Pass Medicine Psychiatry Flashcards
Prefer to be alone don’t like relationships low libido
Schizoid personality disorder
What is the most likely SSRI to cause QT prolongation and torsades de pointed
Cotalopram
What is the recommended SSRI for patients with cardiac disease
Sertraline
Which drugs are important to note the anterograde amnesia which can present as the patient worrying about dementia
Benzos
Most commonly associated side effect of haemolytic anaemia
Nitrofurantoin
First line in patients with schizophrenia
Atypical antipsychotics
Adverse side effects of atypical antipsychotics
Weight gain
Agranulocytosis
Hyperprolactinaemia
When are the atypical antipsychotics?
Increased risk of stroke or VTE
Eh of atypical antipsychotics
Clozapine Olanzapone Risperidone Quetiapine Amisulpride Aripiprazole
How long should a patient be feeling depressed before they are classed as having depression
2 weeks
When is ECT used acutely
Catatonia
A prolonged or severe manic episode
Severe depression that is life threatening
Upper limb weakness and inability to move with normal exam findings
Conversion disorder
What is somatostatin disorder
Multiple physical symptoms present for at least 2 years patient refuses to accept reassurance or negative test results
What is dissociative disorder
Separating off certain memories from normal consciousness involving psychiatric symptoms
What is factitious disorder
Also known as munchausens syndrome where there is an intentional production of physical or psychological symptoms
What is malingering
Fraudulent stimulation or exaggeration of symptoms for financial or other gain
Treat PTSD with
EMDR or CBT trauma focussed
What is akathisia
Severe restlessness
What are extrapyramidal side effects
Parkinsonism
Acute dystonia - sustained muscle contraction
Akathisia severe restlessness
Tar dive dyskinesia - late onset of choreoathetoid movements
Treat extrapyramidal side effects with
Procyclidine
First line for panic disorder
SSRI
What drug is contraindicated with the use of SSRIs
Triptans
When do seizures usually occur in alcohol withdrawal
36 hours
When does delirium tremendous usually occur with alcohol withdrawal
72 hours
What benzo is good in alcohol withdrawal
Chlordiazepoxide
What benzo is good for alcohol withdrawal in patients with her aux failure
Lorazepam
New onset psychosis in elderly do a
CT head
Describe tar dive dyskinesia
Abn involuntary movements like lip smacking
Why is mortazapine. And alpha 2 antagonist often not tolerated
Increased appetite and sedation
What causes the tyramine cheese reaction
MAOI such as phenelzine causes this hypertensive crisis
What is Charles Bonnet syndrome
Visual hallucinations and eye disease
Name 5 short term side effects of eCt
Headache nausea short term memory impairment
Memory loss of events prior to ECT
Cardiac arrythmia
What is agranulocytosis
Low leukocytes severely low
What is circumstantiality
Inability to answer a question without giving excessive unnecessary detail
What are clang association s
Topics are related to each other only by sound
What is tangentially
Wandering from a subject without returning to it
How do you differentiate between knights move and flight of ideas
Knights move - illogical leaps from one to another
Flight of ideas - some sort of link
What are the metabolic side effects of atypical antipsychotics
High lipids high cholesterol high sugar weight gain
SSRIs cause what type of biochemical abn
Hyponatraemia
Patients with poor oral compliance to antipsychotics should be considered for
Monthly IM antipsychotic depot injections
SSRI used during third trimester of pregnancy
Can cause persistent pulmonary hypertension
What commonly prescribed drug is associated with sudden onset psychosis
Prednisalone
Paroxetine in pregnancy has been linked with
Congenital malformation
What can treat tar dive dyskinesia
Tetrabenazine
Treat akathisia
Propranolol
Telepathy acute dystonia
Procylcidine and benzotropine
What are the main side effects of tricyclics
Anticholinergucbside wffects and weight gain
How should you stop an SSRI
Gradually reduce dose over 4 weeks
What is torticollis
Wry neck - unilateral pain and deviation of the neck
What is most commonly associated with SSRI discontinuation syndrome
GI side effects
If clozapine doses are missed for more than 48 hours what should happen
They should be retitrated slowly
SSRI + NSAID =
GI bleeding risk so give a PPI
Which antipsychotics has the best side effect profile particularly in terms of prolactin
Aripiprazole
What psychiatric disorder can be seen post concussion
Headache fatigue anxiety depression dizziness
Long term lithium use can result in what biochemical abn
Hyperparathyroidism and resultant hypercalcaemia
What should happen to the antidepressant before a patient is starting ECT
Reduce the dose
What is more common after ECT - retrograde or anterograde amnesia?
Retrograde
After changing the dose of lithium when should the lithium levels be checked
A week after and 12 hours atter the last dose
For a diagnosis of PTSD symptoms must be present for at least
One months
What is an oculogyric crisis
Acute dystonic reaction of the ocular muscles characterised by bilateral dystonic elevation of the visual gaze lasting from seconds to hours
If you give haloperidol urgently what else do you need to have prepared
Procyclidine in case the patient suffers an acute dystonic reaction
What is othello syndrome
Delusional jealousy usually believing their partner is unfaithful
