Other Psych Topics Flashcards

Question

Psychological consequences of alcohol dependence?

Answer 1

Anxiety Depression Memory problems (alcoholic dementia/Wernicke’s/Korsakoff’s)

Answer 2

* Financial problems * Housing * Family/relationships * Work

Answer 3

* Drink driving * Drunk-related offences * Other substance misuse

Answer 4

* Self-harm/suicide * Risk to others * Safeguarding – children!

Answer 5

1. Oral thiamine + vitamin B 2. Parenteral vitamins if concerned about Wernicke’s 3. Detox with chlordiazepoxide 20-30mg QDS, reducing regime over 5-7 days – use lorazepam if significant liver disease.

Answer 6

1. Simple counselling and advice | 2. Motivational interviewing (esp if in contemplation phase)

Answer 7

• Support to access services – housing, citizens advice bureau etc.

Answer 8

1. Disulferam 200mg OD – aversive agent, blocks alcohol dehydrogenase enzyme – will vomit if ingest alcohol – 6 months to 1 year. 2. Anti-craving agents o Acamprosate 666mg TDS – enhances GABA neurotansmission o Naltrexone 50mg OD – opitate antagonist

Answer 9

• Relapse prevention strategies o CBT o Social network and behavioural therapy  remove from social drinking, have a contact to call when cravings are severe.

Answer 10

* Alcoholics anonymous | * Rehabilitation

Answer 11

Traumatic event results in a disruption of the usually integrated functions of consciousness, memory, identity or perception of the environment

Answer 12

Loss of memory commonly for a traumatic or stressful event

Answer 13

Memory loss or confusion about personal identity or assumption of another identity May last several months When it ends the memory of the fugue is lost

Answer 14

Motionless and mute, no response to stimulation

Answer 15

Commonly involve paralysis of muscle groups Atasia abasia: inability to stand or walk

Answer 16

Commonly glove and stocking distribution

Answer 17

Psuedoseizures with no organic basis

Answer 18

Approximate answers (2+2=5), absurd statements, confusion, hallucintions, psychogenic Sx Shows that they know what the question means but are answering incorrectly

Answer 19

Physical symptoms which cannot be accounted for by a physical disorder or other psychiatric disorder and are thought to result from psychological factors

Answer 20

Long history of multiple and severe physical symptoms that cannot be accounted for by a physical or psychiatric disorder F > M Briquet’s syndrome, St louis hysteria

Answer 21

Fear or belief of having a serious physical disorder despite medical reassurance to the contrary Includes body dysmorphic disorder RF: male, medical students

Answer 22

Chronic pain that cannot be accounted for by a physical disorder or other psychiatric disorder

Answer 23

Sx which are manufactured or exaggerated for the purpose of assuming the sick role Munchausen Syndrome

Answer 24

Sx which are manufactured or exaggerated for a purpose other than assuming the sick role e.g. to evade to police, get compensation

Answer 25

``` Severe N+V Severe diarrhoea Reduced appetite Fine tremor Ataxia Dysarthria Blurred vision Drowsy Confused Seizures Collapse ```

Answer 26

Drugs: ACEi, NSAIDS, diuretics Renal failure UTI Dehydration

Answer 27

Lithium levels >1.5 Check renal function U+E, eGFR and creatinine

Answer 28

STOP LITHIUM Fluid replacement to promote diuresis Consider dialysis Treat the cause

Answer 29

``` Hyperthermia Autonomic dysfunction Rigidity Myoclonus Encephalopathy Diaphoresis ```

Answer 30

Serotonergic agents Combination of agents which stimulate serotonin receptors e.g. SSRIs

Answer 31

No specific Ix Check renal function

Answer 32

``` STOP THE SEROTONERGIC AGENT IV fluids Close monitoring Cooling blankets for hyperthermia Anticonvulsants for seizures Clonazepam for myoclonus Nifedipine for HTN ``` Most recover in 24 hours

Answer 33

Fever Altered mental state Muscle rigidity (lead pipe) Autonomic dysfunction

Answer 34

Dopaminergic agents Rapid antipsychotic inititation or dose increase Withdrawal of antiparkinson meds

Answer 35

Creatine phosphokinase elevated in the 1000’s ECG: tachycardia ABG: metabolic acidosis

Answer 36

STOP ANTIPSYCHOTIC ``` Benzodiazepines for agitation Supportive measures: O2, fluids… Cooling blankets for hyperthermia IV sodium bicarbonate to prevent renal failure Dantrolene/lorazepam for rigidity Close monitoring Bromocriptine prophylaxis ```

Answer 37

``` Respiratory failure CV collapse Renal failure Seizures Arrhythmias DIC 20-30% mortality rate if untreated ```

Answer 38

Behavioural activation is about not waiting till you feel better to start doing stuff or will never do anything and stay in viscious cycle Treatment involves getting people to act according to a plan rather than how they feel and involves DOING things

Answer 39

Focuses on interpersonal difficulties, roles and grief Brief, pragmatic and highly structured

Answer 40

Based on Freud Focus on past conflicts contributing to current difficulties – insight orientated Neutral therapist, focus on patient – therapist relationship - Transference: bring past feelings to present interaction - Counter transference: feelings in therapist given by patient Allow to work through problems in a safe relationship

Answer 41

o Addictions o Compliance o Changing behaviour

Answer 42

Borderline PD Managing feelings and self-harm

Answer 43

Seeing and treating people in context Children, eating disorders, psychosis Improve communication within family

Answer 44

Support/adjustment following diagnosis Self help e.g. AA, weight watchers CBT based groups: anxiety, depression, assertiveness

Answer 45

Risks associated with GA Adverse effects = memory impairment Risks of not receiving ECT Informed consent and right to withdraw consent at any time

Answer 46

A On top of the world, wide-awake, confidence, reduces hunger, short-acting. Tachycardia, raised temperature, MI, HF, hypertension, seizure, depression, anxiety, panic attack, paranoia.

Answer 47

A Warm feeling, mild euphoria, relaxed, drowsiness, analgesia, constricted pupils. Constipation, addiction/dependency, respiratory depression, hallucination

Answer 48

Sweating, malaise, anxiety, depression, akathisia, excessive yawning/sneezing, tears, rhinorrhoea, insomnia, cold sweats, chills, aching, nausea, vomiting, diarrhoea, involuntary limb spasms, cramps.

Answer 49

A Energised, happy, alertness, increased affection, chatty, dilated pupils. Anxiousness, panic attacks, confused episodes, paranoia, psychosis, tachycardia, hyperpyrexia, electrolyte disturbances, de- and over-hydration.

Answer 50

A Disorientation, lethargy, giddiness, relaxed, euphoria, perceptual and sensory changes, hallucinations. Poisoning, death, nausea, disorientation, diarrhoea, stomach pains, depression, anxiety, paranoia, panic attacks, ‘bad trips’, flashbacks.

Answer 51

B NMDA antagonist. Relaxation, altered bodily sensations, floating feelings, dissociation, altered perceptions, hallucinations Anaesthetic (injectable GA) – ulcerative cystitis, bladder pain, memory problems, dependency, panic attacks, confusion, agitation

Answer 52

B Chilled out, relaxed and happy, giggles, very talkative, hungry Cravings & psychological dependency, anxiety, paranoia, poor concentration, poor memory, psychosis, precipitate schizophrenia.

Answer 53

B Wide awake, excited, talkative, reduced hunger/appetite, more energy. Dependency, insomnia, poor concentration, anxiety, depression, irritability, aggression and paranoia, psychosis, cardiac problems.

Answer 54

B Feel alert, confident, talkative, euphoric, increased affection, reduced appetite. Nausea, anxiety, headache, agitation, hallucinations, seizures, reduced peripheral circulation, epistaxis, addiction, paranoia, self-harm

Answer 55

C Relaxed, calm, less anxious, sedated Respiratory depression, falls, hangover, memory loss, sedation, death with injection

Answer 56

C Euphoria, reduced inhibitions and drowsiness. Nausea, dizziness, drowsiness, agitation, visual disturbances, respiratory depression, unconsciousness, coma, death (esp if mixed with alcohol)

Answer 57

N/A Rush/high Hypotension, unconsciousness, nausea, headache, confusion, arrhythmia and death.

Answer 58

Often painful spastic contraction of certain muscles or muscle groups most commonly affecting the neck, eyes and trunk. For example, tongue protrusion, grimacing, torticollis. May respond to anticholinergics (procyclidine).

Answer 59

Distressed feeling of inner restlessness manifested by fidgety leg movements, shuffling of feet, pacing etc. May respond to anticholinergics, propranolol, cyprohepatadine (antihistamine), benzodiazepines or clonidine.

Answer 60

Parkinsonian triad of tremor, muscle rigidity and bradykinesia. May respond to anticholinergics.

Answer 61

Involuntary, repetitive, purposeless movements of the tongue, lips, face, trunk, and extremities that may be generalised or affect only certain muscle groups, typically orofacial muscle groups. TD occurs after several months or years of antipsychotic treatment and is often irreversible. No consistently beneficial treatment and may be exacerbated by anticholinergics.