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Psychiatry > passmed > Flashcards

passmed Flashcards

1
Q

Charles Bonnet Syndrome?

A

persistent or recurrent complex - - hallucinations (usually visual or auditory)
background of visual impairment (although visual impairment is not mandatory for a diagnosis).
Insight is usually preserved.

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2
Q

Bipolar types?

A

type I disorder: mania and depression (most common)

type II disorder: hypomania and depression

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3
Q

Mania?

A

severe functional impairment or psychotic symptoms for 7 days or more

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4
Q

Hypomania?

A

decreased or increased function for 4 days or more

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5
Q

Key differentiation of mania and hypomania?

A

key differentiation is psychotic symptoms (e.g.delusions of grandeur or auditory hallucinations) which suggest mania

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6
Q

Mood stabiliser of choice for bipolar?

A

lithium (valproate as alternative)

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7
Q

Management of mania/hypomania?

A

consider stopping antidepressant if the patient takes one;

antipsychotic therapy e.g. olanzapine or haloperidol

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8
Q

Management of depression in bipolar?

A

talking therapies

fluoxetine is the antidepressant of choice

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9
Q

Bipolar px are 2-3x more at risk of what? (x3)

A

Diabetes
CVS disease
COPD

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10
Q

Referral - if symptoms suggest hypomania?

A

community mental health team (CMHT) - routine referral

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11
Q

Referral - mania or severe depression?

A

urgent referral to CMHT

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12
Q

Cotard syndrome?

A

believes that they (or in some cases just a part of their body) is either dead or non-existent

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13
Q

Capgras syndrome?

A

patients believe that a relative or friend has been replaced by an identical impostor.

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14
Q

De Clérambault syndrome

A

erotomania, is a rare delusion disorder where patients believe another individual is infatuated with them, often despite the individual being imaginary, deceased or someone the patient has never met.

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15
Q

Is gradual or sudden onset schizophrenia associated with worse prognosis?

A
  • GRADUAL

Others:

  • strong family history
  • low IQ
  • prodromal phase of social withdrawal
  • lack of obvious precipitant
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16
Q

increased risk of completed suicide at a future date?

A
  • efforts to avoid discovery
  • planning
  • leaving a written note
  • final acts such as sorting out finances
  • violent method
17
Q

What’s a pseudo hallucination, commonly occur in what?

A

false sensory perception in the absence of external stimuli when the affected is aware that they are hallucinating.
–> NORMAL GIREF RESPONSE

18
Q

Bipolar: speech/thought?

A

pressured
flight of ideas: characterised by rapid speech with frequent changes in topic based on associations, distractions or word play
poor attention

19
Q

Bipolar: behaviour?

A

insomnia
loss of inhibitions: sexual promiscuity, overspending, risk-taking
increased appetite

20
Q

Peak incidence of delirium tremens?

A

72 hours

21
Q

Peak incidence of seizures (in alcohol withdrawal)?

A

36 hours

22
Q

Peak incidence of symptoms of alcohol withdrawal? Name them?

A

6-12hrs -> tremor, sweating, tachycardia, anxiety

23
Q

Difference between acute stress reaction and PTSD?

A

acute - within 4 weeks of traumatic event

PTSD - after 4 weeks

24
Q

Risk of developing schizophrenia:

a) monozygotic twin with schizo?
b) parent with schizo?
c) sibling with schizo?
d) no relatives?

A

a) 50%
b) 10-15%
c) 10%
d) 1%

25
Q

Sx of post-concussion disorder?

A

headache
fatigue
anxiety/depression
dizziness

26
Q

Which antidepressant may increase appetite and therefore useful to increase weight?
moa?

A

MIRTAZEPINE

alpha2-adrenergic receptors

27
Q

Scoring system to assess severity of alcohol withdrawal?

A

CIWA-Ar (clinical institute withdrawal assessment)

28
Q

Common features of PTSD?

A

1) re-experiencing (flashbacks, nightmares)
2) avoidance (people or situations)
3) hyperarousal (hypervigilance, sleep problems)

29
Q

OCD 1st line medication if CBT/exposure + response therapy is unsuccessful?

A

SSRI e.g, SERTRALINE

fluoxetine if suffers body dysmorphia

30
Q

Which antidepressant warrants addition of PPI if the px takes an NSAID?

A

SSRI’s

31
Q

When does Wernicke’s become Korsakoff?

A

anterograde amnesia, retrograde amnesia, and confabulation

32
Q

Diagnosis of chronic insomnia?

A
  • trouble falling asleep at least 3x a week for at least 3 months
33
Q

Short-term side effects of ECT?

A
  • headache
  • nausea
  • short term memory impairment
  • memory loss of events prior to ECT
    cardiac arrhythmia
34
Q

ECT indications?

A

catatonia
prolonged or severe mania
severe depression that is life-threatening

35
Q

Sign to differentiate orange vs. non-organic cause of limb paresis?

A

HOOVER’S sign

Psychiatry (8 decks)

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