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Passmed Flashcards

1
Q

What SSRI causes increased QT ? What anti-psych causes increased QT?

A

Citalopram

Haloperidol

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2
Q

What SSRI do you use for post-MI depression?

A

Sertraline

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3
Q

What antidepressant do you give children and adults first line?

A

Fluoxetine

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4
Q

What antidepressant can cause congenital malformations?

A

Paroxetine

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5
Q

What do you never give with SSRIs? Why?

A

MAOis - increased risk for serotonin syndrome

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6
Q

What is erotomania?

A

Delusion famous person loves them

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7
Q

How do you manage mania in primary care?

A

Refer urgently to CMHT

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8
Q

Examples of tarditive kinesia

A

Blink excessively, pout, chewing

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9
Q

Blood gases for bulimia

A

Hypochloremic metabolic alkalosis

Hypokalaemia as well

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10
Q

Metabolic side effects of antipsych

A

Dislipidaemia, glycemic, DM

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11
Q

Manage patients with poor compliance to oral anti-psych

A

Switch to once a month injections

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12
Q

Manage antidepressants before ECT

A

Reduce dose but don’t stop

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13
Q

Peak for seizures and delirium after alcohol withdrawal

A

36 hours

72 hours

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14
Q

How do you diagnose schizophrenia?

A 
2 of: 
Delusions, hallucinations, disorganized speech, disorganized / catatonic behaviour, negative symptoms
1 has to be one of the first 3
Ongoing for 6+ months 
Not explained by any other condition
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15
Q

5 subtypes of schiz

A
  1. Paranoid (+ symptoms)
  2. Disorganized (hebenephric)
  3. Catatonic
  4. Undifferentiated
  5. Residual
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16
Q

What are features of paranoid schizophrenia?

A

Positive symptoms: delusions, hallucinations, thought disorder/disorganized speech

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17
Q

What are the features of disorganized schizophrenia?

A

Disorganized speech, behaviour, flat/inappropriate affect

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18
Q

What are the features of catatonic schizophrenia?

A

Immobile, maintained rigid posture, resist movement
Echolalia/praxis
Rocking, nail biting

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19
Q

3 spectrum schiz disorders

A
  1. Schizoaffective: schiz + bipolar
  2. Schizopheniform: shorter duration
  3. Schizotypal: impacted social/interpersonal skills, magical thinking, bizzare fantasies
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20
Q

Features of alcohol withdrawal by hour

A

6-12: anxiety, tremor, tachycardia, sweat

36: seizures
72: delirium, coarse tremor, tachycardia, hallucinations, fever

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21
Q

Acute management of alcohol withdrawal

A

BZD: chlordiazepoxide / diazepam (lorazepam if hepatic failure)

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22
Q

Maintaining alcohol abstinence treat

A

Disulfram: causes severe reaction if they drink - throw up!!
Acamprosate: reduces craving

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23
Q

Features of opioid misuse

A

Pinpoint pupils, needle marks, rhinorrhea, watering eyes, yawning

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24
Q

Opioid overdose treat

A

IV/IM naloxone

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25
Manage opioid dependence with what drugs
1. Methadone | 2. Buprenorphine
26
How long do you monitor opioid dependence treatment
4 weeks in hospital or 12 weeks if in community
27
ECT is useful for
Severe depression
28
Absolute contraindication to ECT
ICP increased
29
Side effects of ECT
Headache, nausea, memory problems, cardiac arrhythmia
30
Othello’s syndrome
Partner is cheating no proof
31
What is Wernick’s encephalopathy?
Neuropsychiatric disorder caused by thiamine deficiency (B1)
32
Who gets Wernicke’s?
Alcoholics, extreme throw up, stomach cancer, dietary deficiency
33
Wernicke’s triad
1. Opthalmoplegia/nystagmus 2. Ataxia 3. Confusion
34
2 other features of Wernicke’s
Petechial haemorrhages in brain | Peripheral sensory neuropathy
35
Tests for Wernicke’s
Decreased RBC transketolase | MRI
36
What is korsakoff’s ?
Wernicke’s +: Anterograde amnesia Retrograde amnesia Confabulation
37
What is impaired in Wernicke’s / Korsakoff’s?
Medial thalamus and mammillary of hypothalamus
38
Treat akathisia
Propanolol
39
Treat acute dystonia
Procyclidine
40
Treat tar dive dyskinesia
Tetrabenazine
41
Severe OCD treat
SSRI and CBT
42
Lithium with increased WBC
Normal - leave it !
43
How long do you continue antidepressants for?
6 months
44
ECT is clinically indicated for who?
A catatonic patient with severe depression
45
TCAs cause _____ incontinence
Overflow
46
Having a high/low IQ is linked to a good prognosis for schizophrenia
High
47
AMTS for dementia has to be
8
48
Next steps when you suspect dementia
Blood tests to rule out B12 and folate and thyroid function Urine dip Referral to memory clinic
49
What ECG finding is more common in patients with severe anorexia?
Prolonged QT - due to hypokalaemia
50
Alzheimer's post-mortem
Widespread cerebral atrophy
51
How long does it take for antidepressants to work?
2-4 weeks
52
What is the mechanism of action for atypical antipsychotics?
Inhibition of 5HT2 and D2 receptors
53
St. John's wort on COCP
Reduces the effect due to enzyme induction
54
Which dopaminergic areas does haloperidol act on?
Mesolimbic and mesocortical
55
________ pathway is responsible for the positive symptoms of schizophrenia and the ________ pathway is responsible for the negative symptoms
Mesolimbic, mesocortical
56
Relative risk calculation
Experimental event rate/control event rate
57
Orthostatic hypotension is a side effect of which anti-psychotic drugs?
Typical
58
Single most important screening test before starting olanzapine
Blood glucose
59
Don't use BZD in
Panic disorder
60
Don't use propanolol in
Anxiety disorder
61
What drug reduces your seizure threshold?
Clozapine
62
Side effects of anti-psychotic medications
Sedation, weight gain, reduced seizure, increased QT, increased prolactin, impaired glucose, neuroleptic
63
SNRIs can cause what?
Hypertension
64
SSRIs side effect to look for
Hyponaturemia
65
Lithium measure when?
12 hours post dose Weekly after starting or changing dose until levels are stable Then 3 monthly
66
Patient comes in with dizziness, increased anxiety, and electric shocks
SSRI discontinuation
67
Can you stop SSRIs all at once?
No, need to over 4 week period
68
Patient comes in with elevated levels of clozapine, what can cause this?
Smoking cessation
69
Clozapine GI symptom
Chronic constipation
70
Flight of ideas is characteristic of
Mania
71
Lithium endocrine
Hyperparathyroid and hypothyroid

Psychiatry (22 decks)

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