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psychiatry > Management > Flashcards

Management Flashcards

1
Q

Anorexia nervosa (Mx + prognosis)

A

Psych - CBT/supportive

Social - support groups (BEAT)

Bio - raise calorie intake

Hospital admission >35% weight loss
50% recover
5% mortality

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2
Q

Bulimia nervosa (Mx + prognosis)

A

Bio - SSRI

Psych -

Social - support group (BEAT)

70% recover within 5 years
No increased mortality

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3
Q

Mania (Mx)

A

Acute - neurolytics (olanzapine, haloperidol)

Prophylaxis - mood stabilisers (lithium, sodium valproate, carbamazepine)

ECT

Psychological therapies - improve concordance with therapies

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4
Q

Severe depression (Mx)

A

Bio -

Psycho -

Social - Mind website/depression alliance

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5
Q

Moderate depression (Mx)

A

Bio -

Psycho -

Social - Mind website/depression alliance

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6
Q

Mild depression (Mx)

A

Bio -

Psycho -

Social - Mind website/depression alliance

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7
Q

Psychosis (Mx)

A

Bio -

Psycho -

Social -

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8
Q

OCD (Mx)

A

Bio - SSRI (if moderate)

Psycho - Exposure and response prevention

Social -

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9
Q

PTSD (Mx)

A

Bio -

Psycho - trauma focused CBT
Eye movement desensitisation and reprocessing

Social -

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10
Q

Social Phobia (Mx)

A

Bio - SSRI, benzodiazepines ONLY for specific situations

Psycho - CBT, graded exposure

Social -

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11
Q

Agoraphobia (Mx)

A

Bio - SSRI if moderate

Psycho - systematic desensitisation (graded exposure to feared scenario)

Social -

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12
Q

Acute alcohol withdrawal(Mx)

A

Admit to hospital if:
- high risk of seizures/DT
-

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13
Q

Opiate abuse/withdrawal (Mx)

A

Bio -

Psycho -

Social - AA meetings

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14
Q

Alzhiemers disease (Mx)

A

MDT

Bio - Donepezil, rivastigmine, galantamine (mild-moderate), memantine (moderate-severe)

Psycho - structured group cognitive stimulation programme, co-morbid depression/anxiety - CBT, tailored interventions

Social - Alzhiemer’s society, support for carers (psychotherapy, peer-support groups, educational support), financial support, housing - environmental modification, inpatient care

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15
Q

Dementia (Mx)

A

Bio -

Psycho -

Social - Dementia UK

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16
Q

Parkinson’s Disease (Mx)

A

Bio -
Early PD - Levodopa, non-ergot dopamine agonist, MAO-B inhibitors, specialist referral

Late PC - modified release levodopa, dopamine agonist, MAO-B

Psycho - depression treatment (CBT etc.), psychosis management (avoid drugs that effect motor function)

Social - Parkinsons UK

17
Q

Post-partum psychosis (Mx)

A

Bio -

Psycho -

Social - admit to mother and Baby care unit

18
Q

Post-partum depression (Mx)

A

Bio - SSRI, TCA, SNRI

Psycho - CBT

Social - admit to mother and Baby care unit, Action on Posttpartum psychosis network

19
Q

ADHD (Mx)

A

Bio -

Psycho -

Social -

20
Q

Conduct disorder (Mx)

A

Bio -

Psycho -

Social -

21
Q

Personality disorders (Mx)

A

Bio -

Psycho -

Social -

22
Q

Autism (Mx)

A

Bio -

Psycho -

Social -

23
Q

Lewy-body dementia (Mx)

A

Bio -

Psycho -

Social -

24
Q

Cyclothymia (Mx)

A

Bio -

Psycho -

Social -

25
Q

Learning disabilities (Mx)

A

Bio -

Psycho -

Social -

26
Q

Vascular dementia (Mx)

A

Bio -

Psycho -

Social -

27
Q

Alcohol withdrawal seizures

A

Short acting benzodiazepine (eg. lorazepam)

NOT phenytoin

28
Q

Delirium Tremens

A

1st Oral lorazepam

2nd parenteral lorazepam, haloperidol or olanzapine

Review any medication

29
Q

Alcohol dependence Mx

A

Specialist alcohol services

Bio - thiamine (oral/ parenteral if necessary)
- Nalmefene (if not detox)

Psycho:

  • CBT (alcohol focus),
  • behavioural therapies
  • Social network
  • environmental therapies
  • couples therapy

Social - AA

30
Q

Wernicke-Korsakoff Syndrome

A

Supported independent living if mild cognitive impairment

Supported 24 hour care for moderate/severe cognitive impairment

31
Q

Assisted alcohol withdrawal

Inpatient criteria

A

(>15 units/day or >20 AUDIT)

drink over 30 units of alcohol per day
• have a score of more than 30 on the SADQ
• have a history of epilepsy, or experience of withdrawal-related seizures or delirium tremens during previous assisted withdrawal programmes
• need concurrent withdrawal from alcohol and benzodiazepines
• regularly drink between 15 and 30 units of alcohol per day and have:
• significant psychiatric or physical comorbidities (for example, chronic severe depression, psychosis, malnutrition, congestive cardiac failure, unstable angina, chronic liver disease) or
• Significant learning disability or cognitive impairment.

32
Q

Alcohol dependence drugs

A

Acamprosate

Naltrexone

Disulfiram - worse hangover

psychiatry (8 decks)

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