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Depression Screening Tools

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5961. Congenital Infections in Neonates

falciparum (malaria), rubella and cytomegalovirus (CMV). Ascending maternal infection and chorioamnionitis causing fetal infection, usually subsequent to prolonged rupture of membranes. Perinatal infection acquired during birth via the haematogenous or genital route. These include human immunodeficiency virus (HIV), herpes zoster virus (HZV), hepatitis B virus (HBV) and Chlamydia trachomatis . Postnatal infection transmitted via breast-feeding. Pre-pregnancy or routine antenatal screening can determine (...) the presence or susceptibility to some of these infections, enabling appropriate management to prevent adverse fetal or perinatal outcomes. Always try to consider the possibility of congenital infection when reviewing an unwell pregnant woman. Screening programmes vary throughout the UK. See the links for the UK regional screening programmes under 'Further reading & references', below . Whilst infections can occur in utero, birth represents an abrupt transition from a highly protected environment

2008 Mentor

5962. Complications of HIV Infection

histological evidence of brain damage. Before the introduction of ART, the HIV-associated neurocognitive impairment was categorised as AIDS-dementia complex, HIV encephalitis or encephalopathy, with an estimated prevalence of 16% in patients with a diagnosis of AIDS. This has been given the umbrella term HIV-associated neurocognitive disorder (HAND). In the early stages, the concentration or memory is affected, with apparent depression and a gradual diminution of intellect. There may be increasing motor (...) from cytomegalovirus (CMV) encephalitis, which usually presents with rapidly progressive convulsion and dementia. Investigations to exclude other causes of neurocognitive impairment may need to be carried out - eg, vitamin B12, folate level, TSH, syphilis, hepatitis C, glucose and vitamin B1 as well as screening for dyslipidaemia. CSF examination may be required, especially when there are other signs of CNS infection - eg, fever, CD4 cell counts below 200 cells/mm3 or positive serology for syphilis

2008 Mentor

5963. Childhood and Congenital Hypothyroidism

primary hypothyroidism rather than CH. Children with untreated primary hypothyroidism do not experience the irreversible neurological problems that are seen with untreated CH. Epidemiology In the UK, 1 in 4,000 live births have CH. The incidence is twice as common in girls. [ ] Areas with iodine deficiency associated with endemic CH are Bangladesh, China, Peru and Zaire. This has in part been counteracted by compulsory iodination of salt. Italian screening for CH suggests it is more prevalent (...) and mottled skin on the extremities Jaundice - prolongation of the physiological jaundice Umbilical hernia Hypotonia Hoarse voice Cardiomegaly Bradycardia Pericardial effusion - usually asymptomatic Failure of fusion of distal femoral epiphyses The growing child will have short stature, hypertelorism, depressed bridge of nose, narrow palpebral fissures and swollen eyelids Refractory anaemia A may be present (more likely with dyshormonogenesis, thyroid hormone resistance and transient hypothyroidism) 5

2008 Mentor

5964. Child Abuse - Recognition

to appropriate medical care or education Consider neglect if: Parents or carers do not administer prescribed medication. There is repeated failure to attend appointments. There is persistent failure to engage with immunisations, regular development reviews or screening. There is failure to seek treatment for dental caries. Suspect neglect if: There is failure to seek medical care to the extent that the child's health or well-being is compromised. Unjustified poor attendance at school. Physical abuse (...) causing - eg, , Mongolian blue spot (a congenital mark), which can resemble a bruise. Medical conditions predisposing to fractures - eg, metabolic bone disease in neonates, , copper deficiency, , leukaemia and disseminated . , which may be a rare cause of subdural haematoma. Investigations [ ] Depending on the presentation, investigations may be required. Investigations which may be of relevance include: Blood tests: FBC, clotting screen. Skeletal survey or bone scan: Where physical abuse is suspected

2008 Mentor

5965. Bronchiectasis

: Serum immunoglobulins (IgG, IgA, IgM) and serum electrophoresis. Serum IgE, skin prick testing or serum IgE testing to Aspergillus fumigatus and aspergillosis precipitins. All patients with bronchiectasis should be screened at presentation for gross antibody deficiency by routine measurement of serum IgG, IgA and IgM levels and serum electrophoresis. Respiratory and immunology units should develop additional local protocols for screening assessment of humoral responses to specific antigens (...) . Measurement of baseline specific antibody levels against tetanus toxoid and the capsular polysaccharides of both S. pneumoniae and H. influenzae type b (or suitable alternative peptide and polysaccharide antigens). Immunisation with appropriate vaccines followed by re-assay of individual specific antibody responses after 21 days where screening baseline levels are low. Further assessment of immune competence is recommended in the following circumstances: Antibody screening investigations have demonstrated

2008 Mentor

5966. Cerebrovascular Event Rehabilitation

that psychological needs may change over time and in different settings. When new or persisting emotional difficulties are identified at the person's six-month or annual stroke reviews, refer them to appropriate services for detailed assessment and treatment. Manage depression or generalised anxiety as indicated. See separate and articles. Swallowing All stroke patients should be screened for dysphagia before being given food or drink [ ] . Offer swallowing therapy at least three times a week to people (...) , speech and language therapists, clinical psychologists and social workers. Other services that may be needed include continence advice, dietetics, electronic aids (eg, remote controls for doors, lights and heating and communication aids), liaison psychiatry, orthoptics, orthotics, podiatry and wheelchair services. On admission to hospital, any person with stroke should be screened and, if problems are identified, management started as soon as possible for the following: orientation, positioning

2008 Mentor

5967. Cerebellar Signs including Cerebellar Ataxia

of the ventricular system, of which there are two types: Brief attacks which may benefit from acetazolamide or phenytoin and the patient is usually well between attacks. More prolonged attacks which are often associated with nausea, vertigo and vomiting. More severe in childhood with drowsiness, headache and fever and interictal nystagmus; slow deterioration in the ataxia and responds to acetazolamide (screen for metabolic disorder). Chronic progressive ataxias Commonly caused by chronic alcohol abuse associated (...) , and linguistic abilities, with affective disturbance ranging from emotional blunting and depression, to disinhibition and psychotic features. Examination Check eye movement - looking for ophthalmoplegia or nystagmus. Check fundi for papilloedema. Get the patient to stick his/her tongue out and move it from side to side (movement slowed). Ask the patient to repeat "baby hippopotamus" - look for dysarthria and abnormal speech rhythm and syllable emphasis. Examine arms for limb ataxia (see above): rebound

2008 Mentor

5968. Cerebrovascular Events

) [ ] . Polycythaemia vera. Carotid artery occlusion; carotid bruit. Combined oral contraceptive pill. Hyperlipidaemia. Excess alcohol. Clotting disorders. Presentation Either sudden onset or a step-wise progression of symptoms and signs over hours (or even days) is typical. In people with sudden onset of neurological symptoms, a validated tool, such as FAST ( F ace, A rm, S peech, T ime to call 999/112/911), should be used outside hospital to screen for a diagnosis of stroke or TIA [ ] . Focal signs relate (...) treatment. Is currently taking anticoagulant treatment. Has a known bleeding tendency. Has a depressed level of consciousness (Glasgow Coma Score below 13). Has unexplained progressive or fluctuating symptoms. Has papilloedema, neck stiffness or fever. Has severe headache at onset of stroke symptoms. Brain imaging [ ] : CT scanning is recommended for most patients in the acute phase of stroke. CT is widely available, practical, quick and easy to use in ill patients. CT is very sensitive in diagnosing

2008 Mentor

5969. Drug Misuse and Dependence: UK Guidelines

on clinical management. London: Dept of Health (July 2017) ; NICE Clinical Guideline (July 2007) ; NICE Clinical Guideline (July 2007) ; NICE Technology Appraisal Guidance, January 2007 ; NICE Public Health Guidance, March 2007 ; NICE Clinical Guideline (March 2011) i was placed on subutex after a year long codeine addiction 13 years ago i was kept. on it for 8 years then had a detox due to the most dramatic depressive state i was in i relapsed, back on subs... Tez22 Health Tools Feeling unwell? Assess (...) are dependent on opioids and they should screen patients for drug misuse. A good initial assessment is essential: This may involve a multidisciplinary team. Good assessment is vital to the continuing care of the patient. It can enable the patient to become engaged in treatment and may begin a process of change even before a full assessment is completed. Confirmation of drug taking should be gained (through history, examination and drug testing). Any risks to their children should be assessed and child

2008 Mentor

5970. Drugs and Sport

- how big is the risk to athletes. Med Sport Sci. 201359:143-52. doi: 10.1159/000341970. Epub 2012 Oct 15. ; The Guardian, 2015 ; BBC News, 2016 i was placed on subutex after a year long codeine addiction 13 years ago i was kept. on it for 8 years then had a detox due to the most dramatic depressive state i was in i relapsed, back on subs... Tez22 Health Tools Feeling unwell? Assess your symptoms online with our free symptom checker. Article Information Last Reviewed 12 May 2016 Next Review 11 May (...) , as is paracetamol. Opiate-related analgesics are more problematic. Codeine is not on the WADA list of banned substances and combinations such as co-codamol appear acceptable. It is the stronger narcotic agents that are banned. However, screening does not always differentiate adequately between the various narcotic- or codeine-related compounds and they are best avoided. Sometimes an athlete will ask the doctor to give an injection into an injured part to permit competition. Pain is an important warning

2008 Mentor

5971. Abnormal Weight Loss

infections. Drug abuse, heavy smoking . Malnutrition, social isolation . Psychological - for example: Stressful life events. Depression. Anorexia nervosa. Psychoses. Manipulative behaviour, food phobias. Parkinson's disease . [ ] Presentation Patients may realise themselves that they have lost weight or this may be brought to their attention by friends or family. A clinician may note that the patient has dramatically lost weight or notice that their clothing is loose-fitting. The clinical assessment (...) includes both consideration of possible physical causes as well as careful evaluation of possible psychological causes such as depression. It is very important to avoid inappropriate, unnecessary and potentially harmful investigations. The presentation will depend on the underlying cause. A thorough history and examination are essential in establishing the underlying cause and identifying appropriate investigations. Associated symptoms may include: Gastrointestinal symptoms. Lethargy, weakness

2008 Mentor

5972. Abdominal Pain In Pregnancy

monitoring. Initial investigations Blood tests - depending on the clinical scenario, consider: FBC. Group and save/cross-match. Rhesus blood group (if not known). Serum beta-hCG - can aid diagnosis/management decisions regarding suspected ectopic pregnancy or miscarriage. [ ] Biochemistry: renal and liver function, glucose, calcium, amylase, hepatitis serology. Clotting screen if haemorrhage, placental abruption or liver disease suspected. Sickle cell screen. Blood film (for evidence of haemolysis (...) . ; Royal College of Obstetricians and Gynaecologists (April 2015) ; Diagnosis and management of ectopic pregnancy. J Fam Plann Reprod Health Care. 2011 Oct37(4):231-40. doi: 10.1136/jfprhc-2011-0073. Epub 2011 Jul 4. ; How I manage venous thromboembolism in pregnancy. Br J Haematol. 2011 Jun153(6):698-708. doi: 10.1111/j.1365-2141.2011.08684.x. Epub 2011 Apr 18. I don't even know where to start. I am 31, male, and health wise am pretty healthy. I do have big depression and anxiety issues and have been

2008 Mentor

5973. Abbreviations

Consultation Observation Tool CMP casual male partner CPAP continuous positive airway pressure CPD continuing professional development CQC Care Quality Commission CRP C-reactive protein CRT cardiac resynchronisation therapy CSDD Cornell Scale for Depression in Dementia CSE combined spinal-epidural CSII continuous subcutaneous insulin infusion CSSD central sterile supply department CSSRs councils with social services responsibilities CT computed tomography CTG cardiotocograph CTPA computed tomography (...) pulseless electrical activity PECS picture exchange communication system PEEP positive end-expiratory pressure PEG percutaneous endoscopic gastrostomy PEP post-exposure prophylaxis PEPSE post-exposure prophylaxis after sexual exposure PERLA pupils equal + react to light and accommodation PEST psoriasis epidemiology screening tool PET positron emission tomography PF(R) peak flow (rate) PI protease inhibitor PIC punctate inner choroidopathy PICU paediatric intensive care unit PIP proximal interphalangeal

2008 Mentor

5974. Benzodiazepine Dependence

and European Guidelines. You may find the article more useful, or one of our other . In this article In This Article Benzodiazepine Dependence In this article The first benzodiazepine was marketed in 1959. It was described as a 'minor tranquilliser' and an alternative to barbiturates. Benzodiazepines act by enhancing the effect of gamma-aminobutyric acid on the GABA-A receptor, thereby resulting in CNS depression. They are anxiolytic, hypnotic, anticonvulsant and muscle relaxants. They also cause (...) [ ] Tolerance develops so they are no longer effective for the condition for which they were prescribed. Dependence may develop, so that stopping will result in withdrawal symptoms, and the end result is long-term continuation in order to avoid withdrawal syndromes. Prevention of adverse effects such as cognitive and psychomotor impairment, depression, irritability, loss of concentration and emotional blunting. Reduce risk of falls in the elderly. Reduce risk of accidents while driving. Avoid potential

2008 Mentor

5975. Barthel's Index of Activities of Daily Living

in Brazil found that the main risk factors for functional disability in elderly people in the community were lack of schooling, rented housing, chronic diseases, arthritis, diabetes, visual impairment, obesity, poor self-perceived health, cognitive impairment, depression, slow gait, sedentary lifestyle, tiredness while performing daily activities, and limited diversity in social relations. [ ] These factors may be influenced by access to healthcare and the cost of healthcare in different countries (...) to heart failure, angina or myocardial infarction. Diabetes - complications which can contribute to disability in a variety of ways (eg, the contribution of diabetic neuropathy to poor mobility) may be underestimated. Alzheimer's disease is the most common neurodegenerative disease. By the age of 85 years, 30% of the population has Alzheimer's disease. Urinary problems can be disabling, particularly if causing incontinence. Depression is often the result of disability but it also makes disability worse

2008 Mentor

5976. Back Pain in Children

.0b013e32834df622. ; UK National Screening Committee, July 2016 Hi I have suffered from back pain all my life since I slipped and fell in the rain as a teenager and landed directly on my coccyx. Most of my life it has been manageable but with the odd nasty flare... hypercat Health Tools Feeling unwell? Assess your symptoms online with our free symptom checker. Article Information Last Reviewed 24 July 2018 Next Review 23 July 2023 Document ID 1043 (v24) Author Peer reviewer Dr John Cox The information (...) dysfunction). Past medical history - eg, previous episodes of neck or back pain, arthritis, trauma. Family history - eg, arthritis, scoliosis. Psychological history - eg, depression aggravating back pain or back pain causing depression. See the separate article. Social history - eg, carrying school bags, school activities, sports activities (especially contact sports, gymnastics, diving, bowling in cricket). Examination [ ] See also the separate article. Examination should include: Localisation

2008 Mentor

5977. Brain Natriuretic Peptide

, such as screening for asymptomatic ventricular dysfunction, establishing the prognosis or guiding the titration of drug therapy and prediction of future cardiovascular events, are under investigation but have not yet been sufficiently validated for widespread clinical use. [ ] BNP is a biologically active peptide of 32 amino acids and has vasodilator and natriuretic properties. BNP is cleaved from the 108-amino acid pro-brain natriuretic peptide released from the cardiac ventricles in response to stretching (...) (possibly due to tissue hypoxia or secondary myocardial depression). Chronic obstructive pulmonary disease with cor pulmonale or respiratory failure. Hyperthyroidism. Acute or chronic kidney injury. BNP levels may be lower than expected when heart failure is secondary to causes proximal to the left ventricle - eg, acute mitral regurgitation, mitral stenosis or atrial myxoma. Potential use of brain natriuretic peptide measurement [ ] Heart failure Assay of BNP is a potential aid in the diagnosis of heart

2008 Mentor

5978. Borderline Personality Disorder

and females, emotionally unstable personality disorder is more common amongst females. One study reported a prevalence of 30.1% in males and 52.8% in females. [ ] Presentation [ ] Patients with the disorder can present with: Relationship difficulties. Recurrent self-harm. Threats of suicide. Depression. Bouts of anger. Impulsivity. Social difficulties. Transient psychotic symptoms. These were mooted to occur in 'borderline personality disorder' but were not included in the ICD-10 criteria (...) . [ , ] Differential diagnosis . Mental disorders secondary to medical conditions ( , ). . . . Brief psychotic disorder. . . . . . Investigations Toxicology screen because substance abuse is common (as with many personality disorders). Intoxication can lead patients to present with some features of personality disorders. [ ] Screening for HIV and other sexually transmitted diseases may be appropriate because of the poor impulse control and disregard of risk associated with personality disorder. [ ] Psychological

2008 Mentor

5979. Body Dysmorphic Disorder (BDD)

to send you our articles and latest news by email, giving you the best opportunity to stay up to date with expert written health and lifestyle content. By clicking 'Subscribe' you agree to our and . Subscribe Thanks for your feedback. if you would like to report a specific issue with this page, please visit our . Thank you, we just sent a survey email to confirm your preferences. Further reading and references ; Screening tools for body dysmorphic disorder in a cosmetic surgery setting. Laryngoscope (...) likely to have lifetime suicidal ideation, as well as lifetime major depressive disorder and a lifetime substance use disorder. See also the separate article. The General Practitioner's role [ ] The National Institute for Health and Care Excellence (NICE) recommends referral to a specialist multidisciplinary team offering age-appropriate care. This is unlikely to be available in many areas, due to lack of resources; however, it is worth getting in touch with local mental health trusts to see what

2008 Mentor

5980. Assessment of Drug Dependence

depressive state i was in i relapsed, back on subs... Tez22 Health Tools Feeling unwell? Assess your symptoms online with our free symptom checker. Article Information Last Reviewed 06 November 2014 Next Review 05 November 2019 Document ID 8720 (v4) Author Peer reviewer Dr John Cox The information on this page is written and peer reviewed by qualified clinicians. Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Patient Platform (...) use, including quantity, frequency and pattern of use. Alcohol dependence symptoms. Drug testing Staff performing drug testing should be competent in taking samples and, if appropriate, in reading results. Laboratory testing must be done in accredited laboratories. Screening tests : these are usually carried out first. They are quick, cheap and easy. They are usually done using immunoassay and can be done in the laboratory or using point of care or dipstick tests. Negative results can be reliably

2008 Mentor

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