Personality disorders, psych emergencies

Question 1

What are the 3 main categories of personality disorders?

Answer 1

A (WEIRD)
B (WILD)
C (WORRIED)

Question 2

What are the A personality types?

Answer 2

Paranoid
Schizotypal
Schizoid

Question 3

what is a paranoid personality disorder?

Answer 3

Sensitive, Unforgiving, takes attack on character seriously (persecutory - snowflake)

Question 4

what is a schizotypal pd?

Answer 4

Inappropriate affect, magical thinking, ideas of reference, odd behaviour
‘mad hatter’

Question 5

what is a schizoid pd?

Answer 5

Cold, solitude, low libido, thinks world is uncaring

Question 6

what are the B PD?

Answer 6

Narcissistic
Histrionic
EUPD
Antisocial

Question 7

what is a narcissistic pd?

Answer 7

Believes life is a competition, grandiose, entitled

Question 8

what is a histrionic pd?

Answer 8

crave centre of attention, flirtatious, consider Rs closer than they are

Question 9

what is EUPD?

Answer 9

crave sympathy, impulsive acts (eg. self harm), poor relationship Hx

Question 10

What is anti social PD?

Answer 10

Repeated unlawful violent acts eg. arson, animal cruelty, remorseless

Question 11

what is a precursor to anti social PD?
age?
% that develop into antisocial PD?

Answer 11

Conduct disorder
<18
25% develop into anti social PD

Question 12

what is a sociopath and psychpath?

Answer 12

socio - antisocial + no law involvement

psycho - antisocial + law involvement

Question 13

what are the C PD?

Answer 13

Anakastic (OCPD)
Avoidant
dependent

Question 14

what is an anakastic PD?

Answer 14

Strict time regulation, inflexible, refuses to delegate, perfectionist

Question 15

What is an avoidant PD?

Answer 15

Craves companionship + intimacy but afraid of rejection

Question 16

what is a dependent PD?

Answer 16

wants others to make big decisions for them, submissive

Question 17

Dx of Personality disorders?

Answer 17

MMPI
Minnessota Multiple Personality Inventory

Question 18

Tx for PD and EUPD specifically?

Answer 18

CBT (Changes thoughts)
BA (Behavioural activation) therapy
DBT for EUPD (re inforces acceptance and change thought perception)

Question 19

What is always the first line Tx for psych emergencies?

Answer 19

ABCDE

Question 20

What are 3 psych emergencies?

Answer 20

NMS
Serotonin syndrome
Lithium toxicity

Question 21

What is the Tx for lithium toxicity?

Answer 21

ABCDE
Supportive (+ alkaline diuresis IV Na2CO3)
Definitive, may need haemodialysis

Question 22

What are 2 psych emergencies of alcohol overuse?

Answer 22

Wernicke (reversible B1 deficiency)
Korsakoff psychosis

Question 23

what is the acronym for alcohol overuse?
what does it stand for?

Answer 23

COAT RACK
Confusion
Opthalmoplegia
Ataxia
Thiamine (wernickes)

Retro
Antero (Amnesia)
Confabulations (make things up)
Korsakoff

Question 24

What are the Sx of wernicke?

Answer 24

AMS (altered mental state), Int ophthalmoplegia, Nystagmus, ataxia

Question 25

Tx of wernicke?

Answer 25

IV Pabrinex (thiamine) 500mg TDS for 2-3 days then 250mg daily for next 3-5 days

Question 26

what would be seen on MRI in wernickes?

Answer 26

Reversible cytotoxic oedema

Question 27

Sx of Korsakoff psychosis?

Answer 27

Wernicke + confabulation

Question 28

Tx of Korsakoff? what would be seen on MRI?

Answer 28

PO Pabrinex for 2+ years Mammillary body + thalamic atrophy

Question 29

What is catatonia? what is it associated with?

Answer 29

Abrupt ceases in speech or movement Akinetic, mutism, malignant types Assoc with mania + schizophrenia