Mental Health - Review and delete duplicates and drugs

Question 1

+1 Sedation Assessment Tool (SAT) behaviour score description

Answer 1

very anxious/restless

Question 2

+1 Sedation Assessment Tool (SAT) verbal score description

Answer 2

normal/talkative

Question 3

+2 Sedation Assessment Tool (SAT) behaviour score description

Answer 3

very anxious and agitated

Question 4

+2 Sedation Assessment Tool (SAT) verbal score description

Answer 4

loud outbursts

Question 5

+3 Sedation Assessment Tool (SAT) behaviour score description

Answer 5

combative, violent, out of control

Question 6

+3 Sedation Assessment Tool (SAT) verbal score description

Answer 6

continual loud outbursts

Question 7

-1 Sedation Assessment Tool (SAT) behaviour score description

Answer 7

asleep

Question 8

-1 Sedation Assessment Tool (SAT) verbal score description

Answer 8

slurring or prominent slowing

Question 9

-2 Sedation Assessment Tool (SAT) behaviour score description

Answer 9

physical stimulation

Question 10

-2 Sedation Assessment Tool (SAT) verbal score description

Answer 10

few recognisable words

Question 11

-3 Sedation Assessment Tool (SAT) behaviour score description

Answer 11

no response to stimulation

Question 12

-3 Sedation Assessment Tool (SAT) verbal score description

Answer 12

nil

Question 13

0 Sedation Assessment Tool (SAT) behaviour score description

Answer 13

Awake/calm and cooperative

Question 14

0 Sedation Assessment Tool (SAT) verbal score description

Answer 14

speaks normally

Question 15

Acute Behavioural Disturbance (ABD) treatments

Answer 15

Verbal de-escalation
Correct any underlying organic causes

Question 16

Acute Behavioural Disturbance (ABD) treatments

Answer 16

Verbal de-escalation
Correct any underlying organic causes

Question 17

Are schizophrenia Pts more likely to be aggressive or victims of aggression?

Answer 17

victims

Question 18

Are schizophrenia Pts more likely to be aggressive or victims of aggression?

Answer 18

victims

Question 19

Can substance misuse appear like manic behaviour?

Answer 19

yes

Question 20

Can the physical exertion and resultant acidosis and hyperthermia compound the toxic effects of some poisonings?

Answer 20

yes

Question 21

Causes of Persistent Depressive Disorder (Dysthymic Disorder)

Answer 21

Can include but not limited to:
* Childhood issues
* Endochrinologic factors
* Genetic factors
* Interpersonal issues
* Substance abuse
* Stress
* Trauma

Question 22

Define dissociative reactions

Answer 22

a feeling of being disconnected from yourself and the world around you

Question 23

Do the symptoms in the manic episode severe enough to cause dysfunction and problems with work, family or social activities and responsibilities?

Answer 23

yes

Question 24

Do we treat the physical signs of panic attacks as chest pain?

Answer 24

yes

Question 25

Does Bipolar II diagnosis require a manic episode?

Answer 25

no

Question 26

Does Bipolar II diagnosis require a manic episode?

Answer 26

no

Question 27

Does capacity fluctuate with improvement or deterioration in the patient’s condition?

Answer 27

Yes

Question 28

Does hypomania cause impairment for Bipolar II Pts?

Answer 28

not usually

Question 29

Does the hypmanic or depressive episode precede or follow the manic episode in Bipolar I?

Answer 29

either

Question 30

Droperidol Adult 13-15 years IM or IV dose for Acute behavioural disturbances (with a SAT Score ≥ 2)

Answer 30

QAS Clinical Consultation and Advice Line consultation and approval required in all patients 65 or older and 13-15 yrs 0.1–0.2 mg/kg Single max dose 10 mg Repeated once at 15 minutes Total max dose 20 mg

Question 31

Droperidol Adult 13-15 years IM or IV dose for Acute behavioural disturbances (with a SAT Score ≥ 2)

Answer 31

QAS Clinical Consultation and Advice Line consultation and approval required in all patients 65 or older and 13-15 yrs 0.1–0.2 mg/kg Single max dose 10 mg Repeated once at 15 minutes Total max dose 20 mg

Question 32

Droperidol Adult 16 - 65 years IM or IV dose for Acute behavioural disturbances (with a SAT Score ≥ 2)

Answer 32

10 mg Repeated once at 15 minutes Total max dose 20 mg

Question 33

Droperidol Paediatric 8 - 12 years IM or IV dose for Acute behavioural disturbances (with a SAT Score ≥ 2)

Answer 33

QAS Clinical Consultation and Advice Line consultation and approval required in all situations 0.1 - 0.2 mg/kg Single max dose 10 mg Repeated once at 15 minutes Total max dose 20 mg

Question 34

Droperidol Adult 16 - <65 years IM or IV dose for Acute behavioural disturbances (with a SAT Score ≥ 2)

Answer 34

10 mg Repeated once at 15 minutes Total max dose 20 mg

Question 35

Droperidol Paediatric 8 - 12 years IM or IV dose for Acute behavioural disturbances (with a SAT Score ≥ 2)

Answer 35

QAS Clinical Consultation and Advice Line consultation and approval required in all situations 0.1 - 0.2 mg/kg Single max dose 10 mg Repeated once at 15 minutes Total max dose 20 mg

Question 36

Droperidol Adult 65 and older years IM or IV dose for Acute behavioural disturbances (with a SAT Score ≥ 2)

Answer 36

QAS Clinical Consultation and Advice Line consultation and approval required in all patients 65 or older and 13-15 yrs 5 mg Repeated once at 15 minutes Total max dose 10 mg

Question 37

Droperidol Adult 65 and older years IM or IV dose for Acute behavioural disturbances (with a SAT Score ≥ 2)

Answer 37

QAS Clinical Consultation and Advice Line consultation and approval required in all patients 65 or older and 13-15 yrs 5 mg Repeated once at 15 minutes Total max dose 10 mg

Question 38

Droperidol Contraindications

Answer 38

**Absolute**: Allergy AND/OR KSAR Parkinson’s disease Known Lewy body dementia Previous dystonic reaction to droperidol Patients less than 8 years of age **Relative** (requires consultation with the QAS Clinical Consultation & Advice Line) suspected sepsis

Question 39

Droperidol Contraindications

Answer 39

**Absolute**: Allergy AND/OR KSAR Parkinson’s disease Known Lewy body dementia Previous dystonic reaction to droperidol Patients less than 8 years of age **Relative** (requires consultation with the QAS Clinical Consultation & Advice Line) suspected sepsis

Question 40

Droperidol Drug Class

Answer 40

antipsychotic

Question 41

Droperidol Drug Class

Answer 41

antipsychotic

Question 42

Droperidol Indications

Answer 42

Acute behavioural disturbances (with a SAT Score ≥ 2)

Question 43

Droperidol Indications

Answer 43

Acute behavioural disturbances (with a SAT Score ≥ 2)

Question 44

Droperidol Metabolism

Answer 44

Metabolised by the liver with biliary/renal excretion as inactive metabolites

Question 45

Droperidol Metabolism

Answer 45

Metabolised by the liver with biliary/renal excretion as inactive metabolites

Question 46

Droperidol Pharmacology

Answer 46

Dopamine-2 receptor antagonist that increases brain turnover of dopamine; and Mild alpha-adrenergic receptor blockade which can result in mild hypotension

Question 47

Droperidol Pharmacology

Answer 47

Dopamine-2 receptor antagonist that increases brain turnover of dopamine; and Mild alpha-adrenergic receptor blockade which can result in mild hypotension

Question 48

Droperidol Precautions

Answer 48

Hypoperfused state Concurrent use of CNS depressants

Question 49

Droperidol Precautions

Answer 49

Hypoperfused state Concurrent use of CNS depressants

Question 50

Droperidol Presentation

Answer 50

Vial, 10 mg/2 mL

Question 51

Droperidol Presentation

Answer 51

Vial, 10 mg/2 mL

Question 52

Droperidol Routes of Administration

Answer 52

IM IV

Question 53

Droperidol Routes of Administration

Answer 53

IM IV

Question 54

Droperidol side Effects

Answer 54

Vasodilation/hypotension Extrapyramidal effects e.g. dystonic reactions (rare)

Question 55

Droperidol side Effects

Answer 55

Vasodilation/hypotension Extrapyramidal effects e.g. dystonic reactions (rare)

Question 56

Droperidol Special Notes

Answer 56

CCP to be requested after second dose of droperidol by ACPII but may be cancelled if the second dose of droperidol achieves the desired sedation effect Dosages and times of administration prior to QAS arrival must be considerd to ensure compliance with the QAS Droperidol DTP In Lewy body dementia, antipsychotic (e.g. droperidol) can cause deterioration in cognitive and motor function, and may paradoxically increase agitation and worsen behaviour For other presentations of dementia (e.g. Alzeheimer’s disease) droperidol is a suitable pharmacological agent for the management of acute behavioural disturbance Under no circumstances is an IV cannula to be inserted for the sole purpose of droperidol administration. IV droperidol administration is only to occur when an IV cannula is already insitu

Question 57

Droperidol Special Notes

Answer 57

CCP to be requested after second dose of droperidol by ACPII but may be cancelled if the second dose of droperidol achieves the desired sedation effect Dosages and times of administration prior to QAS arrival must be considerd to ensure compliance with the QAS Droperidol DTP In Lewy body dementia, antipsychotic (e.g. droperidol) can cause deterioration in cognitive and motor function, and may paradoxically increase agitation and worsen behaviour For other presentations of dementia (e.g. Alzeheimer’s disease) droperidol is a suitable pharmacological agent for the management of acute behavioural disturbance Under no circumstances is an IV cannula to be inserted for the sole purpose of droperidol administration. IV droperidol administration is only to occur when an IV cannula is already insitu

Question 58

Droperidol Timing

Answer 58

**Onset** 5-15 minutes **Duration** 4-6 hours **Half-Life** N/A

Question 59

Droperidol Timing

Answer 59

**Onset** 5-15 minutes **Duration** 4-6 hours **Half-Life** N/A

Question 60

Drug Checks

Answer 60

Right pt - Pt doesn't have any: Allergies, Contras, Precautions, Meds that may interact, Age appropriate Right drug - Indication - the right drug to treat this presentation Right dose - Right dose, expressed as mass only, e.g. “Five milligrams of midazolam”, consider also noting timing & max dose Right route - Clearly stated, and dose must be correct for this route Right Strength/Presentation - Mass in volume as provided in the drug kit Right Appearance & Drug Safety Check - The ampoule is unbroken, does not leak, and the liquid is clear and free of floaties * The drug is , , and expires E.g.: “This bag of sodium chloride 0.9% is undamaged, does not leak when squeezed, and the fluid is clear and uncontaminated. Drug check: Sodium chloride 0.9%, 500mL bag, expires 10/2023” * E.g.: “Ampoule is unbroken with clear liquid; adrenaline; 1mg in 1mL; expires 10/2023”

Question 61

Emergency Sedation Complications

Answer 61

* Patient loss of consciousness * Respiratory depression − particularly when associated with other CNS depressants such as alcohol or narcotics * Depressed cardiovascular system – hypotension, bradycardia * Unpredictable responses related to the interaction of the sedation medication with other medications or substances (prescribed and unprescribed) that the patient may have taken * Variation in individual patient responses to the dosage(s) that are recommended and administered

Question 62

Emergency Sedation Complications

Answer 62

* Loss of consciousness * Respiratory depression − particularly when associated with other CNS depressants such as alcohol or narcotics * Depressed cardiovascular system – hypotension, bradycardia * Unpredictable responses to the interaction of the sedation medication with other medications or substances (prescribed and unprescribed) that the patient may have taken * Variation in individual patient responses to the dosage(s) that are recommended and administered

Question 63

Emergency Sedation Contraindications

Answer 63

* confirmed or suspected haemodynamic instability evidenced by one or more of: hypotension, arrhythmias, shortness of breath, decreased peripheral perfusion, cyanosis. * A compromised airway or, where securing the airway would be difficult * Contraindications listed in the DTP, specific to each sedation medication that is to be administered

Question 64

Emergency Sedation Contraindications

Answer 64

* Where the patient is suffering or suspected to be suffering from haemodynamic instability evidenced by one or more of the following: hypotension, arrhythmias, shortness of breath, decreased peripheral perfusion, cyanosis. * The patient is suffering from a compromised airway or, where securing the airway would be difficult. * Contraindications listed in the DTP, specific to each sedation medication that is to be administered.

Question 65

Emergency Sedation Indications

Answer 65

Acute behavioural disturbance in which the following applies: * Patient SAT Score of two (2) or greater; and * The patient’s behaviour indicates imminent risk of serious harm to themselves and/or others; and * Verbal de-escalation has been attempted by a QAS clinician and has failed to calm the patient and reduce the risk of harm.

Question 66

Emergency Sedation Indications

Answer 66

Acute behavioural disturbance in which the following applies: * Patient SAT Score of two (2) or greater; and * The patient’s behaviour indicates imminent risk of serious harm to themselves and/or others; and * Verbal de-escalation has been attempted by a QAS clinician and has failed to calm the patient and reduce the risk of harm

Question 67

Features of a hypomanic episode

Answer 67

* associated with an unequivocal change in functioning that is uncharacteristic of the individual when not symptomatic * The disturbance in mood and any changes in functioning are observable by others * The episode is not severe enough to cause marked impairment in social or occupational functioning or necessitate hospitalisation * The episode cannot be attributed to substance use

Question 68

Features of deeply disparing level of depression

Answer 68

* Endless, brooding interospection * Mull over things to an exaggerated degree * Become paralysed and feel crushed * Ruminations and regurgitation of past happenings

Question 69

Features of deeply disparing level of depression

Answer 69

* Endless, brooding interospection * Mull over things to an exaggerated degree * Become paralysed and feel crushed * Ruminations and regurgitation of past happenings

Question 70

Features of middle ground level of depression

Answer 70

* Depth of emotion * Experience sorrow * Fluid state * Post traumatic growth * Reasonable amount of introspection

Question 71

Features of middle ground level of depression

Answer 71

* Experience sorrow * Depth of emotion * Reasonable amount of introspection * Fluid state * Post traumatic growth

Question 72

Features of shallow - indifference level of depression

Answer 72

* no introspection * difficulty learning from mistakes

Question 73

Features of shallow - indifference level of depression

Answer 73

* no introspection * difficulty learning from mistakes

Question 74

Features of the depression Spectrum

Answer 74

* Black and White distinctions are abandoned * Functioning and severity of presentation can fluctuate

Question 75

Features of the depression Spectrum

Answer 75

* Black and White distinctions are abandoned * Functioning and severity of presentation can fluctuate

Question 76

For cyclothymic disorder to be classifed, what criteria must be met over a 2 year period?

Answer 76

* many periods of hypomanic and depressive symptoms, that do not meet the criteria for hypomanic or depressive episode * the symptoms have lasted for at least half the time and have never stopped for more than 2 months

Question 77

Generalised Anxiety Disorder (GAD) treatment plans

Answer 77

* Antidepressants * Beta Blockers * Biofeedback * Cognitive behaviour psychotherapy * Sedatives

Question 78

Generalised Anxiety Disorder (GAD) treatment plans

Answer 78

* Cognitive behaviour psychotherapy * Biofeedback * Antidepressants * Beta Blockers * Sedatives

Question 79

How late in life can the first episode of Bipolar I be?

Answer 79

60s or 70s

Question 80

How long can a person be detained for under a VIRCA?

Answer 80

* six hours in the first instance * doctor or health practitioner examining the patient can extend it for another six hours

Question 81

How long does a hypomanic episode last?

Answer 81

most of the day, nearly every daye for at least 4 consecutive days

Question 82

How long does a manic episode last if hospitalised?

Answer 82

any duration

Question 83

How long does a manic episode last?

Answer 83

present most of the day, nearly every day for at least 1 week

Question 84

How long to Pts need SIG E CAPSS to be classified as Major Depressive Disorder?

Answer 84

2 weeks

Question 85

How many symptoms and for what duration are required for a schizophrenia diagnosis?

Answer 85

2 or more for 1 month or more

Question 86

How many symptoms and for what duration are required for a schizophrenia diagnosis?

Answer 86

2 or more for 1 month or more

Question 87

How many symptoms are required to be recognised as a hypomanic episode?

Answer 87

3; or 4 if mood is only irritable

Question 88

How many symptoms are required to be recognised as a manic episode?

Answer 88

3; or 4 if mood is only irritable

Question 89

If physical restraint is required, what type is to be used?

Answer 89

the least restrictive and minimally forceful options that do not illicit pain

Question 90

Is it possible for a person to live with a mental illness but still have positive mental health?

Answer 90

yes

Question 91

Is the clinical information from other informants useful in establishing the diagnosis of Bipolar II?

Answer 91

yes

Question 92

Is the Gillick Competency assessment speccific to a particular treatment?

Answer 92

yes

Question 93

List the complications of minor alcohol abuse withdrawal

Answer 93

Confusion Insomnia Disorientation Irritability Tachycardia Nausea, abdo pain & loss of appetite Tremors Paroxysmal sweats (come & go) Profuse sweat & flushed appearance

Question 94

List the complications of minor alcohol abuse withdrawal

Answer 94

Confusion Insomnia Disorientation Irritability Tachycardia Nausea, abdo pain & loss of appetite Tremors Paroxysmal sweats (come & go) Profuse sweat & flushed appearance

Question 95

List the complications of severe alcohol abuse withdrawal

Answer 95

Seizures – usually occur 6 – 48hrs post last drink Delirium tremors Anxiety Agitation Dysphoria Hallucinations – may be visual, tactile or auditory

Question 96

List the complications of severe alcohol abuse withdrawal

Answer 96

Seizures – usually occur 6 – 48hrs post last drink Delirium tremors Anxiety Agitation Dysphoria Hallucinations – may be visual, tactile or auditory

Question 97

What are the intrusive symptoms for Post Traumatic Stress Disorder (PTSD)?

Answer 97

* Recurrent, involuntary distressing memories of the event(s) * Recurrent distressing dreams relating to the event(s) * Dissociative reactions such as flashbacks in which the person feels or acts like the event(s) is/are recurring * Intense or prolonged psychological distress at exposure to internal or external cues that symbolise or resemble the event(s) * Marked physiological reactions to internal or external cues that symbolise the event(s)

Question 98

What are the intrusive symptoms for Post Traumatic Stress Disorder (PTSD)?

Answer 98

* Recurrent, involuntary distressing memories of the event(s) * Recurrent distressing dreams relating to the event(s) * Dissociative reactions such as flashbacks in which the person feels or acts like the event(s) is/are recurring * Intense or prolonged psychological distress at exposure to internal or external cues that symbolise or resemble the event(s) * Marked physiological reactions to internal or external cues that symbolise the event(s)

Question 99

Midazolam Adult IM Dose - Acute Behavioural Disturbance (SAT score ≥2) unresponsive to droperidol (max dose) administration

Answer 99

QAS Clinical Consultation and Advice Line approval required in all situations

Question 100

Midazolam Adult IV Dose - Acute Behavioural Disturbance (SAT score ≥2) unresponsive to droperidol (max dose) administration

Answer 100

QAS Clinical Consultation and Advice Line approval required in all situations

Question 101

Midazolam Adult NAS Dose - Generalised Seizure/Focal Seizure

Answer 101

5mg Repeat every 10 minutes Total max dose 20mg

Question 102

Midazolam Adult IM Dose - Generalised Seizure/Focal Seizure

Answer 102

5mg Repeat every 10 minutes Total max dose 20mg

Question 103

Midazolam Contraindications

Answer 103

allergy and/or adverse drug reaction

Question 104

Midazolam Drug Class

Answer 104

Benzodiazepine (short acting)

Question 105

Midazolam Indications

Answer 105

Generalised seizure/focal seizure (GCS ≤12) Acute behaviour disturbance (SAT score ≥2) unresponsive to droperidol (max dose) administration Sedation - CCP only

Question 106

Midazolam Metabolism

Answer 106

Metabolised by the liver, excreted by the kidneys

Question 107

Midazolam Adult IV Dose - Generalised Seizure/Focal Seizure

Answer 107

**If IV already there** 5mg Repeat every 5 minutes Total max dose 20mg

Question 108

Midazolam Paediatric IM Dose for Acute Behavioural Disturbance (with a SAT score ≥2), unresponsive to droperidol (max dose) administration

Answer 108

QAS clinical consultation and advice line approval required in all situations

Question 109

Midazolam Paediatric IV Dose for Acute Behavioural Disturbance (with a SAT score ≥2), unresponsive to droperidol (max dose) administration

Answer 109

QAS clinical consultation and advice line approval required in all situations

Question 110

Midazolam Paediatric IM Dose for Generalised/Focal Seizures (GCS ≤12)

Answer 110

200 microg/kg Single dose not to exceed 5 mg Repeated at half initial dose every 10 min (max 2.5 mg) Total max dose 10 mg

Question 111

Midazolam Paediatric NAS Dose for Generalised/Focal Seizures (GCS ≤12)

Answer 111

200 microg/kg Single dose not to exceed 5 mg Repeated at half initial dose every 10 min (max 2.5 mg) Total max dose 10 mg

Question 112

Midazolam Pharmacology

Answer 112

Short acting CNS depressant that enhances the action of the inhibitory neurotransmitter GABA, inducing amnesia, anaesthesia, hypnosis and sedation

Question 113

Midazolam Precautions

Answer 113

* Reduced dosages must be considered in: * low body weight, older or cachectic Pts * Pts with chronic renal failure, congestive heart failure or shock * can cause severe respiratory depression in Pts with COPD * myasthenia gravis * multiple sclerosis

Question 114

Midazolam Presentation

Answer 114

Ampoule, 5mg/1mL, midazolam

Question 115

Midazolam Routes of Administration

Answer 115

NAS IM IV

Question 116

Midazolam Side Effects

Answer 116

hypotension respiratory depression particularly when associated with other CNS depressants incl alcohol and narcotics

Question 117

Midazolam Special Notes

Answer 117

Focal seizure activity in an unconscious or altered (GCS_\<_12) treated as a generalised seizure - GCS \>12 contact QAS Clinical Consultation and Advice Line Take into account previous doses prior to arrival of midazolam or diazepam Contact QAS Clinical Consltation and Advice Line if not responding to QAS initiated Tx First dose of midazolam for seizures must be administered NAS or IM injection unless IV cannula already in situ All IV doses must be diluted with sodium chloride 0.9% to make 5 mg midazolam in 5 mL presentation

Question 118

Midazolam Timing

Answer 118

**Onset** 5-15 minutes (IM) 1-3 minutes (IV) **Duration** Variable * *Half Life** 2. 5 hours

Question 119

Objective signs of panic attacks

Answer 119

* Increased muscular tension * HR increase - palpitations * Sweating * Shaking * Hyperventilation

Question 120

Objective signs of Social Phobia

Answer 120

* Increased muscular tension * HR increase - palpitations * Sweating * Shaking * Hyperventilation

Question 121

Post Traumatic Stress Disorder (PTSD) treatments

Answer 121

* Prolonged exposure therapy * Cognitive therapy * Stress management * Psychodynamic therapy * Eye movement desensitization and reprocessing (EMDR) * Pharmacology * SSRIs – Selective Serotonin reuptake inhibitors * MAOIs – Monoamine oxidase inhibitors * SNRIs – Seretonin-nonadrenaline reuptake inhibitors * TCAs – Tricyclic antidepressants (Mirtazapine)

Question 122

Post Traumatic Stress Disorder (PTSD) treatments

Answer 122

* Prolonged exposure therapy * Cognitive therapy * Stress management * Psychodynamic therapy * Eye movement desensitization and reprocessing (EMDR) * Pharmacology * SSRIs – Selective Serotonin reuptake inhibitors * MAOIs – Monoamine oxidase inhibitors * SNRIs – Seretonin-nonadrenaline reuptake inhibitors * TCAs – Tricyclic antidepressants (Mirtazapine)

Question 123

Signs and symptoms of Generalised Anxiety Disorder (GAD)

Answer 123

* Fatigue * Tension * Poor concentration * Insomnia * Irritability

Question 124

Questions to ask schizophrenic pts

Answer 124

* Do you suffer from any mental health illnesses? * Are you diagnosed with schizoprenia? * Do you have any hallucinations? - if yes, ask Do you see them or hear them? if yes - I have to ask you this for my own safety, are the voices/visions telling you to hurt yourself or others including me? If yes - get QPS escort

Question 125

Questions to ask schizophrenic pts

Answer 125

* Do you suffer from any mental health illnesses? * Are you diagnosed with schizoprenia? * Do you have any hallucinations? - if yes, ask Do you see them or hear them? if yes - I have to ask you this for my own safety, are the voices/visions telling you to hurt yourself or others including me? If yes - get QPS escort

Question 126

Should CCP back-up be considired for all behaviourally disturbed, physically restrained pts?

Answer 126

yes

Question 127

Should receiving hospitals be notified of the impending arrival of a physically restrained or behaviurally distrubed pts? If so, why?

Answer 127

Yes, to ensure rapid assessment, management and appropriate resource allocation

Question 128

Steps in the management of an excited delirium patient?

Answer 128

Team brief and role allocation Prepare resuscitation equipment Prepare the sedation pharmacology Ensure everyone is safe Prepare for complications Hyperthermia - cool pt If possible obtain VSS Transport

Question 129

What are the steps when completing a mental status assessment (MSA)?

Answer 129

1. Assess the Pt -ascertain cause of current presentation 2. Exclude and/or treat organic causes 3. Treat Pt only if safe 4. Observe, question and note relevant information 5. Be respectful and empathetic 6. Do not judge or interrogate 7. Be aware and respectful of possible cultural beliefs

Question 130

Steps when treating a mental health patient

Answer 130

1. Assess the Pt -ascertain cause of current presentation 2. Exclude and/or treat organic causes 3. Treat Pt only if safe 4. Observe, question and note relevant information 5. Be respectful and empathetic 6. Judgmental attitudes, interrogation or disrespectful stances will only escalate or deteriorate situation 7. Be aware and respectful of possible cultural beliefs

Question 131

What are the steps when completing a mental status assessment (MSA)?

Answer 131

1. Assess the Pt -ascertain cause of current presentation 2. Exclude and/or treat organic causes 3. Treat Pt only if safe 4. Observe, question and note relevant information 5. Be respectful and empathetic 6. Do not judge or interrogate 7. Be aware and respectful of possible cultural beliefs

Question 132

Subjective symptoms of panic attacks

Answer 132

* “I’m having a heart attack” * “I’m going to die” * Feeling faint/Light headedness * Amnesia * Hallucinations * Visual disturbances * Depersonalisation * Pins & Needles * Feeling numb

Question 133

Subjective symptoms of Social Phobia

Answer 133

* Faint/lightheaded * Visual disturbances * Depersonalisation * Pins & Needles * Feeling numb

Question 134

Suicide has a strong association with which diagnoses?

Answer 134

* Alcohol and other substance use disorders * Anxiety * Borderline personality disorder * Eating disorders * Major depression * Psychosis * Previous trauma

Question 135

Symptoms of antisocial personality disorder

Answer 135

Disregard for safety Impulsivity Irritability or aggressiveness Irresponsible behaviour Lying Lack of remorse Violating social norms

Question 136

Symptoms of antisocial personality disorder

Answer 136

Violating social norms Lying Impulsivity Irritability or aggressiveness Irresponsible behaviour Disregard for safety Lack of remorse

Question 137

Symptoms of antisocial personality disorder

Answer 137

Violating social norms Lying Impulsivity Irritability or aggressiveness Irresponsible behaviour Disregard for safety Lack of remorse

Question 138

Symptoms of avoidant personality disorder

Answer 138

Avoiding work with social aspects Caution with relationships Feeling inept or inferior Avoiding risks Difficulties with intimacy Difficulties with new relationships

Question 139

Symptoms of avoidant personality disorder

Answer 139

Avoiding work with social aspects Caution with relationships Feeling inept or inferior Avoiding risks Difficulties with intimacy Difficulties with new relationships

Question 140

Symptoms of Bipolar II

Answer 140

High level of impulsivity leading to suicide attempts and substance use disorder Heightened creativity noticed in less affected individuals

Question 141

Symptoms of Bipolar II

Answer 141

High level of impulsivity leading to suicide attempts and substance use disorder Heightened creativity noticed in less affected individuals

Question 142

Symptoms of borderline personality disorder

Answer 142

Efforts to avoid abandonment Identity disturbance Unstable relationship pattern Impulsivity Suicidal/Self Harm behaviour Feeling of emptiness Anger

Question 143

Symptoms of dependent personality disorder

Answer 143

Difficulty with everyday decisions Avoiding disagreement Effort to get and keep support Fear of being left alone

Question 144

Symptoms of dependent personality disorder

Answer 144

Difficulty with everyday decisions Avoiding disagreement Effort to get and keep support Fear of being left alone

Question 145

Symptoms of dependent personality disorder

Answer 145

Difficulty with everyday decisions Avoiding disagreement Effort to get and keep support Fear of being left alone

Question 146

Symptoms of dysphoric mood

Answer 146

anxiety anger depression reversed sleep pattern lack of interest in food

Question 147

Symptoms of histrionic personality disorder

Answer 147

Attention seeking Sexually seductive or provocative Use appearance to attract attention Shallow expression of emotion Impressionistic style of speech Exaggerated emotions Suggestible

Question 148

Symptoms of narcissistic personality disorder

Answer 148

Arrogance Fantasies of power and success Feeling special Grandiosity Lack of empathy Need for excessive admiration Sense of entitlement

Question 149

Symptoms of obsessive compulsive personality disorder (OCPD) personality disorder

Answer 149

Lists, schedules, order and rules Perfectionism Devoted to productivity Overconscientious Rigid and stubborn (

Question 150

Symptoms of paranoid personality disorder

Answer 150

Suspiciousness Distrusting Misinterpreting remarks Holding Grudges Worried about infidelity

Question 151

Symptoms of schizoid personality disorder

Answer 151

No desire for relationships Solitary No interest in sex Little pleasure in activities Lacking close friends Indifference to praise or criticism Cold, detached or flat affect

Question 152

Symptoms of schizotypal personality disorder

Answer 152

Ideas of reference Odd beliefs Magical thinking Odd behaviour or appearance Perceptual distortions Constricted affect Lacking close friends Social anxiety

Question 153

Symptoms of schizotypal personality disorder

Answer 153

Ideas of reference Odd beliefs Magical thinking Odd behaviour or appearance Perceptual distortions Constricted affect Lacking close friends Social anxiety

Question 154

To ascertain the degree of schizophreni, ask what question?

Answer 154

How strong are your dreams and visions?

Question 155

To ascertain the degree of schizophreni, ask what question?

Answer 155

How strong are your dreams and visions?

Question 156

Treatment plan for Major Depressive Disorder

Answer 156

* Cognitive behaviour psychotherapy * Antidepressants * Combination of 1 & 2

Question 157

Treatment plans for anxiety

Answer 157

Cognitive behaviour psychotherapy Low dose antidepressants +/-Mental Health referral

Question 158

Treatment plans for Persistent Depressive Disorder (Dysthymic Disorder)

Answer 158

* Therapy * Antidepressants * Combination of 1 & 2

Question 159

Treatment plans for Premenstrual Dysphoric Disorder (previously PMS)

Answer 159

* Exercise * Diet * Antidepressants * Hormonal treatment * Psychotherapy

Question 160

Treatment plans for Social Phobia

Answer 160

* Cognitive behavior psychotherapy * Skills training – ‘tools in your tool kit” * Antidepressants * Sedatives * Validation

Question 161

Treatment plans for Specific Phobias

Answer 161

* Cognitive behaviour psychotherapy * Desensitisation * Flooding techniques

Question 162

What age is the onset of Bipolar II?

Answer 162

mid 20s

Question 163

What are delusions?

Answer 163

False, irrational beliefs that can’t be changed by evidence and aren't shared by other people from the same cultural background

Question 164

What are delusions?

Answer 164

False, irrational beliefs that can’t be changed by evidence and aren't shared by other people from the same cultural background

Question 165

What are hallucinations?

Answer 165

Seeing, hearing, feeling, tasting or smelling something that isn't there

Question 166

What are hallucinations?

Answer 166

Hearing, seeing, smelling, tasting or feeling something that isn't there

Question 167

What are indicators of psychosis?

Answer 167

Depression and anxiety Preoccupation with a subject Speech or writing that is very fast, muddled, irrational or hard to understand Increased anger, aggression or suspiciousness Decreased or disturbed sleep Loss of concentration, memory and/or attention Increased sensitivity to light, noise and/or other sensory inputs Talking much less Withdrawing from relationships or hobbies Inactivity or hyperactivity Behaving in a way that’s reckless, strange or out of character Laughing or crying inappropriately, or being unable to laugh or cry Inattention to personal hygiene Being unable to feel or express happiness

Question 168

What are mood stabiliser drugs prescribed for?

Answer 168

to treat or prevent mania or hypomania episodes

Question 169

Symptoms of negative thoughts and feelings?

Answer 169

* Less interest in activities previously enjoyed * feeling estranged from others * ongoing fear, horror, guilt, anger or shame * distorted beliefs about themselves

Question 170

What are social cognition deficits?

Answer 170

inability to infer the intent of others

Question 171

What are some common mood stabiliser drugs?

Answer 171

Carbamazepine (Tegretol) Divalproex sodium (Depakote) Lamotrigine (Lamictal) – more useful for treating depression Lithium – better for treating mania Valproic acid (Depakene)

Question 172

What are some common SNRIs?

Answer 172

**GENERIC NAME BRAND NAME** Desvenlafaxine Pristiq Duloxetine Cymbalta Levomilnacipran Fetzmia Milnacipran Ixal Venlafaxine Effexor

Question 173

What are some common SSRIs?

Answer 173

**GENERIC NAME BRAND NAME** Escitalopram Lexapro Sertraline Zoloft Citalopram Celexa Fluoxetine Prozac Paroxetine Paxil Fluvoxamine Luvox

Question 174

What are some examples of arousal and reactive symptoms?

Answer 174

* angry outburst * difficulty sleeping or concentrating * easily startled * irritability * reckless and destructive behaviour

Question 175

What are some examples of avoiding reminders?

Answer 175

avoiding particular people, places, activities, situations and objects that bring back distressing memories

Question 176

What are some mimics of excited delirium?

Answer 176

Diabetic hypoglycaemia Heat stroke Neuroleptic malignant syndrome Serotonin syndrome

Question 177

What are some names for cannabis?

Answer 177

marijuana hashish has oil weed pot grass dope mull reefer

Question 178

What are some names for opioids?

Answer 178

heroin smack hammer harry H junk gear

Question 179

What are some of the delierient drugs?

Answer 179

datura (angels dust) chopped flower and infused in tea

Question 180

What are some of the delierient drugs?

Answer 180

datura (angels dust) chopped flower and infused in tea

Question 181

What are some of the dissociateive hallucinogen drugs?

Answer 181

Ketamine (special K) Gamma hydroxybutyrate (GHB) Phencyclidine (PCP, angel dust) dissociative anaesthetic properties nitrous oxide (laughing gas, nangs)

Question 182

What are some of the dissociateive hallucinogen drugs?

Answer 182

Ketamine (special K) Gamma hydroxybutyrate (GHB) Phencyclidine (PCP, angel dust) dissociative anaesthetic properties nitrous oxide (laughing gas, nangs)

Question 183

What are some of the MDMA drugs?

Answer 183

E ecstasy eccies

Question 184

What are some of the MDMA drugs?

Answer 184

E ecstasy eccies

Question 185

What are some of the medications used to treat alcoholics that you might see on road?

Answer 185

Naltrexone (Depade) Acamprosate (Campral) Diulfram (Antabuse)

Question 186

What are some of the medications used to treat alcoholics that you might see on road?

Answer 186

Naltrexone (Depade) Acamprosate (Campral) Diulfram (Antabuse)

Question 187

What are some of the possible triggers for self harm?

Answer 187

* alcohol or drug abuse * physical illness * poor living circumstances * mental illness * stressful life events * trauma

Question 188

What are some of the psychedelic drugs?

Answer 188

Lysergic acid diethylamide (LSD) acid Magic Mushrooms – (gold tops, mushies)

Question 189

What are some of the psychedelic drugs?

Answer 189

Lysergic acid diethylamide (LSD) acid Magic Mushrooms – (gold tops, mushies)

Question 190

What are some of the second generation or atypical antipsychotics?

Answer 190

Aripiprazole Clozapine Olanzapine Quetiapine Risperidone Ziprasidone

Question 191

What are some of the types of hallucinogens?

Answer 191

psychedelics MDMA DMT delirients Dissociative

Question 192

What are some other names for excited delirium (ExD)?

Answer 192

acute delirious mania malethal catatonia nic-depressive exhaustion typhoma

Question 193

What are some signs of dementia?

Answer 193

language impairment/aphasia agigation pacing fiddling repeated questioning

Question 194

What are some suicidal behaviours?

Answer 194

* self-poisoning (overdose) * jumping from a height or in front of a moving vehicle * driving a car into a tree at a high speed * poisoning from gases and vapours (including motor vehicle exhaust) * use of a lethal weapon * hanging

Question 195

What are the 2 names for self harm?

Answer 195

Deliberate Self Harm (DSH) Deliberate Self Injury (DSI)

Question 196

What are the 2 requirements for Post Traumatic Stress Disorder (PTSD) symptoms for diagnosis?

Answer 196

* present for > 1 month * cause clinically significant distress or impairment in social, occupational or other areas of functioning

Question 197

What are the 2 requirements for Post Traumatic Stress Disorder (PTSD) symptoms for diagnosis?

Answer 197

* present for > 1 month * cause clinically significant distress or impairment in social, occupational or other areas of functioning

Question 198

What are the 3 depressant drugs?

Answer 198

benzodiazepines cannabis opioids

Question 199

What are the 3 most common diagonsis in sufferers of Post Traumatic Stress Disorder (PTSD)?

Answer 199

Major Depressive Disorder Alcohol abuse Anxiety Disorders

Question 200

What are the 3 most common diagonsis in sufferers of Post Traumatic Stress Disorder (PTSD)?

Answer 200

Major Depressive Disorder Alcohol abuse Anxiety Disorders

Question 201

What are the 3 stimulants?

Answer 201

amphetamines methylamphetamines cocaine

Question 202

What are the 5 domains of Post Traumatic Growth (PTG)?

Answer 202

Spiritual Development (contented - I accept) Personal Strength (optimistic - I can) Close Relationships (intimate - I cherish) Greater appreciation for life (grateful - I thank) New Possibilities (thriving - I dream)

Question 203

What are the 5 domains of Post Traumatic Growth (PTG)?

Answer 203

Spiritual Development (contented - I accept) Personal Strength (optimistic - I can) Close Relationships (intimate - I cherish) Greater appreciation for life (grateful - I thank) New Possibilities (thriving - I dream)

Question 204

What are the 7 ethical principles on which codes of ethics are based?

Answer 204

autonomy beneficence confidentiality fidelity justice nonmaleficence veracity

Question 205

What are the 7 ethical principles on which codes of ethics are based?

Answer 205

autonomy beneficence nonmaleficence justice confidentiality fidelity veracity

Question 206

What are the ABD post sedation measures?

Answer 206

1. Position the Pt in lateral position or other appropriate position where face can be viewed, airway maintained and VSS monitored. 2. Record Pts SAT score and vitals every 5 minutes 3. If SAT score <0 apply nasal prong ETCO2 if tolerated 4. Remove restraints when safe to do so 5. Early hospital prenotification

Question 207

What are the ABD post sedation measures?

Answer 207

1. Position the Pt in lateral position or other appropriate position where face can be viewed, airway maintained and VSS monitored. 2. Record Pts SAT score and vitals every 5 minutes 3. If SAT score <0 apply nasal prong ETCO2 if tolerated 4. Remove restraints when safe to do so 5. Early hospital prenotification

Question 208

What are the alterations in arousal and reactivity in cognition or mood in Post Traumatic Stress Disorder (PTSD)?

Answer 208

* Exaggerated startle response * Difficulty concentrating * Hypervigilance * Irritability and angry outbursts * Reckless or self-destructive behaviour * Sleep disturbance - insomnia or increased sleep

Question 209

What are the alterations in arousal and reactivity in cognition or mood in Post Traumatic Stress Disorder (PTSD)?

Answer 209

* Exaggerated startle response * Difficulty concentrating * Hypervigilance * Irritability and angry outbursts * Reckless or self-destructive behaviour * Sleep disturbance - insomnia or increased sleep

Question 210

What are the avoidance symptons in Post Traumatic Stress Disorder (PTSD)?

Answer 210

* Avoidance or efforts to avoid distressing memories, thoughts or feelings associated or closely associated with the traumatic event(s) * Avoidance or efforts to avoid external reminders that bring about distressing memories, thoughts or feelings about the event(s)

Question 211

What are the avoidance symptons in Post Traumatic Stress Disorder (PTSD)?

Answer 211

* Avoidance or efforts to avoid distressing memories, thoughts or feelings associated or closely associated with the traumatic event(s) * Avoidance or efforts to avoid external reminders that bring about distressing memories, thoughts or feelings about the event(s)

Question 212

What are the cascade of events in sepsis that leads to cellular dyfunction?

Answer 212

Capillary leak Cell adhesion Tissue hypoxia Impaired Vascular tone Free Radical damage

Question 213

What are the categories of symptoms in Post Traumatic Stress Disorder (PTSD)?

Answer 213

Intrusive symptoms Avoidance symptoms Negative Alterations in cognition or mood Alterations in arousal and reactivity

Question 214

What are the categories of symptoms in Post Traumatic Stress Disorder (PTSD)?

Answer 214

Intrusive symptoms Avoidance symptoms Negative Alterations in cognition or mood Alterations in arousal and reactivity

Question 215

What are the cluster C personality disorders?

Answer 215

avoidant dependent obsessive compulsive personality disorder (OCPD)

Question 216

What are the cognitive deficits seen in schizophrenia?

Answer 216

memory language slower processing speeds

Question 217

What are the cognitive deficits seen in schizophrenia?

Answer 217

memory language slower processing speeds

Question 218

What are the components of a POP assessment?

Answer 218

Person Object Place

Question 219

What are the components of a POP assessment?

Answer 219

Person Object Place

Question 220

What are the components to the Axis of Vigilance?

Answer 220

* vigilance is necessary to avoid danger * more vigilance = more likely to progress to clinical anxiety * recklessness – lack of ability to properly evaluate risk * emotional effect on selective attention * justification of fear or lack of fear

Question 221

What are the criteria that are required for involuntary detention of a mental health patient?

Answer 221

* The person is experiencing a mental health illness and are a danger to themselves or others * Immediate treatment is required * Appropriate treatment in approved mental health setting is available * The person has impaired decision –making capacity in relation to their mental illness

Question 222

What are the criteria that are required for involuntery dentention of a mental health patient?

Answer 222

* The person is experiencing a mental health illness * The person is a danger to themselves or others * Immediate treatment is required * Appropriate treatment in approved mental health setting is available * The person has impaired decision –making capacity in relation to their mental illness

Question 223

What are the de-escalation strategies for Acute Behavioural Disturbances (ABD)?

Answer 223

Approach the situation with the right attitude and maintain self-control Non-aggression – voice and body language Match energy levels - ?? Empathise and active listening Focus on the issue at hand

Question 224

What are the de-escalation strategies for Acute Behavioural Disturbances (ABD)?

Answer 224

Approach with the right attitude maintain self-control Non-aggression – voice and body language Match energy levels - ?? Empathise and active listening Focus on the issue at hand

Question 225

What are the early signs of dementia?

Answer 225

Progressive and frequent memory loss Confusion Personality change Apathy and withdrawal Loss of ability to perform everyday tasks

Question 226

What are the exclusions to panic disorder symptoms?

Answer 226

* The disturbance is attributable to the physiological effects of a substance or another medical condition * The disturbance is not better explained by another mental disorder

Question 227

What are the features of major depressive episode?

Answer 227

* symptoms cause clinically significant distress or impairment in social, * occupational, or other important areas of functioning * The episode cannot be attributed to substance use

Question 228

What are the features of schizophrenia?

Answer 228

* Manifests slowly with gradual development of clinical signs/symptoms * ½ complain of depressive symptoms * Early age onset usually a predictor of worse prognosis * Psychotic symptoms tend to diminish over life of the illness * Cognitive symptoms appear to worsen over life of the illness

Question 229

What are the features of schizophrenia?

Answer 229

* Manifests slowly with gradual development of clinical signs/symptoms * ½ complain of depressive symptoms * Early age onset usually a predictor of worse prognosis * Psychotic symptoms tend to diminish over life of the illness * Cognitive symptoms appear to worsen over life of the illness

Question 230

What are the four types of methylamphetamines?

Answer 230

crystal - looks like crushed ice powder - looks like white or coloured powder pills - looks like prescription ppills base - looks like gluggy paste

Question 231

What are the general categories of Acute Behavioural Disturbance (ABD)?

Answer 231

Organic disorders Psychiatric disorders Substance related Situational

Question 232

What are the general categories of Acute Beavioural Disturbance (ABD)?

Answer 232

Psychiatric disorders Substance related Organic disorders Situational

Question 233

What are the indicators of complicated grief?

Answer 233

agitated, aggressive and demanding behaviours depressive disorders life-depleting behaviours (compulsive or excessive behaviours) post-traumatic stress reactions persistent grief reactions. suicidal thoughts and gestures

Question 234

What are the indicators of complicated grief?

Answer 234

suicidal thoughts and gestures depressive disorders post-traumatic stress reactions persistent grief reactions. life-depleting behaviours (compulsive or excessive behaviours) agitated, aggressive and demanding behaviours

Question 235

What are the Kuber-Ross 5 stages of grief?

Answer 235

Denial Anger Bargaining Depression Acceptance

Question 236

What are the Kuber-Ross 5 stages of grief?

Answer 236

Denial Anger Bargaining Depression Acceptance

Question 237

What are the limitations for the prone position when restraining patients?

Answer 237

not in prone position for longer than 2 minutes as it may impede breathing and result in positional asphyxia

Question 238

What are the negative alterations in cognition or mood in Post Traumatic Stress Disorder (PTSD)?

Answer 238

* Inability to remember an important aspect of the traumatic event(s) * Persistent and exaggerated negative beliefs or expectations about oneself, others or the world * Persistent distorted cognitions about the cause or consequences of the traumatic event(s) that lead to the person blaming themselves or others * Persistent negative emotional state – e.g. fear, anger, guilt * Markedly diminished interest or participation in significant activities * Feelings of detachment or estrangement from others * Persistent inability to experience positive emotions

Question 239

What are the negative alterations in cognition or mood in Post Traumatic Stress Disorder (PTSD)?

Answer 239

* Inability to remember an important aspect of the traumatic event(s) * Persistent and exaggerated negative beliefs or expectations about oneself, others or the world * Persistent distorted cognitions about the cause or consequences of the traumatic event(s) that lead to the person blaming themselves or others * Persistent negative emotional state – e.g. fear, anger, guilt * Markedly diminished interest or participation in significant activities * Feelings of detachment or estrangement from others * Persistent inability to experience positive emotions

Question 240

What are the negative symptoms of schizophrenia?

Answer 240

* Diminished emotional expression * Avolition - a total lack of motivation that makes it hard to get anything done * Alogia - a poverty of speech that results from impairment in thinking that affects language abilities * Anhedonia - the inability to feel pleasure

Question 241

What are the negative symptoms of schizophrenia?

Answer 241

* Diminished emotional expression * Avolition - a total lack of motivation that makes it hard to get anything done * Alogia - a poverty of speech that results from impairment in thinking that affects language abilities * Anhedonia - the inability to feel pleasure

Question 242

What are the physical and emotional symptoms of Premenstrual Dysphoric Disorder (previously PMS)?

Answer 242

* Anger * Anxiety * Irritability * Mood swings * Outbursts * Severe depression

Question 243

What is Premenstrual Dysphoric Disorder (previously PMS)

Answer 243

* physical and emotional symptoms prior to the onset of menstruation * 1 week prior is typical * Range in severity from mild to severe disruptive changes * Symptoms resolve or substantially improve once menstruation begins * Pt’s lives are restricted by their cycle * Can be exhausting and exasperating*

Question 244

What are the positive symptoms of schizophrenia?

Answer 244

* Hallucinations * Delusions * Disorganised thinking * Grossly disorganized or abnormal motor behaviour

Question 245

What are the positive symptoms of schizophrenia?

Answer 245

* Hallucinations * Delusions * Disorganised thinking * Grossly disorganized or abnormal motor behaviour

Question 246

What are the presentations of Acute Behavioural Disturbance (ABD)?

Answer 246

Agitation Anxiety Delusions Hallucinations Impulsivity Panic Thought disorders Unpredictabity

Question 247

What are the presumptive causes in Post Traumatic Stress Disorder (PTSD)?

Answer 247

* Personal experience * itnessing an event first hand * earning of a traumatic event that occurred to a close friend or family member * experiencing repeated or extreme exposure to aversive details of traumatic events (First responders)

Question 248

What are the presumptive causes in Post Traumatic Stress Disorder (PTSD)?

Answer 248

* Personal experience * itnessing an event first hand * earning of a traumatic event that occurred to a close friend or family member * experiencing repeated or extreme exposure to aversive details of traumatic events (First responders)

Question 249

What are the reasons that a pt can not be involuntarily detained?

Answer 249

* political, religious or personal beliefs * sexual preferences * criminal behaviour * illegal drug use * intellectual disability

Question 250

What are the side effects of antipsychotics?

Answer 250

Drowsiness Dizziness Eyesight problems Weight gain Unusually dry or watery mouth Nausea Restlessness Trembling, especially in the limbs Extrapyramidal symptoms Issues with libido Constipation Pain or irregularity in menstruation Increased sweating

Question 251

What are the signs of benzodiazepine intoxication?

Answer 251

confusion and disorientation extreme dizziness decreased RR

Question 252

What are the signs of cannabis intoxication?

Answer 252

talkative increased hunger

Question 253

What are the signs of excited delirium?

Answer 253

aggressive behaviour paranoia, panic excessive sweating violence towards others incredible strength hyperthermia

Question 254

What are the signs of hallucinogen intoxication?

Answer 254

Autonomic arousal Uncontrolled body movement Pupil dilation Clenched Jaw Tachycardia Chest pain

Question 255

What are the signs of heroin intoxication?

Answer 255

anxiety disorders chronic constipation loss of sex drive

Question 256

What are the signs of hypoglycaemia?

Answer 256

ALOC/confusion seizures anxiety lethargy headaches change in behaviour dizziness visual disturbances slurred speech tachycardia tremors

Question 257

What are the signs of sepsis?

Answer 257

presumed or known site of infection and 2 or more of: ALOC Temp less than 36 or greater than 38.3 HR greater than 90 RR greater than 20 BGL greater than 6.6 (unless diabetic)

Question 258

What are the signs of severe sepsis?

Answer 258

presumed or known site of infection and 2 or more of: ALOC Temp less than 36 or greater than 38.3 HR greater than 90 RR greater than 20 BGL greater than 6.6 (unless diabetic) and one or more of: SBP less than 90 or MAP less than 65 SPO2 less than 90 no urine for greater than 8 hours prolong bleeding from minor injury or gums

Question 259

What are the signs of stimulant intoxication?

Answer 259

Seizures Psychosis Dysphoria Depression Delirium Sleep disorders Dilated pupils Damaged septum Sore throat, bloody sputum Tachypneoa Tachycardia Hypertension Cardiovascular collapse Increased body temperature Sexual dysfunction

Question 260

What are the ABD pre sedation checks?

Answer 260

1. Appropriate QAS and QPS resources available? 2. Assign team roles Sedation Supervisor Sedation Assistant Additional Personnel as required 3. Review DTP for Droperidol 4. Consult if required 5. Paramedic at Pts head for ongoing monitoring of airway and physical condition (avoid prone position and pressure on head, neck, chest or back) 6. Defibrillator pads or 12 lead on for continuous monitoring of ECG 7. Resuscitation equipment immediately available 8. All sedation team members briefed.

Question 261

What are the ABD pre sedation checks?

Answer 261

1. Appropriate QAS and QPS resources available? 2. Assign team roles Sedation Supervisor Sedation Assistant Additional Personnel as required 3. Review DTP for Droperidol 4. Consult if required 5. Paramedic at Pts head for ongoing monitoring of airway and physical condition (avoid prone position and pressure on head, neck, chest or back) 6. Defibrillator pads or 12 lead on for continuous monitoring of ECG 7. Resuscitation equipment immediately available 8. All sedation team members briefed.

Question 262

What are the steps in emergency sedation?

Answer 262

1. Assign team roles 2. Review DTP for Droperidol 3. Consult if required 4. Attempt to obtain baseline VSS 5. Complete ABD checklist (each administration of pharmacology) 6. Remove pt restrainds 7. Posture pt appropriately 8. Continaul moitoring of VSS 9. Consider EtCO2 10. Ensure early hospital prenotification

Question 263

What are the symptoms of a hypomanic episode?

Answer 263

Exaggerated self-esteem or grandiosity Less need for sleep Talking more than usual, talking loudly and quickly Easily distracted Doing many activities at once, over scheduling Increased risky behaviour Uncontrollable racing thoughts or quickly changing ideas or topics Less severe than manic episode

Question 264

What are the symptoms of a hypomanic episode?

Answer 264

Inflated self-esteem or grandiosity Decreased need for sleep More talkative than normal Flight of ideas Distractibilty Increase in goal-directed activity or psychomotor agitation Excessive imvolvementr in activities that have a high potential for painful consequences

Question 265

What are the symptoms of a major depressive episode?

Answer 265

Intense sadness or despair Feeling helpless, hopeless, worthless or guilty Feeling restless or agitated, or slowed speech or movements Frequent thoughts of death or suicide Difficulty concentrating, remembering making decisions Sleep problems – too little or too much Loss of interest in activities once enjoyed Changes in appetite - increase or decrease Loss of energy, fatigue

Question 266

What are the symptoms of a manic episode?

Answer 266

Inflated self-esteem or grandiosity Decreased need for sleep More talkative than normal Flight of ideas Distractibilty Increase in goal-directed activity or psychomotor agitation Excessive imvolvement in activities that have a high potential for painful consequences

Question 267

What are the symptoms of a manic episode?

Answer 267

Exaggerated self-esteem or grandiosity Less need for sleep Talking more than usual, talking loudly and quickly Easily distracted Doing many activities at once, over scheduling Increased risky behaviour Uncontrollable racing thoughts or quickly changing ideas or topics

Question 268

What are the symptoms of bipolar I?

Answer 268

Dramatic mood swings Manic episode Hypomanic episode Major Depressive Episode Perods of normal mood between episodes

Question 269

What are the symptoms of cyclothymic disorder?

Answer 269

hypomania depression

Question 270

What are the symptoms of psychosis?

Answer 270

delusions hallucinations disordered thinking disordered behaviour

Question 271

What are the symptoms of schizophrenia?

Answer 271

* Delusions * Hallucinations * Disorganised speech – derailment or incoherence * Grossly disorganised or catatonic behaviour * Negative symptoms – diminished emotional expression or avolotion

Question 272

What are the symptoms of schizophrenia?

Answer 272

* anosognosia * anxiety and phobias * attention reduction * cognitive deficits * display inappropriate affect, eg laughing without stimulus * dysphoric mood * depersonalisation, derealization, and somatic concerns * hostility and aggression * lack of insight * sensory processing and inhibition abnormalities * social cognition deficis * vocational and functional abilities

Question 273

What are the symptoms of schizophrenia?

Answer 273

* Delusions * Hallucinations * Disorganised speech – derailment or incoherence * Grossly disorganised or catatonic behaviour * Negative symptoms – diminished emotional expression or avolotion

Question 274

What are the symptoms of schizophrenia?

Answer 274

* anosognosia * anxiety and phobias * attention reduction * cognitive deficits * display inappropriate affect, eg laughing without stimulus * dysphoric mood * depersonalisation, derealization, and somatic concerns * hostility and aggression * lack of insight * sensory processing and inhibition abnormalities * social cognition deficis * vocational and functional abilities

Question 275

What are the symptoms of social phobia?

Answer 275

Hate being in the spotlight or drawing attention Interacting with strangers is painful for them Avoid situations in “public” Limit social, educational and career opportunities

Question 276

What are the symptoms of suicide?

Answer 276

* make a plan * become withdrawn * mood swings * become destructive & Act recklessly * increased alcohol and/or drug misuse * continually talk about death, dying and/or suicide * withdrawn from family and friends

Question 277

What are the three conditions of bipolar?

Answer 277

Bipolar I Bipolar II cyclothymic disorder

Question 278

What are the three conditions of bipolar?

Answer 278

Bipolar I Bipolar II cyclothymic disorder

Question 279

What are the three main questions for a POP Assessment?

Answer 279

Is the scene safe to enter? On entering the scene is there imminent danger to QAS personnel? Can personnel safely withdraw from scene?

Question 280

What are the three main questions for a POP Assessment?

Answer 280

Is the scene safe to enter? On entering the scene is there imminent danger to QAS personnel? Can personnel safely withdraw from scene?

Question 281

What are the three main questions for a POP Assessment?

Answer 281

Is the scene safe to enter? On entering the scene is there imminent danger to QAS personnel? Can personnel safely withdraw from scene?

Question 282

What are the treatment options for bipolar disorder?

Answer 282

Medication – mood stabilisers and antidepressants Psychotherapy Electroconvulsive therapy (ECT) – if medications and psychotherapy have not been helpful Antipsychotics (e.g. Haloperidol, Loxapine, Risperidone)

Question 283

What are the two requirements for a Post Traumatic Stress Disorder (PTSD) diagnosis?

Answer 283

presumptive cause symptoms

Question 284

What are the two requirements for a Post Traumatic Stress Disorder (PTSD) diagnosis?

Answer 284

presumptive cause symptoms

Question 285

What are traumatic events for those suffering Post Traumatic Stress Disorder (PTSD)?

Answer 285

events that threatened the life or safety of the person or those around them

Question 286

What are traumatic events for those suffering Post Traumatic Stress Disorder (PTSD)?

Answer 286

events that threatened the life or safety of the person or those around them

Question 287

What areas should not have pressure placed on them when the patient is sedated?

Answer 287

head neck back

Question 288

What areas should not have pressure placed on them when the patient is sedated?

Answer 288

head neck back

Question 289

What behaviours are included in Deliberate Self Harm (DSH) or Deliberate Self Injury (DSI)?

Answer 289

* Deliberately cutting the body * Scratching * Hitting * Head banging * Burning and scalding * Hair pulling * Excessive use of substances such as alcohol and illicit drugs * Self-poisoning (overdose) * Jumping from a height or in front of a moving vehicle

Question 290

What conditions does mental illness/mental disorder cover?

Answer 290

a range of conditions where the impact of the symptoms is clinically significant and can be diagnosed according to standard criteria

Question 291

What do hallucinogens do?

Answer 291

Distort a persons perception

Question 292

What do you look at when assessing the appearance of your patient?

Answer 292

Grooming Posture Build Clothing Cleanliness

Question 293

When doing an MSA, what do you look at when assessing the appearance of your patient?

Answer 293

Build Clothing Cleanliness Grooming Posture

Question 294

When doing an MSA, what do you look at when assessing the appearance of your patient?

Answer 294

Build Clothing Cleanliness Grooming Posture

Question 295

What do you look for when assessing the affect of your patient?

Answer 295

Blunt Restricted Labile

Question 296

What do you look for when assessing the affect of your patient?

Answer 296

Blunt Restricted Labile

Question 297

What do you look for when assessing the affect of your patient?

Answer 297

Blunt Restricted Labile

Question 298

When doing and MSA, what do you look for when assessing the affect of your patient?

Answer 298

Blunt Labile Restricted

Question 299

When doing and MSA, what do you look for when assessing the affect of your patient?

Answer 299

Blunt Labile Restricted

Question 300

What do you look for when assessing the behaviour of your patient?

Answer 300

Eye contact Mannerisms Gait Activity level

Question 301

When doing and MSA, what do you look for when assessing the behaviour of your patient?

Answer 301

Activity level Eye contact Gait Mannerisms

Question 302

When doing and MSA, what do you look for when assessing the behaviour of your patient?

Answer 302

Activity level Eye contact Gait Mannerisms

Question 303

When doing and MSA, what do you look for when assessing the insight and judgement of your patient?

Answer 303

Cause and effect Cognition Illness Understanding

Question 304

When doing and MSA, what do you look for when assessing the insight of your patient?

Answer 304

* Is there an appreciation that their illness may affect their life * Do they even think they have an illness * Do they partially or fully understand the situation * Can they explain why an ambulance was actually called

Question 305

What do you look for when assessing the insight of your patient?

Answer 305

* Is there an appreciation that their illness may affect their life * Do they even think they have an illness * Do they understand the situation either fully or partially * Can they explain why an ambulance was actually called

Question 306

What do you look for when assessing the judgement of your patient?

Answer 306

* Are the judgements socially appropriate * Are judgements about personal relationships appropriate * Are they able to manage their own finances

Question 307

When doin an MSA what do you look for when assessing the judgement of your patient?

Answer 307

* Are their judgements socially appropriate * Are their judgements about personal relationships appropriate * Are they able to manage their own finances

Question 308

When doing and MSA, what do you look for when assessing the mood of your patient?

Answer 308

Anxious Cheerful Depressed

Question 309

What do you look for when assessing the mood of your patient?

Answer 309

Anxious Depressed Cheerful

Question 310

What do you look for when assessing the mood of your patient?

Answer 310

Anxious Depressed Cheerful

Question 311

What do you look for when assessing the mood of your patient?

Answer 311

Anxious Depressed Cheerful

Question 312

When doing and MSA, what do you look for when assessing the mood of your patient?

Answer 312

Anxious Cheerful Depressed

Question 313

When doing and MSA, what do you look for when assessing the perceptions of your patient?

Answer 313

* Broadcasting * Hallucinations – Auditory, Visual, Olfactory, Gustatory & Tactile * Illusions – misinterpretation of an actual external stimulus * Thought insertion

Question 314

What do you look for when assessing the perceptions of your patient?

Answer 314

* Hallucinations – Auditory, Visual, Olfactory, Gustatory & Tactile * Illusions – misinterpretation of an actual external stimulus * Thought insertion * Broadcasting

Question 315

When doing and MSA, what do you look for when assessing the perceptions of your patient?

Answer 315

* Broadcasting * Hallucinations – Auditory, Visual, Olfactory, Gustatory & Tactile * Illusions – misinterpretation of an actual external stimulus * Thought insertion

Question 316

When doing and MSA, what do you look for when assessing the speech of your patient?

Answer 316

Flow Pitch Pressure Rate Tone Volume

Question 317

What do you look for when assessing the speech of your patient?

Answer 317

Rate volume Pitch Tone Flow Pressure

Question 318

When doing and MSA, what do you look for when assessing the speech of your patient?

Answer 318

Flow Pitch Pressure Rate Tone Volume

Question 319

What do you look for when assessing the thought content of your patient?

Answer 319

Disturbances Delusions Suicidal Obsessions

Question 320

When doing an MSA, what do you look for when assessing the thought content of your patient?

Answer 320

Disturbances Delusions Obsessions Suicidal

Question 321

When doing an MSA, what do you look for when assessing the thought content of your patient?

Answer 321

Disturbances Delusions Obsessions Suicidal

Question 322

What do you look for when assessing the thought form of your patient?

Answer 322

Rate Amount Flight of ideas Derailment

Question 323

What does a mental status assessment do?

Answer 323

assesses a persons current neurological & psychological functionings

Question 324

What does a mental status assessment do?

Answer 324

assesses a persons current neurological & psychological functionings

Question 325

What does a mental status assessment include?

Answer 325

* Appearance * Behaviour * Perceptions * Speech * Affect * Mood * Thought content * Thought form * Insight & Judgement

Question 326

What does a mental status assessment include?

Answer 326

* Affect * Appearance * Behaviour * Insight * Judgement * Mood * Perceptions * Speech * Thought content * Thought form

Question 327

What is a POP assessment for?

Answer 327

Hazard identification - pre-empting what could cause harm

Question 328

What is a POP assessment for?

Answer 328

Hazard identification - pre-empting what could cause harm

Question 329

What does a Selective Serotonin Reuptake Inhibitor (SSRI) do?

Answer 329

blocks the 5-HT transporter (T) reuptake process, in turn allowing more 5-HT (Serotonin) to act on postsynaptic 5-HT receptors

Question 330

What does a Selective Serotonin Reuptake Inhibitor (SSRI) do?

Answer 330

blocks the 5-HT transporter (T) reuptake process, allowing more 5-HT (Serotonin) to act on postsynaptic 5-HT receptors

Question 331

What does a Serotonin and Norepinephrine Reuptake Inhibitor (SNRI) do?

Answer 331

block both NET (noradrenalin uptake transporter) and T, increasing the availability of NA (Noradrenalin) and 5-HT for receptor action

Question 332

What does a Serotonin and Norepinephrine Reuptake Inhibitor (SNRI) do?

Answer 332

block both NET (noradrenalin uptake transporter) and T, therefore increasing the availability of NA (Noradrenalin) an 5-HT for receptor action

Question 333

What does capacity mean with regards to VIRCA?

Answer 333

the ability to understand their current medical position and the consequences involved in refusing treatment.

Question 334

What does SAFETY stand for?

Answer 334

Safety Aggression Fix Evaluate Tactical Yes

Question 335

What does SAFETY stand for?

Answer 335

Safety Aggression Fix Evaluate Tactical Yes

Question 336

What does SAFETY stand for?

Answer 336

Safety Aggression Fix Evaluate Tactical Yes

Question 337

What does SIG E CAPSS stand for?

Answer 337

**S**leep **I**nterest **G**uilt/hopelessness **E**nergy **C**oncentration **A**ppetite **P**sychomotor **S**exuality (sex drive) **S**uicidality

Question 338

What does SIG E CAPSS stand for?

Answer 338

**S**leep **I**nterest **G**uilt/hopelessness **E**nergy **C**oncentration **A**ppetite **P**sychomotor **S**exuality (sex drive) **S**uicidality

Question 339

What does the mental status assessment affect component assess?

Answer 339

Emotion as observed (Objective)

Question 340

What does the mental status assessment appearance component assess?

Answer 340

the general appearance of your pt

Question 341

What does the mental status assessment beviour component assess?

Answer 341

attitude manner observed behaviours

Question 342

What does the mental status assessment behaviour component assess?

Answer 342

attitude manner observed behaviours

Question 343

What does the mental status assessment insight component assess?

Answer 343

degree to which the client understands the importance of their illness or current state

Question 344

What does the mental status assessment insight component assess?

Answer 344

degree to which the Pt understands the importance of their illness or current state

Question 345

What does the mental status assessment judgement component assess?

Answer 345

ability to evaluate and make appropriate choices

Question 346

What does the mental status assessment judgement component assess?

Answer 346

ability to evaluate and make appropriate choices

Question 347

What does the mental status assessment judgement component assess?

Answer 347

ability to evaluate choices and make appropriate choices

Question 348

What does the mental status assessment mood component assess?

Answer 348

Emotion as described (Subjective)

Question 349

What does the mental status assessment mood component assess?

Answer 349

Emotion as described (Subjective)

Question 350

What does the mental status assessment perceptions component assess?

Answer 350

How they perceive their world

Question 351

What does the mental status assessment perceptions component assess?

Answer 351

How they perceive their world

Question 352

What does the mental status assessment speech component assess?

Answer 352

volume at which they speak

Question 353

What does the mental status assessment speech component assess?

Answer 353

volume at which they speak

Question 354

What does the mental status assessment thought content component assess?

Answer 354

the content of their thoughts

Question 355

What does the mental status assessment thought content component assess?

Answer 355

the content of their thoughts

Question 356

What does the mental status assessment thought form component assess?

Answer 356

the amount of thought and the rate of production

Question 357

What does the mental status assessment thought form component assess?

Answer 357

the amount of thought and the rate of production

Question 358

What does VIRCA stand for?

Answer 358

Voluntary Informed Relevant Capacity Advice

Question 359

What does VIRCA stand for?

Answer 359

Voluntary Informed Relevant Capacity Advice

Question 360

What effect do depressants have on the CNS?

Answer 360

slow down, depress

Question 361

What effect do depressants have on the CNS?

Answer 361

slow down, depress

Question 362

What effect do stimulants have on the CNS?

Answer 362

Speed up or excite

Question 363

What follows hyperthermia in excited delirium?

Answer 363

acidosis hyperkalaemia

Question 364

What i the aetiology of psychosis?

Answer 364

genetics early childhood development adverse life experiences drug use mental illness

Question 365

What influences mental illness?

Answer 365

* poverty * education level * marital status * culture * environment * political factors

Question 366

What is a hypomanic episode?

Answer 366

A distinct period of abnormally and persistently elevated, expansive or irritable mood and abnormally and persistently increased goal-directed activity or energy

Question 367

What is a manic episode?

Answer 367

A distinct period of abnormally and persistently elevated, expansive or irritable mood and abnormally and persistently increased goal-directed activity or energy

Question 368

What is a panic attack?

Answer 368

an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes,with 4 or more of the following: * Sweating * Trembling or shaking * Unsteadiness, feeling dizzy * Depersonalisation/Derealisation * Heart Palpitations, tachycardia, pounding heart * Nausea or abdominal distress * Paraesthesias (tingling sensation) * Shortness of breath * Fear of dying * Fear of losing control or ‘going crazy’ * Chest pain or discomfort * Chills or heat sensations * Feelings of choking

Question 369

What is a psychosis prodrome?

Answer 369

the time just prior to symptoms being severe enough for a diagnosis

Question 370

What is ACPII level emergency sedation?

Answer 370

the administration of a pharmacology to produce a state of calm

Question 371

What is ACPII level emergency sedation?

Answer 371

the administration of a pharmacology to produce a state of calm

Question 372

What is an additional risk factor for sudden death in psychostimulant use and/or pts with the existence of underlying heart or chronic disease?

Answer 372

physical restraint

Question 373

What is an EEA?

Answer 373

legal mechanism where a person can be taken involuntarily to a public sector health facility if their behaviour indicates they are at immediate risk of serious harm due to their mental capacity

Question 374

What is an EEA?

Answer 374

legal mechanism where a person can be taken involuntarily to a public sector health facility if their behaviour indicates they are at immediate risk of serious harm due to their mental capacity

Question 375

What is anxiety?

Answer 375

* warning system for our body and mind * a small amount needed for fight or flight response

Question 376

What is anxiety?

Answer 376

* warning system for our body and mind * a small amount needed for fight or flight response

Question 377

What is Bipolar I?

Answer 377

Classic manic-depressive disorder or affective psychosis

Question 378

What is Bipolar I?

Answer 378

Classic manic-depressive disorder or affective psychosis

Question 379

What is Bipolar II?

Answer 379

the lifetime experience of at least 1 episode of major depression and at least 1 hypomanic episode

Question 380

What is Bipolar II?

Answer 380

the lifetime experience of at least 1 episode of major depression and at least 1 hypomanic episode

Question 381

What is Bipolar?

Answer 381

a bridge between the Schizophrenia spectrum and other psychotic/depressive disorders

Question 382

What is Bipolar?

Answer 382

a bridge between the Schizophrenia spectrum and other psychotic/depressive disorders

Question 383

What is Bipolar?

Answer 383

a bridge between the Schizophrenia spectrum and other psychotic/depressive disorders

Question 384

What is Bipolar?

Answer 384

a bridge between the Schizophrenia spectrum and other psychotic/depressive disorders

Question 385

What is Cyclothymic disorder?

Answer 385

a milder form of bipolar disorder involving mood swings, hypomania and depressive symptoms

Question 386

What is Cyclothymic disorder?

Answer 386

a milder form of bipolar disorder involving mood swings, hypomania and depressive symptoms

Question 387

What is depression?

Answer 387

One of the deepest forms of human suffering which features suicide and/or suicidal idealisations

Question 388

What is depression?

Answer 388

One of the deepest forms of human suffering which features suicide and/or suicidal idealisations

Question 389

What is diffuse axonal injury?

Answer 389

brain injury in which scattered lesions in white matter tracts as well as gray matter over a widespread area

Question 390

What is disordered behaviour?

Answer 390

agitation childishness mutter, swear or otherwise act inappropriately neglect their personal hygiene and housework unresponsive to the world around them

Question 391

What is disordered thinking?

Answer 391

Thoughts and speech that become jumbled or slowed

Question 392

What is Disruptive Mood Dysregulation Disorder?

Answer 392

Frequent outbursts combined with persistent angry and irritable baseline in children between 6-10yrs

Question 393

What is excited delirium?

Answer 393

a condition that presents with psychomotor agitation, delirium, and sweating

Question 394

What is Generalised Anxiety Disorder (GAD)?

Answer 394

A worrier - less acute & overwhelming than panic disorder BUT still causes considerable distress

Question 395

What is Gillick Competency?

Answer 395

is used to decide whether a child (a person under 18 years of age) is able to consent to their own medical treatment, without the need for parental permission or knowledge

Question 396

What is Gillick Competency?

Answer 396

is used to decide whether a child (a person under 16 years of age) is able to consent to their own medical treatment, without the need for parental permission or knowledge

Question 397

What is panic disorder?

Answer 397

Recurrent (1 month or more) panic attacks and followed by 1 or both of: * persistent concern or worry about additional panic attacks or their consequences * significant maladaptive change in behaviour relating to the panic attacks * intense anxiety * terrifying to Pts * initial episode is remembered in vivid detail * comprised of discrete episodes of panic and frequently also a significant component of anticipatory anxiety

Question 398

What is Persistent Depressive Disorder (Dysthymic Disorder)?

Answer 398

Consolidates: * Major Depression * Recurrent / Chronic Depression

Question 399

What is personality disorder?

Answer 399

persistent traits that are maladaptive

Question 400

What is Post Traumatic Growth (PTG)?

Answer 400

Sorrow and introspection are tolerated and turned into useful growth

Question 401

What is psychosis?

Answer 401

a state of being experienced by a person who has lost touch with reality

Question 402

What is Schizoaffective Disorder?

Answer 402

Mixture of Schizophrenia and Mood Disorders (Bipolar/Depression)

Question 403

What is Schizoaffective Disorder?

Answer 403

Mixture of Schizophrenia and Mood Disorders (Bipolar/Depression)

Question 404

What is Schizophrenia?

Answer 404

losing touch with reality - a perception without an assoc stimulus

Question 405

What is Schizophrenia?

Answer 405

losing touch with reality - a perception without an assoc stimulus

Question 406

What is sedation?

Answer 406

an individual having a reduced awareness of their environment and/or a decreased level of consciousness, which has been drug induced

Question 407

What is selective attention?

Answer 407

to select and focus on particular input for further processing while simultaneously suppressing irrelevant or distracting information

Question 408

What is sepsis?

Answer 408

a syndrome of infection complicated by systemic inflammation and can result in organ dysfunction, shock and death

Question 409

What is Social Phobia?

Answer 409

A chronic mental health condition in which social interactions cause irrational anxiety

Question 410

What is Specific Phobia?

Answer 410

Broad range of fears arising in relation to a specific stimulus: * heights * snakes * spiders * Avoidance tactics are often used by Pts

Question 411

What is substance misuse?

Answer 411

over use of substances causing a variety of social, physical and mental health problems

Question 412

What is substance use?

Answer 412

use of substances without significant adverse consequences

Question 413

What is suicidal ideation?

Answer 413

the thoughts, ideas or plans a person has about causing their own death

Question 414

What is suicide?

Answer 414

the act of a person intentionally causing their own death

Question 415

What is the adaptive aspect of anxiety?

Answer 415

confronting problem directly and changing your reactions to it

Question 416

What is the adaptive aspect of anxiety?

Answer 416

confronting problem directly and changing your reactions to it

Question 417

What is the aetiology of bipolar disorder?

Answer 417

family Hx environmental factors (extreme stress sleep disruption, drugs, alcohol)

Question 418

What is the aetiology of PTSD?

Answer 418

Acts of terrorism Domestic Violence Natural disasters Serious accidents Sexual Violence War/Combat

Question 419

What is the aetiology of PTSD?

Answer 419

Acts of terrorism Domestic Violence Natural disasters Serious accidents Sexual Violence War/Combat

Question 420

What is the Agression component of SAFETY?

Answer 420

Be aware of common triggers of aggression and violence

Question 421

What is the Agression component of SAFETY?

Answer 421

Be aware of common triggers of aggression and violence

Question 422

What is the aim of sedation?

Answer 422

to ensure safety of patient and paramedics, a safe transfer to medical care and to facilitate assessment and management of any underlying organic disorders

Question 423

What is the appropriate positioning for pts who are physically restrained?

Answer 423

on their side with hands in front of their body

Question 424

What is the CNS stimulant cocaine derived from?

Answer 424

cocoa plant

Question 425

What is the definition of advice in VIRCA?

Answer 425

Comfort and safety measures What to look out for – Red Flags Advise to seek further medical assistance or call 000 if any issues arise in the future

Question 426

What is the definition of advice in VIRCA?

Answer 426

The Pt is advised of: Comfort and safety measures What to look out for – Red Flags Advise to seek further medical assistance or call 000 if any issues arise in the future

Question 427

What is the definition of bereavement?

Answer 427

The experience of grief and mourning

Question 428

What is the definition of bereavement?

Answer 428

The experience of grief and mourning

Question 429

What is the definition of capacity in VIRCA?

Answer 429

The patient has the ability to understand their current medical position and the consequences involved in refusing treatment

Question 430

What is the definition of capacity in VIRCA?

Answer 430

* A patient must have capacity in order to make a choice about * their own health care. * Capacity is the ability to understand their current medical position and the consequences involved in refusing treatment. * Young people (<18 years old) – Gillick Competency * Capacity fluctuates with improvement or deterioration in the patient’s condition

Question 431

What is the definition of grief?

Answer 431

The emotional component of mourning, including the painful feelings associated with the loss (e.g. sadness, anger, guilt, shame, anxiety)

Question 432

What is the definition of grief?

Answer 432

The emotional component of mourning, including the painful feelings associated with the loss (e.g. sadness, anger, guilt, shame, anxiety)

Question 433

What is the definition of informed in VIRCA?

Answer 433

* Information about suspected or known condition * Treatment options * Risks associated with NOT seeking medical aid * Explanation must be understood by pt

Question 434

What is the definition of informed in VIRCA?

Answer 434

Informed about the suspected or known condition, treatment options and risks associated with not seeking medical aid and they understand the information

Question 435

What is the definition of loss?

Answer 435

Being parted from someone or something that the person values

Question 436

What is the definition of loss?

Answer 436

Being parted from someone or something that the person values

Question 437

What is the definition of mental health?

Answer 437

* the well-being and effective functioning of individuals * the ability to think, learn, and understand one’s emotions and the reactions of others * a state of balance, both within and with the environment

Question 438

What is the definition of mental health?

Answer 438

the well-being and effective functioning of individuals, their ability to think, learn, and understand their emotions and the reactions of others

Question 439

What is the definition of mental illness/mental disorder

Answer 439

the presence of cognitive, affective and/or behavioural symptoms which are persistent and pervasive and impair the individual’s functioning

Question 440

What is the definition of mourning?

Answer 440

The behavioural component of bereavement, which includes biological reactions, behavioural responses, and cognitive and defensive reactions related to the loss

Question 441

What is the definition of mourning?

Answer 441

The behavioural component of bereavement, which includes biological reactions, behavioural responses, and cognitive and defensive reactions related to the loss

Question 442

What is Post Traumatic Stress Disorder (PTSD)?

Answer 442

the long-term anxiety reaction and health complications following a traumatic or catastrophic event

Question 443

What is Post Traumatic Stress Disorder (PTSD)?

Answer 443

the long-term anxiety reaction and health complications following a traumatic or catastrophic event

Question 444

What is the definition of relevant in VIRCA?

Answer 444

Any refusal must be relevant to the current situation with the information made available to the Paramedic and Patient

Question 445

What is the definition of relevant in VIRCA?

Answer 445

Any refusal must be relevant to the current situation with the information made available to the Paramedic and Patient

Question 446

What is the definition of self harm?

Answer 446

a range of intentional behaviours that can be planned, impulsive or hidden to deliberately injure oneself

Question 447

What is the definition of voluntary in VIRCA?

Answer 447

* Decision made voluntarily by Pt * NIL coercion (from anyone) * Decisions cannot be made under duress

Question 448

What is the definition of voluntary in VIRCA?

Answer 448

* Decision made voluntarily by Pt without coercion (from anyone) and not be made under duress

Question 449

What is the Environment component of LIFEMORTS?

Answer 449

Personal Space

Question 450

What is the Environment component of LIFEMORTS?

Answer 450

Personal Space

Question 451

What is the Evaluate component of SAFETY?

Answer 451

VSS (vital sign survey) PSA (perfusion status assessment) RSA (respiratory status assessment) NSA (neurological status assessment) SAT Score SAMPLE

Question 452

What is the Evaluate component of SAFETY?

Answer 452

VSS (vital sign survey) PSA (perfusion status assessment) RSA (respiratory status assessment) NSA (neurological status assessment) SAT Score SAMPLE

Question 453

What is the Family component of LIFEMORTS?

Answer 453

Instincts tell us to protect our nearest and dearest

Question 454

What is the Family component of LIFEMORTS?

Answer 454

Instincts tell us to protect our nearest and dearest

Question 455

What is the Fix component of SAFETY?

Answer 455

Fix underlying organic causes – Focus on de-escalation

Question 456

What is the Fix component of SAFETY?

Answer 456

Underlying organic causes – Focus on de-escalation

Question 457

What is the goal of ACPII level emergency sedation?

Answer 457

remove the threat and allow for safe transport

Question 458

What is the goal of ACPII level emergency sedation?

Answer 458

remove the threat and allow for safe transport

Question 459

What is the increase in suicide ideations in sufferers of Post Traumatic Stress Disorder (PTSD) pts?

Answer 459

3-5x

Question 460

What is the increase in suicide ideations in sufferers of Post Traumatic Stress Disorder (PTSD) pts?

Answer 460

3-5x

Question 461

What is the Insult component of LIFEMORTS?

Answer 461

Verbal or Physical

Question 462

What is the Insult component of LIFEMORTS?

Answer 462

Verbal or Physical

Question 463

What is the Life or Limb component of LIFEMORTS?

Answer 463

Self defence against a perceived threat

Question 464

What is the Life or Limb component of LIFEMORTS?

Answer 464

Self defence against a perceived threat

Question 465

What is the LIFEMORTS mnemonic?

Answer 465

identifies riggers of sudden aggression

Question 466

What is the LIFEMORTS mnemonic?

Answer 466

identifies triggers of sudden aggression

Question 467

What is the maladaptive aspect of anxiety?

Answer 467

using alcohol and/or drugs to cope

Question 468

What is the maladaptive aspect of anxiety?

Answer 468

using alcohol and/or drugs to cope

Question 469

What is the management for all substance abuse patients?

Answer 469

treat symptomatically verbal de-escalation QPS assistance EEA Consider: 12 Lead oxygen IPPV IV access fluids antiemetics droperidol

Question 470

What is the management for all substance abuse patients?

Answer 470

treat symptomatically verbal de-escalation if required QPS assistance if required EEA Consider: 12 Lead oxygen IPPV IV access fluids antiemetics droperidol

Question 471

What is the management/treatment for mild alcohol abuse withdrawal

Answer 471

destimulate the environment communicate in a calm, quiet, reassuring and confident manner continue to reorientate the person if required consider paracetamol, anti emetics and fluids transport

Question 472

What is the management/treatment for severe alcohol abuse withdrawal

Answer 472

destimulate the environment communicate in a calm, quiet, reassuring and confident manner continue to reorientate the person if required consider paracetamol, anti emetics and fluids transport

Question 473

What is the management/treatment for mild alcohol abuse withdrawal

Answer 473

destimulate the environment communicate in a calm, quiet, reassuring and confident manner continue to reorientate the person if required consider paracetamol, anti emetics and fluids transport

Question 474

What is the management/treatment for severe alcohol abuse withdrawal

Answer 474

destimulate the environment communicate in a calm, quiet, reassuring and confident manner continue to reorientate the person if required consider paracetamol, anti emetics and fluids transport

Question 475

What is the Mates component of LIFEMORTS?

Answer 475

Can be perceived as attractive (cool to be aggressive in front of mates)

Question 476

What is the Mates component of LIFEMORTS?

Answer 476

Can be perceived as attractive (cool to be aggressive in front of mates)

Question 477

What is the mean age of onset for first episode of Bipolar I?

Answer 477

18 yrs

Question 478

What is the mental status assessment based on?

Answer 478

family, social, medical, recreational and employment hx, developmental hx

Question 479

What is the mental status assessment based on?

Answer 479

Hx of: family social recreational employment medical developmental

Question 480

What is the Order component of LIFEMORTS?

Answer 480

Threat to disrupt an established system of rules

Question 481

What is the Order component of LIFEMORTS?

Answer 481

Threat to disrupt an established system of rules

Question 482

What is the order of preference for restraint of a patient?

Answer 482

simple reassurance verbal de-escalation pharmacological physical restraint

Question 483

What is the peak age of onset of schizophrenia?

Answer 483

Early to mid 20s for males Late 20s for females

Question 484

What is the peak age of onset of schizophrenia?

Answer 484

Early to mid 20s for males Late 20s for females

Question 485

What is the pharmacology of amphetamines?

Answer 485

stimulate dopaminergic, serotonergic & noradrenergic activity gives the feeling of euphoria

Question 486

What is the pharmacology of amphetamines?

Answer 486

stimulate dopaminergic, serotonergic & noradrenergic activity gives the feeling of euphoria

Question 487

What is the psychosis management pathway?

Answer 487

Antipsychotic medication Specialist psychological therapies Community support programs

Question 488

What is the Resources component of LIFEMORTS?

Answer 488

money or valuables

Question 489

What is the Resources component of LIFEMORTS?

Answer 489

money or valuables

Question 490

What is the Safety component of SAFETY?

Answer 490

POP assessment, constant reassessment of all parties

Question 491

What is the Safety component of SAFETY?

Answer 491

POP assessment, constant reassessment of all parties

Question 492

What is the SAFETY mnemonic?

Answer 492

QAS acronym for the treatment of acute behavioural disturbance

Question 493

What is the SAFETY mnemonic?

Answer 493

QAS acronym for the treatment of acute behavioural disturbance

Question 494

What is the Sedation Assessment Tool (SAT) score for combative, violent, out of control?

Answer 494

+3

Question 495

What is the Sedation Assessment Tool (SAT) score for continual loud outbursts?

Answer 495

+3

Question 496

What is the Sedation Assessment Tool (SAT) score for combative, violent, out of control with continual loud outbursts?

Answer 496

+3

Question 497

What is the Sedation Assessment Tool (SAT) score for no response to stimulation?

Answer 497

-3

Question 498

What is the Sedation Assessment Tool (SAT) score for nil?

Answer 498

-3

Question 499

What is the Sedation Assessment Tool (SAT) score for no response to stimulation and nil?

Answer 499

-3

Question 500

What is the Sedation Assessment Tool (SAT) score for responds to physical stimulation?

Answer 500

-2

Question 501

What is the Sedation Assessment Tool (SAT) score for few recognisable words?

Answer 501

-2

Question 502

What is the Sedation Assessment Tool (SAT) score for responds to physical stimulation and few recognisable words?

Answer 502

-2

Question 503

What is the Sedation Assessment Tool (SAT) score for very anxious and agitated?

Answer 503

+2

Question 504

What is the Sedation Assessment Tool (SAT) score for very anxious/restless?

Answer 504

+1

Question 505

What is the Sedation Assessment Tool (SAT) score for loud outbursts?

Answer 505

+2

Question 506

What is the Sedation Assessment Tool (SAT) score for normal/talkative?

Answer 506

+1

Question 507

What is the Sedation Assessment Tool (SAT) score for very anxious and agitated and loud outbursts?

Answer 507

+2

Question 508

What is the Sedation Assessment Tool (SAT) score for very anxious/restless and normal/talkative?

Answer 508

+1

Question 509

What is the Sedation Assessment Tool (SAT) score for awake/calm and cooperative?

Answer 509

0

Question 510

What is the Sedation Assessment Tool (SAT) score for speaks normally?

Answer 510

0

Question 511

What is the Sedation Assessment Tool (SAT) score for very awake and calm/cooperative and speaks normally?

Answer 511

0

Question 512

What is the Sedation Assessment Tool (SAT) score for asleep?

Answer 512

-1

Question 513

What is the Sedation Assessment Tool (SAT) score for slurring or prominent slowing?

Answer 513

-1

Question 514

What is the Sedation Assessment Tool (SAT) score for asleep but rouses if name is called and slurring or prominent slowing?

Answer 514

-1

Question 515

What is the Stopped component of LIFEMORTS?

Answer 515

Being obstructed by a situation or person

Question 516

What is the Stopped component of LIFEMORTS?

Answer 516

Being obstructed by a situation or person

Question 517

What is the suffix for benzodiazepine drugs?

Answer 517

pam

Question 518

What is the Tactical component of SAFETY?

Answer 518

Communication – active listening, empathy, rapport, influence & behaviour change

Question 519

What is the Tactical component of SAFETY?

Answer 519

Communication – active listening, empathy, rapport, influence & behaviour change

Question 520

What is the Tribe component of LIFEMORTS?

Answer 520

Defend those with whom we identify

Question 521

What is the Tribe component of LIFEMORTS?

Answer 521

Defend those with whom we identify

Question 522

What is the triggers of sudden aggression - LIFEMORTS stand for?

Answer 522

Life or Limb Insult Family Environment Mates Order Resources Tribe Stopped

Question 523

What is the triggers of sudden aggression - LIFEMORTS?

Answer 523

Life or Limb Insult Family Environment Mates Order Resources Tribe Stopped

Question 524

What is the Yes component of SAFETY?

Answer 524

I have the right resources – QPS, CCP & other

Question 525

What is the Yes component of SAFETY?

Answer 525

I have the right resources – QPS, CCP & other

Question 526

What law is an EEA written under?

Answer 526

Public Health Act 2005 – Chapter 4A Pages 137 – 158

Question 527

What observations should be undertaken on the restrained patient?

Answer 527

BGL - initially Temp - intially and then every 15 minutes continual visual for signs of distress/difficulty vital signs every 5 minutes of: GCS RR HR BP SPO2 Perfusion assessment distal to mechanical restraint

Question 528

What organic disorders can cause acute behavioural disturbances (ABD)?

Answer 528

Hypoglycaemia Sepsis Dementia Head Injury

Question 529

What phrase should you avoid saying when dealing with someone greiving?

Answer 529

“I know how you feel”

Question 530

What phrase should you avoid saying when dealing with someone greiving?

Answer 530

“I know how you feel”

Question 531

What position should be avoided in sedation?

Answer 531

prone

Question 532

What position should be avoided in sedation?

Answer 532

prone

Question 533

What pt behaviours warrant an EEA/when is it needed?

Answer 533

* Pts at risk of serious harm * Pt requires urgent examination or treatment and care for the disturbance * Risk due to major disturbance in mental capacity by illness, disability, injury, intoxication or another reason

Question 534

What pt behaviours warrant an EEA?

Answer 534

* Pts at risk of serious harm * Risk due to major disturbance in mental capacity by illness, disability, injury, intoxication or another reason * Pt requires urent examination or treatment and care for the disturbace

Question 535

What pt behaviours warrant an EEA/when is it needed?

Answer 535

* Pts at risk of serious harm * Risk due to major disturbance in mental capacity by illness, disability, injury, intoxication or another reason * Pt requires urent examination or treatment and care for the disturbace

Question 536

What should you consider when doing an MSA?

Answer 536

* Your personal safety * Approach slowly * Be confident * Don’t invade personal space * Gain a rapport and trust with the client * Making sure the client feels safe * Privacy

Question 537

What should you consider when doing an MSA?

Answer 537

* Personal safety * Approach slowly * Be confident * Make sure the client feels safe * Don’t invade personal space * Gain a rapport and trust with the client * Privacy

Question 538

What symptom is the main cause for suicide in schizophrenic pts?

Answer 538

hallucinations

Question 539

What symptom is the main cause for suicide in schizophrenic pts?

Answer 539

hallucinations

Question 540

What tool is used to assess competency in Pts <18 yrs?

Answer 540

Gillick Competency

Question 541

What tools can be used in communicating with someone grieving?

Answer 541

Empathy Time (give them time to process, give yourself time to think what to say) Space Listen Explain (what you've done and why - in manner fit for audience) Accept Actions (can i make you a cuppa, get you a glass of water, ring somebody)

Question 542

What traits are seen in personality disorder?

Answer 542

difficulty with daily functioning externalise blame exhibit rigidity & inflexibility problems relating to others

Question 543

What type of drug is DMT

Answer 543

short acting plant based psychedelic

Question 544

What type of drug is DMT

Answer 544

short acting plant based psychedelic

Question 545

What type of drug is excited delirium (ExD) generally associated with?

Answer 545

psychostimulants

Question 546

What type of hallucinogens contain contains atropine & scopolamine?

Answer 546

delirients

Question 547

What type of jobs do we see Loss & Grief?

Answer 547

Miscarriage ROLE Suicide Stroke Traumas – Injuries & Property

Question 548

What type of jobs do we see Loss & Grief?

Answer 548

Traumas – Injuries & Property ROLE Miscarriage Suicide Stroke Others

Question 549

What type of neurotransmitter and hormone excess causes excited delirium?

Answer 549

dopamine

Question 550

When do Bipolar II Pts often present?

Answer 550

during a depressive episode

Question 551

When do Bipolar II Pts often present?

Answer 551

during a depressive episode

Question 552

When do withdrawal symptoms for alcohol abuse start?

Answer 552

usually within 6 – 24 hrs after last drink

Question 553

When do withdrawal symptoms for alcohol abuse start?

Answer 553

usually within 6 – 24 hrs after last drink

Question 554

When does hospitilisation occur in manic episodes?

Answer 554

to prevent harm to self or others psychotic features

Question 555

When does schizophrenia psychotic features usually emerge?

Answer 555

late teens to mid 30s

Question 556

When does schizophrenia psychotic features usually emerge?

Answer 556

late teens to mid 30s

Question 557

When should you be suspicious of an organic aetiology in Acute Behavioural Disturbances (ABD)?

Answer 557

* 40 years of age with 1st presentation of psychosis or altered mental state * Disorientation/ALOC * Altered VSS * Visual, tactile or olfactory hallucinations * Sudden onset * Fluctuating conscious state

Question 558

When should you be suspicious of an organic aetiology in Acute Behavioural Disturbances (ABD)?

Answer 558

* 40 years of age with 1st presentation of psychosis or altered mental state * Disorientation/ALOC * Altered VSS * Visual, tactile or olfactory hallucinations * Sudden onset * Fluctuating conscious state

Question 559

Who do pts suffering from Acute Behavioural Disturbance (ABD) pose a risk to?

Answer 559

themselves and others around them (incl health professionals)

Question 560

Who has the power to make an EEA?

Answer 560

QAS Officers QPS Officers

Question 561

Who has the power to make an EEA?

Answer 561

QAS Officers QPS Officers

Question 562

Who is at higher risk for suicide amongst schizophrenic pts?

Answer 562

young males with co-morbid substance use

Question 563

Who is at higher risk for suicide amongst schizophrenic pts?

Answer 563

young males with co-morbid substance use

Question 564

Why do people with Mental Health Issues often turn to substance use?

Answer 564

* Self-medication – to manage the symptoms of mental illness * Self-medication – to manage side effects of psychotropics * Lower levels of coping or capacity to deal with stress * Boredom * Loneliness

Question 565

Why do we do a MSA?

Answer 565

* To collect information about the client * To allow them to tell their story * To gain a full picture and make a formulation * To develop an action plan and/or treatment plan

Question 566

Why do we do an MSA?

Answer 566

* To collect information about the client * To allow them to tell their story * To gain a full picture and make a formulation * To develop an action plan and/or treatment plan

Question 567

Why does excited delirium lead to hyperthermia?

Answer 567

increased dopamine causes increased metabolic activity