Pastest/passmedicine Flashcards
Pharmacological treatment of mild to moderate Alzheimer’s
Acetylcholinesterase inhibitors e.g. rivastigmine, donepezil, gelantamine
Pharmacological treatment of moderate to severe Alzheimer’s
NMDA antagonist- memantine
Preferred SSRI post-MI
Sertraline
MMSE cut-off suggestive of dementia
24 or less
First-line drug treatment for anxiety disorders
SSRI e.g. sertraline
SSRI of choice in adolescents and teenagers
Fluoexetine
Process of “separating” certain memories from normal consciousness; differs from conversion disorder in that involves psychiatric symptoms e.g. amnesia, fugue
Dissociative disorder spectrum
Rating scale used to detect post-natal depression
Edinburgh scale- 10 item questionnaire indicating how mother has felt over previous week. Score >13 indicates depressive illness
Treatment of post-traumatic stress disorder
Watchful waiting (symptoms less than 4 weeks) CBT or Eye Movement Desensitization and Reprocessing
What is akathisia and what drugs can cause it?
Severe restlessness; antipsychotics
Examples of acute dystonic reactions that can be caused by antipsychotics
Torticollis
Oculogyric crisis
Possible side effects of antipsychotics (other than extrapyramidal/dystonic) (3)
Weight gain
Reduced seizure threshold
Galactorrhoea
Factors which might suggestive depression over dementia as a cause of low MMSE score (4)
Short history
“Biological” symptoms
Patient worried about poor memory
Global memory loss rather than “recent” memory loss
Things that are raised in anorexia
G’s and C’s: growth hormone, glucose, (salivary) glands, cortisol, cholesterol, carotin
Important drugs with which St Johns Wort interacts (2)
COCP
Warfarin
Patient with a history of flat affect, no interest in interpersonal relationships, prefers to work/play alone, but lacks weird/magical thinking/psychotic symptoms
Schizoid personality disorder
What is adjustment disorder?
Depressive/anxiety symptoms presenting within 3 months of a stressor event, and lasting less than 6 months
Raised creatine phospokinase, hyperpyrexia, rigidity and altered conscious state in a patient recently started on haloperidol
Neuroleptic malignant syndrome
First-line treatment of generalised anxiety disorder
SSRI e.g. sertraline
What can ECT be used for?(3)
Severe depression
Prolonged/severe mania
Catatonia
Why do antipsychotics cause a) galactorrhoea and B) extrapyramidal effects?
a) dopamine blockade caused rising PRL levels
b) effect of dopamine blockade in the extrapyramidal system
Poor prognosis in schizophrenia is associated with what kind of symptoms?
“Negative” symptoms
Why might lithium cause weight gain, constipation, cold hands and bradycardia?
Lithium toxicity can cause hypothyroidism
Parkinsonism + memory impairment + visual hallucinations
Lewy body dementia
What should be done regarding anti-depressants at the outset of an acute manic episode?
Should be withdrawn
For schizophrenic patients how many antipsychotics should be tried before commencing clozapine?
At least 2
Consequence of the interaction between monoamine A oxidase inhibitors and SSRI
Serotonin syndrome- potentially life threatening condition
Difference between an overvalued idea and a delusion
An overvalued idea is understandable when the patients background is known, whereas a delusion is not in keeping with the social context
Regarding the “baby blues”
a) what proportion of women get it?
b) how long does it usually take to resolve?
a) 50%
b) 10-14 days
PET scan in a schizphrenic patient with negative symptoms is likely to show…
b) what condition does this lie in contrast to?
Hypoactivity of the prefrontal lobes
b) OCD, where there is increased activity
What symptoms would bilateral destruction of the hippocampus lead to?
Loss of capacity for new learning and short-term memory
