Random Flashcards
(25 cards)
What is somatisation disorder? (2)
Repeated presentation of physical symptoms with persistent requests for medical investigations and no physical basis is found.
Describe 3 clinical features of somatisation disorder. (3)
- Multiple, recurrent and frequently changing physical symptoms eg abdo pain, headache, fatigue, dizziness
- System may affect any system but most commonly: GI, derm, menstrual.
- No physical explanation is found for symtoms
- Symptoms are present for more than 2 years
- Persistent refusal to accept advice and reassurance of several doctors
- Social or occupational functioning is impaired as a result
What is the CAGE questionnaire? (4)
Screening tool for alcohol problems. wanted to Cut down on drinking? Annoyed by criticism of drinking? ever felt Guilty regarding drinking? ever had an Eye-opener in morning?
Yes to 2 - undertake full alcohol history
What features is it important to determine in a full alcohol history? (3)
Establish drinking pattern and quantity consumed. - Who with? - What they drinking? - Where? - When? steadily or binge; what time is first drink Features of alcohol dependence - Difficult to control intake. - Primacy of drink - Compulsion to drink - Tolerance - Withdrawal - Use despite evidence of harm Establish impact - Physical (liver or neurological) - Mental (depression, amnesia) - Social (unemployed, divorce, debt) - Legal (drunk driving, drunk and disorderly)
What features is it important to illicit in a full drug history? (3)
Establish drug taking pattern. - Who? - What? do they use, what route, how much, how often - When? how long for, how long at current usage level - Why? what effect are they seeking Features of opioid dependence - Difficult to control intake. - Primacy of drugs - Compulsion to take drugs - Tolerance - Withdrawal (flu like symptoms, sweating, dilated pupils - Use despite evidence of harm Establish impact - Physical (infections, abscesses, HIV, HepB/C) - Mental (psychosis, anxiety) - Social (unemployed, divorce, debt) - Legal (drug offences, theft)
What are the recommended alcohol limits for men and women? (1)
Women 14u per week
men 21 units per week
Define substance misuse. (2)
Consumption of alcohol/use of drugs sufficient to cause physical, psychiatric or social harm.
When would you expect to see delirium tremens? (1)
Describe a mental state exam of a patient with delirium tremens. (5)
48-72 hours after drinking cessation.
A+B: agitated, tremor, fearful, nausea, seizures, ataxia Speech: confused Mood: labile, may be anxious Thought: delusions Perception: hallucinations or illusions Cognition: confused, poor attention Insight: poor
Name 3 adverse effects of cocaine. (3)
Cardiac problems Chest pain Convulsions Permanent damage to inside of nose Overdose psychosis Post-high depression
Give 3 adverse effects of ecstasy. (3)
Nausea, sweating, palpitations, comedown depression, liver and kidney problems
Define post-traumatic stress disorder. (3)
Intense, delayed, prolonged reaction to an exceptionally stressful event.
(The event would be likely to cause pervasive distress in anyone and involved threat of severe injury or death.
What criteria can help diagnose a patient with PTSD? (5)
Clue: TRAUMA
Traumatic event
Re-experience: nightmares, flashbacks, intrusive thoughts
Avoidance and emotional numbing
Unable to function: impaired social and occupational life
Month long symptoms, within 6 months of event.
Arousal: startle, poor concentration, insomnia, hypervigilence
Name 3 psychiatric disorders that are precipitated by a stressful event. (3)
PTSD
Acute stress disorder
Adjustment disorder
Name 3 types of personality disorders. (3)
Paranoid Schizoid Dissocial Histrionic Anxious Dependent Anankastic
What are the 3 clusters of personality disorders? (3)
Cluster A: Odd/eccentric ie paranoid and schizoid
Cluster B: Dramatic/emotional eg histrionic, dissocial
Cluster C: Fearful/anxious ie anankastic, dependent, anxious
What is section 5(2) of the mental health act? (1)
Recommendation by the responsible clinician or their nominated deputy that a patient may be held for 72 hours in order for a full MHA assessment to take place.
What is a section 2 of the mental health act? (2)
Has a maximum duration of 28 days to allow for assessment and potentially treatment of a mental disorder.
It requires 2 medical recommendations and recommendation of an approved mental health practitioner (AMHP)
What is section 3 of the mental health act? (2)
Is for treatment of a mental health disorder and has an initial duration of 6 months which can be extended for a further 6 months and yearly increments.
it requires 2 medical recommendations and that of an approved mental health practitioner. (AMHP)
What is the difference between a section 136 and section 135 of the mental health act? (20
136: police can detain people who they believe to be mentally disordered in a public place to a place of safety for up to 72 hours
135: magistrate can issue warrant allowing entry to private premises to search for an remove patients thought to be in need of urgent medical attention.
What is a section 5 (4) of the mental health act? (1)
Nurses holding power for inpatients that lasts up to 6 hours.
Name some associates or risk factors for deliberate self-harm. (4)
Single/divorced Lower social class Previous history of child abuse Unemployment Recent stressful event Borderline personality disorder Depression Substance misuse More common in young women
Lucy attends A+E following an episode of DSH (paracetamol OD).
You are the psychiatric F2 on-call.
Name 3 indicators that would suggest this was a serious suicidal attempt. (3)
Planned and pre-meditated
Attempt to carryout in isolation
Final acts in anticipation of death e.g. notes
Violent/dangerous method e.g. slitting neck
Person thought the act would be final and irreversible
Did not seek help after act
Person regrets surviving
Numerous previous attempts
Name 3 precipitating factors for attempted suicide. (3)
Psychiatric: (90% of suicides) depression, schizophrenia, substance misuse, personality disorder, anorexia
Medical: chronic pain, cancer
Social: loss of shared values, lack of social support
Give 3 associations or risk factors for suicide. (3)
Previous attempts Previous DSH Age: young men and elderly Males > females Loss events e.g. bereavement Unemployment Living alone Single, divorced or widowed.
