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Genetics > Classification in Psychiatry > Flashcards

Classification in Psychiatry Flashcards

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Biology 101 flashcards
1
Q

Sick euthyroid pattern?

A

Low T3.

Normal TSH and T4.

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2
Q

Brief Psychiatric Rating Scale

A 
Largely replaced by PANNS.
Assessed schizophrenia.
Clinican rated.
24 items. 
Each out of 7.
Higher score = worst disease.
Including guilt, self-neglect and suicidality.
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3
Q

Types of primary delusion?

What is a secondary delusion?

A

Delusional perception - A normal perception followed by a delusional interpretation
Delusional memory - The recollection of an event or idea that is clearly delusional in nature
Delusional mood - Delusion arising from a strange mood
Autochthonous delusion - A delusion that appears out of the blue (spontaneously), i.e. not following a perception, memory or mood

A secondary delusion arises out of an abnormal experience (i.e. a hallucination arising out of auditory hallucination).

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4
Q

BPRS

A

Brief psychiatric rating scale, used to assess psychotic and affective symptoms in people with functional mental illness.

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5
Q

Rating scales used in personality disorder

A

SAPAS (Standardised assessment of personality abbreviated scale)
FFMRF (Five factor model rating form)
IPDE (International Personality Disorder Examination Screen)
PDQ-R (Personality Diagnostic Questionnaire-Revised)
IPDS (Iowa Personality Disorder Screen)
IIP-PD (IIP Personality Disorder Scales)

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6
Q

First rank symptoms

Who came up with?
Seen in anything else?
Prognosis

A

Thought Insertion, Withdrawal, Broadcasting (delusions)
Running commentary, thought echo, voices heard arguing (auditory hallucinations)
Delusional perception
Somatic passivity (The patient believes that sensation are being imposed upon his body by an outside force.)
Made affect (belief that feelings are controlled by an outside force)
Made volition ( belief that impulses and/or behaviour are controlled by an outside force)

Kurt Schneider
Also seen in mood disorders and PD.
NOT pathagnomic therefore
No indication as for prognosis

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7
Q

Most common feature of schizophrenia

A

Apparently it is lack of insight

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8
Q

Who came up with original clinical description of catatonia?
What is:
- waxy flexibility (and what is the other name for it)
- mitmachen
- mitgehen
- other name for negativism? what is negativism?

A

Karl Ludwig Kahlbaum

waxy flexibility (cerea flexibilitas) - body can be put in strange positions and then stays
mitmachen- a form of automatic obedience whereby the body of the patient can be put into any posture, even if the patient is given instructions to resist. The body part immediately returns to the original position once the force is removed (unlike in waxy flexibility)
mitgehen - extreme form where a tap on the arm and it flies up

(Gegenhalten) - patient resists the attempts of the examiner to move parts of their body and, according to the original definition, the resistance offered is exactly equal to the strength applied

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9
Q

Somatostatin

Where made?
What does?

A

Hypothalamus

inhibits the secretion of thyroid-stimulating hormone and growth hormone from somatotrope cells.

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10
Q

Edinburgh Postnatal Depression Scale

Scores?

A

10-item self-report questionnaire
Designed as screen in primary . care
Does not cover harm to baby thoughts
0-9 The likelihood of depression is considered low
10-12 The likelihood of depression is considered moderate
13 or more The likelihood of depression can be considered high

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11
Q

Types of patient-doctor relationship

A

Paternalistic- Doctor decides tx. Patient is expected to comply.
Informative- Doctor provides info. Patient decides.
Interpretative - Doctor helps them make decision based on their circumstance. Ultimately shared decision.
Deliberative- doctor acts as friend. attempts to steer, but ultiamtely patient decision.

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12
Q

What were the 5 axes of DSM IV?

A

Axis I: clinical disorders, including major mental disorders, as well as developmental and learning disorders
Axis II: underlying pervasive or personality conditions, as well as mental retardation
Axis III: acute medical conditions and physical disorders
Axis IV: psychosocial and environmental factors contributing to the disorder
Axis V: Global Assessment of Functioning or Children’s Global Assessment Scale for children and teens under the age of 18

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13
Q

Major changes between DSM IV and DSM V?

A

Got rid of GAF –> not though to be relaible.
Austism, aspergers etc collated into ASD
Binge eating disorder, premenstrual dysphoric disorder, and hoarding disorder gained recognition as ‘real’

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14
Q

What are the five big personality traits?

A 
Openness to experience
Conscientiousness
Extraversion (aka surgency)
Agreeableness
Neuroticism (aka emotional stability)
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15
Q

WHat is a systematised delusion?

State 3 ways to describe structure of a delusion.

A

Highly organised, logical delusions are referred to as systematised.

Polarised - the delusion and fact are mingled together
Juxtaposed - the delusion and fact exist together but sit side by side and do not interact
Autistic - actual reality is not taken into account and the patient lives in a delusional world

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16
Q

What tests are used to test problem solving and decision making?

A

Tower of London, Cambridge stockings, gambling tasks

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17
Q

Abstraction tests?

A

Proverbs, similarities, cognitive estimates

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18
Q

5 major differences between DSMIV and ICD10?

A 
ICD 
Single axis
Multiple languages
Alphanumerical coding
Worldwide
10 major categories
DSMIV
Multi-axial
Single language
Numerical coding
National 
17 major categories
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19
Q

Which rating scales are self-rated?

A 
Edinburgh Postnatal Depression Score (EPDS)
Becks Depression Inventory (BDI)
GHQ (General health questionnaire)
GDS (geriatric depression scale)	
HADS 
ZSRDS (Zung self rated depression scale)
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20
Q

Which scoring system for mania?

A

YMRS (Young mania rating scale)

The YMRS is an 11-item instrument used to assess the severity of mania in patients with a diagnosis of bipolar disorder.

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21
Q

Which scoring system for OCD?

A

The Y-BOCS is used to measure both the severity of OCD and the response to treatment.

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22
Q

Which scoring system for schizoprhenia?

A

Originally brief psychiatric rating scale

Now usually Positive and negative syndrome scale

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23
Q

Which scoring system for anxiety?

A

HAMA (Hamilton anxiety rating scale)

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24
Q

Old lady with bilaterally small pupils that don’t dilate in dark and are sluggish to accomodation?
Difference between this and argyll robertson?

A

Senile miosis.
Difference is argyll robertson is found in those with syphyllis or diabetic eye disease, and these do not react to light but do accomodate

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25
Q

which rating scale specifically looks at changes brought on by antidepressants and other treatments

A

Montgomery asperg depression rating scale
The MADRS is a ten-item diagnostic questionnaire used to measure the severity of depressive episodes. It was designed to be more sensitive to the changes brought on by antidepressants and other forms of treatment.

26
Q

List four factors associated with depersonalisation.

A

Emotional numbness
Changes in sensory experience
Distorted sense of time
Heightened self observation

27
Q

Lesions of which area can lead to flight of ideas (as well as ocurring in mania (the usual time it happens)

A

Hypothalamus

28
Q

What is the SF36?

name 4 parts of it

A

The SF-36 (Short-form 36) is a 36-item, patient-reported survey that measures patient-rated functioning and well-being.

physical functioning
role limitations due to physical health problems
bodily pain
general health
vitality (energy/fatigue)
social functioning
role limitations due to emotional problems
mental health (psychological distress and psychological well being).

29
Q

Illusions.
What are they?
Name and describe 3 types.

A

an altered perception of a stimulus and differs from a hallucination in that in hallucinations there is no stimulus

Completion illusion - describe the tendency to fill in missing information in order to make sense of a stimulus
Affect illusion - due to specific mood (affective) states e.g. a woman is walking home in the dark and is frightened, she mistakes a tree for a tall man in a long coat.
Pareidolic illusion - arise when detailed images are seen from shapes. E.g. seeing the man in the moon, or Jesus Christ on a piece of burnt toast.

30
Q

Luria Motor series
what does it test
other tests in this area

A

Bundled into a series of tests that test set shifting and response inhibiton

Other tests: Alternating sequences, go-no-go test, Luria motor test, trail making test, Wisconsin card sorting test, Stroop test

set-shifting is an executive function that involves the ability to unconsciously shift attention between one task and another

31
Q

Which is the test that requires a clinician to know how they were in the past?

A

The Clinical Global Impression.

The CGI is a scale that requires the clinician to rate the severity of the patient’s illness at the time of assessment, relative to the clinician’s past experience with patients who have the same diagnosis.

32
Q

What does the term delusional misidentification syndrome mean?

Give examples

A

covers a group of disorders which are characterised by a belief that the identity of a person, object or place has somehow changed or has been altered.

Capgras- someone they know has been replaced by an exact double.
Fregoli- various people they meet are the same person in disguise
Intermetamorphosis- You think people have swapped identities while maintaining the same appearance (e.g. believing your brother is your father)
Subjective doubles- you think you have a doppleganger
Reduplicative paramnesia - (i) Place Reduplication means that two places exist that are identical, but geograhpically distant, (ii) chimeric assimilation; two places have combined e.g. home and hospital, (iii) Extravagant spatial localisation; belief that current location is somewhere else, usually somewhere known to them.

Mirrored self- someone in mirror is a stranger
Delusional companions - non human items are friends
clonal plurisation - multiple copies of himself who are physically and psychologically similar to themselves

33
Q

What rating systems are used in depression?

A

Hamilton Depression rating scale (HAMD) … not to be confused with HAMA which is the hamilton rating scale for anxiety
Zung self rated depression scale - one of the self-rated ones
HADS (self rated)
MADRS (Montgomery-Asberg depression rating scale) - clinican rated, looks at changes with antidepressant
Becks Depression Inventory (self rated)
GDS (geriatric depression scale) (self rated)

34
Q

Describe components of GCS

A 
Eyes - out of 4.
4; spontanteous.
3; to voice.
2; to pain.
1; not open.
Verbal - out of 5.
5; normal.
4; confused
3; inappropriate talk
2; noises
1; no sound
Motor - out of 6.
6; normal
5; localises 
4; withdraws
3; flexion
2; extension
1; no response
35
Q

Paramnesia.
What does it mean?
Who came up with it?

A

describes qualitative disorders in memory where fantasy and reality are confused.
Kraeplin.
deja vu: The experience of feeling that one has witnessed or experienced a new situation before
jamais vu: The experience of being unfamiliar with a person or situation that is actually very familiar

confabulation: The unconscious filling in of gaps in the memory by events which never took place

the reduplicative paramnesias are forms of paramnesia, as well as delusional misidentification syndrome.
includes chimeric assimilaton, Extravagant spatial localisation and place reduplication

retrospective falsification: The process of distorting a memory

cryptomnesia: This is characterised by having a thought without realising you have had the thought before (for example, some plagiarists claim they are unaware that they were recounting other peoples work)

36
Q

What are the Kraeplin mixed states?

These have been condensed into what?

A

Manic stupor.
Inhibited mania.
Mania with poverty of thought.

Depressive-anxious mania.
Excited depression.
Depression with flight of ideas.

Dysphoric mania (when full mania is present with some depressive symptoms)
Depressive mixed state (when full depression is present with some manic symptoms).
37
Q

What is LUNSERS?
What did it check?
What important thing did it include?

A

Liverpool University Neuroleptic Side Effect Rating Scale.
Side effects of neuroleptic medication.
It included red herring items like chilbains.

38
Q

Patient Health Questionnaire

A

asks patients ‘over the last 2 weeks, how often have you been bothered by any of the following problems?’
9 items which can then be scored 0-3
includes items asking about thoughts of self-harm
depression severity: 0-4 none, 5-9 mild, 10-14 moderate, 15-19 moderately severe, 20-27 severe

39
Q

What are the differences between the catatonic behaviours of mannerisms and stereotypes

A

Mannerisms - These are repetitive, goal-directed movements (e.g. Saluting)

Stereotypies - These are repetitive, regular movements that are not goal-directed (e.g. Rocking)

40
Q

Describe three different types of attitude scale

A

Thurstone- a list of statements relating to an issue are drawn up. They are rated for how positive or negative they are. Then people have to say whether they agree or disagree. If they disagree with all, they score 0.

Likert- you rate from highly agree to highly disagree.

Semantic differential- everyone gets a score between two bipolar labels (e.g. 1 to 9; 1= submissive, 9=dominant, 4=neutral)

41
Q

Which feature of catatonia is associated with anglepoise lamp sign?

A

Mitgehen

42
Q

What test for current level of intelligence?

A

Wechsler Adult Intelligence scale (WAIS)

43
Q

What is digit span?

What kind of memory does it test?

A

Say 123.
Then in reverse order.

Tests short term/working memory.

44
Q 
What standard tests would you use for:
Attention?
ST Memory?
LT Memory?
Executive Function?
A

Orientation Asking the time, place, and person
Attention/concentration Serial 7’s
Short term memory Digit span
Long term memory Delayed recall of name and address
Executive function Proverbs, similarities, differences, verbal fluency, cognitive estimates

45
Q

What are the four groups of defence mechanisms?

A

Psychotic
Mature
Immature
Neurotic

46
Q

What psychotic defense mechanisms do you know?

A

Distortion
Denial
Delusional projection
Splitting *

47
Q

What mature defence mechanisms do you know?

A 
Altruism
Anticipation
Sublimation
Suppression
Humor
Identification *
Introjection *
48
Q

An examiner asks a patient to name as many animals as he can that start with the letter P. Which specific area of cognition is being assessed?

A

Verbal fluency which is part of executive function

49
Q

What is prosody?
What are two types of disorder?
What areas of brain are malfunctioning in each?

A

‘Emotional flections of language”
Expressive/executive prosody and receptive prosody
Executive/express prosody affects premotor cortex or basal ganglia
Receptive prosody affects posterior superior right temporal lobe

50
Q

Which of the following psychiatric conditions is also known as Briquet’s syndrome?

A

somatisation disotrder

51
Q

Another name for Dhat?
What is ataque de nervios?
What is Nevra?

A

Jiryan.

Ataque de nervios:
Latino-Caribbean cultural syndrome
acute experience involving both typical and atypical panic symptomatology such as loss of control, screaming, crying, rage, aggressiveness, amnesia, and ensuing sense of relief. It is usually precipitated by a stressful event.

Nevra:
feeling of loss of control, of having one’s nerves ‘burst out’ or ‘break out’ or ‘boil over.’
An attack is often accompanied by shouting or screaming and throwing things. Headaches, dizziness, pain, and feelings of melancholy are associated with nevra.

52
Q

In what defence mechanism category is projection and projection identification?

A

Immature

53
Q

Who coined the term schizophrenia?
What was thsi individual also responsible for?
What were his four primary symptoms?
His secondary symptoms?

A

Bleuler.
Terming symptoms as positive or negative.
Ambivalence. Autism. Affect (disturbance of). Association (loosening of).
The secondary symptoms are suggested as being psychically determined and include delusions, hallucinations, mannerisms, and catatonic symptoms.

54
Q

Most commonly affected area in body dysmorphic disorder?

A

Skin

55
Q

How long does a GAF take to complete?

A

Around 3 minutes

56
Q

What is alexithymia?

A

Alexithymia refers to a deficiency in understanding, processing, or describing emotions.

57
Q

What does the Simpson Angus scale do?

A

The Simpson-Angus scale was devised to measure drug-induced parkinsonism, providing standardised ratings for rigidity, tremor and salivation. The scale is entirely sign led.

Discuss
Improve

58
Q

Best tests for
premorbid intelligence
current intelligence

A

Premorbid intelligence National Adult Reading Test (NART)

Intelligence Wechsler Adult Intelligence scale (WAIS), Raven’s Progressive Matrices

59
Q

Describe briefly the three models of selective attention

A

Broadbent’s Filter model (1958)
The first model.
‘early selection model’
Input is filtered before it is analysed for meaning
Filtered by way of physical characteristics (e.g. for voice this might be volume, pitch, speed etc).
Left and right ears are separate channels and work independently of one another.

Treisman’s Attenuation Theory (1960)
Intermediate selection model
Leaky filter model. Instead of a filter it is actually an attenuator (attenuate = reduce in force or effect) rather than being an all or nothing filter, it allows some things though be weakens them.

Deutsch and Deutsch Late stage model (1963)

Late selection model.
Input is analysed for meaning before filtering occurs.
Selection does not occur until the meaning has been processed.

60
Q

deja vu is an example of which type of memory issue

A

7) Misattribution - attribution of memories to incorrect sources or believing that you have seen or heard something you haven’t. Deja Vu and cryptamnesia are examples of this.

Genetics (11 decks)

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