PassMed learning Flashcards
Atypical antipsychotic associated with the least side effects
Aripriprazole (particularly good for patients with prolactin elevation using other APs)
Key side effects of antipsychotics
Prolactin elevation
Weight gain
Stroke/ VTE
Low white cells (clozapine)
Side effect profile of clozapine
Agranulocytosis and neutropenia
Reduced seizure threshold
Constipation
Hypersalvation
Myocarditis (baseline ECG before)
When can clozapine be introduced
Schizophrenia when 2 other antipsychotics have failed for 6-8 weeks each
Definition of somatisation disorder
Multiple physical symptoms present for 2+ years
AND
Patients refuses to accept negative results
Definition of hypochondriasis (illness anxiety disorder)
Persistent belief in presence of underlying disease
Patient refuses to accept negative results
Difference between somatisation and hypochondriac
Somatisation = symptoms (multiple for at least 2 years) Hypochondriac = disease belief
Both refuse to accept negative results
Conversion disorder definition
Patient loses motor or sensory function
Does not consciously fake the symptoms
What is Munchausens syndrome
Intentional production of physical or psychological symptoms
What is malingering
Fraudulent simulation or exaggeration of symptoms for gain (normally financial)
What is dissociative disorder
Separating off certain memories from normal consciousness
What psychiatric drug increases risk of VTE in elderly
Atypical antipsychotics
Name 2 main typical antipsychotics
Haloperidol
Chlorpromazine
When should lithium levels be monitored in a patient starting treatment today and continuing for 2 years
12 hours after dose
Every week until stable
Every 3 months then on
Catatonia definition
Inability to move correctly
Abnormal movements
First line treatment for anorexia in children
Focused family therapy
Two types of bipolar?
1: Depression and mania (psychotic beliefs lasting more than 7 days)
2: Depression and hypomania
Treatment for OCD if mild vs severe
Mild: CBT
Severe: SSRI
Fluoxetine for body dysmorphic disorder
Two common monoamine oxidase inhibitors
tranylcypromine and phenelzine
Why are monoamine oxidase inhibitors not really used
Cannot consume tyramine containing foods (cheese, marmite, broad beans)
As causes hypertensive reaction
What is rasagaline
Inhibitor or monoamine oxidaseB used to treat Parkinson’s
What are clang associations
Ideas that are linked by rhyme or similarity of word sounds alone. This is sometimes seen in schizophrenia or bipolar disorder.
What is avoidant personality disorder
Avoid social activities
Preoccupied with ideas that they are rejected in social situations
Isolate them self but crave interaction
What is key symptoms of borderline personality disorder
Emotionally unstable
Avoid abandonment
Difference between Knights Move thinking and flight of ideas
KM: no connection between ideas
FOI: some connection, however remote
Key side effect of atypical AP vs typical AP
Weight gain
Drug management for bipolar
Lithium
Antipsychotic can be used at low dose (quetiapine (sedative))
Antiepileptics for mood stability
In patients presenting with ?anorexia what is a key first part of the assessment
Physical state - including HR temp BMI
What is anankastic personality disorder
OCD
What is conversion disorder
When a person develops blindness or paralysis
Key difference between panic disorder and GAD
Panic disorder is short spells that happen acutely and last a few minutes
Patient with broad based gate, confusion and delusions. What needs to be given
Thiamine first!! This is Wernicke’s
Urine left for 3 days - turns red…
What is it and whats the cause
Porphyria
Liver disfunction
Man insists wife is unfaithful and sleeping with whole neighbourhood - DX?
Othello syndorme
What is dissociative fugue
After a stress, people temporarily lose their identity and wander away from their homes
What is agroraphobia
Anxiety disorder that causes fear of social situations that might cause embarrassment, helpless or trapped
What is cortards syndrome
Belief one is dead, missing blood or organs
Other than lithium what cases of drugs can be used in BP disorder
Anti psychotics for short periods of mania
Anti epileptic as mood stabiliers
SSRI contraindicated with UGI bleeds
Fluoxitiene
SSRI of choice in children
Fluoxetine
How to manage hypomania in primary care
Routine referral to community mental health
How should an SSRI be stopped
Over 4 weeks slowly
Compulsion vs obsession
Compulsion is a senseless action taken to remove an anxiety
Obsession is an intrusive unwanted thought
O->C
Hands dirty -> wash them
SSRI of choice in patients with cardiac conditions
Sertraline
Main electrolyte disturbance from an SSRI
hyponatraemia
Difference between acute stress reaction and PTSD
Acute stress reaction up to 4 weeks
If CBT fails, first line drug in PTSD
Venlafaxine
How long must symptoms last to become a depressive episode
Only 2 weeks
How to treat lithium toxicity
Fluid resuscitation
Worse SSRI for QTC prolongation
Citalopram
Anti depressants that causes prolonged QTC
TCAs, Citalopram, venlafaxine
