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Year 3 GP > Mental Health > Flashcards

Mental Health Flashcards

1
Q

Symptoms of depression

A

Core symptoms:

  • Low mood - no obvious cause
  • Loss of enjoyment - anhedonia
Other:
Feeling tired and sad 
Lack of confidence and motivation 
Persists for more than 2 weeks 
Frustrated, irritated or angry 
Feeling hopeless

Lack of concentration
Suicidal thoughts or ideas

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2
Q

Signs of depression

A

Weight change
Loss of limbido
Sleep disturbances

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3
Q

Assessment of depression

A 
PHQ - 9 - severity
Safeguarding 
Alcohol or substance misuse 
Anxiety 
Eating disorders 
Psychotic symptoms 
Dementia
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4
Q

Conservated tx of depression

A 
Talk to someone 
Healthier lifestyle - exercise and eat healthy 
Mindfulness 
Raise self esteem 
Set small targets 
Do things you enjoy
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5
Q

Ix for depression

A

Assess risk of suicide
PHQ - 9

Bloods:

  • FBC, Fe, B12, Folic acid, TFTs
  • Cortisol
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6
Q

Mx of depression

A

Sub-threshold or mild depression:
- Low intensity intervention

Moderate to severe:
- High intensity intervention

  • CBT - computerised or group
  • Counselling
  • Antidepressants - SSRI
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7
Q

Antidepressants

A

SSRI - citalopram, sertraline or fluoxetine

Sertraline has a low risk of drug interactions

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8
Q

Help lines

A 
MIND
Depression alliance 
Depression UK 
Mental Health Foundation 
Samaritans 
SafeLine
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9
Q

RAPRIOP

A 
Reasssurance 
Advise
Prescribe or procedure 
Refer 
Inform 
Observe and follow up 
Prevention/ promotion
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10
Q

Presentation of generalised anxiety disorder

A

Symptoms lasting 6+ months:

Chronic excessive worry unrelated to circumstances and disproportionate to risk

At least 3 of:

  • Restlessness
  • Nervousness
  • Fatigue
  • Poor concentration

Insomnia
Muscle tension

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11
Q

Risk factors for GAD

A 
Femal 
FHx 
Current physical or emotional distress 
Physical or emotional trauma 
History of anxiety disorders 
Substance misuse 
Sleep disturbance
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12
Q

Anxiety disorders

A 
Generalised anxiety disorder
Panic disorder 
Social phobia 
Specific phobia 
Situational anxiety 
OCD
PTSD
Anorexia
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13
Q

Physical signs of anxiety

A 
Tachycardia 
Palpitations
Dyspnoea 
Trembling 
Exaggerated startled response
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14
Q

Tool for anxiety

A

GAD 7

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15
Q

Mx of anxiety

A

Assess severity - GAD 7
Manage co morbidities
Low intensity psychological intervention - mild
High intensity psychological intervention - moderate 0 severe
Anti- anxiolytics: SSRI, SNRI
Specialist referral

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16
Q

Contraindications of SSRI

A

Not given with drugs that prolong QT interval
Bipolar - increases mania
CKD stage 4 - 5
Caution in epilepsy

Sertraline is fine during pregnancy and breastfeeding

17
Q

Mild depression

A

excess of five symptoms and they only result in minor functional impairment

18
Q

Severe depression

A

diagnosed if the person has most symptoms and they markedly interfere with functioning – they can occur with or without psychotic symptoms

19
Q

High risk group for suicide

A
  • Young and middle-aged men
  • People in contact with the criminal justice system.
  • Specific occupational groups, for example, doctors, nurses, veterinary workers, farmers, agricultural workers
20
Q

Crisis resolution and home treatment (CRHT)

A

Psychiatrist, mental health nurses, social workers and support workers and are available 24 hours a day, 7 days a week

Assesses the person’s needs, manages the risks of being at home, assists with self-help strategies, offers psychological and practical help, and administers medication

21
Q

Low-intensity psychosocial interventions

A

Individual guided self-help - CBT
Computerized cognitive behavioural therapy (CCBT)
- Structured group-based physical activity programme - 3x sessions per week - 14 weeks

22
Q

Check medication before giving SSRI

A 
NSAIDs
Warfarin 
Heparin 
Aspirin
Triptans - migraines 
Flecainide 
Theophylline 
MAO - B inhibitors 
Anti epileptics

Year 3 GP (20 decks)

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