IPE Flashcards

Question

What gives a poor prognosis of schizophrenia?

Answer 1

``` Strong FH gradual onset decreased IQ premorbid history of social withdrawal no obvious precipitant ```

Answer 2

Appears at the time of puberty Disorganised behaviour and speech Less likely to hallucinate or have delusions Emotional response is often silly and inappropriate - acting silly or childish, inappropriate laughter or facial responses

Answer 3

``` Stop medication treat hyperthermia aggressively - cooling packs airway and breathing support Benzos IV fluid and dialysis Dantrolene Bromocriptiene - dopamine agonist ```

Answer 4

GI - gastroparesis, colonic dysfunction, volvulus and abormal LFTs CV- bradycardia, arrhthymias, hypotension and reduced cardiac mass Electrolyes - all low Nutritional deficiencies - decreased B1, zinc, B12, folate and iron Endocrine - low sex hormones leading to osteoporosis

Answer 5

2 a week for 3 months of 1 a week for 6 months

Answer 6

CBT and interpersonal psychotherapy Self help guides Treat consequences and underlying MH conditions

Answer 7

Echolalia - repeition of a word or phrase Palilalia - repeat one word used by others Logoclonia - repeat first syallable of a word

Answer 8

6 month decline in memory,cognition, personality, behaviour and executivve functioning with preserved awareness of enviroment.

Answer 9

evidence of decline in memory and decline in other cognitive abilities Preserved awareness of enviroment decline in emotional control or motivation or change in social behaviour must have been present for 6/12

Answer 10

UMNL signs

Answer 11

Lewy bodies in the neurones - especially in the hippocampus, cerebrum and substantia nigra

Answer 12

DVLA must be informed

Answer 13

``` Blood tests - anaemia and infection, Hypoglycaemia Hypercalcaemia Hypothyroidism Urine dip - UTI CXR Sphyllis - reversible dementia Imaging of the brain ECG - any ischaemic events and ACE-I cant be prescribed in bradycardia EEG - fronto temporal of CJD suspected ```

Answer 14

Mild 50-69 Moderate 50-35 Severe <34

Answer 15

Triad of low intellectual performance, onset at birth and wide range of functional impairment Diagnosed by 18y/o IQ <70

Answer 16

Presence of abnormal development before the age of 3 Qualitative abnormalities in social interaction Qualitative abnormalities in communication Restrictive, repetitive and stereotyped pattern of behaviours, interest and activities Clinical picture not attributable to other varieties of pervasive developmental disorders

Answer 17

Demonstrate abnormalities of attention, activity and impulsivitiy at home Demonstrate abnormalities of attention, activity and impulsivitiy at school Directly observed abnormalities of attention or activity Doesnt meet the diagnosis of pervasive developmental disorder, Mania, depressive or anxiety disorder Onset before 7 Duration of at least 6 months IQ >50

Answer 18

Exhibit interaction and behaviour outside their age Often violate the rights of others around them Often ignore and disobey rules- vindictive and spiteful

Answer 19

CBT and screen for other mental health disorders

Answer 20

``` Lacrimation Yawning tremor dilated pupils cold clammy skin abdo cramps increased BP and HR ```

Answer 21

Acamprosate- blocks GABA and reduced NMDA excitation- decrease craving Naltrexone - competative antagonist at opioid receptor-decreases the pleasure from drinking Disulfaram- acetaldehyde dehydrogenase inhibitor so hangover while drinking

Answer 22

Motivational interviewing

Answer 23

Acute dystonia- eg oculogyric crisis Parkinsonism Tardive dyskinesia -late onset of choreoathetoid movements, abnormal, involuntary, may occur in 40% of patients, may be irreversible, most common is chewing and pouting of jaw Akathisia- severe restlessness Due to blocking of dopamine in the basal ganglia at the nigrostrial pathway

Answer 24

Second person - may be telling patient to do things | In risk assessment - assess what they would do if they couldnt do what the patient was asking them to

Answer 25

Fluoxetine

IPE Flashcards

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