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Year 3: Sofia COPY > Mental Health > Flashcards

Flashcards in Mental Health Deck (20)
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1

What is alcohol dependence?

Characterised by 3 or more of:
- Withdrawal on cessation of alcohol
- Tolerance
- Compulsion to drink, difficulty controlling termination or the levels of use
- Persistent desire to cut down or control use
- Time is spent obtaining, using, or recovering from alcohol
- Neglect of other interests (social, occupational or recreational)
- Continues use despite physical and psychological problems

2

What is the aetiology of alcohol dependence?

- Genetic factors suggests by twin studies and family history
- Environmental factors include cultural, parental and peer group influences, availability of alcohol, occupation (e.g. increased risk in publicans, doctors, lawyers)
- Pts with depressive and anxiety states are at risk

3

What is alcohol withdrawal?

- Alcohol enhances inhibitory GABA inactivity and inhibits excitatory glutamate neurotransmission
- Chronic alcohol exposure results in a compensatory reduction in GABA receptor function and upregulation of the glutamate NMDA receptors
- Abrupt alcohol cessation leads to overactivation of the excitatory NMDA system relative to the GABA system

4

What is the epidemiology of alcohol dependence?

The prevalence of alcohol dependence in primary care populations in the United States was reported as 2–9 % in 2004.

5

What should be noted when taking an alcohol history?

Record how much, what, when and with whom alcohol is taken
- Evaluate for associated comorbidities including smoking, other substance abuse, depression, anxiety and panic attacks

6

What are the CAGE screening questions for alcohol dependence?

- Cut down: '...felt that you should cut down on intake?'
- Annoyed: '...felt annoyed by criticism of your drinking
- Guilt: '...felt guilty about how much you drink?'
- Eye-opener: '... feel that you need a drink when you wake up?'

7

What are the presenting symptoms of acute alcohol intoxication?

- Amnesia
- Ataxia
- Dysarthria
- Disorientation
- Palpitations
- Flushing
- Coa

8

What are the symptoms of alcohol withdrawal?

- Nausea
- Sweating and tremor
- Restlessness
- Agitation
- Visual hallucination
- Confusion
- Seizures

9

What are the signs of alcohol dependence on examination?

- Signs suggestive of chronic alcohol misuse: Dupuytren's contracture, palmar erythema, bruising, spider naevi, telangiectasia, facial mooning, bilateral parotid enlargement, gynaeocomastia, smell of alcohol
- Signs of complications

10

What are the investigations for alcohol dependence?

- Blood: Raised MCV, GGT, Transaminases. Raised uric acids and triglycerides or markers of end organ damage (e.g. bilirubin, albumin, PT in liver)
- Acute overdose: Blood alcohol, glucose, ABG (risk of ketoacidosis or lactic acidosis), U&E, toxic screen (e.g. barbiturates, paracetamol)

11

What is a generalised anxiety disorder?

-Common condition defined as chronic, excessive worry for at least 6 months that causes distress or impairment
- At least 3 key symptoms required to make diagnosis: nervousness/restlessness, easy fatiguability, poor concentration, irritability, muscle tension or sleep disturbance

12

What is a social anxiety disorder?

- Excess fear of social and performance situations where individual is afraid of being embarrassed or negatively evaluated by others

13

What is the epidemiology of anxiety disorders?

- Common
- 4-6% of primary care pts

14

What is the aetiology of anxiety disorder?

- Increased in minor life stressors, presence of physical or emotional trauma and genetic factors
- Risk factors: Having another mental disorder, female, FHx

15

What are the signs of symptoms of anxiety disorders?

Nervousness/restlessness, easy fatiguability, poor concentration, irritability, muscle tension or sleep disturbance

16

What are the investigations for anxiety disorders?

Clinical diagnosis

17

What is a depressive disorder?

Chronic depression in which depressive symptoms are present for more than a 2 year period

18

What is the aetiology of a depressive disorder?

Risk factors: Having another mental disorder, female, FHx

19

What are the presenting symptoms of a depressive disorder?

- Presence of risk factors
- Depressed mood
- Anhedonia
- Functional impairment
- Weight change
- Libido changes
- Sleep disturbance
- Psychomotor problems
- Low energy
- Excessive guilt
- Poor concentration
- Suicidal idealation

20

What are the investigations for a depressive disorder?

- Clinical diagnosis: DSM-5 diagnostic criteria depending on the depressive subcategory
- Metabolic panel: normal
- FBC: normal
- TFTs: normal