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27 Cards in this Set
- Front
- Back
What is delirium?
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Acute confusional state with clouding of consciousness.
Can be fluctuant Onset in hours/days |
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What is dementia?
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Global cognitive impairment
Decline in higher functions - memory, thinking, orientation, comprehension, calculation, learning capability, language and judgment) |
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How long does it take to diagnose dementia?
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>6 months for confirmed diagnosis
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Main types of risk in risk assessment
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Risk to self (suicide, self-harm, neglect)
Risk to others (dependents e.g. children) Risk to health (non-adherence to medication) |
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What is Beck's suicide scale?
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1. Preparation (advance planning e.g. stockpiling Rx; suicide note; final acts e.g. will)
2. Circumstances (alone; intervention unlikely; took precautions against discovery) 3. After the act (Did not seek help; expressed wish to die; Believed act would be fatal; regrets failure) |
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Main symptoms of depression
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Low mood
Anhedonia Lethargy |
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Beck's cognitive triad
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Negative thoughts about:
Self World/environment Future (hopelessness) |
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Risk factors for deliberate self harm
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Female
Age group 16-24 Recent stressful life event Personality disorder Areas w/ high unemployment, overcrowding etc |
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1st rank symptoms in schizophrenia
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A: auditory hallucinations
B: thought broadcasting C: controlled thought D: delusional perception |
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Examples of thought manipulation in schizophrenia
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thought withdrawal
thought insertion thought broadcasting |
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Symptoms of alcohol dependency
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Tolerance
Withdrawal/use to prevent withdrawal Compulsion Use despite harm Difficulties controlling use Reinstatement after abstinence Narrowed repetoire Primacy |
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Bleuler's 4A's of schizoprehnia
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Associative loosening (incoherence of thought)
Ambivalence (experiencing 2 emotions at once) Affective incongruity Autism (self-absorption and withdrawal into fantasy world) |
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Differential diagnosis for schizophrenia
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Drug induced (amphetamines, LSD, cannabis)
Temporal lobe epilepsy Encephalitis Dementia Neurosyphilis Mania |
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Risk factors for schizophrenia
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Low birth weight
Maternal influenza FH Obstetric complications Male sex + older father Substance misuse Social deprivation Urban birth Low IQ |
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How do you manage psychiatric conditions?
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Bio
Psycho Social |
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Management of schizophrenia
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Bio - antipsychotics, drug and alcohol detox, ECT
Psycho - CBT, compliance therapy, community psychiatric nurse (CPN), supportive psychotherapy Social - community alcohol team (CAT), financial help (benefits, DAL), housing assistance, social worker |
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Symptoms of anxiety
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Dyspnoea + air hunger
Palpitations Sweating Dry mouth Chest pain/discomfort |
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Differentials for mania
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Psychotic disorders - bipolar, schizophrenia
Illicit drugs - stimulants e.g. cocaine, meth Rx - steroids, isoniazid, SSRIs, L-dopa Thyrotoxicosis Renal failure Cerebral insults - neoplasm, infarcts |
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Main types of dementia
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Alzheimer's
Vascular dementia Lewy body Fronto-temporal Huntingdon's |
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DDx for dementia
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Wernicke's encephalopathy
Korsakoff's syndrome Pseudodementia Normal pressure hydrocephalus Wilson's disease Vitamin B12/folate/niacin deficiency Hypothyroidism Autoimmune: SLE, GCA, neurosarcoid CNS trauma: diffuse axonal injury, dementia pugilistica |
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What is the screening tool for anorexia called?
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SCOFF
S - do you make yourself SICK when you feel uncomfortably full C - worry you've lost CONTROL over how much/what you eat O - Lost more than ONE stone in 3 months F - think you're FAT when people say you're too thin F - does FOOD dominate your life? |
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Characteristics noted in anorexia nervosa
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Deliberate weight loss + restricted food intake
Weight <85% predicted (BMI <17.5) Dread of gaining weight + impaired self image Amenorrhoea for 3 months or more |
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Physical Sx of anorexia
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Fatigue
Hypothermia Hypotension + slow pulse Peripheral oedema Lanugo hair Delay in secondary sexual characteristics |
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Characteristics of bulimia
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Intense preoccupation w body image
Repetitive episodes of binge eating Ritualistic preoccupation with food Russel's sign Cycle of counteractive extreme weight control (self-induced vomiting, laxative/diuretic abuse, fasting, excessive exercise) |
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Sx of PTSD
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Re-experiencing
Avoidance Hyperarousal Impaired social functioning |
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Tests undertaken before starting lithium therapy
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FBC
U&Es TFTs pregnancy test ECG |
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Risk factors for Li toxicity
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Dehydration
Diuretics, NSAIDs, anti-epileptics, CCBs, ACE-i Low salt diets Abnormal TFTs and U&Es |