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ART_MRCPSYCH_B_MENTOR > Misc. - 1 > Flashcards

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

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
Q

how hepatic failure affects prescription in mental health?

A
  • 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
Q

How long main symptoms of GAD are required to last in ICD 11

A

Several months

26
Q

How - reduced hepatic ability to metabolize affects psychotropics

A

toxicity and enhanced dose-related side effects

27
Q

how -Reduced hepatic ability to synthesize plasma proteins affects psychotropics

A

toxicity of protein bound drugs

28
Q

how - -Reduced hepatic blood flow affects psychotropics

A

elevated levels of drugs subject to first pass

29
Q

safe antipsychotics in hepatic impairments

A

PAS the hepatics:

Paliperidone
Amisulpride
Sulpride

30
Q

safe antidepressants in hepatic impairment

A

Sertraline
Citalopram
Paroxetine
Vorioxetine

31
Q

safe mood stabilizers in hepatic impairment

A

lithium

32
Q

safe sedatives in hepatic impairment

A

LOTZ

Lorazepam
Oxazepam
Temazepam
Zopiclone 3.75 (with care)

33
Q

photosensitivity & heptaic toxicity are side effect which antidepressant herb?

A

St John’s wort

34
Q

St john’s wort drug interactions?

A

Oral contraceptives
Warfarin
Ciclosporin
HIV drugs
Antiepileptics

35
Q

potential active compounds in st john’s wort

A

Hypericin
Hyperforin
flavonoids

36
Q

NICE stance on st johns wort?

A

urged not to avoid recommending it (due to issues with dose standardisation)

37
Q

Maudsley stance on st johns wort?

A

same as NICE

38
Q

safety profile of st john’s wort

A

same side effects as palcebo but do not mix it with other serotonergics to avoid serotonin syndrome

39
Q

Cochrane revewi 2016 on effectiveness of st john’s wort?

A

mild to moderate depression ==effective

more effective than placebo

similarly effective to SSRI and TCAs

40
Q

st john worts - P450 system

A

CYP3A4

41
Q

what is KAVA

A

piper methysticum

42
Q

what is kava known to be effective for?

A

sedative and anxiolytic properties

43
Q

mechanism of action for kava

A

modulation of gabanergic neurons (like benzo)…
inhibition of voltage gate calcium and sodium channels

44
Q

meta-analysis support for kava

A

yes
reduces symptoms of GAD cmpared to placebo

45
Q

concern about kava

A

liver damage (hence remains off the recommendation list)

46
Q

what is saffron suggested to be good for

A

antidepressant (mild to moderate) [more research required]

47
Q

what is valerian thought to be good for

A

anxiety and insomnia (not robustly supported)

48
Q
A

ART_MRCPSYCH_B_MENTOR (38 decks)

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