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Showing posts from 2018

Mnemonic for Types of Stress

Mnemonic for Types of Stress Here is a silly but worthwhile mnemonic to remember the major types of stress  Change  of pressure created the conflict , which frustrated everyone.

Q1 2013 October FCPS 2

Q.1 A 21-year old lady with history of chaotic Interpersonal relationships presented with history of several self-inflicted cut marks on her wrist. Her psychologist describes that she alternates between periods in which she idealises the therapist and periods of anger when she is convinced that therapist is unhelpful and the therapeutic work is worthless. What is the likely provisional diagnosis? Define the defense mechanisms she is using. What is type of psychotherapy is recommended in this case and what are the different modules steps in this particular psychotherapy? 1. Personality disorder, borderline pattern (ICD11) 6D11.5 Borderline pattern Parent: 6D11 Prominent personality traits or patterns 6D10 Personality disorder 2. Splitting: the person sees everyone in a black and white pattern. Someone can either be good or bad. There is no inbetween. At different times, this image of someone changes. Splitting (also called black-and-white thinking or all-or-nothing thinkin

Treatment of Borderline personality disorder, Summary

1. Problem solving counselling 2. Antipsychotics and mood stabilisers (improvement in affective instability, impulsive behavioural dyscontrol, cognitive perceptual symptoms). Only for the short term. 3. Dynamic psychotherapy- difficult 4. Expressive psychotherapy- excellent results in clinical trials 5. Dialectical behavioural therapy- Reduces self haRM, very demanding, effects last for long 5. Group therapy, transference reactions are spread across the group 6. Psychoanalytically oriented psychodynamic psychotherapy, two trials, favourable

Electroconvulsive Therapy

Electroconvulsive therapy Steps of application summarised. Step-1:  Preparing the patient Obtain consent, pass intravenous line, perform a physical examination. Get the patient nil -by-mouth at midnight. Before shifting the patient to the electroconvulsive therapy room, Check case notes including the medication chart for medications that affect seizure threshold or interact with anaesthesia, the outcome of earlier electroconvulsive treatments, especially seizure duration and complications. Check for the placement—whether unilateral or bilateral—agreed. Confirm there is a valid consent form.  The nursing staff checks vital signs, have the patient void, remove dentures, jewelry, hairpins, eyeglasses, and change into a gown.  Step-2: Pre-p rocedure When the patient enters the treatment room, introduce yourself, put the patient at the ease, and confirm their identity. Also, confirm the patient has been nil-by-mouth for at least 5-hours. Confirm the patient continues to consent. Check vital