individuals with LDs + healthcare environment
signs and symptoms of schizophrenia
learning disabilities
approaches and MOA to psychotic illnesses
random
100
What is a hospital passport?
A hospital passport tells the hospital about the patient’s healthcare, learning disability, how they like to communicate and how to make things easier for them. Patients can carry a hospital passport and show it to healthcare staff at the hospital. It can help them to get the care they need in an easier to understand way
100
Typical onset of schizophrenia
In late teens and early adulthood
100
What percentage of children have learning disabilities?
(+100...)
Approximately 2.5% (353,000) of children in the UK are believed to have a learning disability
100
The two neurotransmitters hypothesised to be involved in schizophrenia
Dopamine and glutamate
100
What are all the types of the attachment?
Secure
Insecure avoidant
Insecure ambivalent/ resistant
Disorganised
200
What is diagnostic overshadowing?
Symptoms of physical ill health are mistakenly attributed to either a mental health/behavioural problem or as being inherent in the person's learning disability
200
What are the most common co-morbidities in people with learning disorders? List 2.
The five most prevalent conditions found in a study were visual impairment, obesity, epilepsy, constipation and ataxic / gait disorders
200
Side effects of anti-psychotics
Sedation
Weight gain
QTc prolongation on ECG
Hyperprolactinaemia
involuntary movements
200
What are the Stages of Grief (Kübler-Ross)?
1. Denial
2. Anger
3. Bargaining
4. Depression
5. Acceptance
300
Give examples of 3 reasonable adjustments
(+100...)
Reformatting letters to make it easier for patients with a learning disability to read
Scheduling longer appointments
Annual health checks from their GP - everyone with a learning disability can have an annual health check from the age of 14.
Summary care record – provides additional information on needs a person with a learning disability has
Hospital passport
300
Name the 3 components of Liddle's 3 syndrome model for schizophrenia
reality distortion e.g., hallucination and delusions
disorganisation e.g., thought disorder and inappropriate affect
psychomotor poverty e.g., poverty of speech (alogia) and blunt affect
300
What is the definition of PMLD and what does it stand for?
Profound and multiple learning disability
Have more than one disability
The most significant of which is a profound intellectual disability. These individuals all have great difficulty communicating, often requiring those who know them well to interpret their responses and intent.
300
In which circumstances is clozapine used?
(+100...)
for resistant symptoms - where 2 other psychotics including at least one 2nd generation anti-psychotics have failed or not been tolerated
300
Define margin of error
A statistical expression of the amount of random sampling error in the results of a survey. The larger the margin of error, the less confident you can be that the results reflect onto the population.
- > A way of measuring how effective your survey is
400
5 Principles of the Mental Capacity Act
A presumption of Capacity
Individuals being supported to make their own decisions
Unwise decisions
Best Interests
Less restrictive option
400
List at least 5 A's for negative symptoms of schizophrenia
- Alogia – complete lack of speech
- Anhedonia – inability to feel pleasure
- Apathy – lack of feeling or emotion
- Avolition – absence of will or drive to act
- Anergia – lack of energy/ continual feeling of tiredness
- Affective flattening – absence of certain emotion or behaviour
- Asociality – lack of motivation to engage in social interaction
- Impaired attention – inability to maintain focus
400
What are some risk factors that cause people with learning disabilities to suffer with mental illness?
Higher incidence of negative life events, poverty
Stigma and people’s attitudes towards them, discrimination, social exclusion
Access to fewer resources and coping skills
Poor physical health
Poverty
400
Health inequalities that people with severe mental illnesses tend to face in excess
- Poverty
- Homelessness
- Incarceration
- Social isolation
- Employment
400
WHAT TYPE OF ATTACHMENT IS THIS?
Usually, a pattern developed from inconsistent responsiveness from the caregiver
The child expresses high levels of distress and turn all their attention (exaggerate) to their parent to comfort them but when they receive attempts of comfort, they don’t calm down (not soothed)
When the caregiver is reunited with the child, they continue to be upset as if cross at the patient and exert violence against the parent
Insecure ambivalent/ resistant
500
What does TEACH stand for?
Time: This might be offering a double appointment with the GP or an early morning appointment when the waiting room is quieter
Environment: This might mean the dentist visiting at home or the operating theatre nurses meeting the individual in casual clothes rather than in gowns and masks
Attitude: This means treating everyone with dignity and respect and as an individual
Communication: This means using accessible information to ensure it can be understood, eg easy read leaflets, pictures, symbols or sign language
Help: This means listening to others (family carers/supporters) and knowing where to get specialist help when needed (community learning disability nurse, acute liaison nurse, social worker, safeguarding teams)
500
Auditory hallucinations in schizophrenia shows patterns of activity in which area of the brain?
(+50...)
Broca's area
500
Identify 4 services available to assist patients with learning disability
Learning disability hotline
Local groups
Short breaks and respite services
Social care support funded by government - practical, professional support for people who need extra support with everyday life. This might be help with cooking, shopping, personal care or support with managing money or getting a job.
Primary care
Secondary care
Advocacy
Support from private trusts
500
List different approaches to treating psychotic illness, excluding pharmacological approaches
Family therapy
Cognitive psychosis based therapy (CBTp)
Community engagement
Trauma focus
Help with hearing voices
Managing social aspects like housing, employment & education support
Treatment for substance use and other co-morbid problems
Hope
500
What causes defence mechanism to arise? And name 3 examples
When tension between different aspects of personality become too great, defence mechanism arise which reduce anxiety by distorting reality.
- Repression: removal of threatening thoughts from awareness
- Projection: attribution of unacceptable impulses to other
- Regression: return to a less mature, anxiety reducing behaviour i.e., thumbing sucking
- Denial: refusal to recognise a threatening situation or thought
- Reaction formation: expression of the opposite of disturbing ideas
- Displacement: substituting a less threatening object for impulses
- Sublimation: channelling of impulses to socially acceptable outlets