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3 PSYCH > passmed/pastest > Flashcards

passmed/pastest Flashcards

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1
Q

a prodromal phase of schizophrenia is associated with a poor/good prognosis

A

poor prognosis

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2
Q

factors associated with a poor prognosis in schizophrenia

A 
strong family history 
gradual onset 
low IQ
premorbid history of social withdrawal 
lack of obvious precipitant
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3
Q

where in the body does lithium get concentrated?

A

bone and thyroid

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4
Q

what is the most commonly used prophylactic mood stabiliser used in bipolar disorder

A

lithium

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5
Q

adverse effects of lithium

A 
nausea/vomiting, diarrhoea 
fine tremor 
nephrotoxicity 
nephrogenic DI
T wave flattening/inversion 
weight gain
idiopathic intracranial hypertension
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6
Q

how often should lithium levels be tested when started

A

weekly, and after each dose change until concentrations are stable

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7
Q

once lithium concentrations are stable, how often should lithium levels be checked

A

every 3 months

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8
Q

when should lithium levels be checked

A

12 hours post dose

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9
Q

how often should thyroid and renal function be checked in patients on lithium

A

every 6 months

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10
Q

which serious side effect is relatively common with clozapine?

A

agranulocytosis

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11
Q

what is passivity

A

the belief that your movements or sensations are controlled by an external force

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12
Q

what is avolition

A

a decrease in motivation to perform directed, purposeful activities

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13
Q

what is catatonia

A

a state of unresponsiveness that may include repetitive movements or abnormal postures

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14
Q

what is neologism

A

creation of new words

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15
Q

what type of hallucinations are most common in schizophrenia

A

3rd person auditory hallucinations discussing the patient or a running commentary on the patient’s behaviour

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16
Q

which antipsychotic most commonly causes galactorrhea

A

risperidone

also may occur with olanzapine or quetiapine

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17
Q

what are signs of somatisation disorder

A

multiple physical symptoms present for at least 2 years

patient refuses to accept reassurance or negative test results

18
Q

what are signs of hypochondriacal disorder

A

persistent belief in the presence of an underlying serious disease, eg cancer
patient refuses to accept reassurance or negative test results

19
Q

what are signs of conversion disorder

A

typically involves loss of motor or sensory function
the patient doesn’t consciously feign the symptoms (factitious disorder) or seek lateral gain (malingering)
patients may be indifferent to their apparent disorder

20
Q

what is dissociative disorder

A

dissociation is a process of ‘separating off’ certain memories from normal consciousness
in contrast to conversion disorder it involves psychiatric symptoms, eg amnesia, fugue, stupor
dissociative identity disorder is the new term for multiple personality disorder as is the most severe form of dissociative disorder

21
Q

what are signs of munchausen’s syndrome

A

also known as factitious disorder

the intentional production of physical or psychological symptoms

22
Q

what are sings of malingering

A

fraudulent simulation or exaggeration of symptoms with the intention of financial or other gain

23
Q

what are risk factors for suicide completion

A 
sex (male)
age (young adult or elderly)
depression 
previous attempt (highest risk factor)
alcohol or drug use 
no spouse or other social support 
stated future intent
24
Q

what does a sore throat in a patient taking clozapine suggest and what should the investigation be

A

agranulocytosis

FBC

25
Q

what is the underlying mechanism of tar dive dyskinesia

A

long term dopamine receptor blockade causing hypersensitive of dopamine receptors in the nigrostriatal pathway

26
Q

what is a potential serious side effect of BDZs

A

respiratory depression

especially when prescribed with other respiratory depressant drugs eg opioids

27
Q

symptoms of BDZ withdrawal syndrome

A

tremor
anxiety
perspiration
seizures

28
Q

which ions flow through GABA receptor-gated channels

A

chloride

29
Q

how does GABA cause inhibitory effects

A

binds to GABA receptors, causing an influx of chloride ions and hyper polarisation, reducing the membrane potential

30
Q

what is an obsession

A

an intrusive, unpleasant and unwanted thought

31
Q

what is a compulsion

A

a senseless action taken to reduce the anxiety caused by an obsession

32
Q

when is Eye Movement Desensitisation and Reprocessing (EMDR) therapy used

A

PTSD

33
Q

what is Dialectical Behaviour Therapy (DBT) used for

A

borderline personality disorder

34
Q

what is exposure-response prevention (ERP) therapy used for

A

OCD

35
Q

protective factors of suicide completion

A

family support
having children at home
religious belief

36
Q

mechanism of amitriptyline

A

inhibits monoamine reuptake on the presynaptic membrane

37
Q

symptoms of SSRI discontinuation syndrome

A 
increased mood change 
restlessness
difficulty sleeping 
unsteadiness 
sweating 
GI symptoms (pain, cramping, diarrhoea, vomiting)
paraesthesia
38
Q

mechanism of action of haloperidol

A

block dopamine receptors

39
Q

what is Korsakoff’s syndrome

A

marked memory disorder often seen in alcoholics
thiamine deficiency causes damage and haemorrhage to the mammillary bodies of the hypothalamus and the medial thalamus
often follows on from untreated Wernicke’s encephalopathy

40
Q

features of Korsakoff’s syndrome

A

anterograde amnesia (inability to acquire new memories)
retrograde amnesia
confabulation

41
Q

features of wernicke’s encephalopathy

A

nystagmus
ophthalmoplegia
ataxia

3 PSYCH (4 decks)

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