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How about an EMI string

42 posts in this topic

We do loads of ISQ's, are we all so good at EMI's so as not to need some focus.

Diagnosis of anxiety disorders

a PTSD

b agorophobia with panic disorder

c generalised anxiety disorder

d phobic disorder

e social phobia

f depressive episode with mixed anxiety symptoms

g mixed anxiety depressive disorder

h acute stress reaction

1 29 yr old man. Father died in car accident, 8m later developed chest pain , headache, anxious, dizziness. No physical cause found. Fearful and worse when travelling in car. (give 1 option)

2 35 yr old woman, frightened to leave house, prefers staying home. When has to go out can't sleep the night before. Fears are that she will die before returning and also returns back very soon. Recent alcohol abuse. (give 1 option)

3 45 yr old man developed sad feeling, was unable to relax with poor appetite and loss of weight. Very reluctant to go out and meet friends because more anxious and tearful. He uses alcohol excessively to see them. (give 2 options)

My thoughts-

1-->agoraphobia with panic disorder

Not PTSD... didn't witness event and 6m limit, also symptoms not right-reexperiencing,avoidance and autonomic.

2-->phobic disorder (agorophobia without panic attacks)

Fear of leaving home, many completly house bound

3-->depressive episode with anxiety symptoms and social phobia

I think there are enough criteria met for full depressive episode. (Only use mixed anx-dep when neither one is met) The social phobia is a grope in the dark.

Any other ideas?

I will post another EMI- prob without answers

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dear umfazi

its a good idea to start emi string.

I agree with all the three answers for this one.

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Drugs of abuse linked to clinical presentations

amphetamine

ketamine

caffeine

alcohol

cocaine

phencyclidine

mushrooms

volatile gases

1 young guy at a party with mild respiratory depression, dilated pupils and hypotension

2 young guy experiencing bad trip, dilated pupils, tachcardia and sweating

3 young guy depressed past 3 months dilated pupils, some muscle stiffness

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1 young guy at a party with mild respiratory depression, dilated pupils and hypotension .cocaine

2 young guy experiencing bad trip, dilated pupils, tachcardia and sweating .amphetamine

3 young guy depressed past 3 months dilated pupils, some muscle stiffness .?phencyclidine (muscle stiffness,miosis/mydriasis,?depression)

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My guess was:-

1 alcohol -sounds like your avg drunk sleeping it off

2 cocaine- stimulant  so tachy and big pupils but amphetamine fits the bill as well

3 cocaine- chronic use but just a guess. Chronic use depletes 5HT. Can get dystonias.

Still not sure though. The only drug I can find that causes muscle stiffness is GHB but that wasn't on the original list.

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EMI 3 Validity

a a sister screening for depression on ward selects 8 people with depression out of a total of nine who have depression

b a sister screening for depression on a ward selects 80 people who haven't got depression out of a total of 100 who havn't got depression

c we usually choose diagnostic categories from ICD 10

 

d concordance in diagnosis between GHQ and Becks depression inventory

e 95 % of people diagnosed with LBD screened with test x?? have Lewy Body Dementia

f the sister in a and b checks her figures na dfinds a total of 8 people with depression test positive from a total of 28 with depression on the ward

g some Alzhemers test that is very reliable for AD??

1Construct Validity

2Criterion Validity

3Divergent Validity

others

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Defence Mechanisms Linked to clinical story

denigration

Denial

Idealisation

Projective Identification

Reaction Formation

Sublimation

Splitting

intellectualisation

reaction formation

1 patient taken large overdose and admitted. wants to discharge herself. doctor feeling anxious about discharging her, patient now seems better  PROJECTIVE IDENTIFICATION

2 patient tells of how  his mother put him in care becoz she could not luk after him when in reality he was taken by social services as was found to be starving n poor self careis showing REPRESSION

3 a psychologist c/o pt telling him he was rude when last week pt told him he was the best psychologist.what is the psychologist forgeting..

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a psychologist c/o pt telling him he was rude when last week pt told him he was the best psychologist.what is the psychologist forgeting ..

SPLITTING

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Drugs adverse effects

pulmonary embolism

lithium toxicity

nms

serotonin syndrome

diabetes insipidus

diabetes mellitus

cardiomyopathy

+ others

1on clozapine, palpitations, tachycardia, breathless

2 on lithium polydipsia, polyuria, lethargy high Na levels

3 on olanzapine, muscle rigidity

IP Logged

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Defence Mechanisms Linked to clinical story

denigration

Denial

Idealisation

Projective Identification

Reaction Formation

Sublimation

Splitting

intellectualisation

reaction formation

1 patient taken large overdose and admitted. wants to discharge herself. doctor feeling anxious about discharging her, patient now seems better  

2 patient tells of how his mother put him in care becoz she could not look after him when in reality he was taken by social services as was found to be starving n poor self care is showing

3 a psychologist c/o pt telling him he was rude when last week pt told him he was the best psychologist.what is the psychologist forgeting..

1 I would go with projective identification- naming what the dr is feeling but have to say I'm not sure. For where the patient is at I'd like to go with repression but that's not in the options.

2 The only answer here I would go with is denial but again prefer repression but again not an option

3 I'd go for splitting or if there devaluation, I don't think denigration is a name of a defence mechanism or am I wrong.

Note:idealization- derives from need to  belive that carers are omnipotent; devaluation is the expected outcome. Especially seen in narcissistic PD

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Re: Psychologist forgetting

I think the psychologist has forgotten about the idealization...devaluation patten of defence mechanism.

I asked our psychotherapist about this idea of projective identification. She says it's the way you end up feeling identified with the people/environment around us and take that on as our own. Eg I walk into a busy acute ward and do 30 minutes work there.Then I  leave but find on leaving my mood is completely different. On going there my day was going okay on leaving I can't wait to escape, I'm angry, frustrated and feel chaotic. Where do these emotions come from? I've completely identified with what the patients or more probably the way the nursing staff are feeling.

I'm completely happy that I understand this defense mechanism now. Just don't know what's different between that and the dreaded counter-transferance now.

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EMI Basic Sciences 5

oh yes!!!

the worst question of them all

radioligands and different imaging modalities

really unusuall ligands

fmri

volumetric mri

t1 weighted MRI

in which research scenario would each one be best employed???

ie measuring neuronal loss in anterior cingulate??

So this is my made up radio ligand question.

Radio ligands and in which research scenario they are best employed.

[3H]SCH23390

3H(MDL)100907

[125I]NCQ

BTA-1 11C

[3H]-trans-H2PAT

Iomazenil

[3H]mepyramine

1 Investigating the extent of intact neurons after focal cortical ischaemia

2 Investigation the distribution of amyloid plaques in people affected with Alzheimer's

3 To investigate D2 receptor distribution.

This is my nightmare come true. For those that wrote the paper with the radioligand question, was it anything like this because if it was it's a big fat f for me.

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Choose the most appropriate next step for each of the following situations

A. Beck Depression Inventory

B. Discussion with the informant

C. Full blood count

D. Liver function tests

E. Serum antimanic drug level

F. Mini-mental state examination

G. Thyroid function tests

H. Narcotic drug screen

I. Blood gases

J. Blood screen for analgesics

1. A 58 year old man is admitted to a medical ward after a suicide attempt. He regrets the attempt and says he will not repeat it. He has a long history of affective disorder and is taking lithium. (CHOOSE ONE)

2. A 73 year old lady is brought to hospital by her son. She is withdrawn, not eating, not taking self care and has been experiencing suicidal ideas for the last six months. Her problems have worsened since the death of her husband 6 weeks ago. She has been on antihypertensives for a long time. (CHOOSE THREE)

3. A 47 year old man is admitted after he attempted to hang himself. He is found to more subjectively depressed than objectively. He has a history of alcohol and drug problems. (CHOOSE THREE)

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1 A 58 year old man is admitted to a medical ward after a suicide attempt. He regrets the attempt and says he will not repeat it. He has a long history of affective disorder and is taking lithium. (CHOOSE ONE)

ans B Discussion with the informant

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. A 73 year old lady is brought to hospital by her son. She is withdrawn, not eating, not taking self care and has been experiencing suicidal ideas for the last six months. Her problems have worsened since the death of her husband 6 weeks ago. She has been on antihypertensives for a long time. (CHOOSE THREE)    

ans

mmse

discuss with informant

bdi

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All but the radioligand one are from different parts of this website/board. The idea for the radioligand one came from the post by Melme I quoted and then doing some reading on the topic. That could be a real b****** question but I think it's of a far higher standard than what the college would ask.

This other investigation one, see

http://www.superego-cafe.com/cgi-bin/forum/YaBB.pl?board=isq;action=display;num=1116867822;start=1#1

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This investigations one I found doesn't have a great range in the answers.

1, the 73 yr old man post suicide attempt on Li in medical ward.

BDI

Zonk, the only reason I didn't go with discussion is there is none mentioned. Also BDI is good to use in medical wards cos relies on psychological features of depression.

Your guess as good as mine.

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2) 73 year old woman withdrawn, not eating. Worse over past 6 m since husband died. On antiHT  for many years.

MMSE

discussion with informant

BDI

2/3 we're in agreement.

BDI vs fbc. I don't know, for me I went for BDI cos if I went for physical I'd want the whole lot of them incl thyroid fxn. and that would be one too many answers.

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47 year old woman, post hanging. Subjectively depressed. Past alcohol & drug Hx

fbc

LFT

BDI

Answer really does n't feel clinically comfortable with me though.

In the original post the answers were blood gases, drug screen and BDI. On rereading I like that.

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EMI 3 Validity

a a sister screening for depression on ward selects 8 people with depression out of a total of nine who have depression

b a sister screening for depression on a ward selects 80 people who haven't got depression out of a total of 100 who havn't got depression

c we usually choose diagnostic categories from ICD 10

 

d concordance in diagnosis between GHQ and Becks depression inventory

e 95 % of people diagnosed with LBD screened with test x?? have Lewy Body Dementia

f the sister in a and b checks her figures and finds a total of 8 people with depression test positive from a total of 28 with depression on the ward

g some Alzhemers test that is very reliable for AD??

1Construct Validity

2Criterion Validity

3Divergent Validity

This is a toughie. Did I miss this section in Lawrie? I found this website helpful for definitions.

http://www.wilderdom.com/personality/L3-2EssentialsGoodPsychologicalTest.html

a) This is referring to concurrent validity which is part of criterion validity.

B) Discriminant validity- important that a measure doesn't measure what it isn't meant to measure

c) Construct validity- this includes criteion, convergent and discriminant validity in it.

d)Convergent validity but not in the answers. So don't know

e) Criterion validity

f) Concurrent validity which is part of criterion validity and in this example is poor/low.

g) Construct validity but not sure my understanding is that something can be reliably bad and then there would be no construct validity so then I'm stuck.

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Clin EMI 4

Child Psych

Logotherapy

Parent training

Family Therapy

Methylphenidate

Lithium

paroxetine

venlefaxine

1 4 year old taking the piss at school wit teachers and not respecting his mother at home

2 17 year old agrressive to the point parents have court injunction against him, he is aggressive in all circumstances but no other symptoms

3 13 year old girl aggressive, trouble at school, diagnosed as hyperkinetic by a psychologist

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Convergent and Divergent Validity - still stuck on this, but am glad this came up as its something that can be used in the essays as well if there is a question about Screening questionnaires.

Thanks Zonk!

Convergent and divergent validity are specific types of criterion-related validity. They could be addressing either concurrent or predictive variables. Essentially, if you have evidence that two things that should be similar to each other, are similar to each other (converge) you have evidence of convergent validity. Likewise, if two things that should be different from each other, actually are different from each other (diverge), you have evidence of divergent validity.

Evidence of convergent validity is demonstratedwhenthe recommendations in a LCP for an individual who has lower extremity paralysis are similar, in some ways, to those in a plan for an individual who has lower extremity amputation. On the other hand,therecommendations for an individual who has congestive heart failure would be expectedto differfrom those of an individual who has a hearing impairment. If the life care plans for these two individuals are not different, then the divergent validity of the two plans is not demonstrated.

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Clin EMI 4

Child Psych

Logotherapy

Parent training

Family Therapy

Methylphenidate

Lithium

paroxetine

venlefaxine

1 4 year old taking the piss at school wit teachers and not respecting his mother at home

2 17 year old agrressive to the point parents have court injunction against him, he is aggressive in all circumstances but no other symptoms

3 13 year old girl aggressive, trouble at school, diagnosed as hyperkinetic by a psychologist

1. Parent training - am guessing this one

2. Logotherapy - a type of talking therapy introduced by Viktor Frankl, that is helpful with juvenile delinquents, etc

3. Methylphenidate for hyperkinesis

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