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passmed qs Flashcards

1
Q

what is 1st line med for PTSD

A

venlafaxine (SNRI)

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2
Q

what is a oculogyric crisis

A

type of acute dystonic reaction

prolonged involuntary upward deviation of the eye

associated with first-generation antipsychotics, as they most commonly cause extrapyramidal side effects

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3
Q

what is torticollis

A

acute dystonic reaction

‘wry’ neck can be diagnosed where there is unilateral pain and deviation of the neck with pain on palpation and restricted range of motion.

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4
Q

what are acute dystonic reactions

A

includetorticollis, opisthotonus, dysarthria and oculogyric crises.

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5
Q

what are common adverse effects of atypical antipsychotic

A

Dyslipidaemia , Weight gain and Diabetes mellitusi

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6
Q

what is raised in anorexia

A

G’s andC’s raised:
growth hormone,
glucose, salivaryglands,
cortisol,
cholesterol,
carotinaemia

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7
Q

what physical abnormalities are associated with anorexia

A
  • hypokalaemia
  • low FSH, LH, oestrogens and testosterone
  • raised cortisol and growth hormone
  • impaired glucose tolerance
  • hypercholesterolaemia
  • hypercarotinaemia
  • low T3
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8
Q

how is SchizOID different to SchizoTYPal

A

SchizOID = avOIDant behaviour
SchizoTYPal = aTYPical (odd, eccentric) behaviour

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9
Q

what is 1st line med for alc withdrawl

A

Chlordiazepoxide

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10
Q

what is 1st line med for alc withdrawl if hepatic impaired

A

lorezapam

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11
Q

what is a short term SE of ECT

A

cardiac arrhythmias

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12
Q

how does avoidant personality disorder present

A

fearful of criticism, being unliked, rejection and ridicule

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13
Q

what are signs of Parkinsonism

A

resting tremor, bradykinesia (slowness of movement), rigidity and postural instability.

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14
Q

what is SSRi of choice in under 18

A

Fluoxetine

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15
Q

what is SSRi of choice post MI

A

Sertraline

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16
Q

what is medication of choice for GAD

A

Sertraline

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17
Q

what is a life-threatening side effect ofclozapine

A

Agranulocytosis/neutropenia

monitor FBC

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18
Q

how is lithium dose monitored

A

lithium levels should be taken a week later and weekly until the levels are stable

then every 3 months

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19
Q

what are a nticholinergic effects

A

dry mouth and constipation, orthostatic hypotension, weight gain and potential cardiac toxicity

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20
Q

what medications together can cause serotonin syndrome

A

SSRI + triptan

SSRIs and MAOIs

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21
Q

what is akathisia and what causes it

A

severe restlessness

Antipsychotics

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22
Q

what does Clozapine reduce the threshold of

A

reduces seizure threshold, making seizures more likely

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23
Q

when is Mirtazapine useful to prescribe

A

useful side effects (sedation and increased appetite)

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24
Q

what are Adverse effects of clozapine

A
  • agranulocytosis (1%), neutropaenia (3%)
  • reduced seizure threshold- can induce seizures in up to 3% of patients
  • constipation
  • myocarditis: a baseline ECG should be taken before starting treatment
  • hypersalivation
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25
what can long term use of lithium cause
hyperparathyroidism and resultant hypercalcaemia
26
how should SSRI be stopped
dose should be gradually reduced over a 4 week period
27
what is Duloxetine
SNRI
28
what SE is associated with SNRI
hypertension
29
what SE is associated with SSRI
hyponatraemia monitor U&Es
30
what is Venlafaxine
SNRI
31
what SE is assoc with Citalopram
prolonged QT
32
what is clomipramine and when is it prescribed
TCA for OCD as alt to SSRI
33
what is Amitriptyline and when is it prescribed
TCA for neuropathic pain
34
what are side effects of clomipramine (TCAs)
Dry mouth (anticholinergic) and weight gain (antihistaminic)
35
what are Discontinuation symptoms of SSRI
* increased mood change * restlessness * difficulty sleeping * unsteadiness * sweating * gastrointestinal symptoms: pain, cramping, diarrhoea, vomiting * paraesthesia
36
what are adverse effects of atypical antipsychotics
* weight gain * clozapine is associated with agranulocytosis (see below) * hyperprolactinaemia
37
what are examples of atypical antipsychotics
* clozapine * olanzapine: higher risk of dyslipidemia and obesity * risperidone * quetiapine * amisulpride * aripiprazole: generally good side-effect profile, particularly for prolactin elevation
38
what are common SE of both typical and atypical antipsychotics
Cardiac (Long QT), Anticholingeric (dry mouth etc)
39
what is 1st line treatment for acute stress disorder
trauma focused CBT
40
what is used as a deterrent to prevent alcohol relapse
Disulfiram (also known as Antabuse)
41
what medication is used for anti-craving
Acamprosate (or Campral)
42
what is an alternative opiate replacement therapy to methadone
Buprenorphine
43
what are Schneider's first rank symptoms
auditory hallucinations, thought disorders, passivity phenomena and delusional perceptions:
44
what is Passivity phenomena
* bodily sensations being controlled by external influence
45
what are negative symptoms for schizophrenia
* incongruity/blunting of affect * anhedonia (inability to derive pleasure) * alogia (poverty of speech) * avolition (poor motivation) * social withdrawal
46
what is used to assess alcohol withdrawal severity
Clinical Institute Withdrawal Assessment for Alcohol (CIWA) scale
47
what is time diff between acute stress disorder and PTSD
acute stress disorder = <4weeks PTSD = >4 weeks
48
what are features of PTSD
* re-experiencing e.g. flashbacks, nightmares * avoidance e.g. avoiding people or situations * hyperarousal e.g.hypervigilance, sleep problems * often emotionally numbed
49
when is chronic insomnia diagnosed
after three months, if a person has trouble falling asleep or staying asleep at least three nights per week
50
what is acute management of manic episodes
rapidly acting antipsychotic (or a benzodiazepine) and discontinuing antidepressants. quetiapine
51
what is De Clerambault's syndrome
Erotomania presence of a delusion that a famous is in love with them, with the absence of other psychotic symptoms
52
what us hypomania
elevated mood, pressured speech and flight of ideas but without psychotic symptoms <7days
53
what is MC endocrine disorder developing as a result of chronic lithium toxicity
Hypothyroidism
54
what are SE of lithium
* nausea/vomiting, diarrhoea * fine tremor * nephrotoxicity: polyuria, secondary to nephrogenic diabetes insipidus * thyroid enlargement, may lead to hypothyroidism * ECG: T wave flattening/inversion * weight gain * idiopathic intracranial hypertension * leucocytosis * hyperparathyroidism and resultant hypercalcaemia
55
what is difference between flight of ideas and knights move thinking
flight of ideas = link btwn topics = mania knights move thinking = no link btwn topics = schizo
56
what is Circumstantiality
return to point but a lot of detail
57
what is Tangentiality
wandering off from topic w/o returning
58
what is Neologisms
forming new words
59
what is clang association
word association related to rhyming
60
what is word salad
real word random sentences
61
what is preservtion
repeating words
62
what is echolalia
repeating someone elses words back to them
63
what is diff between BPT1 and BPT2
* type I disorder: mania and depression (most common) * type II disorder: hypomania and depression
64
what type of drug is Mirtazapine
Noradrenergic and specific serotonergic antidepressants (NaSSAs)
65
what is Dependent personality disorder
difficulties making decisions about everyday decisions without excessive reassurance from others.
66
what are examples of MAOIs
phenelzine, tranylcypromine, and isocarboxazid
67
what are Dizziness, electric shock sensations and anxiety symptoms of
SSRI discontinuation syndrome
68
what are examples of TCAs
amitriptyline, imipramine, and nortriptyline.
69
what do Antipsychotics in the elderly increase risk of
increased risk of stroke and VTE
70
how do Benzodiazepines work
enhance the effect of GABA, the main inhibitory neurotransmitter
71
what is 2nd line med for anxiety if no SSRI
clomipramine a TCA
72
what is a SE of benzodiazepine
retrograde amneasia
73
how isAcute dystonia secondary to antipsychotics managed
procyclidine = anti-cholinergic
74
how does memory loss related to depression present
global memory loss affecting both short and longer-term memory, over a short history of four weeks with reluctance to engage with clinical assessment.
75
what can causes a rise in clozapine blood levels
Smoking cessation
76
what is the triad of Korsakoff's syndrome
confusion, ataxia (broad-based gait) and oculomotor dysfunction (seen in this patient as CN 6 palsies and nystagmus).
77
what are RF for GAD
* Aged 35- 54 * Being divorced or separated * Living alone * Being a lone parent
78
what ius diff between Somatisation and hypochondria
* Somatisation = Symptoms * hypoChondria = Cancer
79
what psych symptom can a course of corticosteroids cause
Sudden onset psychosis
80
what is Cotard syndrome
characterised by a person believing they are dead or non-existent
81
what are SE of Zopiclone
agitation, bitter taste in mouth, constipation, decreased muscle tone, dizziness, dry mouth, and increased risk of falls (especially in the elderly).
82
what is Zopiclone
works on GABA similar to benzos
83
when should patients on SSRi be reviewed
Patients ≤ 25 years who have been started on an SSRI should be reviewed after 1 week Patients >25 years who have been started on an SSRI should be reviewed after 2 week
84
what is Functional neurological disorder
(conversion disorder) - typically involves loss of motor or sensory function present safter peroid of stress - hoover test positibe

3a psychiatry (2 decks)

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