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Y5 OSCE > Knowledge revision - Psych > Flashcards

Knowledge revision - Psych Flashcards

1
Q

What are the key options for depression and anxiety?

A

Medication
Lifestyle modifications
Counselling/CBT

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2
Q

What are the first-line medications for depression and anxiety?

A

SSRIs

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3
Q

Which SSRI is licensed in young people?

A

Fluoxetine

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4
Q

What is the major side effect of SSRIs for patients to be aware of?

A

Potential increase in suicidal ideation in first 4 weeks

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5
Q

Give differential diagnoses for psychosis.

A

Medication or drug-induced
Schizophrenia
Bipolar (mania)
Psychotic depression
Delirium

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6
Q

What are the first-rank symptoms of schizophrenia?

A

Auditory hallucinations
Delusions (usually persecutory)
Thought insertion, withdrawal, broadcasting
Made actions/feelings
Somatic hallucinations

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7
Q

Which medication class are typically used in the management of schizophrenia?

A

Anti-psychotics

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8
Q

Give examples of typical antipsychotics.

A

Haloperidol, chlorpromazine

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9
Q

Give examples of atypical antipsychotics.

A

Olanzapine, Quetiapine, Risperidone, clozapine

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10
Q

What is the major side effect to be aware of of typical antipsychotics?

A

Parkinsonism

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11
Q

What is the major side effect to be aware of for atypical antipsychotics?

A

Metabolic syndrome

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12
Q

What is the major risk with clozapine?

A

Agranulocytosis

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13
Q

Under which circumstances can clozapine be initiated?

A

psychosis/schizophrenia resistant to at least 2 antipsychotics from different classes

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14
Q

How is mania typically managed?

A

Anti-psychotics

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15
Q

How is bipolar depression typically managed?

A

Antipsychotics +/- antidepressants

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16
Q

How is bipolar managed long-term?

A

Mood stabilisers eg. lithium, lamotrigine etc

17
Q

How long after a dose of lithium should levels be measured?

A

12 hours

18
Q

Which symptoms may suggest lithium toxicity?

A

Confusion
Drowsiness
Visual problems
Excessive thirst/urination

19
Q

What are the main headings for mental state examination?

A

Appearance
Behaviour
Speech
Mood
Affect
Thought
Perception
Cognition
Insight

20
Q

Which areas should be considered under ‘thought’ in a MSE?

A

Form, content, possession

21
Q

Moving quickly from one topic to another is called…

A

Flight of ideas

22
Q

Give potential causes of memory loss.

A

o Dementia – Alzheimer’s, Parkinsons, vascular, LBD
o Delirium
o Head injury
o Encephalitis
o Thyroid/kidney/liver disease
o B12 deficiency

23
Q

How would you investigate memory loss?

A

o Cognitive assessment eg. MMSE, MoCA
o Bloods inc Folate/B12, TFTs, LFTs etc
o CT head if ? bleed
o MRI brain may be useful if suspecting dementia

24
Q

What is delirium?

A

Acute & fluctuating disturbance in consciousness, attention & cognition

25
Q

Give causes of delirium

A

o Stroke, tumour, subdural haematoma
o Drugs
o Infection – CNS, UTI, sepsis
o Pain
o Electrolyte imbalance
o Change in environment, acute stress etc

26
Q

What should you look for when examining someone with delirium?

A

Signs of infection & neuro exam

27
Q

Which screening test is used for delirium?

A

4AT

28
Q

What is included in 4AT?

A

 Attentiveness
 AMT4 – age, DOB, place, current year
 Attention – months of the year backwards
 Acute change or fluctuating?

29
Q

How should delirium be managed?

A

o Treating any underlying cause
o Remove any aggravating drugs
o Environmental – orientating themselves – clock, date, room, people, hearing aids/glasses

30
Q

Which drugs may aggravate delirium?

A

Opioids, anticholinergics, steroids, TCAs, zopiclone, BZDs

31
Q

What can be given for agitation in deliriun?

A

0.5-1mg Haloperidol or lorazepam if very agitated/danger to self or others

32
Q

What are the conditions for detention under the MH Act?

A

o Has a mental disorder
o Ability to make decisions is sig impaired due to mental disorder
o Detention in the patient’s best interests
o Sig risk to self or others if not detained
o Treatment is available & necessary

33
Q

Which areas are important in assessing a person’s capacity?

A

ability to understand, weigh and retain information/decisions

Y5 OSCE (7 decks)

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