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Psychiatry for finals > High yield exam cram > Flashcards

High yield exam cram Flashcards

1
Q

When can a power of attorney be put in place?

A

Before capacity is lost

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2
Q

When is a power of attorney activated?

A

When the patient looses capacity

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3
Q

When is a guardianship order used?

A

when a patient no longer has the ability to make decisions about their care and they do not have a power of attorney

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4
Q

what section of the mental health (care and treatment) act 2003 is nursing holding power?

A

299

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5
Q

How many hours can a patient be held for under the nursing holding powers (299) in SCOTLAND?

A

3 hours

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6
Q

What kind of nurse can use a nursing holding power (299)?

A

psych nurse

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7
Q

What section of the mental health act is an emergency detention certificate?

A

5(2)

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8
Q

Who can use an emergency detention certificate 5(2)?

A

FY2 and above

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9
Q

How long does an emergency detention certificate 5(2) last?

A

72 hours

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10
Q

What can be done under an emergency detention certificate 5(2)?

A

Assessment only (NO TREATMENT ALLOWED)

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11
Q

can an emergency detetion certificate 5(2) be appealed?

A

No

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12
Q

What section of the mental health act is a short term detention certificate?

A

Section 2

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13
Q

Who can put a short term detention certificate in place?

A

Psych consultants

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14
Q

how long does a short term detention certificate last for?

A

28 days

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15
Q

What can be done under a short term detention certificate?

A

Treatment

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16
Q

Can a short term detention certificate be appealed?

A

Yes

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17
Q

what section of the mental health act is a compulsory treatment order under?

A

Section 3

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18
Q

How is a compulsory treatment order obtained?

A

Consultants apply for it and then it goes through a tribunal

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19
Q

how long does a compulsory treatment order last?

A

6 months

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20
Q

Can a compulsory treatment order be extended?

A

Yes- by 6 months each time

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21
Q

What is a section 297

A

Police can remove somebody from a public space and take them to a place of safety

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22
Q

What does dispositional drug tolerance mean?

A

There is less drug reaching the active site

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23
Q

What does functional/pharmacodynamic drug tolerance mean?

A

The drug is reaching the active site but is unable to act upon it

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24
Q

Name the pleasure/reward centre of the brain

A

Ventral tegmental

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25
Q

What is the mechanism of action of cocaine

A

Monoamine reuptake inhibitor

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26
Q

What is the mechanism of action of diazepines?

A

GABA agonists (promote all inhibitory systems causing relaxation)

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27
Q

Name an alcohol screening tool

A

CAGE/ FAST or CIW_AR

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28
Q

What are the features of wernickes encephalopathy?

A

confusion, ataxia, nystagmus, ophthalmoplegia

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29
Q

What are the features of korsakoffs?

A

Symptoms of Wernicke’s + memory loss (Alcohol induced ‘dementia’)

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30
Q

Which drug do you give in alcohol withdrawal to control anxiety and agitation

A

Chlordiazepoxide (benzo) or Lorazepam (benzo)

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31
Q

Which drug to you give to avoid/manage wernicke-korsakoffs?

A

Pabrinex (thiamine. vit B1)

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32
Q

which drug creates a deterrent effect when mixed with alcohol?

A

Disulfiram (Antabuse)

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33
Q

Which drug reduces the reward sensation associated with drinking alcohol?

A

Naltrexone

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34
Q

How long must symptoms persist for before a diagnosis of depression can be made?

A

Most of the day, nearly every day for >2 weeks

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35
Q

Name two tools used to assess depression

A
  • Hamilton Depression Rating Score
  • Patient Health Questionnaire (PHQ-9)
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36
Q

How long must symptoms persist for before a diagnosis of mania or hypomania can be made?

A

> 1 week

37
Q

What is the difference between mania and hypomania?

A

Mania causes impaired functioning. Hypomania does not impair functioning.

38
Q

What is the diagnostic criteria for bipolar I

A

At least 1 manic or mixed manic/depressive episode lasting >1 week

39
Q

What is the diagnostic criteria for bipolar II?

A

At least 1 hypomanic + at least 1 depressive episode lasting >1 week

40
Q

What is the difference between bipolar I and bipolar II

A

Bipolar I - severe form with manic episodes
Bipolar II- milder form with hypomanic episodes

41
Q

What is the diagnostic criteria for cyclothymia?

A

Persistent mood instability >2 years

42
Q

What is cyclothymia?

A

Mood instability but not severe enough for a depression diagnosis

43
Q

What psych disorder has the highest mortality

A

Anorexia Nervosa

44
Q

What is the BMI required for an anorexia diagnosis?

A

<18.5

45
Q

what weight within 6 months loss would raise suspicion of anorexia?

A

> 20%

46
Q

What is the average recovery time for anorexia?

A

6-7 years

47
Q

name the antipsychotic drug that is often given to anorexic patients and explain why it is given

A

olanzapine (causes hunger and weight gain)

48
Q

what is the difference between bulimia and binge eating disorder?

A
  • Bulimia= binge/purge
  • Binge eating = no purge
49
Q

What is the diagnostic criteria required for a personality disorder diagnosis?

A

personality difficulties for >2Y

50
Q

Which attachment style is associated with personality disorders?

A

Disorganised attachment

51
Q

What is surgency?

A

The liveliness of a baby

52
Q

What is negative affectivity?

A

the extent to which a baby gets upset

53
Q

what is effortful control?

A

How well behaviour can be supressed and controlled

54
Q

what is the most common cause of psychosis?

A

Schizophrenia

55
Q

What kind of drugs are used to treat schizophrenia?

A

Antipsychotics

56
Q

how long must symptoms have persisted for in order to make a diagnosis of schizophrenia?

A

1 month

57
Q

What is the diagnostic criteria for ADHD?

A

> 6 months of inattention/hyperactivity

58
Q

What type of drug is given to treat ADHD?

A

Stimulant

59
Q

What is the difference between oppositional defiant disorder and conduct disorder?

A

Oppositional defiant Disorder
- Usually <10 years old
- Mostly related to mood

Conduct Disorder
- Usually >11 years old
- Mostly related to behaviour (law breaking and violence/aggression)

60
Q

What is the diagnostic criteria for a learning disorder?

A

IQ 2 or more standard deviations below the mean (IQ<70)

61
Q

What is the diagnostic criteria for PTSD

A

Hyperarousal, flashbacks & avoidance persisting for more than 4 weeks after the traumatic incident

62
Q

What does CBT aim to do?

A

Change negative patterns of thinking

63
Q

Can CBT deal with issues from the past?

A

No

64
Q

What do interpersonal therapies aim to do?

A

Help depressed people deal with issues within their relationships

65
Q

What dies moticational interviewing aim to achieve?

A

Help people find the motivation to make a positive behavioural change

66
Q

What is the main feature of Alzheimer’s dementia?

A

Gradual loss of memory

67
Q

What is the main feature of vascular dementia?

A

Stepwise decline in memory

68
Q

What is the main feature of lewy body dementia?

A

non-threatening hallucinations

69
Q

what is the main feature of fronto-temporal dementia (picks disease)?

A

Personality change

70
Q

what would you see in the brain of a patient with alzherimer’s dementia?

A

Amyloid Plaques & Tau tangles
Atrophy

71
Q

How is alzherimer’s dementia treated?

A

Mild- treat with ACh inhibitors (donepezil)
Moderate- (treat with glutamate receptor antagonists)

72
Q

How is dementia assessesd?

A

MMSE

73
Q

How is delerium assessed?

A

4AT

74
Q

Which psych drugs cause agranulocytosis?

A

Carbamazepine and clozapine

75
Q

Which psych drug reduces the seizure threshold?

A

Mirtazepine

76
Q

Which psych drugs cause massive weight gain

A

Olanzepine and mirtazepine

77
Q

Which psych drug causes a massive increase in serum cholesterol?

A

Mirtazepine

78
Q

Which drug causes lactation

A

Risperidone

79
Q

Which psych drugs have the biggest risk of extra-pyramidal side effects?

A

Typical antipsychotics e.g. haloperidol
(Atypical antipsychotics still carry the risk but it is not as great)

80
Q

how long can it take to feel the benefit of antidepressants?

A

2-4 weeks

81
Q

What is the correct stepping up of antidepressive therapy?

A

SSRI
SNRI
SSRI/SNRI + Mirtazapine OR SSRI/SNRI
Lithium/antipsychotic
MOI
TCA

82
Q

What is a common side effect seen when initiating antidepressant therapy?

A

GI upset

83
Q

How long should you wait to feel the effect of an antidepressant before you move on to something different?

A

4-8 weeks

84
Q

How long should an antidepressant be taken for?

A

After the first depressive episode, continue medications for 6 months to a year
After a second episode, continue medications for 2 years
After a third episode, medication should be given for life

85
Q

Patient is anxious, depressed AND has neuropathic pain. What are you giving?

A

Duloxetine

86
Q

Describe how lithium levels should be checked

A

Check lithium 12 hours after 1st dose, weekly until levels stable then every 3 months. If dose changes, go back to weekly checks until stable.

87
Q

What else should be checked if a patient is on lithium?

A

Check renal and thyroid every 6 months.

88
Q

What lithium blood level should be aimed for?

A

0.6-1.2

89
Q

Describe the lithium blood levels associated with mild, moderate and severe toxicity

A
  • Mild toxicity = 1.5-2.0
  • Moderate toxicity = 2.0-2.5
  • Severe toxicity = >2.5

Psychiatry for finals (1 decks)

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