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Year 4 DECK OF MANY THINGS > Day 1 PSYCH > Flashcards

Day 1 PSYCH Flashcards

1
Q

Difference between typical and atypical antipsychotics

(2)

A

Typical antipsychotics

Dopamine D2 receptor antagonists, blocking dopaminergic transmission in the mesolimbic pathways

Atypical antipsychotics

Act on a variety of receptors (D2, D3, D4, 5-HT)

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2
Q

Extrapyramidal side-effects (EPSEs)

(4)

A
  1. Parkinsonism
  2. Acute dystonia -sustained muscle contraction (e.g. torticollis, oculogyric crisis), may be managed with procyclidine
  3. Akathisia (severe restlessness)
  4. Tardive dyskinesia (late onset of choreoathetoid movements, abnormal, involuntary, may occur in 40% of patients, may be irreversible, most common is chewing and pouting of jaw)
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3
Q

What are choreoathetoid movements?

A

Choreoathetosis is a movement disorder that is usually a symptom of another underlying cause. It causes involuntary movements throughout the body.

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4
Q

Side effects of antipsychotic medications

(7)

A
  1. antimuscarinic: dry mouth, blurred vision, urinary retention, constipation
  2. sedation, weight gain
  3. raised prolactin; may result in galactorrhoea due to inhibition of the dopaminergic tuberoinfundibular pathway
  4. impaired glucose tolerance
  5. neuroleptic malignant syndrome: pyrexia, muscle stiffness
  6. reduced seizure threshold (greater with atypicals)
  7. prolonged QT interval (particularly haloperidol)
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5
Q

The Medicines and Healthcare products Regulatory Agency has issued specific warnings when antipsychotics are used in elderly patients:

(2)

A
  • increased risk of stroke
  • increased risk of venous thromboembolism
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6
Q

Examples of

Typical (2)

and

Atypical antipsychotics (3)

A

Haloperidol
Chlopromazine

Clozapine
Risperidone
Olanzapine

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7
Q

Case

A young athlete presents with paralysis of his right leg before an athletics meet.

Neurological examination is inconsistent

What is the diagnosis?

A

Conversion disorder

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8
Q

Case

A middle-aged man with a history of depression presents with multiple unrelated physical symptoms over the past 5 years

A

Somatisation disorder

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9
Q

Characteristics of conversion disorder

(3)

A
  • typically involves loss of motor or sensory function
  • the patient doesn’t consciously feign the symptoms (factitious disorder) or seek material gain (malingering)
  • patients may be indifferent to their apparent disorder - la belle indifference - although this has not been backed up by some studies
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10
Q

Characteristics of Somatisation disorder

(2)

A
  • multiple physical SYMPTOMS present for at least 2 years
  • patient refuses to accept reassurance or negative test results
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11
Q

Characteristics of Illness anxiety disorder

(3)

A
  • persistent belief in the presence of an underlying serious DISEASE, e.g. cancer
  • patient again refuses to accept reassurance or negative test results
  • Also known as hypochondriasis
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12
Q

Characteristics of Dissociative disorder

A
  • dissociation as a process of ‘separating off’ certain memories from normal consciousness
  • in contrast to conversion disorder, it involves psychiatric symptoms e.g. Amnesia, fugue, stupor
  • dissociative identity disorder (DID) is the new term for multiple personality disorder as is the most severe form of dissociative disorder
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13
Q

Characteristics of Factitious disorder (2)

A

also known as Munchausen’s syndrome

the intentional production of physical or psychological symptoms

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14
Q

What is Malingering?

A

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

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15
Q

What is the treatment of choice for generalised anxiety disorder?

A

Sertraline

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16
Q

Side effects of TCAs

(6)

A
  1. drowsiness
  2. dry mouth
  3. blurred vision
  4. constipation
  5. urinary retention
  6. lengthening of QT interval
17
Q

Case

A middle-aged woman asks for help after splitting up with her partner, who apparently felt she was too ‘needy’.

She describes him as ‘my world’ and thinks she won’t be able to cope by herself and wants your advice on how to find a new partner quickly is a stereotypical history of:

A

Dependent personality disorder

18
Q

Side effects of lithium

(9)

A
  1. nausea/vomiting, diarrhoea
  2. fine tremor
  3. nephrotoxicity: polyuria, secondary to nephrogenic diabetes insipidus
  4. thyroid enlargement, may lead to hypothyroidism
  5. ECG: T wave flattening/inversion
  6. weight gain
  7. idiopathic intracranial hypertension
  8. leucocytosis
  9. hyperparathyroidism and resultant hypercalcaemia
19
Q

How are patients monitored on lithium?

(5)

A

when checking lithium levels, the sample should be taken 12 hours post-dose

after starting lithium levels should be performed weekly and after each dose change until concentrations are stable

once established, lithium blood level should ‘normally’ be checked every 3 months

after a change in dose, lithium levels should be taken a week later and weekly until the levels are stable.

thyroid and renal function should be checked every 6 months

20
Q

Case

A young woman comes for relationship advice. She is constantly questioning the loyalty of her partner and regularly accuses him of having affairs for no reason. She also regularly falls out with her female friends as she thinks they are belittling her is a stereotypical history of:

A

paranoid personality disorder

21
Q

Case

A young woman complains of feeling lonely. She has stopped seeing her old friends as she is worried about not being liked or criticised is a stereotypical history of:

A

Avoidant personality disorder

22
Q

Case

a woman presents to her male family doctor wearing a low-cut top and a short skirt. She tries to flirt with the doctor. The consultation is filled with drama and she becomes annoyed with the centre of attention shifts from her

A

Histrionic personality disorder

23
Q

Which word is used to describe a twisting of the neck that causes the head to rotate and tilt at an odd angle?

A

Torticollis

24
Q

Describes the mechanism of action of benzodiazepines

A

Enhance the effect of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA)

25
Q

Define Hallucination

A

A false perception in the absence of a stimulus that seems real

26
Q

How is cyclosthymic disorder diagnosed?

A

Cyclothymic disorder is characterised by at least 2 years of symptoms, marked by periods of hypomanic symptoms that do not meet the criteria for a manic episode and periods of depressive symptoms that do not meet criteria for a major depressive episode

Year 4 DECK OF MANY THINGS (42 decks)

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