wk 8 2 - Psychiatry and GI Flashcards
globus sensation
sensation of a lump in the throat
causes of globus sensation
foreign body Gord inflammation of pharynx Pharyngeal pouch cancers neurological conditions pollen/oral allergy syndrome
t/f globus is a diagnosis of exclusion
true
t/f functional dysphagia is a diagnosis of exclusion
true
causes of psychosis
mood disorders
schizophrenia
drug induced
organic causes (dementia/delirium/tumours)
how long does IBS symptoms need to persist before diagnosis
6 months (nice guideline) or 3 months (ROME criteria)
symptoms of IBS
stomach pain/discomfort (RIF/LIF,cramping,stabbing,achy,sharp)
-relieved by poos
associated with a need to go to poopoo
change in stool consistency
along with pain/discomfort, what are the associated symptoms of IBS
(atleast 2)
bloating, guarding in abs
change in passing stool (tenesmus, straining, urgency) (consto/diarrhoea)
worse after eating
passing mucus
outline the pathophysiology of IBS
motor/sensory dysfunction in GI tract
- may occur post bacterial gasroenteritis
- stress
dysregulation of brain-gut axis
-greater stress reactivity - modifies perception of afferent signals from ENS
(history of abuse in ~1/3 patients)
T/F ulceration of bowels can occur in IBS
false
symptoms which may indicate IBD rather than IBS
ulceration
bleeding
dark stool
t/f IBS is more common in males
false
twice as common in females
- more common in western cultures, but if from eastern 4 times more likely to be male
red flags for IBS patients
co-morbid mental health conditions most likely - anxiety and depression
psychological treatment for IBS
Psychodynamic Therapy
Hypnotherapy
CBT (Cognitive behavioural therapy)
malingering and factitious disorders may be evident in consultation, define each
Malingering - lying for external gain (drugs,benefits,court case)
Factitious - pulling a sickie
signs of anorexia nervosa
significant weight loss (BMI <17.5/child - failure to grow)
self induced vomiting - callous fingertips - Russells sign
intrusive/overvalued idea of success/failure (lean/fat)
body image distortion
widespread endocrine abnormality
different types of anorexia
atypical
restricting - no binging
bing eating/purging
bulimia nervosa
attempts to restrict intake fail, leading to binges
low/normal/incr weight
no endocrine abnormalities
1/3 pmh anorexia nervosa
3 asscotiated psychiatric morbidity issues of anorexia/bulimia
depressiuve
OCD
personality disorders
treatment for AN/BN
weight gain
establish therapeutic alliance
psychologicl interventions
drugs - antideppressants, fluoxetine prevents relapse after wight gain
