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Psychiatry > Clinical Psychiatry > Flashcards

Clinical Psychiatry Flashcards

1
Q

Is depression more common in males or females?

A

females (2:1)

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2
Q

How long do symptoms need to last for depression be exist?

A

at least 2 weeks

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3
Q

Depression must include 2 out of what 3 symptoms?

A

low mood, anhedonia, anergia

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4
Q

What is speech like in depression?

A

reduced rate, lower pitch, reduced volume, reduced intonation, limited content etc

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5
Q

What is dysthymia?

A

chronic low mood

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6
Q

Can people with dysthymia cope with every day life?

A

yes

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7
Q

Is suicidal ideation common in depression of old age?

A

no - but passive thoughts of death are

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8
Q

Pregnancy increases depression risk by how many times?

A

3

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9
Q

How quickly does post natal depression tend to resolve itself?

A

6 months

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10
Q

How can depression of old age present itself?

A

pseudodementia

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11
Q

Causes of mania?

A

infection, hyperthyroidism, SLE, stroke, water dysregulation, drugs eg amphetamines
OR
Bipolar disorder

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12
Q

What happens to sleeping habits in mania?

A

There is a decreased need for sleep

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13
Q

How can mania be managed acutely?

A

assessment, olanzapine, valproate semisodium

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14
Q

What is the key difference between mania and hypomania?

A

there is no psychosis in hypomania (hallucinations/delusion)

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15
Q

Lifetime risk of suicide in Bipolar disorder?

A

12-15%

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16
Q

What is cyclothymia?

A

hypomania and mild depression

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17
Q

What is bipolar 1?

A

mania or a mixed episode of mania and depression

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18
Q

What is bipolar 2?

A

more common type, hypomania and depression

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19
Q

Mean age of onset of bipolar disorder?

A

21 years

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20
Q

What is the risk of bipolar disorder if a 1st degree relative is affected?

A

7 times greater risk

50% chance they will be affected

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21
Q

What is the median length of an untreated episode of bipolar disorder?

A

3 months

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22
Q

What is rapid cycling?

A

4 or more moore episodes in 1 year, may be interspersed with periods of wellness
But cycling may take place in a matter of days

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23
Q

What is prophylatic treatment of mania?

A

lithium

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24
Q

What should be checked before treating with lithium?

A

Us and Es, ECG and Thyroid function T4

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25
Q

How often should lithium levels be checked?

A

weekly - can be nephrotoxic

26
Q

Signs of lithium toxicity?

A

decreased vision, D and V, hypokalaemia, ataxia, tremor, dysarthria, coma

27
Q

Acute cessation of lithium can precipitate what?

A

mania

28
Q

Treatment of bipolar disorder is lithium is not effective?

A

anticonvulsants (sodium valproate, carbamazepine)
Antipsychotics eg olanzapine
Anti depressants AND lithium (SSRI or MAOI)
ECT if all else fails

29
Q

Schizoaffective disorder?

A

symptoms of both schizophrenia and bipolar affective disorder by insufficient to justify either diagnosis alone

30
Q

BMI in anorexia nervosa?

A

17.5 or less

31
Q

Investigations for anorexia nervosa?

A

FBC, u and E, ECG, DEXA bone scan

32
Q

Mortality in anorexia?

A

up to 20% (half die due to suicide)

33
Q

Effects on brain from anorexia nervosa?

A

loss of grey and white matter

34
Q

Is PTSD a normal adaptation to severe stress?

A

no

35
Q

What happens to cortisol levels in PTSD?

A

reduced

36
Q

Treatment for PTSD?

A

CBT / EMDR

37
Q

In how many women does baby blues occur?

A

50%

38
Q

Name 5 typical antipsychotics.

A 
Chlorpromazine
Thioridazine
Fluphenazine
Haloperidol
Zuclopentixol
39
Q

What makes atypical antipsychotics better? 4 reasons.

A

less likely to induce extra pyramidal side effects
High 5HT2a to D2 ratio
Better efficacy against negative symptoms
Effective in patients unresponsive to typical drugs

40
Q

Treatment for antisocial personality disorder?

A

group based therapy

41
Q

Treatment for borderline?

A

dilaectical behavioural therapy (DBT)

42
Q

Treatment of avoidant?

A

social skills training, antidepressants, MAOIs

43
Q

Borderline learning disability IQ?

A

70 +

44
Q

Mild LD IQ?

A

50-69

45
Q

Most common level of learning disability?

A

mild

46
Q

Moderate LD IQ?

A

35-49

47
Q

Severe LD?

A

20-34

48
Q

Profound LD?

A

less than 20

49
Q

What syndrome is caused by deletion of the short arm of chromosome 5?

A

Cri-du-chat

50
Q

Signs of cri-du-chat?

A

moon face, widely spaced eyes, severe learning disability, high pitched cry

51
Q

What syndrome is caused by deletion of segment of maternal chromosome 15?

A

angelman syndrome

52
Q

Signs of angelman syndrome?

A

recurrent seixures, excitable demeanor, short attention span, fascination with water

53
Q

Deletion of a segment of chromosome 15?

A

Prader Willi

54
Q

Signs of Prader Willi?

A

weak muscle tone in infancy

feeding difficulties, insatiable appetite, learning difficulties

55
Q

Deletion of segment on chromosome 22?

A

Velo cardiofacial syndrome

56
Q

What is there an increased risk of in velocardiofacial syndrome?

A

shizophrenia

57
Q

What type of delirium is harder to diagnose and has a higher mortality?

A

hypoactive

58
Q

In a patient with PD/Lewy Body dementia, what should be used to treat delirium?

A

quetiepine

59
Q

Which antipsychotic can be used in delirium?

A

haloperidol (oral, start low dose)

60
Q

How many anorexic patients develop binge eating?

A

30%

Psychiatry (3 decks)

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