CEL Flashcards
In a psychiatric interview with a patient with depressive symptoms, what could you ask about?
- anhedonia (inability to feel pleasure
- sleep
- guilt
- concentration
- apetite
- suicide
What are components of a mental state examination?
- appearance and behaviour
- mood and affect
- thought
- perception
- cognitive state examination - alert, concentrating, memory
- insight and judgment
What are 5 things to consider in a suicide risk assessment protocol?
- predisposing factors
- precipitating factors
- review current episode - suicide intent, MSE, capacity for action
- determine level of intervention
- document the assessments
What are risk factors for suicide?
Sex - F more attempt, M more success Age - teens and elderly Depression Previous attempt Ethanol abuse Rational thinking loss Social support problems Organised plan No spouse Sickness
What are the NT systems targeted by antidepressant drugs?
(1) NA - in locus coeruleus modulates sleep/anxiety/mood
SNRI - Venlafaxine
(2) 5-HT - mainly in raphi nuclei
SSRI - fluoxetine
What is the DSM-V criteria for a major depressive episode?
- depressed mood
- minimum 2 weeks
- accompanied by 5 other symptoms - reduced pleasure and interest, appetite/weight loss, sleep disturbance, psychomotor agitation, impaired concentration, fatigue, thoughts of death or suicide
- causing significant distress
- not explained by another psych condition
What is nociceptive and neuropathic pain?
Nociceptive - damage to body tissue
Neuropathic - damage to peripheral or CNS - burning, painful shocks, hot/cold
What are some non-motor symptoms of Parkinson’s?
Autonomic - orthostatic hypotension, urinary incontinence, sweating,
Mood disturbances
Neuropsychiatric symptoms - anxiety, depression, apathy
Reduced sense of smell
Sleep - insomnia, XS day time sleepiness, vivid dreams
Speech - tone, quiet
Gait - freezing, shuffling, trouble turning
Where is a lumbar puncture done?
L4-5 interspace in the area of caudal equine
What are signs and symptoms of stroke?
FAST - face, arms, speech, time
- disrupted speech
- muscle weakness one side
- fast onset
- loss of vision one eye
- gait changes
- sudden severe headache
- LOC
Stroke risk factors?
- HTN
- smoking
- diabetes
- alcohol
- AF
What is the ABCD^2 assessment of stroke?
- age
- blood pressure
- clinical features
- duration
- diabetes
What is involved in a mental state examination?
- appearance/behaviour
- speech
- emotions
- perception
- thought
- insight and judgment
- cognitive state exam
What are the 5 sections in psychiatric interview?
- history
- mental state examination
- formulation
- Dx and DDx
- Mx - treatment
Suicide risk factors
Sex Age Depression Previous attempt Ethanol Rational thinking lost Social support problems Organised plan No spouse Sickness - chronic illness
