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Year 5: Specialities COPY > Psych > Flashcards

Flashcards in Psych Deck (704)
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1

Components of a psych history 

Introduciton and PC: name, age, occupation, ethnic origin, circumstances of referral and whether voluntary or compulsory 

HPC: NOTEPAD ICE. Impact on life/work. Mood, sleep, appetite, Risk. +Collateral

PPHx: dates, hospitalisations

PMH/SHx

DHx and allergies

FHx: mental health. If deceased close relative: cause of death and time in patients life. 

Personal Hx: Early life and development (pregnancy and birth, any serious illness, bereavements, abusde, separation, developmental delay. Regligious background)

Educational Hx: school, relationship with peers. Bullying

Occupational Hx: job titles and durations and reasons for change of work. 

Relationship hx: marriages etc. 

Drug Hx and ETOH use + Smoking

Forensic Hx: any arrests/ imprisonments

SHx

Premorbid personality: how would you describe yourself before you became unwell? 

 

2

Components of MSE

ASEPTIC

Appearance and behaviour

Speech

Emotion: mood and affect

Perception: hallucination and illusion

Thought content and process

Insight and judgement

Cognition

3

Factors of note in apperance

General appearnce and personal hygiene. Dress

Manner, rapport, eye contact, facial activity

Motor activity (psychomotor agitation or retardation)

Abnormal movements

4

Abnormal movements

Tremor

Braykinesia: slowness of movement

Akathisia

Tardive dyskinesia

Dystonia

Tics

Chorea

Stereotpyp

Mannerisms

Gait abnormalities

5

Bradykinesia

Slowness of movements

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Akathisia

Restlessness

7

Tardive dyskinesia

Usually affects the mouth, lips and tongue. Roling of the tongue or licking the lips

8

Dystonia

Muscular spasm causing abnormal face and body movement or posture

9

Factors of note in speech

Tone, rate and volume

Pressure of speech: increased rate and volume

10

Normal speech

Spontaneous, logical, relevant and coherent

11

Circumstatnial

Speech that takes a long time to get to the point

12

Perseveration

 

Sign of?

Repeating words or topics

 

Frontal lobe impairment

13

Neologisms

 

Seen in

Invention of words

 

Schizophrenia

14

Variations in thought form

Normal 

Flight of ideas: abnormal connection between statements

Looseness of association: no discernible link between statements

Thought block

15

Mood and affect

Mood= climate

Affect= weather

16

Mood

 

Subjective/objective

Underlying emotion

Objective described as dysthymic, euthymic, hyperthymic

17

Different types of affect

Blunted/unreactive (e.g. negative symptoms in Schizophrenia)

Labile

Irritable (mania and depression)

Perplexed

Suspicious

Incongruous

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Normal affect described as

Reactive

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Disorders of thought content

Negative (depressed) cognitions e.g. guilt, hopelessness

Ruminations (persistent, disabling preoccupations)

Obsessions

Depersonalisation or derealisation (NB not psychotic)

Abnormal beliefes: overvalued ideas, ideas of reference (not held with delusional intensity)

Delusions: fixed, false, firmly held beliefs

20

Depersonalisation

Feeling detatched, unreal watching oneself from the outside

21

Derealisation

"The world is made out of cardboard"

22

Different delusional types

Persecutory: someone/something interfering with person in a malicious/destructive way

Grandiose: being famous/supernatural power or wealth

Of reference: actions of other people, events, media are referring to the person/communciating a message

TI/TW/TB

Passivity: actions feelings/impulses can be controlled by outside influence

23

TI/TW/TB

Thought insertion

Withdrawal

Broadcast

24

Assessing suicide risk

 

Thoughts

Do you evel feel that life is so bad you don't want to live anymore?

Plans

Have you ever reached a point where you have thought you might harm yousrelf

Intent

Do you think you would actually do this?

Protective factors

25

Components of perception

Have you seen or head thing sthat other people can't see or hear

Illusions

Hallucinations

Pseudo-hallucinations

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Illusions

Misinterpretations of normal perceptions: can occur in healthy people

27

Hallucinations

Perceptions in absence of abnromal stimulus, experienced as true and coming from the outside world

Can take any medium, though auditory and visual are most common

 

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Pseudo-hallucination

Internal perceptions with preserved insight

29

Cognition

 

GOAL-CRAMP

Can be tested formally using MMSE

Should test:

G- general: Alertness and Co-operation
O- orientation: Time and Place
A- attention: WORLD backwards and Serial Sevens
L- language: Naming and Repetition
C- calculation: Division and Subtraction
R- right Hemisphere Function: Intersecting pentagons and Clock-face
A- abstraction: Proverbs and Similarities
M- memory: Short term and Long-term memory
P- praxis: Wave good-bye and Comb hair

30

Insight

Patient's understanding of their own condition and its cause