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Psychiatry Presentation

Transcript: DONE BY: SAHIL DAYA PSYCHIATRY PRESENTATION HISTORY HISTORY DEMOGRAPHIC DATA MR BM 26 YEAR OLD MALE FROM HORISON PARK LIVES WITH HIS SISTER, PARENTS RESIDE IN THE FREE STATE SINGLE, NO CHILDREN HIGHEST LEVEL OF EDUCATION ACHIEVED: GRADE 12 CURRENTLY UNEMPLOYED, ATTEMPTING TO UPGRADE HIS MATRIC RESULTS CHRISTIAN NOT A KNOWN MHCU BROUGHT TO HOSPITAL BY HIS SISTER WITH INDEX EPISODE OF HALLUCINATING, SPEAKING TO HIMSELF AND AGGRESSIVE BEHAVIOUR SYSTEMATIC ENQUIRY SYSTEMATIC ENQUIRY PSYCHOTIC DELUSIONS GRANDIOSE DELUSIONS- PATIENT BELIEVES THAT HE HAS THE ABILITY TO MANUFACTURE ANYTHING AND IS A GREAT SCIENTIST AND INVENTOR. HE REPORTS HAVING INVENTED A "BENCH" WHICH GIVES YOU THE BEST WORKOUT IN THE WORLD AND CAN MAKE ANYONE AN EXPERT SOCCER PLAYER. HE ALSO BELIEVES THAT HE IS THE DESCENDANT OF UMKHONTO WE SIZWE AND KING KENNETH KAUNDA. PATIENT REPORTS THAT HE IS HIGHLY INTELLIGENT AND GIFTED AND WAS SUPPOSE TO STUDY SCIENCE, BUT INSTEAD HE IS STUDYING MARKETING AT UNISA (COLLATERAL FROM SISTER: PATIENT PERFORMED VERY POORLY AT SCHOOL AND BARELY PASSED MATRIC AFTER FAILING MULTIPLE TIMES, HE DOES NOT STUDY AT UNISA). PSYCHOTIC CLUSTER PERSECUTORY DELUSIONS- THE PATIENT HAD PERSECUTORY DELUSIONS TOWARD HIS SISTER, BELIEIVNG THAT HIS SISTER WAS JEALOUS OF HIM AND HIS TALENTS AND WAS TRYING TO SABOTAGE HIM. HE ALSO BELIEVED THAT HIS SISTER'S FRIEND WAS TRYING TO TAKE OVER THEIR HOUSE AND WAS TRYING TO INFLUENCE BOTH HIM AND HIS SISTER TO FOLLOW "THE WRONG PATH". HE SUSPECTS HIS SISTERS FRIEND OF STEALING HIS FATHER'S PROJECTOR. HE BELIEVES THAT HIS FATHER HATES HIM AND WANTS TO CONTROL EVERY ASPECT OF HIS LIFE BY FORCING HIM TO STUDY MARKETING AND NOT FOLLOWING HIS PASSION FOR SCIENCE. HIS FATHER ALSO PUNISHED HIM BY MAKING HIS SISTER "THE MAN OF THE HOUSE". BIZARRE DELUSIONS- THE PATIENT BELIEVES THAT HIS THREE DOGS HAVE BEEN POSSESSED BY WITCHES AND IN ORDER TO FREE THEM FROM THE WITCHES HE HAS TO SPIT ON THEM AND IN THEIR MOUTHS. HE ALSO BELIEVES THAT HIS SISTER IS THE BOSS OF WESTGATE. NO SOMATIC, NIHILISTIC OR RELIGIOUS DELUSIONS WERE ELICITED, NEITHER ANY DELUSIONS OF REFERENCE HALLUCINATIONS PATIENT DENIED HAVING ANY AUDITORY, VISUAL, OLFACTORY OR TACTILE HALLUCINATIONS. PASSIVITY PHENOMENA NO EVIDENCE OF THOUGHT INSERTION, DELETION, CONTROL, BROADCASTING OR WITHDRAWAL NEGATIVE SYMPTOMS NOT ELICITED MOOD PATIENT WAS NOTED TO HAVE A HIGH MOOD AND WAS VERY TALKATIVE. HE APPEARED TO HAVE GOAL-DIRECTED ACTIVITY, HE SAID THAT HE HAD NO TIME TO BE IN HOSPITAL AS HE HAD MANY THINGS TO DO AND HE HAD TO GO BACK TO HIS STUDIES AND HIS WORK AS A SCIENTIST. HE WAS CARRYING HIS ACADEMIC PORTFOLIO AROUND WITH HIM. NEUROVEGETATIVE FEATURES HE SAID THAT HE SLEEPS WELL (COLLATERAL: PATIENT WANDERS AROUND THE HOUSE AT NIGHT AND DOES NOT SLEEP) HE REPORTED HAVING AN INCREASED LEVEL OF ENERGY NO CHANGES IN APPETITE OR LIBIDO MOOD CLUSTER COGNITIVE FEATURES PATIENT HAD POOR CONCENTRATION AND WOULD OFTEN GET DISTRACTED THROUGHOUT THE INTERVIEW NO CHANGES IN MEMORY ELICITED NO FEELINGS OF GUILT OR RUMINATION NORMAL THOUGHT SPEED PHYSICAL FEATURES NIL ELICITED SUICIDAL IDEATION NIL CURRENT OR PAST ATTEMPTS AT SUICIDE NO FUTURE PLANS OR INTENT ANXIETY NO HISTORY OF PANIC ATTACKS OR GENERALISED ANXIETY NO OBSESSIONS OR COMPULSIONS ELICITED NO HISTORY OF A TRAUMATIC EVENT, OR ANY FEATURES OF POST TRAUMATIC STRESS DISORDER NO SPECIFIC PHOBIAS ANXIETY CLUSTER ICTAL NO HISTORY OF SEIZURES, LOSS OF CONSCIOUSNESS NO PERCEPTUAL DISTURBANCES SUCH AS MICROPSIA, MACROPSIA OR DYSMEGALOPSIA NO HALLUCINATIONS, ILLUSIONS NO MEMORY DISTURBANCES SUCH ASDEJA VU, JAMAIS VU, PREMONITIONS NO DISSOCIATIVE STATES (DEPERSONALISATION, FUGUE STATES) ICTAL CLUSTER EATING DISORDER NO EVIDENCE OF FOOD RESTRICTION, BINGING, PURGING OR VOMITING NO EVIDENCE OF FOOD RESTRICTION NO DISTURBANCES IN BODY IMAGE, WEIGHT ELLICITED EATING DISORDER CLUSTER PAST PSYCH HISTORY THIS IS THE PATIENT'S INDEX PRESENTATION TO HOSPITAL ACCORDING TO FAMILY, THE BIZARRE BEHAVIOUR BEGAN IN JULY 2019, AND HAD SIGNIFICANTLY WORSENED LATELY THE PATIENT IS UNABLE TO LIVE A PRODUCTIVE LIFE BECAUSE OF THE ILLNESS AND IS CURRENTLY UNEMPLOYED AND NOT STUDYING AS THIS IS THE INDEX PRESENTATION, NO DIAGNOSES OR TREATMENT HAVE BEEN GIVEN TO THE PATIENT PAST PSYCHIATRIC HISTORY FAMILY PSYCH HISTORY PATERNAL GRANDMOTHER REPORTEDLY HAD BIZARRE BEHAVIOUR AS WELL AS MAGICL THINKING. SHE WAS NEVER DIAGNOSED WITH A MENTAL ILLNESS NOR TOOK ANY TREATMENT. NO OTHER FAMILY PSYCHIATRIC HISTORY REPORTED. NO HISTORY OF SUICIDE BY ANY FAMILY MEMBERS. FAMILY PSYCHIATRIC HISTORY MED AND SURG HISTORY MEDICAL HISTORY PATIENT HAS NO KNOWN MEDICAL COMORBIDITIES. DOES NOT USE ANY CHRONIC MEDICATIONS. SURGICAL HISTORY NIL OF NOTE. MEDICAL AND SURGICAL HISTORY SUBSTANCE USE AND FORENSIC HISTORY SUBSTANCE USE PATIENT IS A NON-USER OF ALCOHOL OR TOBACCO PRODUCTS. HE STARTED USING CANNABIS DURING HIGH SCHOOL, AND CONTINUES ABUSING THE DRUG. HE ADMITS TO USING CANNABIS 2-3 TIMES DAILY. HE DOES NOT USE ANY OTHER ILLICIT

Psychiatry

Transcript: Psychiatrist Designing treatment programs. Conducting psychotherapy sessions. Prescribing potent mental illness drugs. Supervising electrotherapy treatments. Conducting research. Leading a team of mental health care providers Intellectual (Admission to medical school is highly competitive, Requires candidates to demonstrate a high degree of intellect) Empathy (Psychiatrist often listen to patients tell them about their serious problems. These problems are psychological in nature and require psychiatrist to convey empathy to patients) Communication (Communication with the patient) Reasoning and Logic (Needed to diagnose patients effectively , Need to listen and interpret) Psychiatrists usually work in community mental health centers, hospitals or clinics. They may travel to attend conferences. a psychiatrist in private practice may change their work hours in order to fit their appointments, while those who work in a classroom or a government agency work an average of 35-40 hours every week. The Median salary in Hawaii is Approx. $215,000 (yearly) Duties and Responsibilities Outlook Career Path Working Conditions Educational training Psychiatrists were the third-most-requested physician. Family practice doctors were the most requested, followed by internists. Multiple Science and Math classes help you have a better chance in getting into Medical School. Aptitudes and Abilities Earning Bachelors Degree Medical School (4years) Residency and Board of Certification (4years) By Ariel King Period 3, November 10,2011 Salary

Psychiatry Alzheimers Presentation

Transcript: The cause of Alzheimer's is still veiled under the mysteries of the brain Although, the formation of beta amyloid plaques have been experimentally proven to be linked to both melatonin and orexin, or in general, the sleep-wake cycle However, an inconsistency exists in the data: If melatonin is a light-sensitive hormone, then reduced effects should have been present in the mice that were experiencing constantly dimmed conditions. Since no changes were observed, one would assume that melatonin would have no effects on ISF beta amyloid levels. Amyloid Plaques: The Sleepless Slayer Miguel Pappolla et al. (1997) Recent Study: Strong correlation between ISF beta amyloid levels and the time spent awake, which is strongly regulated by orexin. The injection of orexin and its antagonist both have expected effects on the ISF beta amyloid levels Inhibition of Alzheimer b-Fibrillogenesis by Melatonin Beta amyloid plaques They tested for beta amyloid levels in the brain interstitial fluid via hippocampal microdialysis Many more enzymes and hormones that can affect sleep Melatonin Thank you for listening to my presentation! :) Proposed Melatonin Intereference Beta Amyloid Plaques and their Relationship to Sleep By: Dantong Jia By: Dantong Jia The Source of Amyloid Plaques and Their Effects BUT WAIT! Don't deny it, we need it! "Is there truly a connection between Alzheimer's Disease and the Sleep-Wake Cycle?" Orexin Orexin, the Elusive Hormone Supporting Experiment: Amyloid-βDynamics are Regulated by Orexin and the Sleep-Wake Cycle Jae-Eun Kang et al (2010) Jian-Zhi Wang et al (2006) The Effects of Chronic Sleep Deprivation and Orexin Inhibition Evidence for the connection between ISF Beta Amyloid levels and Orexin Induced Sleep Deprivation Orexin Is Melatonin a possible cure for Beta amyloid plaques? With Melatonin The present results of melatonin are from experiments conducted on animals. No pre-clinical data has shown that melatonin is effective in humans. Results: Human APP Transgenic mouse vs. Wild Type Mouse Role of Melatonin in Alzheimer-like Neurodegeneration Melatonin Findings: ISF AB levels fluctuate proportionally to awakeness Light stimulus does not alter ISF beta amyloid levels in rats Similar diurnal fluctuations exist in humans Diurnal Fluctuations in ISF Beta-Amyloid levels Sleep is COMPLICATED Beta, alpha and gamma secretase Neurons release orexin in the hypothalamus, the control centre of the brain Alzheimer's Disease Without Melatonin Responsible for canine necrolepsy Results support that ISF beta amyloid concentrations greatly effect plaque buildup as sleep deprived specimen exhibited more plaque. Orexin Expression and Inhibition through antagonist, Almorexant Released in the same hippocampal location from where the microdialysis is taken Recap: Alzheimer's Disease Neurodegenerative Disorder Affects: Sleep Wake Cycle Craving for food Symptoms include: Dementia Retrograde memory loss Personality and mood changes

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