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Psychiatry > BAP guidlines; diagnosis and treatment > Flashcards

BAP guidlines; diagnosis and treatment Flashcards

1
Q

Significant anxiety symptoms, impaired function with a history of trauma and flashbacks?

A

PTSD

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2
Q

Significant anxiety symptoms, impaired function with obsessions +/- compulsions

A

OCD

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3
Q

Significant anxiety symptoms, impaired function with uncontrollable worry about several areas

A

GAD

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4
Q

Significant anxiety symptoms, impaired function with intermittent panic/anxiety attacks due to a fear of social scrutiny?

A

Social phobia

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5
Q

Significant anxiety symptoms, impaired function with intermittent panic/anxiety attacks due to a discrete object/ situation?

A

Specific phobia

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6
Q

Significant anxiety symptoms, impaired function with intermittent panic/anxiety attacks which is uncued/spontaneous?

A

Panic disorder

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7
Q

Management of GAS?

A

CBT

Pharmacological: SSRI, duloxetine, pregabalin, quetiapine and benzodiazepines

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8
Q

Difference between management of GAD and panic disorder?

A

Can consider TCA in panic disorder

Consider anticonvulsants; gabapentin and sodium valproate

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9
Q

Which medications should be avoided in panic disorder?

A

Propranolol
Buspirone
Bupropion

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10
Q

Added treatment in OCD management?

A

Clomipramine

Psychological: exposure therapy, CBT

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11
Q

Indication for antidepressant use?

A

Moderate or severe depression in adults irrespective of environmental factors and depression symptoms profile
Depression of any severity that has persisted for more than 2 years
Short term in mild/mod depression

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12
Q

When should ECT be considered as a 1st line?

A

Major depression in urgent and emergent situations such as: depressive stupor, high risk of suicide, extreme levels of distress, poor fluid intake

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13
Q

Symptoms of depression

A

Depressed mood
Loss of interest in activities
Significant wt loss
Insomnia or hypersomnia
Fatigue or energy loss
Feeling of worthlessness or inappropriate guilt
Recurrent thoughts of death or suicidal ideation
Symptoms causing significant reduced functionality

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14
Q

Choice of antidepressant?

A

SSRI (better cardiac profile and MUCH less dangerous in overdose)
Mirtazapine if sedation and weight gain desired
SNRIs

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15
Q

Mania in bipolar disorder?

A

Dopamine antagonist antipsychotics
Valproate
Lithium

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16
Q

Depression in bipolar disorder?

A

Quetiapine
Olanzapine +/- fluoxetine
Antidepressants
Lamotrigine

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17
Q

Long term maintenance of bipolar disorder?

A

Lithium (mania, depresino, suicide)
Valproate and dopamine antagonists ( mainly mania)
Lamotrigine (mainly depression)

18
Q

What is PTSD?

A

Delayed or protracted response to stressful event of an exceptionally threatening or catastrophic nature, which is likely to cause pervasive distress in almost anyone

19
Q

Sy of PTSD?

A 
Flashbacks 
Nightmares
Numbness and emotional blunting 
Detachment from people 
Anhedonia
Avoidance of activities reminiscent of trauma
Autonomic hyperarousal; hypervigilance, enhanced startle reaction, insomnia
Anxiety and depression
20
Q

Hypomania

A

Persistent mild elevation of mood, increased energy and activity
Usually marked feelings of well-being and both physical and mental efficient
Increased sociability, talkativeness and over familiarity
Increased sexual energy
Decreased need for sleep
Irritability

21
Q

Do you get hallucinations or delusions in hypomania?

A

No

22
Q

What delusions and hallucinations tend to accompany mania?

A

Grandiose delusions
Hallucinations; voices speaking directly to patient
Tends to be mood congruent

23
Q

What is cyclothymia?

A

Persistent instability of mood which are not sufficiently severe or prolonged to justify a diagnosis of bipolar affective disorder

24
Q

What is dysthymia?

A

Chronic depressed mood, lasting several years which is not sufficiently severe to justify a diagnosis of depressive disorder

25
Q

Mild depressive disorder?

A

2 or 3 biological symptoms

Still functioning

26
Q

Mod depressive disorder

A

4 or more biological symptoms

Great difficulty in continuing with ordinary activities

27
Q

Severe depressive disorder?

A

Several of biological symptoms are marked and distressing; typically loss of self-esteem and ideas of worthlessness and guilt
Suicidal thoughts common

28
Q

Anorexia nervosa?

A 
Deliberate weight loss, induced and sustained by the patient 
Dread of fatness
Undernutrition 
BMI of less than 17.5 
Restricted dietary choice
Excessive exercise
Induced vomiting and purgation 
Use of depressants and diuretics
29
Q

Bulimia nervosa

A

Repeated bouts of overeating and an excessive preoccupation with control of body weight leading to a pattern of overeating followed by vomiting or use of laxatives

30
Q

Core symptoms of depression?

A

Depressed mood
Reduced enjoyment or interest
Decreased energy

31
Q

Additional symptoms of depression

A 
Loss of confidence
Guilt 
Suicidal ideas or behaviours 
Poor concentration 
Agitation/ retardation 
Sleep disturbance 
Changes in appetite
32
Q

Threshold for moderate depression?

A

2 core
4 others
6 in total

33
Q

Threshold for severe depression

A

All 3 core symptoms
5 others
8 in total

34
Q

Atypical depression

A

Mood reactivity (mood brightens in response to positive events)
2 or more:
Weight gain
Hypersomnia
LEaden paralysis
Long-standing pattern of interpersonal rejection sensitivity

35
Q

Cotard’s syndrome

A

Subtype of psychotic depression

Nihilistic delusions

36
Q

5 Rs of depression?

A 
Response 
Remission 
Relapse 
Recovery 
Recurrence
37
Q

Bipolar 1

A

Mania

Depressive

38
Q

Bipolar 2

A

Hypomania

Depressive episode

39
Q

Hypomanic symptoms

A 
Inc activity or phsical restlessness
Increased talkativeness
Difficulty in concentration or distractibility 
Dec sleep 
Inc sexual energy 
Mild spending sprees 
At least 4 days
STILL FUNCTIONING
40
Q

Manic episode

A 
At least 1 week
Inc activity 
Inc talkativeness
Flight of ideas
Loss of social inhibitions 
Dec sleep
Grandiose delusions 
Distractibility or constant changes in activity or plans
Reckless behaviour
Marked sexual energy or sexual indiscretions 
NOT FUNCTIONING
PSYCHOSIS

Psychiatry (35 decks)

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