Formative Learning Points Flashcards
What is a primary symptom of schizophrenia ?
Thought disorder (insertion, broadcast etc) Hallucinatory voices Delusions of control,influence or passivity Persistent inappropriate delusions
What are secondary symptoms of schizophrenia?
Persistent hallucinations in any modality
Breaks or interpolations in train of thought
Catatonic behaviour
Negative symptoms
What are the positive symptoms of Schizophrenia
Things that are their that shouldn’t be there
Hallucinations
Delusions
Disordered thinking
What are negative symptoms of schizophrenia?
things that are missing
Apathy
Lack of interest
Lack of emotions
What are nihilistic delusions?
Delusions regarding non existing on the self/the world
What is the SCAN classification?
Schedules for clinical assessment in neuropsychiatry
What is the SCID anagram
Severe combined immunotherapy
What is conduct disorder?
Intentional dissocial behaviour
What is somnambulism
Sleep walking
What is a MAOI?
Monoamine oxidase inhibitor- used to treat………
What is the adult support and protection (Scotland) Act 2007?
Vulnerability adult, allows social protection not social protection
What is the mental health act 2007?
The legislation that applies in England and Wales
What is the interpersonal map?
Represents self and peers, used in schema therapy (better for personality disorders)
Shows underlying beliefs/systems
What are the two screening tools used to assess alcohol consumption?
CAGE
FAST (fast alcohol screening tool)
What is the BDI therapy
Becks depression inventory?
What is the MADRS screening scale?
Montgomery and asberg depression scale
How do you monitor lithium levels?
Aiming for blood level between 0.6 and 1.2
Steady state achieved after 5 days, check 12 hours after last dose (taken at night)
Once stable check concentration every 3 months
Check TSH and creatinine every 6 months
What is an assessment order?
Court order requests the assessment of a patient in custody
What is a guardianship order?
Act on a patients behalf when capacity impaired. Only put in place after the the incident and the patient does not have power of attorney
What is a place of safety order?
Police use it to remove people from a public place
What is a restriction order?
Court restricts movements of an individual
What is dysthymia?
Recurrent mild (sub clinical) depression
What is akathisia?
Unpleasant sensation of restlessness
What is Catatonia
Immobility, stupor
What is dysarthria
Difficulty articulating speech
What is dystonia?
Involuntary muscle spasms/contractions
What is agraphia?
Inability to write
What is dyscalculia
Difficulty with numbers
What is alexithymia
Sub clinical emotional blindness
What is Anergia?
Lack of energy
What is cyclothymia?
Relatively mild mood fluctuations
What is poverty of thought?
Thought disorder
What is an idea of reference?
Believing that causal events, remarks and occurrences which happen every day illogically relate to oneself (people laughing at you when they’re not)
What is a delusional perception?
A delusion where you relate something to something else with no relation e.g. I’ve seen a seagull in the park, therefore I must dig up margret thatcher
What is confabulation?
Making up elaborate stories to fill bits of memory that have been lost. Patients believe these stories
What is agoraphobia?
Fear of large crowds
What psychiatric drugs are contraindicated by pregnancy
Lithium- Mood Stabiliser
Valproic acid (depakote)- Anticonvulsant
Benzodiazipines not brilliant but used
Summarise the psychotherapies used to treat disorders?
CBT- operates on the principal that thoughts, feelings and behaviours are intertwined. Aims to stop thoughts that influence behaviours and feelings and vice versa
Behaviour activation- Focuses on the negative behaviours of diseases and the unintended consequences they cause
Interpersonal therapy-Effective for mood and personality disorders. Patient constructs an interpersonal map and aims to reduce symptoms and increase interpersonal skills
Motivational interviewing- considers the cycle of change to help get patients to take the initiative and make a change
What do you do before starting someone on Lithium?
Baseline U&E’s, TSH and pregnancy test
What are the side effects of lithium?
GI distress- reduced appetite, N+V, diarrhoea
Thyroid abnormalities
Nonsignificant leukocytosis
Polyuria/polydypsia secondary to ADH antagonism
Hair loss, Acne
Cognitive slowing
What are the stages and signs of lithium toxicity?
Mild 1.5-2.0- vomiting, diarrhoea, ataxia, dizziness, slurred speech, nystagmus
Moderate 2.0-2.5- N+V, anorexia, blurred vision, clonic limb movements, convulsions, delirium, syncope
Severe>2.5- generalised convulsions, renal failure and oliguria (barely passing urine)
What are the different though disorders that may occur in schizophrenia?
Thought Insertion- someone is making you think their thoughts
Thought broadcasting- everyone else knows your thoughts
Thought blocking- Someone slows thinking
Thought withdrawal- someone takes your thoughts
What is the process of treatment in depression?
SSRI- first line
Combined SSRI and SSRI or SSRI and SNRI- second line
Keep on drugs, also take lithium- third line
Keep on drugs and take atypical antipsychotic- 4th
Electroconvulsive therapy- last line
