精神科 他 メモ
・精神科入院 精神保健福祉法
同意あり… 任意入院
なし … 医療保護入院、措置入院、応急入院
・脳波の読み方
at rest or not
基礎律動 電位、周波数、場所、左右差、出現量
徐波は? sporadic (0-3), random (4-7), scattere (7-10)
突発活動
開閉眼(EOT) α attenuation + or -
PV 光刺激 driving - or +
HV 過呼吸 build up - or +, rebuild up - or +
sleep
・SGB
適応: アレルギ―性鼻炎、動眼神経麻痺、顔面神経麻痺、
2回/day、15日やるとけっこういい。その痕は週1〜2回で
凍傷 …切断寸前だったものもけっこくよくなる
視床痛 …ECTとともにSGBもやる
突発性難聴 …1週間以内なら8割はなおる(この施設なら)。自然治癒率3割、2週目だとつらい…
痛み… サーモグラフィでバランス崩れていることあり
・DMに…
抗精神薬、低血糖発作おきにくくする
βブロッカー、ステロイド、も。
炭水化物でBS如実にあがる。食事内容はたいせつ。
・アスペルガー 精神療法きかない
・摂食障害
女性化否定、「母親みたいにはなりたくない」
・本人つらそうなとき…
統合失調症もありうる。「単純型統合失調症」。幻聴などない。微細な思考障害。
「自明性の消失」。他の人があたりまえと思っていることができない。
統合失調症も神経症的に始まることあり
・ガスモチン
SSRIと一緒につかっても打ち消しあわない?
・解離性障害
下手に精神療法などすると症状を深くすることあり。ほっとくくらいのほうがいい。
(昔は深く気持ち引き出したが…)
・脳振盪
脳波が便利
・抗精神薬で、EEG速波多くなる
・EEGは徐波がヤバイ
・EEG、正常なら揺れる。ずっとαがつづくのは、高齢者。
・EEG、bypolarで局所を見る
・眠りに就くときてんかんでやすい
・Spindle 14Hz
・不貞妄想
・セロクエル 認知症に
アリセプト アルツハイマーに
・ECT
健忘の副作用あるから施行前に認知機能check必要
・患者
1000人なか、診療所に350、病院に80
・健診など、Drいなくてもできるが限界あり
・研修、キャリアパスの変化
昔みたいな徒弟制なら長く射ることが重要だったが。今は、パッケージ化。
・BPPV
「めまいおきそう感」あり。すっとよくなることあり。
・うつscreening
S Sleep
I loss of interest
G gilty
E energy
M move
C concentration
A apatite
P psychomotor agytation
S suicide
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