Mental Health Nursing II & Pharmacology III Revision Guide

According to the Mental Health Act, only a qualified medical officer (doctor with psychiatric training or designated authority) can sign an urgency order for involuntary admission. This ensures medical assessment and legal accountability. The order allows detention for up to 72 hours for assessment and emergency treatment.

Reception is the simplest and fastest admission procedure where a patient (or family) voluntarily seeks admission without legal formalities. It requires consent and basic registration. No court orders or medical officer signatures needed. Contrast with urgency order (involuntary, requires medical officer) and temporary detention (police-initiated).

Serotonin imbalance is a biological/neurochemical factor, not psychogenic. Psychogenic factors are psychological in origin - thoughts, beliefs, experiences. Serotonin deficiency is a biochemical correlate of depression but is not a psychological cause. The question asks specifically for psychogenic (psychological) factors.

A scary and angry tone is confrontational and escalates violence. It provokes fear and defensiveness, increasing agitation. De-escalation principles require calm, respectful communication. The tone should be low, slow, and non-threatening. Matching anger with anger violates therapeutic communication and risks staff/patient safety.

Pharmacological management is NOT paramount in separation anxiety disorder. Psychotherapy (especially CBT) is first-line. Medication (SSRIs) is only adjunct for severe cases or comorbid conditions. The disorder is treated primarily through behavioral interventions, gradual exposure, and family dynamics modification. Over-reliance on medication is inappropriate.

Witchcraft is a cultural belief, not a medical cause of epilepsy. Epilepsy has identifiable pathophysiological causes. Attributing seizures to witchcraft leads to stigma, delayed medical treatment, and harmful traditional practices. All other options are well-established medical etiologies with clear neurobiological mechanisms.

The dopamine hypothesis of schizophrenia proposes that positive symptoms (hallucinations, delusions) result from hyperactivity of dopamine transmission in mesolimbic pathways. This is supported by: (1) antipsychotics block D2 receptors, (2) dopamine agonists (amphetamine) produce psychosis, (3) increased dopamine receptors in post-mortem brains. Modern theory includes glutamate and serotonin involvement too.

Identifying triggers is a realistic, skill-based goal that empowers self-management. This is the foundation of CBT - recognizing antecedents allows application of coping strategies. It's achievable, measurable, and prevents relapse. Eliminating all anxiety is unrealistic (some anxiety is adaptive). Suppressing feelings is maladaptive. Crisis counselor contact is supportive but not a self-management skill.

This approach provides supportive presence without overwhelming the catatonic patient. Silent sitting conveys acceptance and availability. Simple, open-ended questions ("Would you like to sit up?") allow response without pressure. It respects their withdrawal state while maintaining therapeutic contact. Direct questions (b) increase stimulation, leaving alone (a) is neglectful, grouping with similar patients (c) provides no therapeutic benefit.

Dementia is a neurodegenerative disease not typically caused by PTSD. While PTSD can cause cognitive deficits (attention, memory), these are usually reversible with treatment and don't progress to dementia. The other options are extremely common comorbidities: alcohol abuse (self-medication), chronic depression (shared neurobiology), and anxiety disorders (generalized anxiety, panic).

Class A drugs are controlled substances under narcotics laws (e.g., morphine, heroin, cocaine). They have high abuse potential and strict regulations for prescription, storage, dispensing, and record-keeping. In Uganda and most countries, they require special registers, double-locked cabinets, and accountability to narcotics boards.

Oxytocics stimulate uterine contractions (e.g., oxytocin, misoprostol, ergometrine). Used for induction/augmentation of labor, treatment of PPH. The term comes from "oxytocin," the natural hormone. Tocolytics do the opposite - relax uterus to prevent preterm labor.

Hydrocortisone has the shortest biological half-life (8-12 hours) among the options, making it a short-acting corticosteroid. It's the drug of choice for adrenal insufficiency and stress coverage. Betamethasone and dexamethasone are long-acting (36-72 hours), prednisolone is intermediate-acting (18-36 hours).

Codeine is used as an antitussive at low doses (10-30 mg) where it suppresses the cough center in the medulla. It has lower analgesic potency than morphine but effective cough suppression. Found in many OTC cough syrups (though increasingly restricted due to abuse potential). Pethidine and morphine are too potent and sedating for routine cough suppression. Tramadol is synthetic with different mechanism.

Methotrexate is an immunosuppressant used for severe psoriasis, eczema, and other autoimmune skin diseases. It inhibits dihydrofolate reductase, suppressing rapidly dividing cells and immune function. Given weekly (not daily) to minimize toxicity. Requires CBC and LFT monitoring due to hepatotoxicity and myelosuppression.

Acyclovir is an antiviral specific for herpesviruses (HSV-1, HSV-2, VZV). It inhibits viral DNA polymerase. Used for chickenpox (varicella) and shingles (zoster) if started within 24-72 hours of rash onset. Reduces severity, duration, and complications.

These are the three most common chemotherapy side effects due to effects on rapidly dividing normal cells: GI mucosa (vomiting), hair follicles (alopecia), bone marrow (myelosuppression). They occur in >50% of patients. "Autotoxicity" and "atotoxicity" are vague terms. Weight gain and psychosis are uncommon.