Revision Session Flashcards
What is the difference between Section 135 and 136? [1]
Section 135 – warrant to enter and remove patient from private dwelling
Section 136 – police power to remove patient from a publicly accessible place
What is the difference between Section 5(4) and 5(2) ?
Section 5(4)
- Nurse’s holding power for up to 6 hours
- Rarely used in practice
Section 5(2)
- Doctor’s (FY2 and above) holding power for up to 72 hours
- Frequently used in practice
No involuntary treatment can be given under Section 5
Basically buying time in a crisis
What is the difference between section 2 and 3 with regards to assessment and treatment? [2]
Section 2
- For assessment AND treatment
- At the end, Section 2 is rescinded or expires; if further detention required, Section 3 needed
Section 3
- For treatment
What does section 2 or 3 involve / not involve with regards to what a mental disorder is? [2]
Drug/alcohol use not included
Autism and LD are included
How many people needed for a section 2? [1]
3 people need to be involved - 2/3 need to be doctors; other is an AMPH
What is a community treatment order? [1]
- A CTO is an order made by your responsible clinician to give you supervised treatment in the community.
- This means you can be treated in the community for your mental health problem, instead of staying in hospital. But your responsible clinician can return you to hospital and give you immediate treatment if necessary.
- A CTO will come with certain extra conditions that you have to follow. For example, living in a certain place or going to appointments for treatment.
What is a section 17? [1]
Section 17 of the Mental Health Act 1983 (MHA 1983) allows a responsible clinician (consultant) to grant leave of absence to a patient detained under the Act. This leave can be granted indefinitely, for specific occasions, or for a defined period.
Why can’t section 5 be used in A&E? [1]
Public place
Section 135 - warrant to search for and remove patients from a private dwelling to a place of safety.
- What determines this? [4]
- Locally agreed designated place
- A&E
- Section 136 suite
- Police station only in an emergency
How long does Section 136 last? [2]
- Lasts 24 hours
- Can be extended another 12 hours if assessment not possible in first 24 hours
Who is a Deprivation of Liberty Safeguards (DoLS) for? [1]
Give examples of when might be used [2]
Applicable to those who lack capacity to consent to admission BUT not resisting
- Used for deprivation of liberty in care home or hospital i.e. 1) subject to continuous supervision and control and 2) not free to leave – now requires process of law
What types of conditions may visual hallucinations indicate? [3]
post-stroke
dementias
delirium
What form and character do auditory hallucinations commonly take in psychosis? [3]
2nd or 3rd person, often derogatory or threatening, sometimes provide running commentary or thought echo
What is the NT hypothesis for schizophrenia with regards to positive [1] and negative [1] symptoms
excess of dopamine in mesolimbic system causing positive symptoms of schizophrenia.
Reduced dopamine activity in mesocortical tracts linked to negative symptoms of schizophrenia
Extrapyramidal side effects (EPSEs) from 1st gen. antipsychotics can be tx with.. [1]
PO/IM procyclidine.
Hyperprolactinaemia from 1st gen. antipsychotics can be tx with.. [1]
consider adding aripiprazole.
What are the sx of SSRI discontinuation syndrome? [4]
- nausea
- insomnia
- sensory disturbances (“electric shocks”)
- anxiety/nervousness/restlessness/agitation
What is the AE concern of Lamotrigine [1]
Steven
Johnson syndrome
A person presents to the police saying they need to be locked up to protect the public because the are a paedophile. They report to the medical assessor that they have been avoiding schools, any other areas where children might be and the internet as they are very worried they will become aroused by the sight of a child. What is the most likely diagnosis.
A. Paraphilia
B. Specific phobia
C. Personality disorder
D. Obsessive compulsive disorder
E. Delusional disorder
D. Obsessive compulsive disorder
- obessional fear they might be a paedophile
Key words in q: avoidance; fear
A patient admitted for an elective cholecystectomy is kept in for monitoring post operatively. You are called to see them a few hours after the operation, as the nurses are worried. O/E BP 130/80, HR 90, Sats 100% on air, temp 37.0. Abdomen soft, with some tenderness around operation site. They appear sweaty, and shaky, wide eyed and nauseated. What is most likely to help?
A. 20mg Chlordiazapoxide
B. IV Tazocin
C. 5mg IV morphine
D. IV paracetamol
E. Urgently return to theatre
A. 20mg Chlordiazapoxide
A patient with a history of opiate dependence attends the drug and alcohol service and starts buprenorphine 4mg OD the same day. After taking the first dose he says he felt awful and never wants to take it again. What is the most likely explanation?
A. Adverse drug reaction
B. Anaphylaxis
C. Precipitated opiate withdrawal
D. Buprenorphine overdose
E. Delirium tremens
C. Precipitated opiate withdrawal
What is the minimum age that the Mental Health Act can apply to a person?
A. No minimum
B. 10
C. 14
D. 16
E. 18
A. No minimum
An informal patient in a psychiatric ward is asking to be discharged late at night and there are concerns about their safety. Which Section of the MHA may be applicable here?
A. Section 2
B. Section 3
C. Section 5
D. Section 17
E. Section 136
C. Section 5
