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GP > GP - mental health & dementia > Flashcards

GP - mental health & dementia Flashcards

1
Q

What are the categories of symptoms of depression?

A 
emotional 
cognitive 
sleep
eating 
energy and motivation
psychosomatic 
suicide
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2
Q

What are the screening tools for anxiety and depression for GPs?

A

PHQ-9 for depression

GAD-7 for anxiety

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3
Q

What is treatment for depression?

A

CBT/counselling
SSRI e.g. sertraline
Tricyclic e.g. amytripyline
ECT

duloxetine, mirtazapine

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4
Q

What are the treatments for dementia?

A

acetylcholinestarase inhibitors - donepezil, rivastigmine, galantamine
Memantine

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5
Q

Name 3 symptoms of dementia

A 
memory loss 
visuo-spatial problems 
emotional disturbance 
loss of normal social behaviour 
hallucinations
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6
Q

What are the two screening tests used in primary care to assess possible dementia?

A

GPCOG

6-CIT - year? month? address and name? time? 20-1, months in reverse, repeat an address

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7
Q

What are the official types of eating disorder?

A

anorexia nervosa
bulimia nervosa
binge eating disorders
other specified feeding or eating disorder (OSFED)

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8
Q

What is the definition of malnutrition?

A

deficiences, excessess or imbalance in a person’s intake of energy and/or nutritients

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9
Q

Who can assess capacity? Which form would you use?

A

Doctors and nurses
Anyone specially trained e.g. social workers
COP3 form

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10
Q

What is a DoLS?

A

deprivation of liberty safeguards
- procedure prescribed in law when it is necessary to deprive a person of their liberty when they lack capacity to consent to their care and treatment in order to keep them safe from harm

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11
Q

Which act is the principle of best interests in?

A

Mental Capacity Act 2005

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12
Q

What is an IMCA?

A

Independant mental capacity advocate

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13
Q

What is the different between advanced directives and advanced decisions?

A

Advanced directives are legally binding, advanced decisions are not

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14
Q

What is lasting power of attorney?

A

A person nominated by an individual whilst they still have capacity but a loss of capacity is imminent to represent their interests
- one for properly and finances
one for health and welfare

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15
Q

How long does someone need to continue with CBT to see an impact?

A

At least 3 months

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16
Q

Give examples of SSRIs and explain how they work

Give two side effects

A

sertraline, fluoxetine, citalopram
inhibits neuronal uptake of serotonin from synaptic cleft increasing its availability
SE - dry mouth, constipation, diarrhoea, weight disturbance, erectile dysfunction

17
Q

Give examples of TCAs and explain how they work

A

amitriptyline, nortriptyline, imipramine
inhibit neuronal uptake of serotonin and noradrenaline from synaptic cleft
SE - dry mouth, constipation, urinary retention, blurred vision, breast changes

18
Q

What scores for MMSE are significant?

A 
<27 = mild 
<24 = significant
19
Q

What scores for GPCOG are signficant?

A

5-8 mild

0-4 significant

20
Q

What is the definition of dementia?

A

Syndrome defined by acquired loss of higher mental function affecting two or more congnitive domains, of sufficient severity to cause significant social or occupational impairment and occurring in clear consciousness

21
Q

What is distal preservation?

A

Remembering things far in the past but not recent events

22
Q

What are the 6 congnitive domains?

A 
Episodic memory
Language function 
Visuospatial function 
Frontal executive function 
Agnosia (recognition)
Apraxia (purposeful movement)
23
Q

What is it?

memory loss, distal preservation, cognitive dysfunction, visuospatial problems

A

Alzheimer’s

24
Q

What is it?

Memory loss, visual hallucinations, Parkinsonism

A

Lewy body

25
Q

What is it?

Personality change, appetite change, younger age of onset, family history

A

Pick’s disease - sub-type of frontotemporal

26
Q

What is it?

Stepwise decline, smoker, diabetic, atrial fibrillation, IHD

A

Vascular

27
Q

How does donepezil work?

A

Acetylcholinesterase inhibitor - prevents destruction of acetylcholine in synaptic cleft

28
Q

What are SE of anticholinesterase inhibitors?

A

Muscarinic
bradycardia, hypotension, hypersecretion
SLUDGE - salivation, lacrimation, urination, diarrhoea, GI upset, emesis

29
Q

How does memantine work?

A

NMDA-type glutamate receptor antagonist

30
Q

What are some side effects of memantine?

A

Confusion, dizziness, drowsiness, headache, insomnia, agitation, hallucinations

31
Q

When is 2nd line dementia treatment indicated? and which treatment is second line?

A

memantine is 2nd line

32
Q

What needs to be included for DoLs?

A

person needs to be provided with a representative
person must be given the opportunity to challange it via the court of protection
it must be regularly reviewed and monitored

GP (11 decks)

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