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Year 5-Psychiatry > PASTest > Flashcards

PASTest Flashcards

1
Q

what is EUPD typified by?

A

explosive interpersonal relationships
lack of identity
unstable moods
impulsiveness

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2
Q

splitting defence mechanism?

A

immature defence mechanism
unable to reconcile both good/bad traits in a given person

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3
Q

dissociation

A

immature ego defence where one person’s identity is temporarily and drastically modified to avoid distress

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4
Q

Deprivation of liberty
how long can it apply?

A

7 days
care home / hospital

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5
Q

what is an AMHP and what role do they play in section 2

A

approved mental health professional

> Can decide whether a person can be detained under mental health act (section 2)

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6
Q

medication for PTSD

A

paroxetine / sertraline

only if not having trauma focused psychological treatment

venlafaxine can be given

12 months > gradually withdrawn over 4 weeks

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7
Q

what therapy for combat focused PTSD?

A

trauma based CBT
psychoeducation, dealing with hyperarousal and flashbacks and processing trauma related emotions

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8
Q

postpartum blues

A

50% of females experience it
fatigue
tearful
depressed affect

resolves 10-14 days following birth

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9
Q

postpartum depression

A

2 weeks of depressed mood
begins 4 weeks of delivery

5 symptoms:
change in sleep
guilt
loss of interest
decreased energy
diff concentrating
sluggishness
suicidal ideation

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10
Q

how many women get postpartum depression?

A

10%

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11
Q

how many women get postpartum psychosis?

A

0.1%
hallucinations and delusions present

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12
Q

what is regression?

A

immature ego defence where you act like a child / revert to childish behaviour

in setting of stress

regressed to toddler

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13
Q

flooding refers to?

A

term in behavioural therapy
exposed to worse fear aims to trigger desensitisation

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14
Q

how long does a 5(2) last?

A

needs a dr to do it
72 hours

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15
Q

what are scheider’s frist rank symptoms?

A

Auditory hallucinations
>3rd person commentary
>thought echo
>running commentary

Thought disorder
>Broadcast
>Withdrawal
>insertion

passivity phenomena

delusional perception
2 stage
normal object percieved then delusional insight into object

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16
Q

Poor prognostic indicator for Schizophrenia?

A

strong family history
gradual onset
low IQ
prodrome of social withdrawa;
lack of obvious precipitant

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17
Q

section 136 can be used to?

A

detain from a public place - shopping centre etc

by police

for mental health concern

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18
Q

coping mechanism: Avoidance

A

just avoiding the problem pretending it does not exist
continue their behaviour as if the stressor is not present

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19
Q

hypofunction of ___ is associated with schizophrenia

_____ cerebral ventricles are also present

A

prefrontal cortex

enlarged

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20
Q

Korsakoff’s amnesia

A

severe deficiency in thiamine vitb1

= bilateral loss of mammilary bodies in the brain

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21
Q

what is beri beri?

A

b1 defiency
polyneuritis
muscle waste
dilated cardiomyopathy

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22
Q

Niacin Vit b3

A

can lead to pellagra

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23
Q

how to report on speech? in MSE

A

rate
rhythm
volume

24
Q

how to treat folie a deux

A

shared delusional disorder
1st step is to separate patients

25
Q

acute schizophrenia how to manage?

A

commence an atypical antipsychotic
olanzapine

but this takes 10 days to work
so sedative might be needed - short acting benzodiazepine -Lorazepam

procyclidine can help with acute dystonia

26
Q

social learning?

A

modelling behaviour pattern acquired by watching other people
then assimilating their actions

27
Q

diagnostic criterion for anorexia nervosa?

A

an intesne fear of gaining weight
becoming fat

28
Q

violence and schizophrenia?

A

people with schizophrenia are responsible for 20th of homicides

5% compared to general popupulation 1%

29
Q

alcohol abuse what kind of therapy is best?

A

group self help

30
Q

interpersonal therapy is best for?

A

depression - prolonged grief

31
Q

when would psychoanalytic psychotherapy be best

A

deep rooted problems that did not respond to interpersonal therapy

32
Q

neuroleptic malignant syndrome

A

antipsychotic extreme side effect

fever
muscular rigidity
delirium
hypertensions

33
Q

schizophrenia stats

A

20 million people worldwide have it
1%

46% in monozygotic
14% in dizygotic

34
Q

indications for ECT

A

severe catattonic stupor
high risk of suicide
psychotic features
food refusal
refractory to antidepressants
previous response to ECT

35
Q

how long is a full course of ECT?

A

12 sessions
you can

36
Q

what is displacement?

A

displacing your feelings on people not involved

so if you are angry with partner but shout at cyclist on your way to work

37
Q

projection is?

A

when you assume someone is in the wrong when you actually are

38
Q

motivation interview: RULE

A

resist to employ a firm course of action
understand reason for change in behaviour
listen to ICE
empower the patient that they can change their behaviour

39
Q

Indications for Clozapine?

A

more effective than conventional antipsychotic for resistant psychosis

not used first line

30% of patients improve after 6 weeks of treatment
60% respond after a year

40
Q

hypersalivation - sialorrhoea

how to treat?

A

common s/e of clozapine

hyoscine - anticholinergic

41
Q

procyclidine is a?

A

anticholinergic
helps with acute dystonia as a s/e of antipsychotic - more with typical

42
Q

evaluating a patients suicide risk

A

assess static and dynamic factors
static: age, sex, previous history of self harm

dynamic: drug use, self harm, employment status

43
Q

reward system hormone

A

dopamine
anhedonia is when dopamine in the brian must be affected

44
Q

IQ - normal range

A

70-130
100 is average

45
Q

severe LD?

A

20-34 IQ

46
Q

moderate LD

A

35-49

47
Q

<20 IQ

A

profound LD

48
Q

diagnosing dependence - alcohol

A

strong sense / compulsion

difficult in controlling how substance behvaiour happens so like how long you take it for/ when / where/ not being able to say no if you had planned to but now someone is offering it to you

evidence of tolerance
neglect of other interests
persisting with substance despite clear evidence of harm

49
Q

what can make lewy body dementia worse?

A

haloperidol - first gen antipsychotics

50
Q

what can be used to treat lewy body dementia?

A

clonazepam - sleep
donepezil - acth inhibitor to help with hallucinations

memantine - if can’t take donepezil

rivastigmine - increases acetylcholine in brain

51
Q

acetylcholnesterase inhibitors

A

memantine
donepezil
rivastigmine

increase levels of acetylcholine in brain

52
Q

Cocaine-induced delusional disorder

A
53
Q

what are the findings in Nephrogenic DI?

A

low urine osmolality but high serum osmolality

DI associated with signs of dehydration because you are not able to retain/ reabsorb water

postural drop in bp
sodium - hypernatraemia

54
Q

Bipolar patient presenting with mania
acutely unwell

A

check lithium levels
consider adding an antipsychotic

55
Q

Dementia vs delirum how to differentiate in a&e

A

fluctuating consciousness indicates delirum

56
Q

when is paroxetine > citalopram

A

paroxetine is for a major depressive disorder

57
Q
A

Year 5-Psychiatry (19 decks)

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