug
  • Pregnancy- premature labour, transient, mild effect on the babty
  • Social consequences
24
Q

Cocaine complications and oral manifestations

A
  • Hallucinations, psychosis
  • Perforation of nasal septum
  • Tachycardia, hypertension, sweating, hyperthermia
  • Feeling of invincibility, euphoria, agitation
  • Cardiac arrest

Ulceration especially where held in the mouth
Oronasal fistula

25
Q

Ecstasy

A
  • Appetite suppressant
  • Tablets, capsules
  • Tachycardia, hypertension, sweating, dilated pupils
  • Exacerbated by exertion and dehydration
  • Hyperthermia, acute renal failure

Oral manifestations:

  • Trismus
  • Temperomandibular disorders
  • Dry mouth

-Treatment is just rehydration

26
Q

Qat

A
  • Drug used in Yemen and Ethiopia
  • Stimulant
  • Chewed
  • Kept in buccal sulcus and juices swallowed
  • Abdominal pain
  • Constipation
  • Plasma cell gingivitis
  • Ulceration
  • Lichenoid reactions
27
Q

Solvents

A
  • Glue
  • Paint
  • Nail varnish removers
  • Ingaled

Euphoria, disinhibition, dizziness, blurring of vision, disorientations, hallucinations

Inhalation of vomit, brain damage, poor social functioning

28
Q

Complications of IV drug misuse

A
  • Abscesses
  • Thrombophlebitis
  • Arterial spasm
  • Septicaemia, infective endocarditis
  • Hepatitis B, C
  • HIV
29
Q

Signs and characteristics of drug abuse

A

Signs:

  • Poor historians
  • Lying about intake
  • Disproportionate demand for analgesics
  • Good knowledge of formulary
  • Inappropriate fear of needles in hands of others
  • IV access difficult due to lack of patient’s veins

Signs:

  • Mood swings
  • Loss of interest in appearance
  • Inappropriate wearing of sunglasses
  • Needle tracks
  • Unusual tattoos over veins
30
Q

Detoxification

A

Dose reduction
May need substitution
Symptomatic treatment

May need impatient treatment
Psychological support important

31
Q

Rehabilitation

A 
Leaving drug culture/adopting new life 
May need residential rehabilitation 
Needs involvement of patient and family 
Factual and practical advice 
Counselling 
Use of help groups

Legal
Social
Medical
Psychiatric needs

32
Q

Units in beer/cider, wine and spirits

A
  • 1 unit in half a pint of lager/cider
  • 1 unit in 125ml glass of 9%
  • 1 unit in 25ml of spirits
33
Q

Recommedned weekly max alcohol intake

A

14 units per week male and female

34
Q

Recognising drinking problems

A

Take a drinking history

  • Amount consumed in units
  • Time of first alcoholic drink in a day
  • Pattern of drinking
  • Presence of withdrawal symptoms

CAGE questions
Have u ever felt the need to Cut down
Have people annoyed u about critising your drinking
Have u eveer felt Guilty about ur drinking
Do you need an Eye opened in the morning
2 or more and u got a prob

35
Q

Presentation of alcohol dependence

A

Social:

  • Requests for medical ceritficates
  • Marital, financial problems
  • Violent behaviour
Medical:
GI- Cirrhosis, pancreatitis
CV- Hypertension 
Joints: Gout 
Oral: Smell of alcohol, oral cancer

Psychiatric

  • Depression
  • Anxiety
  • Personality changes

Dental factors:

  • Poor attenders
  • Other drugs, tobacco
  • Oral cancer
  • Liver disease
36
Q

Dental relevance of alcoholism

A

Dental factors:

  • Poor attenders
  • Other drugs, tobacco
  • Oral cancer
  • Liver disease
  • Colleagues and alcoholism
  • Yourself and alcoholism
37
Q

Managing drinking problem

A

Initial Intervention:

  • assess alcohol consumption
  • provide info about the effects of alcohol
  • give advice on reducing consumption

Controlled drinking or abstinence

  • Spacing drinks
  • Alternating non alcoholics and alcoholic ones
  • Eating with drinks

Detoxification

  • Daily supervision to allow early detection of complications
  • Multivitamins
  • Benzosiazepines

Support after withdrawal

38
Q

Withdrawal syndrome from alcohol

A

Onset
3-6 hours after last drink
5-7 days duration
Common sympyoms include nausea and vomiting, sweating, tremor

39
Q

Delirium tremens

A

48-72h after last drink
Delirium and tremor
Fits, hyperthermia, dehydration and shock
High mortality

Human Disease (19 decks)

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