week 1 Flashcards by prion alpha

core conditions in mental health

depression
anxiety
schizophrenia
substance abuse
mood disorders

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core presentations of schizophrenia

hallucinations - auditory/visual
delusional perceptions
self harm
insomnia
loss of concentration
anxiety
social withdrawal

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core presentations of depression

autonomic symptoms
social withdrawal
insomina
low moods
self harm/neglect
low appetite
anhedonia
delusions
slow/unfocused

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key method of differentiating the different disorders?

establish a timeline and determine which symptom came first.

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key additional sections to ask in a psychiatric history

past psychiatric history
personal history
pre-morbid behaviour
collateral history
family history
forensics history

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what is assessed in a mental state exam

appearance
behaviour
speech
mood
though form/contents
perceptions
cognitions
insight

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difference between mood and affect

mood is like climate, affect is like weather.

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thought content vs thought form

thought form is like structure, the relationship between 2 normal thoughts.

thought content is what they are thinking about and if it makes sense at all

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3 factors in a formulation

predisposing factors
precipitating factors
perpetuating factors

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types of thought content common in a schizophrenic person

grandiose
persecutory
paranoid

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3 D’s in old page psychiatry

delirium
depression
dementia

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what is pseudodementia

symptoms that mimick dementia but is actually caused by severe depression

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what are symptoms of pseudodementia

confusion
abnormal thoughts
low mood
memory lapses

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who complains about memory problems in pseudodementia, vs real dementia?

pseudodementia - patients complain

dementia - family complains

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what is the other difference in memory symptoms in pseudodementia and dementia

pseudodementia will not show memory problems in testing

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what are the 5 items in a GDS screening

are u satisfied with life
do you often get bored
do you often feel helpless
do you prefer to stay at home than go out and try new things
do you feel pretty worthless

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how many % of hospital patients >65 experience delirium?

20-30%

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why is delirum underdiagnosed?

mostly old people, falsely attributed to dementia

hypoactive delirium can be missed

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symptoms of delirium

reduced focus/concentration
hallucinations
cognitive impairment
confusion

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criteria in the confusion assessment method (CAM)

acute and fluctuating course
inattention
disorganised thinking
altered level of consciousness

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types of delirium

hyperactive
hypoactive
mixed

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what is the pattern of mixed delirium

fluctuating through the day

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which type of delirum has a poorer prognosis, why?

hypoactive - poor oral intake and dehydration

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causes of delirium

PINCH ME

pain
infection
nutrition
constipation
hydration

medication
environment

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predisposing and precipitating factors of delirium

``` age pre-existing dementia severity of illness metabolic or electrolyte imbalance psychoactive medicaiton hx of previous delirium ```

how to assess delirium

timeline and change collateral history medication history

how to assess dementia

``` full and collateral hx cognitive testing neuroimaging blood tests to rule out others functional assessment ```

what is the pathological characteristic change in ahlzeimers disease

beta amyloid plauqes | neurofibrilary tangles

characteristic of alhzeimer's onset

slow and progressive

what type of medical can slow Alzheimer's

anti-acetylcholinesterase

onset of vacular dementia

sudden and stepwise decline

3 core features of lewy body dementia

visual hallucinations cognitive fluctuation parkinsonism

what is a DAT scan

dopamine active transport scan

which form of dementia has behavioural symptoms

frontotemporal

what affect will someone with anxiety have

fearful | apprehensive

what kind of thoughts will an anxious person have

exaggerated thoughts of misfortune and danger

what behaviour will someone with anxiety have

avoidance

what somatic features can be present in anxiety

``` autonomic features chest pain paraesthesia tachypnea headache N/V/D ```

what is the time duration required for a diagnosis of GAD

most days for at least 6 months

management of GAD

SSRIs CBT/counselling beta blockers

risk factors for depression

psychosocial misfortune chronic illness sexual abuse family history

clinical features of depression

``` low mood low appetite anergia anhedonia sucidal thoughts low motivation impaired concentration insomnia reduced self-esteem ```

substance abuse is not a factor in depression - T or F

differentials of depression

dysthymia anxiety hypothyroid/hypoadrenalism substance abuse

what organic causes can present with psychosis

tertiary syphylis brain tumor post-encephalitic state drugs/medication

what is paranoia defined as

thoughts which relate everything to themselves

peak onset age of schizophrenia

20-30

non-acute features of schizophrenia

``` social withdrawal blunted affect anergia vague speech poor personal hygiene ```

MSE features of schizophrenia - appearance and behaviour

``` perplexity social awkwardness withdrawal impulsivity responding to non-existant stimuli aggression ```

MSE features of schizophrenia - speech

neologisms | poverty of speech/ideas/vocabulary

MSE features of schizophrenia - mood

blunted affect bipolar episodes incongruous moods (inapproriate response)

MSE features of schizophrenia - thought form

loosely linked ideas incomprehensible difficult to follow

MSE features of schizophrenia - thought content

delusions | external control

what types of delusions can manifest in schizophrenia

grandiose persecutory paranoid

what is the most common perception in schizophrenia

auditory hallucination

3 subtypes of schizophrenia

simple schizophrenia - negative symptoms paranoid schizophrenia - complex delusions and hallucinations catatonic schizophrenia - psychomotor disturbance, fluctuating bipolar episodes

core symptoms of depression

low mood anhedonia tiredness

biological features of depression

``` diurnal variation in mood early morning waking libido loss amenorrhea constipation psychomotor retardation ```

psychotic symptoms in depression

delusions hallucinations loss of insight stupor

most important things to ask in depression hx

``` symptoms of mania past hx family hx suicidal thoughts drugs/alcohol ```

why is it important to ask about mania in a depression hx

cannot give SSRI to people who are also manic will cause mania

week 1 Flashcards

(61 cards)