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phase 3a > 3a Psychiatry > Flashcards

3a Psychiatry Flashcards

1
Q

triad for wernickes syndrome

A

ataxia
confusion
opthalmoplegia

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2
Q

Give 4 Sx of mild-moderate lithium toxicity

A

abdominal pain
diarrhoea
polyuria/dipsia
coarse tremor

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3
Q

give 4 Sx of severe lithium toxicity

A

agitation
slurred speech
seizures
renal failure

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4
Q

side effects to
lithium use

A

Leukocytosis
Insipidus
Tremor (fine - therepeutic dose, coarse - toxicity)
Hypothroid
Increased weight
u
Metallic taste

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5
Q

after trialling 2 atypical antispychotics, whats next best Tx

A

clozapine; agranulocytosis

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6
Q

what is the criteria for assisted withdrawal for alcohol

A

> 15units per day
20 on AUDIT questionnaire

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7
Q

pathological finding in the brain for Alzheimer’s disease

A

widespread cerebral atrophy
amyloid plaque
tau protein tangles

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8
Q

which condition are alpha synuclein cytoplasmic inclusions seen in

A

Lewy body dementia

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9
Q

which class of drug in dementia is contraindicated in a patient with QT prolongation

A

anti-cholinesterase inhibitors

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10
Q

most significant risk of long term antispychotic use

A

risk of stroke
Weight gain and abnormal lipid profile –> this increases risk of stroke

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11
Q

time frame to have postnatal depression

A

d3epressive Sx within 12months of giving birth

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12
Q

minimum amount of days required to reinduce methadone for opiate therapy

A

> 5 days

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13
Q

2 side-effects of amitriptyline/Imipramine

A

dry mouth
urinary retention
blurred vision
constipation

Anticholinergic effects

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14
Q

4 Sx for NMS

A

sweating
fever
fluctuating BP
rigdity
confusion
tachycardia

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15
Q

blood marking sugestive of NMS

A

raised creatinine kinase

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16
Q

before commencing lithium as a TX which blood test is conducted

A

TFTs

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17
Q

Px with post Partum psychosis, what is best first line course of management

A

organise admission to a mother and baby unit

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18
Q

which blood result are you most likely to see in a Px with anorexia

A

hypercholestrolaemia

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19
Q

which psychiatric medication can cause erectile dysfunction

A

SSRI

Citalopram

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20
Q

which dementia would we will not give an antipsychotic in

A

demntia with lewy body

Parkinsonism

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21
Q

triad for normal pressure hydrocephalus

A

Wet, wobbly, weird

urinary incontinence
difficulty mobilising
personality change

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22
Q

define Pica

A

eating non-food items / food item in obscene quantities

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23
Q

side effect / thing that needs monitoring on SNRIs

A

BP

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24
Q

ECG change when using TCA

A

prolonged QRS
QTc interval

Also metabolic acidosis

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25
Q

which mental health can be used for Involuntary detainment for an assessment

A

section 2

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26
Q

most common side effect clozapine

A

constipation

Agranulocytosis is serious SE but its rare

27
Q

tx for akathesia

A

Procyclidine

28
Q

for heroin withdrawal, best first line management

A

supportive care and symptomatic Tx

29
Q

define agnosia

A

inabvaility to recognise people/objects/place Px once knew

30
Q

how long should ssri in OCD be continued for once Px feels better

A

12 months

31
Q

in bulimia, what initial investigation should be done

A

U&Es
particularly if using diuretics; loss of electrolytes

32
Q

ECG changes found in haloperidol use

A

prolonged QT interval

33
Q

which med can improve cognitive function in alzheimers disease

A

donepezil

Acetylcholinesterase inhibitor

34
Q

what demenetia are patients with down syndrome most likely to get

A

alzheimers

35
Q

amphetamines plus SSRIs can lead to what

A

serotonin syndrome

36
Q

in refeeding syndrome what electrolyte imblances could you see

A

hypophosphataemia

37
Q
A
38
Q

Is there an age limit for 1 week follow up after using sertraline

A

Yeh
30y/o cut off

39
Q

4 clinical features to NMS

A

Hyperthermia

Altered mental state

Autonomic dysregulation

Rigidity

A 42-year-old male presents to A&E feeling unwell for the past 48 hours. He feels feverish and is concerned as he has developed a tremor. He was recently diagnosed with schizophrenia and commenced on medication last week, but he cannot remember the name or the dose. On examination, there is evidence of muscle rigidity. His AMTS is 4/10. His vital signs are: HR 103bpm, RR 21 breaths per min, O2 saturations on air 98%, BP 138/82mmHg, temperature of 38.5.

40
Q

another name for nephrogenic diabetes insipidus and what psychiatric complication is linked to

A

arginine vasopressin resistance
(AVP-R)

complication of lithium S/E

41
Q

define autoimmune encephalitis

A

non-infectious neuroinflammation altered mental status.

Triggered by * previous viral infection
seizures
psychosis
cognitive impairment*.

42
Q

name the phenomenon in Parkinson’s disease where Px gets stuck on word in a sentence and repeats it over again

A

logoclonia

43
Q

which electrolyte imbalance is seen in a panic disorder

A

Hypocalcaemia

44
Q

why is hypocalcaemia seen in panic disorder

A

panic disorder Px is hyperventilating -> reduced CO2 (blowing off more) -> causes alkalosis.

alkalosis promotes calcium to bind to albumin therefore more being used up; reducing free calcium

45
Q

in anorexia if PX has pan-systolic murmur with ‘click’
what does that suggest

A

loss of myocardium

46
Q

what is de clerambault syndrome

A

delusional disorder that someone is in love with them

i.e. erotomania

47
Q

what class of drug is chlorphenamine and what SE can it cause

A

H1 antagonist
- has anticholinergic activity

high risk of inducing acute delirium
as well as
anti-cholinergic effects; dry mouth, constipation, blurred vision, urinary retention

48
Q

if anorexic Px come in with dizziness and confusion, what blood test is important to conduct

A

cap blood glucose

need to rule out hypoglycemia

49
Q

when are SSRIs contraindicated

A

Warfarin
- give 2nd line instead; SNRI

50
Q

when are SNRIs contraindicated

A

in uncontrolled hypertension

51
Q

what would u give if SSRI and SNRI are both contraindicated

A

give NaSSA
Mirtazapine

52
Q

first line SSRI in patient with anorexia who needs to also gain weight

A

mirtazapine

Olanzapine isn’t 1st line for anorexics because of its other SE

53
Q
A
54
Q

Triad of Sx for normal pressure hydrocephalus

A

Dementia
Gait disturbance
Urinary incontinence

55
Q

Most common side effect of sertraline.

A

GI disturbance
Diarrhoea - can be constipation in some Px though
Gastric ulcer
Sexual dysfunction

56
Q

Give one predisposing factor for anorexia

A

Dieting

57
Q

3 Sx of clozapine toxicity

A

Confusion

Ataxia

Drowsiness

Tachycardia

58
Q

If Px s on 2nd gen antipsychotic;
Displaying confusion, diaphoresis, rigidity, pyrexia
What does he likely have and how do we investigate it

A

NMS

Creatinine kinase

59
Q

2nd line Tx for Alzheimer’s

A

Add Memantine (NMDA class)
to 1st line; Donepezil/galantamine/rivastigmine

60
Q

Area of brain responsible for fight or flight

A

Amygdala

61
Q

Side effect of memantine

A

Constipation

Used in severe Alzheimer’s

62
Q

If stem suggests heavy alcohol use in an acute setting what blood would we want to check

A

Blood glucose
Risk of hypoglycaemia

63
Q

Sodium valproate side effects

A

Remember as VALPROATE

Vomiting

Alopecia

Liver toxicity

Pancytopenia

Retention of fats (weight gain)

Oedema

Anorexia

Tremor

Enzyme inhibition

64
Q

Lithium levels >3. Prompt what

A

Consider Haemodialysis

  • prevent seizure

phase 3a (4 decks)

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