High Yield Psychiatry Flashcards
A 19-year-old female visits her GP with low mood. This has been present for multiple months, with reduced concentration and tiredness. However, she also finds herself waking early each morning and
being unable to get back to sleep. She feels hopeless about the future and no longer enjoys seeing her friends. Her largest concern is that the symptoms significantly affect her university work.
She denies any thoughts of suicide and there are no psychotic features on examination. She does not use drugs, alcohol or smoke.
What would be the most appropriate treatment?
A. Trial amitriptyline
B. Trial fluoxetine with high intensity psychological intervention C. Refer for individual guided self-help
D. Same day referral to mental health services
E. Watch and wait for 2 weeks
Trial fluoxetine combined with psychological intervention
A 19-year-old female visits her GP with low mood. This has been present for multiple months, with reduced concentration and tiredness. However, she also finds herself waking early each morning and
being unable to get back to sleep. She feels hopeless about the future and no longer enjoys seeing her friends. Her largest concern is that the symptoms significantly affect her university work.
She denies any thoughts of suicide and there are no psychotic features on examination. She does not use drugs, alcohol or smoke.
What would be the most appropriate treatment?
A. Trial amitriptyline
B. Trial fluoxetine with high intensity psychological intervention C. Refer for individual guided self-help
D. Same day referral to mental health services
E. Watch and wait for 2 weeks
Trial fluoxetine combined with psychological intervention
mild, mod, severe depression
medication for depressio
Sarah Jones is a 27-year-old woman with a known history of depressive disorder. You are working with the community mental health team when she presents with her wife. You find out that Sarah hasn’t been sleeping for the last week since she has been ‘working on a cure for COVID-19’ in her basement. Her speech is pressured and she appears very active, running around the room performing star jumps. Her wife says that she has been like this for 7 days. She is currently on sertraline after a previous depressive episode 5 months ago. History does not reveal any risk to self or others.
What’s the likely diagnosis and most appropriate first step in management?
A. Schizotypal personality disorder refer to the home treatment team.
B. Schizophrenia refer to the emergency department.
C. Bipolar - stop sertraline
D. Schizophrenia begin an antipsychotic
E. Mania urgent referral to the community mental health team.
Bipolar - stop sertraline
medication for depressio
Sarah Jones is a 27-year-old woman with a known history of depressive disorder. You are working with the community mental health team when she presents with her wife. You find out that Sarah hasn’t been sleeping for the last week since she has been ‘working on a cure for COVID-19’ in her basement. Her speech is pressured and she appears very active, running around the room performing star jumps. Her wife says that she has been like this for 7 days. She is currently on sertraline after a previous depressive episode 5 months ago. History does not reveal any risk to self or others.
What’s the likely diagnosis and most appropriate first step in management?
A. Schizotypal personality disorder refer to the home treatment team.
B. Schizophrenia refer to the emergency department.
C. Bipolar - stop sertraline
D. Schizophrenia begin an antipsychotic
E. Mania urgent referral to the community mental health team.
Bipolar - stop sertraline
Mania vs hypomania
Mania is abnormally elevated mood or irritability, with severe functional impairment or psychotic symptoms for 7 days or more.
Hypomania
describes decreased or increased function for 4 days or more.
Mania management
Consider stopping antidepressant if the patient takes one; antipsychotic therapy e.g. olanzapine or haloperidol
Sarah Jones is a 27-year-old woman with a known history of depressive disorder. You are working with the community mental health team when she presents with her wife. You find out that Sarah hasn’t been sleeping for the last week since she has been ‘working on a cure for COVID-19’ in her basement. Her speech is pressured and she appears very active, running around the room performing star jumps. Her wife says that she has been like this for 7 days. She is currently on sertraline after a previous depressive episode 5 months ago. History does not reveal any risk to self or others.
What’s the likely diagnosis and most appropriate first step in management?
A. Schizotypal personality disorder refer to the home treatment team.
B. Schizophrenia refer to the emergency department.
C. Bipolar - stop sertraline
D. Schizophrenia begin an antipsychotic
E. Mania urgent referral to the community mental health team.
Bipolar - stop sertraline
Mania vs hypomania
Mania is abnormally elevated mood or irritability, with severe functional impairment or psychotic symptoms for 7 days or more.
Hypomania
describes decreased or increased function for 4 days or more.
Mania management
Consider stopping antidepressant if the patient takes one; antipsychotic therapy e.g. olanzapine or haloperidol
medication for depressio
Bipolar
Bipolar disorder is a chronic mental health disorder characterized by periods of mania/hypomania alongside episodes of depression.
Main treatment is lithium which is a mood stabilizer.
Lithium monitoring
- 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
personality disorder
alcohol
section 2 vs section 3
eating disorders
section 5
