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3 Mental Health EJR > week 1 > Flashcards

week 1 Flashcards

1
Q

core conditions in mental health

A 
depression
anxiety
schizophrenia
substance abuse
mood disorders
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2
Q

core presentations of schizophrenia

A 
hallucinations - auditory/visual
delusional perceptions
self harm
insomnia
loss of concentration
anxiety
social withdrawal
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3
Q

core presentations of depression

A 
autonomic symptoms
social withdrawal
insomina
low moods
self harm/neglect
low appetite
anhedonia
delusions
slow/unfocused
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4
Q

key method of differentiating the different disorders?

A

establish a timeline and determine which symptom came first.

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5
Q

key additional sections to ask in a psychiatric history

A 
past psychiatric history
personal history
pre-morbid behaviour
collateral history
family history
forensics history
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6
Q

what is assessed in a mental state exam

A 
appearance
behaviour
speech
mood
though form/contents
perceptions
cognitions
insight
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7
Q

difference between mood and affect

A

mood is like climate, affect is like weather.

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8
Q

thought content vs thought form

A

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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9
Q

3 factors in a formulation

A

predisposing factors
precipitating factors
perpetuating factors

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10
Q

types of thought content common in a schizophrenic person

A

grandiose
persecutory
paranoid

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11
Q

3 D’s in old page psychiatry

A

delirium
depression
dementia

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12
Q

what is pseudodementia

A

symptoms that mimick dementia but is actually caused by severe depression

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13
Q

what are symptoms of pseudodementia

A

confusion
abnormal thoughts
low mood
memory lapses

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14
Q

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

A

pseudodementia - patients complain

dementia - family complains

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15
Q

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

A

pseudodementia will not show memory problems in testing

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16
Q

what are the 5 items in a GDS screening

A 
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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17
Q

how many % of hospital patients >65 experience delirium?

A

20-30%

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18
Q

why is delirum underdiagnosed?

A

mostly old people, falsely attributed to dementia

hypoactive delirium can be missed

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19
Q

symptoms of delirium

A

reduced focus/concentration
hallucinations
cognitive impairment
confusion

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20
Q

criteria in the confusion assessment method (CAM)

A

acute and fluctuating course
inattention
disorganised thinking
altered level of consciousness

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21
Q

types of delirium

A

hyperactive
hypoactive
mixed

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22
Q

what is the pattern of mixed delirium

A

fluctuating through the day

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23
Q

which type of delirum has a poorer prognosis, why?

A

hypoactive - poor oral intake and dehydration

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24
Q

causes of delirium

A

PINCH ME

pain
infection
nutrition
constipation
hydration

medication
environment

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25
Q

predisposing and precipitating factors of delirium

A 
age
pre-existing dementia
severity of illness
metabolic or electrolyte imbalance
psychoactive medicaiton
hx of previous delirium
26
Q

how to assess delirium

A

timeline and change
collateral history
medication history

27
Q

how to assess dementia

A 
full and collateral hx
cognitive testing
neuroimaging
blood tests to rule out others
functional assessment
28
Q

what is the pathological characteristic change in ahlzeimers disease

A

beta amyloid plauqes

neurofibrilary tangles

29
Q

characteristic of alhzeimer’s onset

A

slow and progressive

30
Q

what type of medical can slow Alzheimer’s

A

anti-acetylcholinesterase

31
Q

onset of vacular dementia

A

sudden and stepwise decline

32
Q

3 core features of lewy body dementia

A

visual hallucinations
cognitive fluctuation
parkinsonism

33
Q

what is a DAT scan

A

dopamine active transport scan

34
Q

which form of dementia has behavioural symptoms

A

frontotemporal

35
Q

what affect will someone with anxiety have

A

fearful

apprehensive

36
Q

what kind of thoughts will an anxious person have

A

exaggerated thoughts of misfortune and danger

37
Q

what behaviour will someone with anxiety have

A

avoidance

38
Q

what somatic features can be present in anxiety

A 
autonomic features
chest pain
paraesthesia
tachypnea
headache
N/V/D
39
Q

what is the time duration required for a diagnosis of GAD

A

most days for at least 6 months

40
Q

management of GAD

A

SSRIs
CBT/counselling
beta blockers

41
Q

risk factors for depression

A

psychosocial misfortune
chronic illness
sexual abuse
family history

42
Q

clinical features of depression

A 
low mood
low appetite
anergia
anhedonia
sucidal thoughts
low motivation
impaired concentration
insomnia
reduced self-esteem
43
Q

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

A

F

44
Q

differentials of depression

A

dysthymia
anxiety
hypothyroid/hypoadrenalism
substance abuse

45
Q

what organic causes can present with psychosis

A

tertiary syphylis
brain tumor
post-encephalitic state
drugs/medication

46
Q

what is paranoia defined as

A

thoughts which relate everything to themselves

47
Q

peak onset age of schizophrenia

A

20-30

48
Q

non-acute features of schizophrenia

A 
social withdrawal
blunted affect
anergia
vague speech
poor personal hygiene
49
Q

MSE features of schizophrenia - appearance and behaviour

A 
perplexity
social awkwardness
withdrawal
impulsivity
responding to non-existant stimuli
aggression
50
Q

MSE features of schizophrenia - speech

A

neologisms

poverty of speech/ideas/vocabulary

51
Q

MSE features of schizophrenia - mood

A

blunted affect
bipolar episodes
incongruous moods (inapproriate response)

52
Q

MSE features of schizophrenia - thought form

A

loosely linked ideas
incomprehensible
difficult to follow

53
Q

MSE features of schizophrenia - thought content

A

delusions

external control

54
Q

what types of delusions can manifest in schizophrenia

A

grandiose
persecutory
paranoid

55
Q

what is the most common perception in schizophrenia

A

auditory hallucination

56
Q

3 subtypes of schizophrenia

A

simple schizophrenia - negative symptoms

paranoid schizophrenia - complex delusions and hallucinations

catatonic schizophrenia - psychomotor disturbance, fluctuating bipolar episodes

57
Q

core symptoms of depression

A

low mood
anhedonia
tiredness

58
Q

biological features of depression

A 
diurnal variation in mood
early morning waking
libido loss
amenorrhea
constipation
psychomotor retardation
59
Q

psychotic symptoms in depression

A

delusions
hallucinations
loss of insight
stupor

60
Q

most important things to ask in depression hx

A 
symptoms of mania
past hx
family hx
suicidal thoughts
drugs/alcohol
61
Q

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

A

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

3 Mental Health EJR (4 decks)

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