Signs & symptoms

Question 1

Misperceptions of external stimuli.

Answer 1

illusions - more likely to occur when conscious level is reduced e.g. delirium or anxiety.

Question 2

A percept that is experienced in the absence of an external stimulus to the corresponding sense organ.

Answer 2

Hallucinations

Question 3

hallucinations of noises, music or voices

Answer 3

auditory hallucinations

Question 4

Patient hears voices that talk to them.

Answer 4

second person auditory

Question 5

Patient hears voices which talk to each other about him.

Answer 5

third person auditory

Question 6

Which type of hallucinations are often experienced together? The modalities are often unpleasant.

Answer 6

gustatory and olfactory - unpleasant smells and tastes

Question 7

sensations of being touched, pricked, or strangled; movements along the skin which can be attributed to insects.

Answer 7

tactile hallucinations

Question 8

Patient hearing voices saying “She is washing her face”, “She wants to kiss him” and “She is awful at this job”. (actions, intentions & critical comments). Diagnosis?

Answer 8

third person auditory - schizophrenia

Question 9

Hearing voices saying “You are a failure, you are wicked” - might signpost to which diagnosis?

Answer 9

severe depressive disorder

especially if patient accepts these as justified

Question 10

Voices that anticipate, echo or repeat a patient’s thoughts suggest?

Answer 10

schizophrenia

patient often resents the comments

Question 11

formication? Meaning and which group of people?

Answer 11

the sensation of insects moving under the skin (tactile hallucination) occurs in people who abuse cocaine

Question 12

A delusion arising directly from a normal percept.

Answer 12

delusional perception

Question 13

A belief held firmly on inadequate grounds, that is not affected by rational argument or evidence to the contrary, and is held out with the social, cultural and educational background of the individual.

Answer 13

delusion

Question 14

A delusion that appears suddenly and with full conviction but without any mental events leading up to it.

Answer 14

primary delusion

Question 15

A schizophrenic patient is suddenly and completely convinced, for no reason and with no prior thoughts of this kind, that he is changing sex.

Answer 15

primary delusion

Question 16

Delusions apparently derived from a preceding morbid experience.

Answer 16

secondary delusions

Question 17

Delusion concerning persons or organisations that are trying to inflict harm on the patient, damage their reputation, or make them insane.

Answer 17

persecutory delusion

Question 18

Patient believes that an article in the newspaper is directed specifically at him.

Answer 18

delusion of reference

Question 19

Beliefs of exaggerated self-importance; patient considers themselves wealthy and having special powers.

Answer 19

grandiose delusions

Question 20

Patient believes that a minor infringement of the law in the past will be discovered and bring shame upon the patient and bring retribution to his family.

Answer 20

delusions of guilt

Question 21

Beliefs that some person or thing has ceased, or is about to cease, to exist.

Answer 21

nihilistic delusions

Question 22

Patient says their bowels have been destroyed, they will never be able to pass faeces again.

Answer 22

nihilistic delusions surrounding failure in bodily function - Cotard’s syndrome

Question 23

Patient believes wrongly and despite medical evidence against them, that they are suffering from a disease.

Answer 23

hypochondriacal delusion

Question 24

Patient believes that their actions, impulses or thoughts are controlled by an outside agency.

Answer 24

delusions of control AKA. passivity phenomena

actions = volition

Question 25

Patient complains that the government are implanting thoughts in their mind. Which type of delusion is this?

Answer 25

thought insertion

Question 26

Patient complains of losing train of thought mid-way through sentences and thinks that their mobile phone is sucking their thoughts from their mind. Delusion types?

Answer 26

thought blocking and thought withdrawal

Question 27

patient is scared that their family and neighbours know what they are thinking all the time because they are telepathic.

Answer 27

thought broadcasting

Question 28

Recurrent persistent thoughts, images or impulses that enter the mind despite efforts to exclude them.

Answer 28

obsessions

Question 29

Do patient have insight about their obsessions?

Answer 29

Patient recognises them as their own and not implanted from elsewhere. Patient also regards the obsessions as untrue or senseless.

Question 30

What distinguishes delusions and obsessions?

Answer 30

resisting obsessions, lack of complete or persistent conviction, and knowledge that they are the patient's own ideas is what distinguishes obsessions from delusions

Question 31

Religious patient is distressed by repeated blasphemous thoughts intruding into their mind.

Answer 31

obsessional thoughts

Question 32

Patient is very worried that they can't stop thinking about the world ending.

Answer 32

obsessional ruminations (repeated worrying themes)

Question 33

Repeated urges to carry out actions, usually ones that are aggressive, dangerous, or socially embarrassing.

Answer 33

obsessional impulses - patient has no wish to carry it out, resists it strongly and does not act on it.

Question 34

Name the 6 main categories into which obsessions can fit.

Answer 34

``` dirt and contamination aggression orderliness illness sex religion ```

Question 35

Repetitive and seemingly purposeful behaviours that are performed in a stereotyped way in response to an obsession.

Answer 35

compulsions

Question 36

Name 4 common types of compulsive acts.

Answer 36

checking cleaning counting dressing

Question 37

Patient is talking but their speech is transitioning from one topic to another between sentences, with no logical link between the 2 topics.

Answer 37

Knight's move or derailment