Mental Health Flashcards

Question

What is the key difference between mania and hypomania?

Answer 1

Psychotic symptoms

Answer 2

DSM-5 5/9 symptoms required for diagnosis (everyday for at least 2 week): Core symptoms: 1. Low mood 2. Anhedonia Associated symptoms: 3. Disturbed sleep 4. Decreased or increased appetite 5. Fatigue /loss of energy 6. Agitation or slowing of movements 7. Poor concentration 8. Feelings of worthlessness 9. Suicidal thoughts

Answer 3

HAD scale | PHQ-9

Answer 4

- Bloods to eliminate other causes

Answer 5

Depression which occurs predominately around the winter months.

Answer 6

1. Chronic depressive state (2 years or more) 2. Persistent low mood not meeting depression diagnostic criteria 3. Not the consequence of a partly resolved major depression

Answer 7

Chronic mental health disorder characterised by periods of mania/hypomania alongside episodes of depression.

Answer 8

1. type I disorder: mania and depression (most common) 2. type II disorder: hypomania and depression

Answer 9

1. Hypomania: • Mild elevation of mood and increased energy / activity • 4 days of manic symptoms • Does NOT disrupt life ``` 2. Mania: • Mood change (7 days of persistently high, expansive, or irritable mood) AND 3 manic symptoms: --> Increased activity level --> Talkativeness --> Racing thoughts --> Distractibility --> Reduced need for sleep --> Inflated self esteem --> Faulty judgement ```

Answer 10

1. if symptoms suggest hypomania = routine referral to the community mental health team (CMHT) 2. if there are features of mania or severe depression then an urgent referral to the CMHT should be made

Answer 11

BMI 25-29.9 kg/m2

Answer 12

A. Restriction of energy intake relative to requirements, leading to a significantly low weight in the context of age, sex, developmental trajectory, and physical health B. Intense fear of gaining weight or persistent behaviour that interferes with weight gain C. Disturbance in body image.

Answer 13

- BMI <85% predicted (<17.5 adults). Often rapid loss - Amenorrhea 3/12 or longer - Delayed puberty - Fatigue, fainting, dizziness - Intolerance to cold - GI: constipation, abdo pain - Appearance: wearing baggy clothes

Answer 14

- fear/ dread gaining weight - Distorted body image - Social withdrawal - Denial of problem/ resistance to treatment

Answer 15

1. chronic alcohol consumption enhances GABA mediated inhibition in the CNS (similar to benzodiazepines) + inhibits NMDA-type glutamate receptors 2. alcohol withdrawal is thought to be lead to the opposite (decreased inhibitory GABA and increased NMDA glutamate transmission)

Answer 16

Symptoms start at 6-12 hours: - tremor - sweating - tachycardia - anxiety

Answer 17

1. peak incidence of seizures at 36 hours 2. peak incidence of delirium tremens is at 48-72 hours: - coarse tremor - confusion - delusions - auditory and visual hallucinations - fever - tachycardia

Answer 18

if all the medication is not taken within 1 hour

Answer 19

activated charcoal

Answer 20

Acetylcysteine if: - staggered overdose or doubt of ingestion time - the plasma conc is on or above single line of 100mg/l at 4 hours and 15 mg/L at 15 hours

Answer 21

IV over 1 hour

Answer 22

Aterial pH < 7.3 + 24 hours after ingestion or all of the following: 1. prothrombin time > 100 seconds 2. creatinine > 300 µmol/l 3. grade III or IV encephalopathy

Answer 23

- buprenorphine | - Methadone

Answer 24

- rhinorrhoea - needle track marks - pinpoint pupils - drowsiness - watering eyes - yawning

Answer 25

- Type of eating disorder characterised by: 1. episodes of binge eating followed by 2. intentional vomiting or other purgative behaviours such as the use of laxatives or diuretics or exercising.

Answer 26

A. Recurrent episodes of binge eating, character sited by BOTH: • Eating objectively large amount of food (larger than most would in a similar time period, and circumstances) in a discrete period of time (e.g. 2 hours) • Loss of control overeating during episode B. Recurrent inappropriate compensatory behavior in order to prevent weight gain – e.g. vomiting, using laxatives/ diuretics/enemas/ other meds C. Binge Eating and inappropriately compensatory behaviors both occur, on average at least once a week for 3 months. D. Self-evaluation is unduly influenced by body shape and weight E. Disturbance does not occur exclusively during episodes of anorexia nervosa.

Answer 27

* Weight fluctuation * Low mood * Low self esteem * Body image concerns * Dental erosion * Parotid hypertrophy * Arrhythmias

Answer 28

- Acute stress reaction that occurs first 4 week after a person has exposed to a traumatic event

Answer 29

1. intrusive thoughts e.g. flashbacks, nightmares 2. dissociation e.g. 'being in a daze', time slowing 3. negative mood 4. avoidance 5. arousal e.g. hypervigilance, sleep disturbance

Answer 30

A period of mourning or loss

Answer 31

1. Denial 2. Anger 3. Bargaining 4. Depression 5. Acceptance

Answer 32

1. Neglect 2. Sexual 3. Physical

Answer 33

1. story inconsistent with injuries 2. repeated attendances at A&E departments 3. late presentation 4. child with a frightened, withdrawn appearance - 'frozen watchfulness'

Answer 34

1. bruising 2. fractures: particularly metaphyseal, posterior rib fractures or multiple fractures at different stages of healing 3. torn frenulum: e.g. from forcing a bottle into a child's mouth 4. burns or scalds 5. failure to thrive 6. sexually transmitted infections e.g. Chlamydia, Gonorrhoea, Trichomonas

Answer 35

Any incident or pattern of incidents of controlling, coercive or threatening behaviour, violence, or abuse between people aged 16 years or over who are, or have been, intimate partners or are family members regardless of gender or sexuality

Answer 36

* Psychological * Physical * Sexual * Emotional * financial

Answer 37

Attention Deficit Hyperactivity Disorder

Answer 38

DSM 5: Condition incorporating features relating to inattention and/or hyperactivity/impulsivity that are persistent.

Answer 39

For children up to the age of 16 years, 6 of these features have to be present; in those > 17 y/o the threshold is 5 features: Inattention: 1. Does not follow through on instructions 2. Reluctant to engage in mentally-intense tasks 3. Easily distracted 4. Finds it difficult to sustain tasks 5. Finds it difficult to organise tasks or activities 6. Often forgetful in daily activities 7. Often loses things necessary for tasks or activities 8. Often does not seem to listen when spoken to directly Hyperactivity/Impulsivity: 1. Unable to play quietly 2. Talks excessively 3. Does not wait their turn easily 4. Will spontaneously leave their seat when expected to sit 5. Is often 'on the go' 6. Often interruptive or intrusive to others 7. Will answer prematurely, before a question has been finished 8. Will run and climb in situations where it is not appropriate

Answer 40

Clinical diagnosis

Answer 41

Fundamental and characteristic distortion of thinking and perception and affects that are blunted or inappropriate.

Answer 42

1. Auditory hallucinations 2. Thought disorder: - thought insertion - thought withdrawal - thought broadcasting 3. Passivity phenomena: - bodily sensations being controlled by external influence - actions/impulses/feelings - experiences which are imposed on the individual or influenced by others 4. Delusional perceptions - A two stage process) where first a normal object is perceived then secondly there is a sudden intense delusional insight into the objects meaning for the patient e.g. 'The traffic light is green therefore I am the King'.

Answer 43

Clinical diagnosis

Answer 44

1st line = Atypical antipsychotics e.g. Respirdone Acute setting = haliperidol (aggressive) CBT should be offered to all pts.

Answer 45

False beliefs which are sustained despite contrary evidence

Answer 46

- Grandiose - persecutory - mixed - erotomanic - jealousy - somatic - not classified

Answer 47

1. Jealousy/paranoia 2. Aggression 3. Abnormal behaviours 4. Feeling of persecution 5. Disordered thinking

Answer 48

1. Bloods o To rule out organic causes like anaemia, electrolyte abnormalities 2. X-ray Imaging o CT or MRI brain 3. Special Tests o Urine toxicology

Answer 49

Symptoms of schizophrenia and a mood disorder (depressed or manic) are equally prominent

Answer 50

Trauma Screening Questionnaire

Answer 51

SNRI : Duloxetine

Answer 52

- Warn patients of the increased risk of suicidal thinking & self-harm

Answer 53

Weekly follow-up for the 1st month

Answer 54

DSM-5: core symptoms of excessive widespread worry for more days than not for at least 6 months

Answer 55

* Restlessness * Easily fatigued * Poor concentration * Irritably * Muscle tension * Sleep disturbance

Answer 56

- Agoraphobia - Social phobia - Simple phobia

Answer 57

``` A panic attack is defined as a discrete episode of intense subjective fear, where at least four of the characteristic symptoms: • Palpitation • Sweating • Trembling or shaking • Dry mouth • SOB • Chest pain or discomfort • Dizziness ```

Answer 58

Series of maladaptive personality traits that interfere with normal function in life.

Answer 59

Cluster 1: Odd or eccentric - Paranoid - Schizoid - Schizotypal Cluster 2: Dramatic, emotional or erratic - Antisocial - Borderline (Emotionally Unstable) - Histrionic - Narcissistic Cluster 3: Anxious & Fearful - Obsessive-Compulsive - Avoidant - Dependent

Answer 60

1. Hypersensitivity and an unforgiving attitude when insulted 2. Unwarranted tendency to questions the loyalty of friends 3. Reluctance to confide in others 4. Preoccupation with conspirational beliefs and hidden meaning 5. Unwarranted tendency to perceive attacks on their character

Answer 61

1. Indifference to praise and criticism 2. Preference for solitary activities 3. Lack of interest in sexual interactions 4. Lack of desire for companionship 5. Emotional coldness 6. Few interests 7. Few friends or confidants other than family

Answer 62

1. Ideas of reference (differ from delusions in that some insight is retained) 2. Odd beliefs and magical thinking 3. Unusual perceptual disturbances 4. Paranoid ideation and suspiciousness 5. Odd, eccentric behaviour 6. Lack of close friends other than family members 7. Inappropriate affect 8. Odd speech without being incoherent

Answer 63

1. Deception 2. Impulsiveness 3. Irritability 4. Reckless 5. Consistent irresponsibly 6. Lack of remorse

Answer 64

1. Efforts to avoid real or imagined abandonment 2. Unstable interpersonal relationships 3. Unstable self image 4. Impulsivity in potentially self damaging area 5. Recurrent suicidal behaviour 6. Affective instability 7. Chronic feelings of emptiness 8. Difficulty controlling temper 9. Quasi psychotic thoughts

Answer 65

1. Inappropriate sexual seductiveness 2. Need to be the centre of attention 3. Rapidly shifting and shallow expression of emotions 4. Suggestibility 5. Physical appearance used for attention seeking purposes 6. Impressionistic speech lacking detail 7. Self dramatization 8. Relationships considered to be more intimate than they are

Answer 66

1. Grandiose sense of self importance 2. Preoccupation with fantasies of unlimited success, power, or beauty 3. Sense of entitlement 4. Taking advantage of others to achieve own needs 5. Lack of empathy 6. Excessive need for admiration 7. Chronic envy 8. Arrogant and haughty attitude

Answer 67

1. Is occupied with details 2. perfectionism 3. Is extremely dedicated to work 4. Is meticulous, scrupulous, and rigid about etiquettes 5. Is not capable of disposing worn out or insignificant things 6. Is unwilling to pass on tasks or work with others 7. Takes on a stingy spending style

Answer 68

1. Avoidance of occupational activities which involve significant interpersonal contact due to fears of criticism, or rejection. 2. Unwillingness to be involved unless certain of being liked 3. Views self as inept and inferior to others 4. Social isolation accompanied by a craving for social contact

Answer 69

1. multiple physical SYMPTOMS present for at least 2 years | 2. patient refuses to accept reassurance or negative test results