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YR3 Core Conditions > Mental Health > Flashcards

Mental Health Flashcards

(44 cards)

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1
Q

Types of depressive disorder

A

Major: >= 5 symptoms
Minor: 2-4 symptoms
Persistent: 2 years of symptoms

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2
Q

Epidemiology and depression

A

Leading cause of disability and premature death in 18-44o

2:1 F:M ratio

20% of adults will require medical intervention at some point in their life

2-3x more likely to become depressed if a first degree relative has it

First onset most common in 18-24yo and >65

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3
Q

Pathophysiology of depression

A

Abdnormal levels of neurotransmitter + dysregulation of HPA + abnormalities of secondary messengers

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4
Q

Methods for screening depression

A

PHQ-2 which may lead to PHQ-9

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5
Q

Risk factors for depression

A 
Aged >65
Postnatal
Female
Coritcosteroid use
Propranolol use
1st degree relative affected
Poor lifestyle
Oral contraception
Co-existing medical conditions which may make you sad
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6
Q

Clinical presentation of someone with depression

A 
Low mood
Weight change
Libido change
Anhedonia
Functional impairment
Sleep disturbance
Low energy
Excessive guilt
Suicidal thoughts
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7
Q

Investigations to consider in depression

A

Bloods: TFTs, FBC, U+E

PHQ2/9 + other questionnaires

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8
Q

Management of depression

A

If severe: hospitalise + refer + 2nd or 3rd get antidepressants i.e. SSRIs or SNRIs

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9
Q

Definition of general anxiety disorder

A

> =6 months of excessive worry about everyday issues that are disproportionate to any inherent risk

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10
Q

Symptoms for anxiety disorder

A 
Excessive worry
Muscle tension
Sleep disturbance
Fatigue
Restlessness
Poor concentration
Irritability
Anxiety not confined to any other condition or substance
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11
Q

Investigations to consider in anxiety

A

Usually made from clinical picture
TFTs
FBC
Urine drug screen

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12
Q

Management of anxiety disorder

A

1st: Pharmacotherapy w/ SSRI / SNRI or tricyclic if others are CI
2nd: CBT
3rd: Augmented treatments

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13
Q

What is alcohol use disorder

A

Chronic relapsing condition resulting from multifactorial components, characterised by increased tolerance to the effects of alcohol and impaired control over consumption

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14
Q

Epidemiology of alcohol use disorder

A

Common
7-12% prev. in west
M:F 2:1
3.2% of global deaths due to alcoholism

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15
Q

Pathophysiology of alcohol use disorder

A

Increased use of alcohol sensitises dopaminergic pathway = dependance

Long term exposure increases excitatory receptors and noradrenaline activity

Withdrawal of alcohol leaves excitatory receptors unposed = symptoms of withdrawal

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16
Q

Risk factors for alcohol use disorder

A 
\+ve FHx
Anxiety
Lack of facial flushing on consumption of alcohol
Antisocial behaviour
Low response to effects of alcohol
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17
Q

Clinical presentation of someone with alcohol use disorder

A 
Withdrawal symptoms
Tolerance established
Change in liver size
Jaundice
Acsites
Nictoine dependance
Hyper tension and tachycardia
Broad gait
Social/pysch problems
Impaired nutritional status 
Nausea and vomiting
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18
Q

Investigations to consider in alcohol use disroder

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A

Diagnostic interview with DSM-5
Alcohol level blood test
Withdrawal assessment

19
Q

Management of an acute presentation of alcohol use with severe withdrawal

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A

Detox
Supportive medical care
Inpatient speciality treatment

20
Q

Management of a problematic alcohol abuse with mild dependance

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A

Physician advice + brief interventions

21
Q

Moderate to severe dependance on alcohol: management

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A

Psychological intervention + medication to prevent relapse and support abstinence i.e. Naltrexone

22
Q

What is alzheimers?

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A

A chronic, neurodegenerative disease, with insidious onset and progressively slow decline.

23
Q

Which is the most common form of dementia?

24
Q

What are some epidemiological facts RE AD

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A

Common
6% >65yo
30% > 90yo
Occurs more commonly in women and blacks

25
Aetiology of AD
Amyloid theory currently prevails | Excess amyloid peptide = formation of plaques = inflammation = synaptic and neuritic injury and cell death
26
Pathophysiology of AD
Cortical atrophy apparent in the temp., frontal and parietal areas only Plaques and neurofib. tangles found on autopsy
27
Screening method for AD
MMSE
28
Risk factors for AD
``` Increased age +ve FHx Genetics (presenelin 1/2) Downs CVD Hyperlipidemia ```
29
Clinical presentation of AD
``` Memory loss disorientation misplacing items getting lost dysphasia apathy personality change mood change dyspraxia ```
30
Investigations in AD
``` Bedside cognitive testing FBC to rule out anaemia Metabolic panel to rule out metabolic dementia B12 CT/MRI ```
31
Management of AD
1. support 2. environmental control 3. cholinesterase inhibitors
32
What is vascular dementia
Chronic progressive disorder of the brain, brining about cognitive impairment, where cognitive function is affected more than memory
33
Epidemiology of vascular dementia
2-% of all dementias Men more affected than women Asians/Blacks > Whites
34
Causes of vascular dementia
Often multifactorial - infarction - disease of the white matter - haemorrhage - AD
35
Risk factors for vascular dementia
Age >60 Obesoty HTN Smoker
36
Investigations in vascular dementia
``` FBC ESR Glucose LFTs Renal Syph. serology B12 Folate Thyroid CT/MRI ECG ```
37
Clinical presentation of vascular dementia
``` Inability to solve problems Loss of interest Slower processing Poor attention Memory retrieval difficulty ```
38
Management of vascular dementia
Treat any underlying cause or predisposing factors
39
Clinical presentation of Lewy Body Dementia
``` Visible hallucinations Extrapyrmaidal signs Depression cognitive impairment Antipsychotic sensitivity ```
40
Management of Lewy Body dementia
Cholinesterase inhibitors
41
Causes of Delerium
DELIRIUMS ``` Drugs Eyes/ears and other sensory deficits Low O2 Infection Retention Ictal Under hydration/nutrition Metabolic Subdural haemorrhage ```
42
management of delirium
Correct the initial cause
43
What is delirium?
Acute, fluctuating change in mental status with inattention, disorganised thinking, and levels of consciousness
44
Clinical presentation of delirium
``` Disorentiation to time, place and person Reversal of sleep wake cycle Labile mood Illusions, delusions and hallucinations Cognitive impairment ```

YR3 Core Conditions (32 decks)

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