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Phsyciatry > Conditions > Flashcards

Conditions Flashcards

1
Q

What is the difference between Schizoid and Schizotypal personality disorders?

A

Schizoid is the negative symptoms of schizophrenia (solitary, indifference/ lack of interest to others), whereas schizotypal often have odd beliefs or magical thinking in additionto this.

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2
Q

What are the three clusters of personality disorder?

A

A: Odd/ Eccentric
B: Dramatic, emotional or erratic
C: Anxious and fearful

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3
Q

What are the personality disorders in cluster A (Odd/Eccentric)?

A

Paranoid
Schizoid
Schizotypal

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4
Q

What are the personality disorders in cluster B (Dramatic/Emotional/Erratic)?

A

Antisocial
Borderline (EUPD)
Histrionic
Narcissistic

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5
Q

What are the personality disorders in cluster C (Anxious/Fearful)?

A

Obsessive-Compulsive
Avoidant
Dependent

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6
Q

What are the symptoms of paranoid personality disorder?

A

Hypersensitivity
Reluctance to confide in others
Preoccupation with conspiracies
Question loyalty of friends
Perceive attacks on their character

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7
Q

What are the symptoms of schizoid personality disorder?

A

Indifference to praise/ criticism
Solitary
Indifferent to most relationships (other than close family)
Emotional coldness
Few interests

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8
Q

What are the symptoms of schizotypal personality disorder?

A

Ideas of reference (have some insight)
Odd beliefs/ magical thinking
Unusual perceptual disturbances
Paranoia
Odd/ eccentric behavious
Lack of close friends
Inappropriate affect

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9
Q

What are the symptoms of antisocial personality disorder?

A

Failure to conform to social norms
Often in trouble with the law
Impulsiveness
Deception
Aggressive
Reckless
Irresponsible
Lack of remorse

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10
Q

What are the symptoms of borderline personality disorder?

A

Unstable interpersonal relationships
Unstable self image
Impulsivity
Recurrent suicidal behaviour
Unstable affect

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11
Q

What are the symptoms of histrionic personality disorder?

A

Inappropriate sexual seductiveness
Need to be centre of attetion
Shallow emotions
Attention seeking
Dramatic

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12
Q

What are the symptoms of narcissistic personality disorder?

A

Grandiose sense of self importance
Preoccupation with fantasies of unlimited success, power or beauty
Sense of entitlement
Take advantage of others
Lack of empathy
Excessive need for admiration
Arrogant

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13
Q

What are the symptoms of obsessive- compulsive personality disorder?

A

Obsessively occupied with rules/ organisation
Perfectionism that hampers completion of tasks
Extremely dedicated to work
Rigid about morals/ethics/ values
Unwilling to let other people do tasks unless they do exactly what they say
Stubborn

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14
Q

What are the symptoms of avoidant personality disorder?

A

Avoidant of activities that involve interpersonal contact due to fear of criticism or rejection
Preoccupied with ideas of rejection
Restrained in relationships
Reluctant to take personal risks
Views self as inferior
Personal isolation

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15
Q

What are the symptoms of dependent personality disorder?

A

Difficulty making everyday decisions without reassurance from others
Need others to be responsible for major areas of their life
Lack of initiative
Unrealistic fears of being left to their own devices
Urgent search for close relationships

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16
Q

What is the management for most personality disorders?

A

Psychological therapies (e.g. DBT)
Treatment of coexisting psychiatric conditions

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17
Q

What is the difference between schizophrenia and schizoaffective disorder?

A

Schizoaffective involves symptoms of schizophrenia but also has a mood component with either mania or depression

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18
Q

What are the three common features of PTSD?

A

Re-experiencing
Avoidance
Hyperarousal

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19
Q

How long must symptoms have to have been present to diagnose PTSD?

A

At least one month

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20
Q

What is the management of PTSD?

A

Trauma focused CBT
EMDR
SSRI if talk therapy not affective

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21
Q

What symptoms of alcohol withdrawal usually appear 6-12 hours after their last drink?

A

Agitation, tremors, anxiety, sweating, tachycardia

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22
Q

What is the main risky symptom of alcohol withdrawal and at what point does it occur?

A

Seizures 36 hours after last drink

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23
Q

What symptoms appear 48-72 hours after the last drink in alcohol withdrawal?

A

Coarse tremor, confusions, delusions, auditory and visual hallucinations, fever, tachycardia

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24
Q

What is delirium tremens?

A

Severe form of alcohol withdrawal characterised by acute confusion, hallucinations and extreme agitation.

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25
Q

How long after the last drink can delirium tremens appear?

A

72 hours

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26
Q

What is a potentially fatal consequence of alcohol dependence?

A

Wernicke’s encephalopathy

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27
Q

What is the common triad in Wernicke’s encephalopathy?

A

Ophthalmoplegia, ataxia, and confusion

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28
Q

In which patients would you diagnose Wernicke’s encepalopathy?

A

Those detoxifying and experiencing confusion/ apathy, drowsiness, coma/unconsciousness, hypothermia/hypotension, abnormal eye movements, double vision, poor balance or memory disturbance

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29
Q

What is a complication of Wernicke’s encephalopathy?

A

Korsakoff’s syndrome

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30
Q

What features are seen in Korsakoff’s syndrome?

A

Anterograde amnesia
Retrograde amnesia
Confabulation

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31
Q

What is the difference between Type 1 and Type 2 Bipolar affective disorder?

A

Type 1 is associated with mania and Type 2 with hypomania

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32
Q

What is confabulation?

A

Production of false memories about events that is not deliberate.

33
Q

What nmeumonic can be used to remember the features of Wernicke’s encephalopathy and Korsakoff’s syndrome?

A

COAT RACK
Wernickes:
Confusion
Opthalmoplegia
Ataxia
Thiamine deficiency
Korsakoff’s:
Retrogade amnesia
Anterograde amnesia
Confabulation
Korsakoffs syndrome

34
Q

What is the difference between hypomania and mania?

A

Mania has severe functional impairment of psychotic symptoms for 7 days or more whereas hypomania is 4 days or more and does not include psychotic symptoms

35
Q

How is bipolar diagnosed?

A

At least one episode of depression and one episode of hypomania/mania that last at least a week within a one year period

36
Q

What is the treatment of mild OCD?

A

CBT including ERP

37
Q

What is the treatment of moderate OCD?

A

SSRI and CBT/ERP

38
Q

What is ERP?

A

Exposure and response prevention

39
Q

What is the management of severe OCD?

A

Refer to secondary care mental health team
SSRI and CBT

40
Q

What is anhedonia?

A

Reduced ability to feel pleasure

41
Q

What is the first line treatment for less severe depression?

A

CBT (unless medication is the person’s preference)

42
Q

What PHQ-9 score indicated ‘less severe’ depression?

A

<16

43
Q

What PHQ-9 score indicates ‘more severe’ depression?

A

> /=16

44
Q

What are the different types of unexplained symptoms?

A

Somatisation disorder
Illness anxiety disorder
Conversion disorder
Dissociative disorder
Factitious disorder
Malingering

45
Q

What is somatisation disorder?

A

Multiple physical symptoms present for at least 2 years
Patient refuses to accept reassurance or negative test results

46
Q

What is conversion disorder?

A

Loss of motor or sensory function
Patient doesn’t consciously feign the symptom
May be caused by stress

47
Q

What is dissociative disorder?

A

Like conversion disorder but involves psychiatric symptoms (e.g. amnesia, gugue, stupor)
Most severe is multiple personality disorder

48
Q

What is factitious disorder and what is it otherwise known as?

A

Munchausen’s syndrome
Intentional production of physical or psychological symptoms

49
Q

What is malingering?

A

Fraudulent simulation or exaggeration of symptoms with the intention of financial or other gain

50
Q

What is the first line treatment for EUPD?

A

Dialectical behavioural therapy

51
Q

How is chronic insomnia diagnosed?

A

If a person has trouble falling or staying asleep at least three nights per week for at least three months

52
Q

What is the short term management of insomnia?

A

Identify and treat potential causes
Advise not to drive
Advise good sleep hygiene
Only use medication if daytime impairment is severe

53
Q

What drugs may be used to treat short-term insomnia?

A

Hypnotics

54
Q

What are the adverse effects of hypnotics?

A

Daytime sedation
Poor motor coordination
Cognitive impairment

55
Q

What is Charles-Bonnet syndrome?

A

Persistent or recurrent complex hallucinations, usually associated with visual impairment.

56
Q

Do patients have insight with Charles-Bonnet syndrome?

A

Yes

57
Q

What are the risk factors for Charles-Bonnet syndrome?

A

Advanced age
Peripheral visual impairment
Social isolation
Sensory deprivation
Early cognitive impairment

58
Q

What is the most common ophthalmological condition associated with Charles-Bonnet syndrome?

A

Age-related macular degeneration (ARMD)

59
Q

What physiological changes are seen in anorexia (LOW)?

A

Hypokalaemea, FSH, LH, Oestrogens, testosterone, glucose tolerance, T3

60
Q

What things are raised in anorexia?

A

Raised G’s/C’s:
Growth Hormone
Glucose
Salivary glands
Cortisol
Cholesterol
Carotinaemia

61
Q

What conditions may indicate the use of ECT?

A

Treatment resistant severe depression
Manic episodes
Moderate depression known to respond to ECT in the past
Life threatening catatonia

62
Q

What is the main contraindication to ECT?

A

Raised intracranial pressure

63
Q

What are the short term/ long term side effects of ECT?

A

Short: Headache, nausea, memory impairment, cardiac arrhythmia
Long: May have memory impairment

64
Q

What are first rank symptoms?

A

Symptoms which are indicative of schizophrenia.

65
Q

What are the main first rank symptoms?

A

Thought broadcasting
Thought withdrawal
Delusional perceptions
Auditory hallucinations

66
Q

What are the first rank symptoms divided into?

A

Auditory hallucinations
Thought disorders
Passivity phenomena
Delusional perceptions

67
Q

What is passivity phenomena?

A

That bodily sensations are being controlled by an external influence

68
Q

What are the risk factors for having GAD?

A

Aged 35-45
Being divorced/ separated
Living alone
Being a single parent

69
Q

What are the protective factors for GAD?

A

Aged 16-24
Being married or cohabiting

70
Q

What are important differentials when diagnosing GAD?

A

Hyperthyroidism
Cardiac disease
Medication induced anxiety

71
Q

What medications can trigger anxiety?

A

Salbutamol
Theophylline
Corticosteroids
Antidepressants
Caffeine

72
Q

What is the step-wise approach for managing GAD?

A

1: Education and active monitoring
2: self-help psychological interventions
3: CBT or drug treatment
4: Highly specialised input

73
Q

What is the first line medication for GAD?

A

Sertraline

74
Q

What should be offered in GAD if a person cannot tolerate SSRIs or SNRIs?

A

Pregabalin

75
Q

What is erotomania?

A

The presence of a delusion that a famous is in love with them, with the absence of other psychotic symptoms

76
Q

What is Russell’s sign?

A

Calluses on the knuckles/ back of hand due to repeated self induced vomiting

77
Q

How long do bulimia symptoms usually last to diagnose?

A

At least once a week for three months

78
Q

What is the management for bulimia?

A

Referral for specialist care
Guided self-help
CBT-ED if self help is contraindicated or ineffective after 4 weeks

Phsyciatry (3 decks)

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