Misc. - 1 Flashcards

1
Q

Where does Cotard’s syndrom is seen ?

A

Depression ( most common)
Schizophrenia
Bipolar

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2
Q

as a delusion what is special about cotard’s?

A

it is less dramatic

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3
Q

what is cotards?

A

unshakable belief that one has lost their blood, internal organ, soul or is even dead.

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4
Q

The enzyme from GIT that increase satiety?

A

Cholecystokinin (CCK)

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5
Q

The enzyme from GIT that stimulates feeding?

A

Ghrelin

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6
Q

what do cholecystokinin work on to induce satiety?

A

Vegus Nerve ==>Medula Oblongata

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7
Q

What do Ghrelin work on to induce feeding?

A

Hypothalamus

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8
Q

where gastrin is released from

A

stomach and dudenum

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9
Q

what do gastrin do?

A

stimulates screte of gastric juice

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10
Q

where somatostatin is released form?

A

Stomachw

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11
Q

what does somatostatin do?

A

IN gastric inhibits gastrin
in dudenum inhibits secretin and CCK
in pancrease inhibits glucagon release

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12
Q

what is cisgender?

A

when there is congruency between assigned sex and experienced/identified gender

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13
Q

what is sex?

A

biological inidcator of male and female (sex chromosomes, gonads, sex hormones)

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14
Q

what is gender?

A

is a person’s identification or lived role in society

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15
Q

is gender binary?

A

no

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16
Q

are gender and sexual preferences covered with the same concept in ICD and DSM?

A

no

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17
Q

what did ICD 11 replace transsexualism and gender identity disorders with?

A
  • Gender incongruency in adolescents and adults
    -Gender incongruency in chilldren
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18
Q

are gender related issues considered mental disorders?

A

nope.

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19
Q

ICD 11 criterias for gender incongruency in Children

A
  • marked incongruency between assigned sex and identified/experienced gender
    -dislike towards incongruent body parts associat. with assigned gender (+2nd characteristics)
    -Involved in toys, games and activities of the incongruent preferred gender
    -at least 2 years
  • Gender variant behaviours and preferences cannot be the sole basis for dx
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20
Q

ICD 11 criterias for gender incongruency in adolescent and adults

A

-marked incongruency between assigned sex and identified/experienced gender leading to a desire to transition
-dx cannot be made prior to puberty
-Gender variant behaviours and preferences cannot be sole basis for dxw

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21
Q

what term dsm-5 used to define gender incongruency?

A

gender dysphoria

22
Q

who long dsm-5 requires gender dysphoria symptoms to last?

A

6 months at least

23
Q

despite a marked incongruency between gender and sex, what other symptoms dsm-5 reuires for dx of gender dysphoria

A
  • desire to be rid of on’e sprimary sex
    -desire for primary sex of other gender
    -desire to be treated as the other gender
    -Conviction that one has they typical feelings & reaction of the other gender
    -Marked distress and impairment
24
Q

main symptoms of GAD in ICD 11

A

-Apprehension (more than one setting)
-excessive worry
-muscle tension
-sympathetic autonomic overactivity
-subjective exper. of nervousness, restlessness and being on edge
-difficulty concentrating
-Irritability
-sleep disturbances

25
how hepatic failure affects prescription in mental health?
- reduced ability to metabolize (toxicity and enhanced dose related side effects) -Reduced ability to synthesize plasma proteins (toxicity of protein bound drugs) -Reduced hepatic blood flow (elevated levels of drugs subject to first pass)
25
How long main symptoms of GAD are required to last in ICD 11
Several months
26
How - reduced hepatic ability to metabolize affects psychotropics
toxicity and enhanced dose-related side effects
27
how -Reduced hepatic ability to synthesize plasma proteins affects psychotropics
toxicity of protein bound drugs
28
how - -Reduced hepatic blood flow affects psychotropics
elevated levels of drugs subject to first pass
29
safe antipsychotics in hepatic impairments
PAS the hepatics: Paliperidone Amisulpride Sulpride
30
safe antidepressants in hepatic impairment
Sertraline Citalopram Paroxetine Vorioxetine
31
safe mood stabilizers in hepatic impairment
lithium
32
safe sedatives in hepatic impairment
LOTZ Lorazepam Oxazepam Temazepam Zopiclone 3.75 (with care)
33
photosensitivity & heptaic toxicity are side effect which antidepressant herb?
St John's wort
34
St john's wort drug interactions?
Oral contraceptives Warfarin Ciclosporin HIV drugs Antiepileptics
35
potential active compounds in st john's wort
Hypericin Hyperforin flavonoids
36
NICE stance on st johns wort?
urged not to avoid recommending it (due to issues with dose standardisation)
37
Maudsley stance on st johns wort?
same as NICE
38
safety profile of st john's wort
same side effects as palcebo but do not mix it with other serotonergics to avoid serotonin syndrome
39
Cochrane revewi 2016 on effectiveness of st john's wort?
mild to moderate depression ==effective more effective than placebo similarly effective to SSRI and TCAs
40
st john worts - P450 system
CYP3A4
41
what is KAVA
piper methysticum
42
what is kava known to be effective for?
sedative and anxiolytic properties
43
mechanism of action for kava
modulation of gabanergic neurons (like benzo)... inhibition of voltage gate calcium and sodium channels
44
meta-analysis support for kava
yes reduces symptoms of GAD cmpared to placebo
45
concern about kava
liver damage (hence remains off the recommendation list)
46
what is saffron suggested to be good for
antidepressant (mild to moderate) [more research required]
47
what is valerian thought to be good for
anxiety and insomnia (not robustly supported)
48
typical features for Post-concussion syndrome?
Headache Fatique Dizziness Anxiety & Depression
49