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Specialties summary cards > Psych > Flashcards

Psych Flashcards

1
Q

name SSRIs

A

sertraline
fluoxetine
citalopram

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2
Q

name SNRIs

A

venlafaxine

duloxetine

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3
Q

name NASSAs

A

noradrenergic and specific serotenergic antidepressants

mirtazepine (old + frail)

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4
Q

name NARI

A

ruboxetine

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5
Q

list TCAs

A

amitriptyline
clomipramine
nortryptiline

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6
Q

list MAOi

A

phenelzine

selegiline

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7
Q

name a RIMA

A

reversible inhibitors of monoamine oxidase

moclobemide

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8
Q

list typical antipsychotics

A

chlorpromazine
haloperidol
flupentixol decanoate

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9
Q

list atypical antipsychotics

A 
olanzapine
respiridone
quetiapine
aripiprazole
clozapine 
amisulpride
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10
Q

mild/moderate/severe depression

A

mild - 2/3 core + at least 2 others - normal life

moderate - 2/3 core + at least 3/4 others - difficulty with normal life

severe - 3 core + at least 4 others - marked functional impairment

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11
Q

PHQ9 scale

A 
GP 
rate 0-3
0 = none
5 = mild 
10 = mod
>15 = severe
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12
Q

HADS scale

A

rate 0-3
0-7 = normal
8-10 = borderline
11-21 = abnormal

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13
Q

CDI

A

childrens depression index

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14
Q

medication steps in depression

A 
SSRI 
trial another SSRI
SNRI 
augment with antipsychotic (quetiapine)/ lithium 
ECT
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15
Q

symptoms of serotonin syndrome

A

ABRUPT

mental status change: agitation, confusion, coma

NM change: jerking, twitching, hyperreflexia

autonomic instability: hyperthermia, labile BP, tachycardia, sweating, dilated pupils, diarrhoea

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16
Q

treatment for SS

A

stop drug

bentos eg clonazepam

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17
Q

MOA of NASSA

A

presynaptic alpha 2 blockade - high noradrenaline and serotonin

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18
Q

recurrent depressive disorder

A

at least 1 previous episode lasting minimum 2 w

separated from current episode by at least 2 months

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19
Q

psychotic symptoms in BPAD

A

grandiose delusions
persecutory
auditory hallucinations

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20
Q

cyclothymia

A

persistent mood instability

does not meet criteria for depression/ BPAD

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21
Q

lithium side effects

A 
fine tremor
n+v 
nephrogenic DI 
arrhythmia 
hypothyroidism 
weight gain 
eyebrow hair loss
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22
Q

lithium toxicity symptoms

A

coarse tremor
hyperreflexia
nystagmus
seizures

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23
Q

side effects of sodium valproate

A 
n+v 
diarrhoea
liver failure
thrombocytopenia
hair loss
weight gain
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24
Q

side effects of carbamazepine

A 
(enzyme inducer)
rash 
leukopenia
dizziiness
drowsiness
n+v
oedema 
weight gain 
hyponatraemia
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25
Q

bipolar depression

A

fluoxetine + atypical antipsychotic eg olanzapine

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26
Q

schizophrenia theories

A

+ve symptoms - excess dopamine in mesolimbic

-ve symptoms - dopamine under activity in mesocortiyal

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27
Q

stages of schizophrenia

A

1 - at risk mental state

2 - acute phase (+ve symptoms) - auditory hallucinations and persecutory delusions, loosening of associations, FTD

3 - chronic phase (-ve symptoms)

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28
Q

types of schizophrenia

A

paranoid - most common, d+h

catatonic - psychomotor disturbance, stupor, posturing, waxy flexibility, perseveration

hebephrenic - 15-25 yrs - disorganised chaotic mood

simple - negative only

(residual - mainly +ve symptoms)

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29
Q

schneiders 1st rank symptoms

A

passivity
auditory hallucinations - echo, 3rd person, running comm.
delusional perception
delusions of though interference

PADD

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30
Q

diagnostic criteria for schizophrenia

A

1st rank symptoms + >/=2 of…

  • paranoid, hebephrenic, catatonic, simple

+ present most of the time >/= 1 month

+ not caused by substance use/ organic cause

(<1 mo = brief psychotic disorder)
impact on social/occupational functioning >6 mo

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31
Q

treatment for EPSE

A

Dystonia - procyclidine
Akathisia - lower dose, propranolol
Parkinsonism* - lower dose procyclidine
Tardive dyskinesia - reduce dose, avoid anticholinergics

  • resting tremor, rigidity, bradykinesia
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32
Q

antipsychotics side effects

A 
hyperprolactinaemia - respiridone 
weight gain (o+c)
diabetes
dyslipidaemia 
antichoninergic S/E 
NMS - haloperidol 
arrhythmias - prolonged QT - quetiapine 
stroke + VTE in elderly
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33
Q

symptoms of NMS

A

gradual

mental state changes: catatonia

muscular rigidity

autonomic instability - hyperthermia, labile BP, tachycardia, sweating

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34
Q

blood changes in NMS

A 
High CK 
high WCC
AKI
high hepatic transaminases
(due to low dopamine)
death due to renal failure secondary to rhabdomylosis
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35
Q

NMS treatment

A

stop dose
dantrolene - muscle relaxant
bromocriptine - dopamine agonist

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36
Q

normal QT interval

A

M - <440 m/s

F - <470 m/s

37
Q

good/ bad prognosis in schizophrenia

A

good - sudden onset, late, stressful event, no FH, higher IQ

bad - gradual, early, lack of precipitant, FHx, low IQ

38
Q

acute psychosis

A

sudden onset, no insight, lasts <3 months

manage with short term benzos/ AD/ mood stabilisers

39
Q

delusional disorder

A

persistent, life-long delusions with few/ no hallucination
<3 mo = temporary
>3 mo = persistent

no auditory hallucinations, no schizo symptom, cognition intact

40
Q

3 theories of dependence

A

1 - classical conditioning - craving to cues eg seeing needle
2 - operant conditioning - repetition for known outcome
3 - social learning

41
Q

dependency features

A 
compulsion 
neglect 
tolerance 
lack of control 
physical withdrawal 
persistent abuse despite harm

narrowing of repertoire
salience
reinstatement after abstinence

42
Q

units calculation

A

(volume in ml x % alcohol) / 1000

43
Q

alcohol withdrawal

A 
uncomplicated AWS:
4-12 hours
coarse tremor
sweating 
insomnia
tachycardia 
n+v
psychomotor agitation 
hallucinations
cravings

36 hours:
AWS with seizures
tonic clonic

44
Q

delirium tremens

A 
48-72 hours 
disorientation 
anterograde amnesia
psychomotor agitation
hallucinations (Lilliputian)
fluctuations
45
Q

wernikes encephalopathy

A

reversible
ataxia
opthalmoplegia
acute confusion

treat with IV thiamine/ pabrinex

46
Q

korsakoffs syndrome

A 
irreversible 
anterograde amnesia
confabulation
peripheral neuropathy 
cerebellar degeneration
47
Q

acamprosate vs naltrexone

A

acamprosate - reduces urge

naltrexone - reduces cravings

48
Q

opiate intoxication

A

pinpoint pupils, low RR, bradycardia, constipation, anorexia, low libido

49
Q

opiate withdrawal

A

6 hours post injection
peaks 36-48 hours

nausea, craving, flu-like, runs, lacrimation, diarrhoea, piloerection, pupils dilate

50
Q

benzo withdrawal

A 
insomnia
tachypneoa
tremor
hyperreflexia
anxiety 
sweating
51
Q

bento long-term use

A

cognitive impairment
anxiety
depression
dependence

52
Q

nicotine replacement therapies

A

varenicline - nicotine RA (champix)

bupropion - DA/NA reuptake inhibitor

53
Q

REPORT criteria personality disorders

A 
Relationships 
enduring 
pervasive 
onset in childhood/ adolescence 
results in distress
trouble in occupational/social performance
54
Q

cluster A PD

A

Paranoid - SUSPECT

Schizoid - ALL ALONE

Schizotypal - positive schizophrenia symptoms

55
Q

Cluster B PD

A

histrionic - ACTORS

emotionally unstable ( borderline - scars, impulsive - lose it)

dissocial/antisocial - FIGHTS

*antipsychotics/ antidepressants

56
Q

Cluster C PD

A

anankastic - DETAILED

anxious/ avoidant - AFRAID

dependent - SUFFER

  • antidepressants
57
Q

PD traits

A

splitting - EUPD
dissociation - assumed a different ID
sublimation - uses unacceptable trait to drive respectable work
reaction formation - replace emotions with exact opposite
identification - models behaviour on someone else
regression - revert to immature behaviour
displacement - take out emotions on a neutral person
projection - person assumes an innocent/ neutral character is responsible

58
Q

investigation results in AN + BN

A

increase:
cortisol, cholesterol, carotenaemia, GH, salivary glands, LFTs

ECG - bradycardia, arrhythmia, long QT in BN

DEXA - osteoporosis

59
Q

criteria for AN

A

BMI <17.5 or 15% less than expected
deliberate weight loss
fear of fat

(amenorrhoea, impotence, loss of libido, delayed puberty)

60
Q

AN psychotherapies

A

CBT-ED

SSCM - specialist supportive clinical management - explore problems causing anorexia

MANTRA - causes of their anorexia

61
Q

inpatient for AN/BN

A

BMI<13/ very rapid weight loss
serious physical complications
high suicide risk

62
Q

SCOFF questionnaire

A 
sick 
control 
one stone/3 months 
fat 
food
63
Q

criteria for BN

A

bingeing
purging - laxatives, exercise, diuretics, insulin, vomiting
psychopathy

64
Q

acute stress reaction

A

daze, narrowing of attention, can’t comprehend stimuli, disorientated
at least 3 days
> 1 month - consider ptsd
can use benzos for short-term distress

65
Q

adjustment disorder

A

onset within weeks

lasts <6 months

66
Q

PTSD criteria

A

re-experiencing - flashbacks, nightmares, intrusive thoughts
avoidance
hyper-arousal

67
Q

GAD

A

free floating anxiety
> 6 months
GAD7, BDI, HADS

68
Q

GAD treatment

A

education and active monitoring
low intensity psych interventions
high intensity + applied relaxation
drugs - sertraline, SNRI, pregabalin

*never give benzos

69
Q

OCD criteria

A

recurrent obsessional thoughts and/or compulsive acts
present most days >/2 consecutive weeks

Yale-brown OCD score

70
Q

somatisation

A

multiple, recurrent, frequently changing physical symptoms >/2 years

  • hyperchondriachal
  • somatoform autonomic dysfunction
  • persistent somatoform pain
71
Q

dementia definition

A

acquired, chronic, progressive cognitive impairment sufficient to impair ADLs

<65 = early onset
at least 6 months

AD>VD>DLB

72
Q

development of dementia

A

1 - mood changes
2 - abnormal behaviour
3 - hallucinations/delusions

73
Q

dementia tests

A

AD –> FDG-PET, CSF, MRI
vascular –> AF + emboli
LBD –> DAT scan
FTD –> shrinking of frontal lobe

74
Q

alzheimers theories

A

amyloid - B amyloid - Ab - toxic aggregates
tau - neurofibrillary tangles of hyperphosphorylated tau
inflammation - microglial cells - CNS macrophages

75
Q

alzheimers genes

A

presenilin 1, 2

beta amyloid precursor protein

76
Q

huntingtons features

A

HTT
50% change children
chorea, speech, swallow, clumsiness, problems organising, impulse control, depression, chorea, lack of insight

77
Q

ADHD criteria

A

impaired attention and overactivity
present <6 years lasting >6 months
in 2 or more settings

conners comprehensive behavioural rating scale

78
Q

side effects of ADHD meds

A

cardiac arrhythmia - ECG
HTN - BP
anorexia and growth suppression - monitor weight and height

other - mood changes, palpitations, tics

monitor weight, height, BMI every 3 months

79
Q

ASD diagnosis

A

abnormal/impaired development evident =3yo
>/= 6 of:
- impairment in social interactions
- abnormalities in communication
- restricted/repetative and stereotyped patterns of behaviour, interests and activities

80
Q

ASD scales

A

ADI - autism diagnostic inventory

CARS - childhood autism rating scale

81
Q

types of CD

A

<10 - ODD

>10 - unsocialised CD, socialised CD, CD confined to family context

82
Q

learning disability scale

A

IQ <70 = LD

mild = 50-70

moderate = 35-50

severe = 20-35

profound = <20

  • DS>fragile X
83
Q

tic disorder medications

A

reassure, educate, stress manage
clonidine (alpha agonist)
atypical antipsychotics

84
Q

causes of delirium

A

PINCH ME

pain
infection
constipation 
hydration 
medications
electrolyte imbalance
85
Q

delirium treatment

A

treat cause
behavioural management - reorientation, good lighting etc
meds - benzos at night

86
Q

mmse interpretation

A 
24-30 = no cognitive impairment 
18-23  = mold 
0-17 = severe
87
Q

clozapine side effects

A

blocks d1+d4 receptors
sedation, weight gain, lowers seizure threshold, myocarditis, metabolic syndrome, hyper salivation, GI (swallowing problems, constipation)
smoking cessation - lower dose
agranulocytosis, neutropenia

88
Q

discontinuation syndrome symptoms

A

flu, insomnia, restlessness, mood swings, sweating, tummy problems, off balance, paraesthesia

Specialties summary cards (1 decks)

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