psychiatry

Question 1

ADHD 3 core symptoms

Answer 1

inattention
impulsivity
hyperactivity
persistent and impact on daily functions

Question 2

inattentive symptoms (8)

Answer 2

easily distracted
Does not appear to be listening when spoken to directly
Has difficulty sustaining attention during activities
Avoids or dislikes tasks requiring sustained mental effort
Is forgetful in daily activities
Finds it difficult to follow through instructions and fails to complete tasks
Finds it difficult to organise tasks and activities
Fails to give close attention to detail/makes careless mistakes
Loses important items

Question 3

hyperactivity symptoms (6)

Answer 3

Squirms and fidgets
Cannot remain seated
Runs or climbs excessively in inappropriate situations
Often ‘on the go’ or acts as if ‘driven by a motor’
Talks excessively
Cannot perform leisure activities quietly

Question 4

impulsivity symptoms (3)

Answer 4

Blurts out answers before questionscompleted
Has difficulty awaiting turn
Interrupts or intrudes on others

Question 5

ADHD management

Answer 5

education
ADHD parenting programme
school support and liason
medications - methylphenidate, atomoxetine, lisdexamfetamine

Question 6

autism spectrum disorders

Answer 6

communication
social interaction
behaviour, poor imagination, rigidity

Question 7

autism spectrum disorders - communication difficulties

Answer 7

lack of desire to communicate at all
communicating needs only
disordered or delayed language

Question 8

autism spectrum disorders - social interaction difficulties

Answer 8

no desire to interact with others
being interested in others to have needs met
lack of motivation to please others
affectionate on own terms

Question 9

autism spectrum disorders - imagination rigidity difficulties

Answer 9

using toys as objects
inability to play or write imaginatively
resisting change
playing same game over and over
obsessions/rituals

Question 10

autism - management

Answer 10

education
ADHD parenting programme
school liason / support
manage comorbidity

Question 11

screening for eating disorders SCOFF

Answer 11

do you make yourself Sick because you’re uncomfortably full?
do you worry that you’ve lost Control over how much you eat?
have you recently lost more than 6 kilograms (aboutOne stone) in three months?
do you believe you’re Fat when others say you’re thin?
would you say that Food dominates your life?

Question 12

anorexia clinical signs

Answer 12

Dry skin
Lanugo hair
Orange skin and palms 
Cold hands and feet
Bradycardia
Drop in BP on standing
Oedema
Week proximal muscles - squat test

Question 13

what does CAMHS stand for

Answer 13

Child and Adolescent Mental Health Services

Question 14

anorexia management

Answer 14

Psychological - family therapy, CBT etc
weight gain - 0.5kg / week in outpatients, 0.5-1kg / week in inpatients feeding against the patient’s will is possible under the MHA, monitor for Refeeding syndrome
medication - Multivitamins, thiamine, phosphate. also
Antidepressants for low mood olanzapine for agitation and anxiety

Question 15

anorexia diagnostic criteria ICD-10

Answer 15

Dread of fatness intrusive overvalued idea

Deliberately keeping weight below 85% of expected
restricted dietary choice - excessive exercise, induced vomiting, use of appetite suppressants and diuretics.

Endocrine effects - menstruation stops or puberty is delayed if menarche not yet achieved. In men can manifest as loss of sexual interest/potency