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Y5 Psych > PassMed > Flashcards

PassMed Flashcards

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1
Q

What antipsychotic decreases seizure threshold

A

Clozapine

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2
Q

what therapy is first line for PTSD

A

Trauma based CBT

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3
Q

What is another name for hypochondriasis

A

illness anxiety disorder

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4
Q

what factors are associated with a poor prognosis in schizophrenia

A

gradual onset
low IQ
prodromal phase of social withdrawal
lack of obvious precipitant

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5
Q

what prescribed drug can cause psychotic symptoms

A

steroids e.g. prednisolone

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6
Q

what conditions is ECT indicated in

A

catatonia
a prolonged or severe manic episode
severe depression that is life-threatening

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7
Q

how do you withdraw an SSRI

A

Gradually over 4 weeks

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8
Q

explain risk factors of SSRI in pregnancy

A

Use during the first trimester gives a small increased risk of congenital heart defects
Use during the third trimester can result in persistent pulmonary hypertension of the newborn\

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9
Q

what medication can you give to stop tardive dyskinesia

A

Tetrabenazine

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10
Q

what medication can you give to stop akathisia

A

propanolol

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11
Q

what is the TRIAD that occurs with serotonin syndrome

A
  • altered mental status (e.g. agitation, confusion, coma),
  • autonomic dysfunction (e.g. hyperthermia, hypertension, tachycardia)
  • neuromuscular abnormalities (e.g. tremor, clonus, hyperreflexia)
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12
Q

How do you treat refeeding syndrome

A

Phosphate replacement

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13
Q

What cognitive screening tests are you aware of

A

AMTS = screening tool to assess for cognition
MMSE = usually scored out of 30, cut-off is 23/24 (widely used)
MoCA / Addenbrookes (ACE) = more formally done by specialists
GPCOG / 6 item cognitive impairment test = primary care orientated

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14
Q

How long does prolonged grief disorder last

A

6+ months

ICD11

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15
Q

What are sx of prolonged grief disorder

A

longing for deceased, preoccupied with deceased, emotional pain, low mood, emootional numbing

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16
Q

How do you manage MUS

A

Explain and reassure (symptoms are not serious, but rather common and familiar)

Reattribution model - ensure they feel understood, link ssymptoms and psych factors

Avoid over investigation

Encourage sypport

Encourage normal function (normal physical activities)

Consider antidepressants, CBT, graded exercise

17
Q

What are somatoform disorders

A 
Somatisation disorder
Hypochondriasis
Conversion disorder
Body dysmorphic disorder
Pain disorder
18
Q

How can you manage lithium toxicity

A

Supportive - requires specialist input.

AIMS: electrolyte balance, monitoring renal function, control seizures.

CONSIDER:

  • IV fluid therapy
  • Benzodiazepines ( to treat agitation and seizures)
  • Haemodialysis (if the renal function is poor)
19
Q

how does risk of schizo change if one of the parents has it

A

increeases form 1% to 10%

20
Q

Clinical picture of delirium

A
  • sudden onset
  • fluctuating symptoms
  • worse at night
  • changes in mood (depression/ mania-like)
  • hallucinations, illusions
  • delusions (transient and muddled)
  • sleep disturbed (insomnia, reversal of sleep wake cycle)
21
Q

lewy body dementia 2 key sx

A

fluctuating confusion

vivid visual hallucinations

22
Q

what psych disease causes increased lymphocytes (and nothing else) on LP

A

Autoimmune encephalitis

23
Q

what are symptoms of autoimmune encephalitis

A

rapid changes in mental status, mood liabililty
e.g. crying one second, laughing the next

in young people with an acute onset of new neurological or psychiatric symptoms without a past context of mental health problems.

24
Q

how do you treat autoimmune encephalitis

A

steroids, IV immunoglobulin

wait 2 weeks –> second line tx: add rituximab/cyclophosphamide

25
Q

which type of dementia affects the hippocampus

A

Alzheimer’s

Causes HIPPOCAMPAL ATROPHY

26
Q

triad of Lewy body dementia

A
  • fluctuating cognition
  • hallucinations
  • parkinsonism
27
Q

What is another name for Picks disease

A

Frontotempoiral dementia

28
Q

how do you manage somatisation (biopsych?)

A

Bio: consider SSRI (not first linew)
Psych: CBT, mindfulness (not first line)

29
Q

What age does Picks / frontotemporal dementia occur in

A

in younger people than other dementias

30
Q

explain MANTRA

A

MANTRA involves talking to a therapist to discover the root cause of the eating
disorder and encouraging a behavioural change to develop a non-anorexic
identity.

31
Q

explain SSCM

A

SSCM is similar to MANTRA but is considered to be more practical.

Patients are taught about nutrition and how certain eating habits contribute to physical symptoms.

32
Q

How can you tell alcoholic hallucinosis and delirium tremens apart?

A

AH

  • resolves within 48 hours max from when they stopped drinking
  • patients are AWARE they are hallucinating
  • no autonomic dysfunction
33
Q

What precipitates an Acute Transient Psychotic Episode=?

A

a very stressful life event (1-2 weeks prior)

episode resolves within max 3 months

34
Q

what model defines the five stages of grief

A

Kubler Ross model

35
Q

What are TWO abnormal forms of grief reaction?

A
  1. Delayed grief reaction - onset more than 2 weeks from evenmt
  2. prolonged grief reactions - last more than 6 months
36
Q

How is DBT different to CBT?

A

DBT focuses on validation (i.e. teaching the patient how
to accept who they are) and the relationship between the therapist and the patient, which is used as motivation to change unhelpful behaviours.

37
Q

benzo withdrawal symptoms

A

insomnia, agitation, anxiety, tremor, tinnitus, and sweating

38
Q

what is the first management of paracetamol ovrdose in terms of investigations you should do for the patient?

A

check serum paractamol levels

this will determine whether they are above the threshold and need acetylcisteine

Y5 Psych (17 decks)

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