Unexplained Symptoms

Question 1

are unexplained symptoms common?

Answer 1

yes

- 50% of GP patients

Question 2

give some examples of unexampled symptoms ?

Answer 2

poor memory 
poor concentration
headaches
altered sense of taste
altered sense of smell
tinnitus
dizziness
funny turns 
fatigue
weakness
tingling
pain

Question 3

what three things may cause a disturbance between symptoms and underlying pathology?

Answer 3

mood
emotion
behaviour

Question 4

what is the sick role ?

Answer 4

when someone is ill

• they are exempt from social norms
• not responsible for their condition
• person should want to get well and seek medical advice

Question 5

what is illness behaviour ?

Answer 5

different perceptions people have about illnesses and symptoms

• symptom significance and perception
• consultation behaviour
• treatment compliance

Question 6

what two things are patients with unexplained symptoms more likely to do?

Answer 6

more likely not to have a job

more likely to be on benefits

Question 7

is there is close relationship between physical and psychological symptoms ?

Answer 7

yes

Question 8

state three physical manifestations of anxiety ?

Answer 8

autonomic 
- sweating, palpitations, dizziness
increased motor tone 
- tremor, muscle pain 
hyper vigilance 
- poor concentration, insomnia, easily startled

Question 9

state three physical manifestations of depression ?

Answer 9

sleep 
weight 
appetite 
libido 
energy levels
posture 
pain perception

Question 10

is parkinsons relapsing or progressively worsening ?

Answer 10

progressively worsening

Question 11

what is hypochondriasis?

Answer 11

fear of illness
persistent belief of unidentified disease
request for repeated reassurance
request for repeated investigation

Question 12

what is a good question to ask someone of depression ?

Answer 12

do your symptoms get you down?

Question 13

what is a good question to ask someone of anxiety ?

Answer 13

do you get worried about your health

Question 14

what is somatisation disorder?

Answer 14

abnormal illness behaviour

- chronic symptoms and multiple unexplained symptoms

Question 15

what is conversion disorder?

Answer 15

loss of function which can mimic neurological disease

- patients isn’t conscious of mechanisms

Question 16

what is malingering ?

Answer 16

loss of function which can mimic neurological disease

- patient is conscious of mechanisms

Question 17

in what communities does malingering occur?

Answer 17

institutions

• boarding schools, strict religions
• compensation patients

Question 18

what are the multiple physical symptoms of chronic fatigue syndrome?

Answer 18

fatigue
arthralgia
myalgia

Question 19

what percentage of people with chronic fatigue syndrome have a psychiatric diagnosis ?

Answer 19

70%

Question 20

what are some risk factors for non-epileptic attack disorder?

Answer 20

abuse 
neglect in childhood 
anxiety 
depression 
post traumatic stress disorder

Question 21

what is the management of unexplained symptoms ?

Answer 21

exclude physical disease 
carry out investigations and avoid over investigating 
psychiatric assessment 
explantation to patient 
MDT approach 
consider antidepressant drugs 
consider cognitive behavioural therapy