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Phase 2: Psyk > workbook Questions > Flashcards

workbook Questions Flashcards

1
Q 
What are:
Level 1a
Level 1b
Level 2
General Observations on the ward?
A

1a: nurse in arms reach
1b: nurse can see
2: checked & documents every 15mins
General obs: checked & documented every 60mins

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2
Q

WhatarethechaptersincludedintheICD­10?

A

1-17: Diseases & other morbid conditions

18: symptoms/signs/abnormal clinical & lab findings not elsewhere classified
19: injuries, poisioning & certain other consequences of external causes
20: external causes of morbidity & mortality
21: factors influencing health status & contact with health services

(F01-99: Mental, Behavioural & Neurodevelopmental disorders)

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3
Q

Describetheinteractionsbetweenmentalandphysicalhealth

A

Psychological response to physical illness:
Uncertainty about future, search for meaning, anger, sense of failure, stigma, isolation

Psychiatric illness as a consequence of psychological response to physical illness:
Adjustment disorder, anxiety states, affective disorders, body image probs, sexual probs, eating disorders, substance misuse, PTSD

Patients presenting with mediacally unexplained symptoms may be due to:
Undiagnosed physical illness, somatisation (bodily complaints, assumed to arise from psyk disturbance, but contributed to organic illness), psychiatric illness, malingering (deliberate exacerbation of symptoms for obvious gain), fictitious disorder (fabrication of symptoms without obvious motive), dissociation/conversion disorder

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4
Q

Whatisdysthymia

A

Persistent, mild depression

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5
Q

Whymightdepressionbemorecommoninwomen?

A

Bio: women experience specific forms of depression-related illness, including premenstrual dysphoric disorder, postpartum depression and postmenopausal depression and anxiety, that are associated with changes in ovarian hormones

Psycho: women more often present with internalizing symptoms and men present with externalizing symptoms

Social: differences in socioeconomic factors: including abuse, education and income

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6
Q

Whatsocialfactorsmakepeoplevulnerabletodepression?

A 
Poor childhood experiences
Traumatic life events
Poor relationships
Substance misuse
Financial issues
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7
Q

Whataretheindicationsforelectro­convulsivetherapy(ECT)?

A

Severe depressive illness (concerns over health/safety)
Uncontrolled mania
Catatonia

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8
Q

WhataretheadvantagesanddisadvantagesofSSRIsas

comparedtotricyclicantidepressants?

A

Relatively safe in overdose (TCA: cardiotoxicity, anticholinergic SEs)
More selective & inhibits re-uptake of serotonin (TCAs: mainly NA)

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9
Q

Whatis“thoughtbroadcast”?

A

Delusion that thoughts are being transmitted to everyone around

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10
Q

WhatarethecoresymptomsofschizophreniaaccordingtotheICD classification?

A

Fundamental & characteristic distortions of thinking & perception, and affects that are inappropriate or blunted

Clear consciousness & intellectual capacity usually maintained

Most important psychopathological phenomena:
Thought echo, insertion, withdrawal, broadcasting
Delusional perception, delusions of control
Influence or passivity
Hallucinatory voices commenting or discussing patient in 3rd person
Thought disorders
Negative symptoms

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11
Q

Whatisadelusionandhowcanitbedistinguishedfromnormalexperience?

A

Fixed, firmly held belief which is usually false & is held despite evidence & cannot be reasoned away

Out of keeping with patient’s cultural background

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12
Q

Whatisthedifferencebetweensecondpersonandthirdpersonauditory hallucination

A

2nd: voice appears to address them
3rd: voice(s) talking about them

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13
Q

Whichformsofhallucinationsarecharacteristicof
Schizophrenia
Organic disorders

A

Schizophrenia: Auditory, tactile
Organic: visual, olfactory (in frontal lobe pathology)

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14
Q

Whyisanassessmentofinsightimportant?

A

Risk assessment

Presence of illness, need for treatment, usefulness of treatment

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15
Q

What is a ‘word salad’

A

confused or unintelligible mixture of seemingly random words and phrases
a form of speech indicative of advanced schizophrenia.

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16
Q

Inwhatconditionscanhallucinationsoccur?

A

Schizophrenia (auditory, tactile)
Organic disorders e.g. Dementia, head injury, tumour (visual, olfactory frontal lobe)
Psychotic depression (auditory)
Bipolar disorder (auditory)

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17
Q

Whatisthedefinitionofaneuroticdisorder?

what disorders are included under this umbrella term?

A

mental disorder in which the predominant disturbance is a distressing symptom/group of Sx
which one considers unacceptable and alien to one’s personality
without a marked loss of reality testing
behavior does not actively violate gross social norms although it may be quite disabling
the disturbance is relatively enduring or recurrent without treatment and is not limited to a mild transitory reaction to stress
there is no demonstrable organic etiology

Phobias, anxiety disorders, OCD, adjustment disorders, conversion disorders, somatoform disorders

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18
Q

Whyarepatientswithdependentpersonalitiesatriskof

develpingdepression?

A

Vulnerable when dependence on others breaks down

Insecure
Allows others to take responsibility
Usually compliant
Feel unable to self care
Need help to make decisions
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19
Q

Whyisthediagnosisofpersonalitydisorderpotentiallya

dangerousoneto make?

A

Subjectivity in diagnosis
May not be maladaptive (e.g. Narcassistic PD being a successful businessman)
Often present/becomes problematic when failing
Debate whether it exists entirely separately from co-occuring psychiatric disorder(s)
Repercussions for individual

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20
Q

Whatare“simplephobias”?

A

centre around a particular object, animal, situation or activity.

They often develop during childhood or adolescence and may become less severe as you get older.

E.g. Arachnophobia

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21
Q

What are complex phobias

A

tend to be more disabling than simple phobias
tend to develop during adulthood and are often associated with a deep-rooted fear or anxiety about a particular situation or circumstance.

E.g. Social phobia, agoraphobia

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22
Q

Whatproblemsareassociatedwiththelongtermuseof

benzodiazepines?

A

Dependence

withdrawal

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23
Q

WhyareanticholinergicdrugsusedtotreatParkinsonism?

A

Treat extra-pyramidal side effects associated with low Dopamine
Thought to act by blocking central cholinergic receptors, thus balancing cholinergic & dopaminergic activity of basal ganglia

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24
Q

Whatisneurolepticmalignantsyndrome?

A

Rare idiosyncratic response to antipsychotics
Caused by sudden reduction in dopamine activity
Risk renal failure (a med emerg)
Autonomic dysfunction: hyperpyrexia, tachycardia, unstable BP, excessive sweating, salivation, urinary incontinence
Increase in CK
musc rigidity
(Supportive treatment: stop antipsychotic, fluids, monitoring)

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25
Q

Whatarethesideeffectsoftricyclicantidepressants?

A

Cardiotoxic in overdose
Anticholinergic side effects (e.g. Dry mouth, blurred vision, constipation, drowsiness, cognitive impairment, hallucinations)

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26
Q

Whyshouldchlorpromazinebeavoidedintheelderly?

A

May cause hypotension
Increases risk of DVT/PE
Affects temperature regulation (increased risk hyper/hypothermia)

27
Q

Whataretheextrapyramidaleffectsofantipsychotics?

A

Parkinsonism: bradykinesia, mask face, resting tremor, cogwheel rigidity

28
Q

Whatarethedangersofrapidtranquillisation?

A

when medicines are given to a person who is very agitated or displaying aggressive behaviour to help quickly calm them.
This is to reduce any risk to themselves or others, and allow them to receive the medical care that they need.
Usually using benzodiazepines or antipsychotics

Risk loss of consciousness, hypotension, bradycardia, tardative dyskinesia/NMS etc in benzodiazepines

29
Q

Whatarethesymptomsoflithiumtoxicity?

A

tremor, ataxia, dysarthria, nystagmus, renal impairment, and convulsions

30
Q

WhocanapplyaSection5(2)?

A

(Inpatients only)
RMO or nominated deputy (doctor on call)
Detention for up to 72hrs to allow completion of MHA

31
Q

Who can apply a section 5(4)?

A

(Inpatients only)
RMO
Detention of an inpatient for up to 6hrs for medical assessment where mental illness suspected

32
Q

Whatarethe4stagestoconsiderinmakingaCapacity

Assessment.

A

Understand
Retain
Weigh up
Communicate

33
Q

Whyisregularsupervisionimportantforapsychotherapist?

A

Personal well being
Well being of patients; protect clients & improve ability to value clients

Required by all counsellors & psychotherapists

34
Q

What are the potential advantages of therapeutic community treatment overindividualpsychotherapy?

A

Social relationships and communities provide the context and impetus for a range of psychological developments, from genetic expression to the development of core self-identities. This suggests a need to think about the therapeutic changes and processes that occur within a community context and how communities can enable therapeutic change
Evolving emotion-regulation systems

35
Q

What are the symptoms of obsessive­compulsive disorder and how are they treatedwithCBT?

A

OCD:
Obsession = unwanted intrusive thoughts which are unpleasant & raise anxiety. Derived from own mind
Compulsion: associated behaviour (senseless, repeated rituals but have insight - often a way to reduce distress of obsession)
A need for perfectionism, to control, inability to delegate, feelings of doubt & caution, preoccupation with detail

CBT:
Accept thoughts & divorce of meaning
Response prevention (delay response & see what happens)

36
Q

Whataretheprincipaldifferencesbetweenpsychodynamic

psychotherapyand cognitive­behaviouralpsychotherapy

A 
Psychodynamic psychotherapy (psychoanalytical):
the systematic use of a relationship between a patient and a therapist (as opposed to physical and social methods) to 
produce changes in feelings, cognition and behaviour 
Attempts to re-structure personality (based on Freud's approach to psychoanalysis)

CBT:
Focuses on thoughts & assumptions
Helps change unhelpful thoughts (cognitions) & actions (behaviours)
Theory:
◦we respond to our interpretation of events, not to raw
events alone
◦& if this is the case, cognitive change required to produce
emotional/behavioural change

37
Q

Whatis“transference”?

A

redirection to a substitute, usually a therapist, of emotions that were originally felt in childhood

Past experiences/expectations projected onto real life

38
Q

Whyismotivationimportantinassessingapatient’ssuitabilityforpsychodynamic psychotherapy?

A

Require motivation to enquire about inner self

39
Q

Whydopatientsinpsychodynamic psychotherapyoftengetworsebefore
Theygetbetter?

A

Have to address unresolved issues

Conflict

40
Q

Whatisthedifferencebetweendeliriumanddementia?

A

Delerium: organic reaction, fluctuating impaired consciousness, acute onset

Dementia: syndrome of progressive & global intellectual deterioration without impairment of consciousness

41
Q

Whatisthemostcommonformofdementia?

A

Alzheimers (60%)

42
Q

Whatisparaphrenia?

A

mental disorder characterized by an organized system of paranoid delusions with or without hallucinations (the positive symptoms of schizophrenia) without deterioration of intellect or personality (its negative symptom).

43
Q

WhataretheneuropathologicalfeaturesofAlzheimer’sDisease?

A

Beta amyloid plaque deposition
Neurofibrillary tau tangle formation
Neuronal loss: hippocampal, parietal lobe

44
Q

Whyisamultidisciplinaryapproachimportantinoldagepsychiatry?

A

Multiple symptoms

No cure; manage/minimise symptoms

45
Q

Whatisanencapsulateddelusion?

A

a delusion that usually relates to one specific topic or belief but does not pervade a person’s life or level of functioning.

46
Q

Inwhatwaysmayexcessiveuseofalcoholpresenttothepsychiatrist?

A

Thymine defociency:

Wernicke’s encephalopathy (acute)
Confusion, ataxia, ophthalmoplegia

Korsakoff's syndrome 
Hypothalmic damage & cerebral atrophy
Inability to acquire new memories
Confabulation
Lack insight
Apathy
47
Q

Whatarethehealthrisks(physicalandpsychosocial)ofillicitopioiduse?

A

Overdose: resp depression
Numbness, stupor

Addictive: loss of finances, social support, job

48
Q

Whatismeantby“harmminimisation?”

A

acknowledges that some people in societies will use alcohol and other drugs
therefore incorporates policies/public health strategies which aim to prevent or reduce drug related harms.

49
Q

Whatistherecommendedsafeweeklyintakeofalcohol(a)formen(b)for women?

A

14 units/week, spread over at least 3 days

Units = strength (ABV) x volume (ml) ÷ 1,000 = units

50
Q

Whatarethesymptomsofacutealcoholwithdrawal(deliriumtremens)?

A

Sweats, nausea, tremor

51
Q

Whichillicitdrugsmayproduceaschizophrenia­likestate?

A 
Alcohol
Cannabis
Benzodiazepines
Barbituates
Amphetaines
Cocaine
Hallucinogens
Ffluoroquinolone (permanent)
52
Q

Whatarethediagnosticfeaturesofbulimianervosa?

A

Recurrent binge episodes
Preoccupation with body weight
Inapprop compensatory behaviour to overcome effect of binge

53
Q

Whatisthecauseofamenorrhoeainanorexianervosa?

A

Primary Hypothalmic disturbance = reduced secretion LH & FSH

54
Q

Whatdrugsareusedinthetreatmentofbulimianervosa?

A

Antidepressants

55
Q

Whattypesofpsychotherapyareusedinthetreatmentofanorexianervosa?

A

CBT, family therapy, psychodynamically informed behavioural tx

56
Q

Whyaretricyclicantidepressantspotentiallydangerousinanorexianervosa?

A

Both increase QT interval

57
Q

Whatarethemostseriousphysicalcomplicationsofanorexianervosa

A

Deficiency: Thiamine, K, Na, Ca, phosphate
Endocrine disturbance
Osteoporosis
Sinus bradycardia

58
Q

What are the common causes of acute confusional state?

A 
(Delerium)
Malnutrition
Meds e.g. Benzodiazepines
Alcohol (withdrawal)
Infection
Metabolic abnormalities e.g. Hypoglycaemia
Hypoperfusion
Hypoxia
59
Q

Why are psychiatric disorders difficult to diagnose in people with learning disability?

A

Communication barriers

Psychiatric conditions may present in less usual way

60
Q

Whatisa“behaviouralphenotype”?

A

patterns of behaviour that present in syndromes caused by chromosomal or genetic abnormalities.

61
Q

WhatarethefeaturesofDownsyndrome?

A

Physical abnormalities

Intellectual abnormalities

62
Q

WhatisFragileXsyndrome?

A

genetic disorder. Symptoms often include mild to moderate intellectual disability. Physical features may include a long and narrow face, large ears, flexible fingers, and large testicles. About a third of people have features of autism such as problems with social interactions and delayed speech. Hyperactivity is common and seizures occur in about 10%. Males are usually more affected than females.
Typically due to expansion of CGG triplet repeat

63
Q

Whatarethediagnosticfeaturesofautism?

A 
Core symptoms:
Social difficulties
Restrictuve/repetitive patterns of interest/behaviour/activity
Present early in dev period
Clinically sig impairment
Not due to another condition

Phase 2: Psyk (1 decks)

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