505 screening test characteristics

positive predictive value is low

Sensitivity is true positives specificity is true negatives they not related to the prevalence of the
disorder positive predictive value is the percentage of true positives people with the disorder in
the define population negative predictive power is the prediction of true negatives people
without the disorder in the define population reliability of a test is how will the test performs by a
second rater ,test-retest reliability and how will items correlate with each other,internal
consistency, not affected by prevailance
PPV = (sensitivity x prevailance)/ (sensitivity x prevailance) +( 1- specificity) x 1- prevailance

506 body mass index of the 36 year old woman

woman has BMI of 20
BMI was previously known quartet index, healthy BMI is usually quoted between 20-25 in
adults, young woman normal BMI between 19 and 24, BMI less 18 is underweight and requires
assessment, BMI less than 16 definitely abnormal, less than 14 seriously emaciated, BMI in
children and adolescenct needs to be adjusted for age, between 25-29 overweight, 30- 39
obese 40 or more morbidly obese ,mean BMI of Australian population is 25
BMI is a method of assesing body mass or estimate of fatness ,it is an easily calculated
estimate , it can identify children and men incorrectly who exercise a lot, George Clooney
overweight in 2009 combination of BMI and measurement of waist circumference may be useful
in this instance

507 personality disorder with character stick behaviour pattern

narcissistic personality disorder
Narcissistic personality disorder progressive pattern of self-importance grandiosity craving for
attention and admiration and a lack of concern and regards for others, individuals are easily
identifiable in the community and the workplace as celebrities politicians etc
Generally the behavioral pattern is not consistent with the individual's culture and causes
suffering to others or the person

508 Where can i see insomnia and despondency in a 19 year old woman
suicide ideation
severe weight loss due to bereavement ask about suicide ideation or plans which are the
potentially lethal outcome of major depression due to complicated bereavement and require
immediate action

509 schizophrenia
 unlikely that there are any other cases of schizophrenia in the class of 100 student
point prevalence of schizophrenia is around 1% in the general population, single or cross
sectional measurement of the number of affected individuals in a population is percentage or
rate per 1000 at risk

510 consent for ect in 40 year old

ect does have one level evidence for efficacy from randomised control trials, when compared
with sham ect and antidepressants
ect is associated with memory loss when the patient is being administered the ect and there is
no evidence of continued memory loss once treatment is completed

511 risk factors for eating disorders

sexual abuse in children
are risk factors to mood and eating disorder or substance abuse

512 Insomnia and lethargy in a 72 year old man

suicidal ideation mandatory
Physical symptoms -sleep disturbance, headache, pain and ache, staying home is a behavioral
symptom, person has moderate to severe depression and thus exploring the possiibility of
suicidal ideation, even if it turns out that there is a physical disorder which is a cause of sleep
disturbance, waking in the middle of the night and not being able to get back to sleep known as
middle insomnia is characteristic of moderate depression, complaint of aches, pain and
headaches is a prominent symptoms of depression, social withdrawal is another pointer to
depression may be apart of wider loss of interest in usual pleasures is more prominent than
depressed mood

513 Abdominal discomfort in A 29 year old woman on sertaline

As the woman has clinically responded to the medication continue with another antidepressant
from the same class
a well recognised side effect of sertaline is abdominal pain after 1 week after treatment, as the
women have responded with treatment continue with another antidepressant from the same
class with similar mode of action but different side effect profile

514 site of self inflicted injury in Australia

wrist
Self cutting is common among some cultural groups in the community, where it is socially
acceptable as a rite of passage or a prerequisite in order to belong, simple forms include body
piercings or tattoos or social political or religious protests or conviction, accounts for less than
5% deliberate self-harm attempts, drug overdose that counts for above 80% ,self cutters of
wrist are single and unemployed males between 15 to 24 who misuse alcohol and have low
suicidal intent, but frequently have a history self harm episodes, adolescent and young women
who cut themselves usually cut