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Phase 3a- flashcards I forget > 3A- Psychiatry > Flashcards

3A- Psychiatry Flashcards

1
Q

what medications are used to manage alcohol dependance?

A
  • acomprosate
  • disulfiram
  • naltrexone
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2
Q

what is the function of acomprosate?

A

used in alcohol dependance

reduces cravings

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3
Q

what is the function of disulfiram?

A

used in alcohol dependance

gives hangover type side effects when alcohol is consumed

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4
Q

what is the function of naltrexone?

A

used in alcohol dependance

reduces the pleasure from drinking

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5
Q

management of alcohol withdrawal

A

chloridazepoxide

IV Pabrinex 5 days

thiamine 100mg BD

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6
Q

clinical presentation of delirium tremens

A
  • altered conciousness
  • marked cognitive impairment
  • vivid hallucinations and illusions (can be in any sensory modality):
    1- lilliputian (visual hallucination of small humans/ animals)
    2- formication (insects on skin)
  • paranoid delusions
  • marked tremor
  • autonomic arousal- sweating, raised pulse and BP, fever
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7
Q

what triad is seen in Korsakoff’s syndrome?

A

anterograde amnesia

confabulation

psychosis (lilliputian/ formication)

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8
Q

what are the subtypes of schizophrenia (just the names)

A

paranoid

hebephrenic

catatonic

residual

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9
Q

subtypes of schizophrenia- paranoid

A
  • delusions
  • auditory hallucinations
  • NO THOUGHT DISORDER
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10
Q

subtypes of schizophrenia- hebephrenic

A

thought disorder and flat affect

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11
Q

subtypes of schizophrenia- catatonic

A

subject may be immobile or exhibit agitated, purposeless movement

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12
Q

subtypes of schizophrenia- residual

A

positive symptoms present at a low intensity

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13
Q

pharmaceutical treatment pathway for schizophrenia

A

1st- atypicals- respiridone, olanzapine, quetiapine, aripiprazole etc

2nd- 1st gens- haloperidol/ chloropromazine

3rd- clozapine (if treatment resistant schizophrenia)

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14
Q

side effects of Lithium

A 
course tremor
hyperreflexia 
seizures
heart block 
weight gain 
hypothyroidism 
impaired renal function 
hypotension 
impaired consciousness
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15
Q

treatment pathway in depression

A

1st- SSRI (fluoxetine, citalopram, sertraline)

2nd- alternative SSRI

3rd- NaSSA- mirtazepine
SNRI- venlafaxine/ duloxetine

4th- TCA (amitryptyline, clomipramine)
anti-cholinergic/muscarinic
MAOI’s- moclobemide

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16
Q

why is clomipramine used in the management of OCD?

A

specific non-obsessional action

17
Q

pharmaceutical management of panic disorder

A

1st- SRRI (sertraline)

2nd- TCA (clomipramine)

18
Q

treatment of neuroleptic malignant syndrome

A

bromocriptine (dopamine agonist)

dantrolene (reduces muscle spasms)

19
Q

treatment of serotonin syndrome

A

benzodiazepines

Cyproheptadine- 5HT-2a antagnoist

20
Q

what blood results are present in patients with neuroleptic malignant syndrome and serotonin syndrome?

A

raised CK and WCC

deranged LFT’s

metabolic acidosis

21
Q

what is delusional perception?

A

delusional belief resulting from a real perception (e.g. red light meaning the police are on the way)

22
Q

what is an extracampine hallucination?

A

hallucination that is outside the limits of the sensory field- e.g. hearing voices in another city

23
Q

what is a hypnagognic hallucination?

A

hallucination occuring when falling asleep

24
Q

what is a hypnopompic hallucination?

A

occurs when waking up

25
Q

what is CIWAR?

A

A questionnaire that is used to objectify alcohol withdrawal severity in order to help guide therapy.

26
Q

what physical illnesses need to be ruled out in a suspected diagnosis of anxiety

A
  • hyperthyroid
  • pheochromocytoma
  • hypoglycaemia
  • anaemia
  • cardiac disease
  • withdrawal from alcohol/ benzodiazepines
  • rule out other psych disorders

medication causes- salbutamol, corticosteroids, antidepressants, caffiene

27
Q

tx of OCD

A
  • exposure and response prevention (ERP)
  • SSRI’s- fluoxetine
  • TCA- Clomipramine (specific non-obsessional action)
28
Q

Tx of panic disorder

A

recognisiton and diagnosis, breathing tips etc

CBT
SSRI- sertraline
TCA- Clomipramine (2nd line)

29
Q

what is Somatisation disorder?

A

A long history of multiple and severe physical symptoms that cannot be accounted for by a physical disorder or other psychiatric disorder

symptoms are real !!

30
Q

what is a factitious disorder

A

symptoms and signs made up- playing the sick role

31
Q

what is malingering

A

psychological and physical symptoms that are manufactured or exaggerated for

a purpose other than assuming the sick role, e.g.
evading the police, obtaining compensation, getting a bed
for the night. Malingering is not a psychiatric disorder.

32
Q

suicide risk assessment and management

A

Sex (male)
Age (young or old)
Depression
Previous attempts?
Ethanol abuse- alcohol !
Rational thinking loss (e.g. Schizophrenia)
Supportive network loss
Organised plans (notes, alone, avoiding detection)
No significant others (no friends/ family)
Sickness- physical disease

0-2= send home but signpost
3-4= check ups with GP 
5-6= consider hospitalisation (involuntary or voluntary)
7-10= definitely hospitalise- can be involuntary
33
Q

what is section 4 of the MHA

A

72h

emergency- when waiting for the 2nd doctor would cause delay

1 doc 1 AMHP needed

reason- mental disorder, detained for own safety and not enough time for 2nd doc to attend

34
Q

describe a section 5(4)

A

Section 5(4)

  • In hospital
  • The patient is already admitted to hospital but is wanting to leave (NOT A&E- NOT TECHNICALLY ADMITTED)
  • Nurses’ holding power until doctor can attend
  • 6 hours long
  • Cannot be treated coercively whilst under section
35
Q

describe a section 5(2)

A

Section 5(2)

  • For a patient already admitted but wanting to leave
  • Doctors holding power- 72 hours
  • Allows time for a section 2 or section 3 assessment
  • Cannot be coercively treatment
36
Q

5 principles of the mental health act

A
  • assume capacity
  • individual supported to make own decisions
  • unwise decision do not mean lack of capacity
  • best interests
  • least restrictive practice
37
Q

describe the capacity assessment

A

any impairment of the mind/ brain?

is the person able to:

  • understand
  • retain
  • weigh up
  • communicate their decision

TIME AND DECISION DEPENDENT

RETENTION ONLY NEEDED FOR TIME TO MAKE DECISION

38
Q

Differences between bipolar 1, II and cyclothymia

A

bipolar I= mania + major depression

Bipolar II= hypomania + major depression

Cyclothymia= hypomania + minor depression (for 2 years)

Phase 3a- flashcards I forget (8 decks)

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