Summary: Liason Psychiatry

Read the summary and the most important questions on Liason Psychiatry

• 1 Abortion

  This is a preview. There are 2 more flashcards available for chapter 1
  Show more cards here

• Legal framework of abortion in Malaysia

  
  Abortion is legal in Malaysia, but only under specific circumstances defined by Section 312 of Act 727 of the Penal Code.
  According to the sources, a pregnancy can be legally terminated by a medical practitioner registered under the 1971 Medical Act if they form an opinion in good faith that continuing the pregnancy would pose a greater risk than termination in the following areas:

  • The woman's life.
  • The woman's physical health.
  • The woman's mental health

• 2 Transplant

• Screening tool used for Psychiatric evaluation for donor/recipient

  The assessment covers several key domains for both parties, often utilizing tools like the DASS-21 (Depression, Anxiety, and Stress Scale) and checklists for current psychopathology

• Signs may disqualify candidate to donor

  active psychosis
  suicidal ideation
  significant cognitive deficits (IQ < 50)
  severe personality disorders (e.g., antisocial or borderline)

• Assessment distinctively for donor and recipient

  Donor-Specific Domains: Evaluation for the donor focuses on understanding the procedure, potential complications, and identifying any evidence of coercion, unresolved conflicts, or desired gain/reward
  
  Recipient-Specific Domains: For the recipient, the focus is heavily on personality challenges, treatment adherence history, and the potential mental health effects of immunosuppressive drugs

• 3 Palliative

  This is a preview. There are 3 more flashcards available for chapter 3
  Show more cards here

• Goal of Palliative Care

  - is achievement of the best quality of life for patients and their families

• Fear in Palliative patients due to

  o Loss of functions
  o Disfiguring treatments
  o Loss of autonomy and independence
  o Abandonment and isolation
  o Becoming a burden

• Reasons commonly missed depression in palliative patients

  o Assumption that symptoms are natural reaction to illness
  o Attributing physical symptoms to illness
  o Patient’s unwillingness to report symptoms
  o Doctor’s difficulty in asking about symptoms

• Management of Depressed Palliative patient

  
  o Pharmacological treatment to consider:
  § Antidepressant
  · Initiated at half the usual starting dose
  · Fluoxetine is well tolerated by severely medically ill patients
  § Psychostimulant
  · Useful especially in groups of patients who has only weeks to live
  · A rapid acting agent such as methylphenidate or dextroamphetamine
  § TCA
  · Have side effect profile that can be troublesome for palliatives care of the patients

• Management of Anxiety Disorder in Palliative patient

  o Shorter-acting benzodiazepines are the safest
  o Due to patients mostly have hepatic metabolism
  o Risk of somnolence and confusion, especially in the elderly and those with advanced disease
  o Psychological: CBT, relaxation technique and distraction

• Risk Factor Suicidality in Palliative Care

  oAll regular risk factors for suicidality are important to consider
  oAge, race, history of suicide attempts, psychiatric illness, means, etc
  oAdvanced stages of the disease
  oHopelessness
  oUncontrolled pain
  oConfusional states (delirium)
  oLoss of control and sense of helplessness
  o Fatigue of all forms
  oPhysical
  oFinancial
  oSocial support