Revision Tutorial Flashcards
is collateral history part of mental state examination?
no
only patient testimony and what the doctor observes belongs in mental state examination, testimony from a 3rd party (e.g family member) only later on in different part of history
best predictor of suicide?
hopelessness
examples of components of ICD-10 criteria for anorexia?
morbid dread of fatness
body weight <85% expected
sexual dysfunction in men
delayed puberty
is loss of interest in food seen in anorexia?
no
they are pre-occupied with food
IQ of 60 is what type of learning disability?
average = 100 mild = 50-70 (age 9-12) moderate = 35-50 (age 6-9) severe = 20-35 profound = <20 (age <3)
learning difficulty vs disability?
difficulty = only one area of cognition affected (e.g dyslexia) - does not affect IQ, does make you any less intelligent disability = global cognitive ability affected
non-epileptic seizures are highly associated with childhood trauma, true or false?
true
describe a non-epileptic seizure
patient generally unconscious
can last longer than epileptic
patient usually isnt incontinent like in epilepsy
usually dont cause the injuries seen in epilepsy
outwardly looks very similar to epileptic seizure
what causes a non-epilaptic seizure?
type of functional disorder
no actual lesion in the brain causing abnormal electrical activity, mainly as a result of traumatic experience etc
how are non-epileptic seizures managed?
anticonvulsants not used
psychological therapy
is dissociation seen in functional disorders?
yes, common symptom
what causes the problem in frontotemporal dementia?
same as lewy body - hyperphosphorylated tau proteins forming neurofibrilary tangles
what is the difference between frontotemporal and lewy body dementia?
lewy body is a type of frontotemporal dementia but more wide spread
how does depression affect cortisol?
chronically elevated cortisol seen in long term depression
negative feedback system non-functioning (dexamethasone fails to suppress cortisol production)
increased cortisol excretion in urine
increased adrenal volume due to demand for cortisol production
how may depression affect hippocampus volume?
may be reduced
why are SSRIs 1st line in depression?
not really more effective than tricyclics but have a better side effect profile
mental compulsions in OCD often involve what?
often personal to the individual where mental compulsions are in contrast to their own beliefs/morals
(e.g someone very religious may have blasphemous mental compulsions)
can often be sexual, violent etc
is any heritability seen in OCD?
yes
40% concordance in MZ twins
treatment of OCD?
SSRIs = 1st line pharmacotherapy
psychotherapy very useful despite neurobiological basis of disease
what is the most specific hallmark in schizophrenia?
formal though disorder (thought insertion/withdrawal/broadcasting etc)
- hallucinations/delusions etc also present but not as specific
hazardous drinking?
14+ units per week in men and women
harmful drinking?
35+ units in women
50+ units in men
1st line in schizophrenia?
antypical antipsychotic
- resperidone
- olanzipine
- quetiapine
- clozapine (only given after 2 others have tried and failed)
best atypical antipsychotic in diabetics?
risperidone
olanzipine causes metabolic syndrome, danger in diabetics
what is an obsession?
type of thought that is:
- intrusive
- irrational
- difficult to get rid of
- causes distress
examples of an absession?
“since i had my baby i keep geting thoughts in my head about dropping her or letting go of the pram on the hill. i know its silly and i try and stop thinking about it but i cant help it”
obsession vs delusion?
similar but different in that with an obsession, the person knows that the thought is irrational and doesnt make sense
what is an over-valued idea?
somewhere in between obsession and delusion
what is a mixed affective state?
presentation of bipolar disorder
manic symptoms with aspects of depression and vice versa (e.g been manic, feeling amazing with lots of great ideas etc for a few days, then suddenly still restless and very busy thoughts but all thoughts are negative)
often cycle very quickly, can be in same day
how long must symptoms be present for PTSD diagnosis?
6 months
