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Question 1

What symptoms define psychosis?

Answer 1

• Delusion
  
  • a false FIXED belief that is held in absence of evidence
• Hallucination
  
  • perception of something in the absence of external stimuli
• Formal thought disorder
  
  • disorder in the form of thought

Can have just one or all three but need at least one for psychosis to be present

Question 2

Define
- persecutory delusion
- referential delusion
- Circumstantiality

Answer 2

Persecutory delusion - being targeted

referential delusion - believing that there is a message for them personally in movies, life etc.

Circumstantiality - when conversation takes ages to get to the point

Question 3

What is the differentials be for psychosis?

Answer 3

• Schziophernia
• Depressive psychosis
• Autoimmune encephalitis
• Drug induced pyschosis
  
  • related to dopernagic drugs e.g. cocaine particularly crack, speed
• thyroidtoxicosis

Question 4

How can you help identify schizophrenia?

Answer 4

CHRONIC condition

Positive symptoms
- thought disorder
- hallucinations
- delusions

Negative symptoms
- apathy
- withdrawn
- difficulties with concentration

Question 5

Flight of ideas vs Knights’ move thinking

Answer 5

Conversation all over the place but with link

Knights move thinking - all over the place but w/o link

Question 6

Name examples of typical/first gen and 2nd gen/atypical anti-psychotics

What is the main side effects

Answer 6

Typical
- haloperidol
- chlorpromazine

Atypical
- clozapine
- olanzapine
- quetiapine
- risperidone

1st gen - extra-pyramidal side effects (DO NOT USE IN PARKISONS)

2nd gen - weight gain and sedation
Clozapine - agranulocytosis

Question 7

In what circumstances is IV acteyloine given without paracetamol levels taken first or before recieving paracetomol levels?

Answer 7

Staggered OD or unknown quantity or present 8-24hrs post taking and have taken >150 mg/kg

Question 8

What defines pressured speech?

Answer 8

Difficulty to interrupt

Will be fast but people that are anxious can talk fast

Question 9

What is the difference in hypomania and mania?

Answer 9

Exactly the same

If have psychotic symptoms/being reckless = mania (regardless of time scale)

Hypomania - lasts 4 days
Mania - has to last at least a week

Question 10

Differential diagnosis of mania

Answer 10

Bipolar disorder
Drug induced - cocaine

Question 11

How do you manage mania?

Answer 11

1. Antipsychotic
   +/- Benzos

Question 12

What side effect should patients be warned off when starting SSRIs so they don’t stop?

Answer 12

Nausea + can make you worse before you get better - takes at least 3/4 weeks to see an effect