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Flashcards in Liaison Deck (12)
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1

Conversion disorder (history)

- HPC (onset, duration, ass Sx, previous events)
- Stressors
- La Belle Indifference (concern about Sx, relieved by Ix findings, family response)
- Comorbidity (moos, sleep, appetite, enjoyment, energy, psychosis, risk)
- Personal Hx (PPHx, FHx, PMHx, substance use)

2

Conversion disorder (explanation)

- Summarise findings
- Explain diagnosis and cause
- Explain medication (antidepressant if indicated)
- Explain psychological Rx (CBT)
- Concerns and leaflets

3

Health anxiety (history)

- HPC (onset, duration, exac/relieving factors, ass Sx, Ix, ICEs)
- Impact on functioning (research, family response, relationships, work)
- Personal history (PMHx, medications, recurrent childhood illness, family response, FHx)
- Comorbidities (mood, sleep, appetite, enjoyment, concentration, psychosis, risk)

4

Health anxiety (management)

- Clarify diagnosis and understanding
- Explain cause (family culture, stress, genetic risk)
- Explain medication (antidepressant)
- Explain psych Rx (CBT)
- Questions and concerns

5

Somatoform pain disorder (history)

- HPC (onset, duration, previous Rx, ICEs)
- Stressors (relationships, work, finances, medical)
- Impact on functioning
- Comorbidity (mood, sleep, appetite, concentration, enjoyment, psychosis, substances, risk)

6

Traumatic brain injury (history)

- HPC (onset, duration, progression, injury)
- Personality change (premorbid, disinhibition, impulsive)
- Behavioural change (irritable, verbal/physical aggression)
- Judgement (attention, concentration, decision making, risk)
- Memory (short-term, long-term, planning, orientation TPP, word-finding)
- Functioning (washing, dressing, finances)
- Comorbidity (mood, sleep, appetite, enjoyment, abnormal behaviour, substances, risk)

7

Traumatic brain injury (examination)

- Day/date/month/year
- Animals in 1 min
- Objects x3
- Clock drawing
- Objects recall
- Similarities (banana/orange, table/chair, tulip/rose/daisy)
- Programming (fist-edge-palm, x3 together then alone, 6 reps for 3 points)
- Cognitive estimates (elephants in London)
- Letter on the floor

8

Post MI depression (history)

- HPC (admission, progress, treatment, medications, follow-up)
- Depressive Sx
- Current stressors (relationships, work, financial)
- Understanding (cardiac rehab, lifestyle changes)

9

Post MI depression (d/w cons)

- Summary of case
- Prevalence (20%, 2-6x higher mortality)
- Medical Rx (sertraline - SADHART trial, avoid venlafaxine & tricyclics)
- Psychological Rx (CBT and lifestyle support)
- Liaise with cardiology

10

Antidepressant induced sexual dysfunction (history)

- Clarify diagnosis, medication and onset S/Es
- Current depressive Sx & risk
- Explore sexual difficulties (interest, erection, orgasm, priapism, relationship in general)
- Other causes (PMHx, medication)
- Options (continue - timing of meds, sildenafil, drug holiday; switch meds; stop - relapse)
- Other Treatment (CBT, couples therapy)

11

Antidepressant induced sexual dysfunction (d/w wife)

- Clarify diagnosis
- Wife's perception of Sx (mood, sleep, appetite, risk)
- Explain depression vs side-effects
- Management plan (continue - timing of meds, sildenafil, drug holiday; switch meds; stop - relapse)
- Questions and concerns

12

Post-concussion syndrome (history)

- HPC (injury, LOC, amnesia, admission, Ix)
- Ongoing neurology (weakness, headache, dizziness, tinnitus)
- Psych Sx (mood, anxiety, irritability, sensitivity to noise)
- Risk (falls, memory, self)
- Brief memory Ax (3 items, WORLD, recall, fluency)