Passmedicine Mix Flashcards
how are extrapyramidal side effects of antipsychotics managed?
procyclidine
examples of extrapyramidal side effects of antipsychotics?
parkinsonism
acute dystonic reaction
akathisia (restlessness)
tardive dyskinesia (lip smacking, grimacing etc)
mechanism of tricyclics?
inhibit monoamine reuptake at presynaptic membrane
what type of drug is methylphenidate and what is it used to treat>
dopamine/norepinephrine reuptake inhibitor
type of stimulant used to treat ADHD
what type of hallucinations are experienced in PTSD?
pseudohallucinations
what is a primary delusion?
not understandable or due to any previous psychopathological state
3 things which indicate mania rather than hypomania?
delusions of grandiosity
auditory hallucinations
impaired social functioning
what is circumstantiality?
common feature of anxiety disorder or hypomania
over-inclusive speech that is delayed in reaching its final goal
still possible to follow speech and it does eventually get to the point but takes a long time as goes into detail about every tiny aspect
metabolic effects of bulimia?
metabolic alkalosis
hypokalaemia
hypochloraemia
what are non-epileptic seizures associated with?
childhood trauma (e.g abuse etc)
describe a non-epileptic seizure
type of functional disorder usually unconscious presents similarly to epilepsy however - lasts longer - usually dont have injuries seen in epilepsy - remain continent - different triggers - no actual brain lesion
how are non-epileptic seizures managed?
anticonvulsants dont work
psychotherapy used
what is a functional disorder?
same as conversion disorder
features of functional disorders as a whole?
generally in keeping with patient’s cultures and beliefs
dissociation is a common symptom
timescale important as clear triggers are often seen
fronto-temporal dementia vs lewy body dementia?
both have the same underlying cause (hyperphosphorylated tau protein causing neurofibrilary tangles)
however the tau proteins are more widespread in lewy body
how is cortisol affected in long term unipolar depression?
chronically elevated
- increased corticotropin releasing factor (CRF) from hypothalamus > ACTH released from pituitary > cortisol released from adrenal glands (can cause adrenal hypertrophy) > impaired negative feedback of cortisol to hypothalamus/pituitary >continued activation of HPA axis and excess cortisol release
effects of excess cortisol in chronic depression?
cortisol receptors are desensitized causing increased activity of pr-inflammatory mediators and disturbances in neurotransmitter transmission
excess cortisol excreted in urine
increased adrenal gland volume
how is thyroid function affected in chronic unipolar depression?
dont change
how does unipolar depression affect hippocampal volume?
can be reduced but not in everyone
best treatment in depression?
combination of antidepressants and CBT
first line in depression and why?
SSRI
- not really more effective but better side effect profile
describe mental compulsions seen in OCD?
often in keeping with patients own morals and beliefs (e.g someone very religious may have blasphemous mental compulsions et)
compulsions are often the worst thing the person can think of in terms of their morals
is heritability seen in OCD?
yes
around 40% concordance seen in identical twins
how useful is psychotherapy in OCD?
very (despite strong neurobiological basis of disorder)
first line pharmacological treatment in OCD?
SSRI
most specific hallmark in schizophrenia?
formal thought disorder (broadcasting/withdrawal/insertion etc)
other features which are usually present in schizophrenia?
paranoid delusions of reference
hallucinations
definition of hazardous drinking?
14+ units per week
harmful drinking definition?
men = 50+ units per week women = 35+ units per week
2 months history of paranoid delusions of the neighbours poisoning the food in his fridge and auditory hallucinations of the neighbours talking about him, some formal though disorder but no mood disturbance
what is the best management?
atypical antipsychotic
which atypical antipsychotic is best in type 2 diabetes?
resperidone (doesnt cause metabolic syndrome which is a risk in type 2 diabetes)
which atypical antipsychotic has a risk of metabolic syndrome?
olanzapine
examples of obesession?
intrusive thoughts about dropping baby or letting go of pram in post partum period
features of an obsession?
type of thought that is invasive, irrational, difficult to get rid of and causes distress
obsession vs delusional thought?
similar but in obsession, the person knows that the thought is ridiculous and doesnt make sense (insight preserved)
what is an overvalued idea?
somewhere between delusion and obsession
what is a mixed affective state?
can be a presentation of bipolar disorder
patients have been manic/hypomanic then suddenly develop depressive symptoms and vice versa
(e.g manic symptoms with aspects of depression)
often cycle very quickly (even within same day)
example of history of mixed affective state?
was on top of the world, so many amazing ideas, felt great and excited, then after a few days is still restless and very busy with lots of thoughts and ideas but all thoughts are very negative etc)
how long must symptoms be present for PTSD diagnosis?
6 months
