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Psych Flashcards

1
Q

What is transient global amnesia?

A

A neurological condition characterised by a temporary but total disruption of both short and long term memory. Other cognitive functions are preserved

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2
Q

Give 3 questionnaires used for depression severity

A

PHQ-9
HADS
BDI-II

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3
Q

What is 1st line in moderate-severe depression?

A

CBT and SSRI/SNRI

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4
Q

How should an antidepressant be stopped?

A

Reduce the dose/frequency gradually over a 4 week period (not necessary for fluoxetine)

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5
Q

How long does it take for the effects of antidepressants to be seen

A

2 weeks

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6
Q

How long should you give somebody on an antidepressant with inadequate response?

A

6-8 weeks then consider switching

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7
Q

Give some features of serotonin syndrome

A 
Confusion
Delirium 
Shivering 
Sweating 
Changes in blood pressure 
Myoclonus
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8
Q

What drug class is citalopram?

A

SSRI

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9
Q

If somebody presents with new onset palpitations and feeling on edge, what is the 1st line next step management?

A

48hr holter ECG

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10
Q

What is 1st line drug management of Alzheimers?

A

Acetylcholinesterase inhibitors e.g. donepezil, galantamine, rivastigmine

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11
Q

When are drugs like donepezil and rivastigmine contraindicated in Alzheimers?

A

Long QT syndrome, sinus bradycardia (less than 50), 2nd/3rd degree heart block

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12
Q

What is 1st line in treating MND?

A

Riluzole (anti-glutamate) - potentiates movement

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13
Q

How does autoimmune encephalitis present?

A

VIRAL ILLNESS prior to symptom onset (demyelination)

Confusion
Seizures
Movement disorders
Behavioural changes 
Emotional lability
Cognitive impairment 
Reduced Conscious level
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14
Q

How do you treat autoimmune encephalitis?

A

Steroids and IV IgG/Plasma exchange

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15
Q

What is cotard delusion

A

Belief that the patient is dead, non-existant or rotting

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16
Q

What pathological findings are seen in the brain in Alzheimers?

A

Beta-amyloid plaques
Neurofibrillary tangles
Hyperphosphorylated TAU proteins

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17
Q

What symptoms does Lewy Body dementia classically present with?

A

Triad of:

  1. REM sleep disorder
  2. History of falls
  3. Lilliputian hallucinations
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18
Q

What antipsychotic should be switched to if patients experience prolactinaemia from other antispsychotics

A

Aripiprazole

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19
Q

Why do patients commonly experience prolactinaemia from antipsychotics e.g. rispiridone/haliperodol

A

They are dopamine receptor antagonists

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20
Q

Which SSRIs are most appropriate in breastfeeding?

A

Sertraline and paroxetine

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21
Q

What are 1st line in ACUTE mania mangement?

A

Antipsychotics e.g. haloperidol, risperidone, quetiapine

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22
Q

What is 1st line in long term management of bipolar?

A

Lithium

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23
Q

How long must symptoms of anxiety be present to diagnose GAD?

A

6 months

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24
Q

How long must depression symptoms be there to diagnose depression

A

2 weeks

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25
Q

What are the criteria for mild depression

A

2 core symptoms and 1 biological symptom

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26
Q

What is 1st line for mild depression?

A

Low intensity psychological intervention - guided self help or group CBT

27
Q

What features are associated with better prognosis in schizophrenia?

A 
High IQ
Sudden onset 
Obvious precipitating factor
Strong support network 
Positive symptoms predominant
28
Q

What is 1st line in schizophrenia?

A

Atypical antipsychotics e.g. risperidone

29
Q

When should clozapine (atypical antipsychotic) be started in schizophrenia

A

When schizophrenia has not responded to 6-8 week courses of 2 different antipsychotics

30
Q

How do you treat Delirium tremens?

A

Chlordiazeproxide
Fluids
Pabrinex
Anti-emetics

31
Q

What can be used to treat the somatic symptoms of anxiety? e.g. tremor in hands

A

Beta blockers

32
Q

What is fronto-temporal dementia also known as?

A

Pick’s disease

33
Q

What are the pathology findings in FT dementia?

A

Intracellular TAU protiens

Atrophy of frontal and temporal lobes

34
Q

What class of drug is venlafaxine?

A

SNRI

35
Q

What does SNRI stand for?

A

Serotonin and noradrenaline reuptake inhibitor

36
Q

Give some short term side effects of ECT

A 
Headache
Nausea
Short term memory impairment 
Memory loss of events prior to ECT 
Cardiac arrhythmia
37
Q

What is Munchausen’s syndrome?

A

Purposefully causing symptoms e.g. taking too much insulin to cause hypos

38
Q

What is an oculogyric crisis?

A

Involuntary upward deviation of the eyes with restlessness and agitation. It is a dystonic reaction to certain drugs e.g. antipsychotics

39
Q

How do you treat an oculogyric crisis?

A

IV antimuscarinic e.g. benztropine/procyclidine

40
Q

If a patient responds well to SSRI treatment, how long should they stay on them to prevent relapse?

A

6 months

41
Q

What class of drug is amitryptyline?

A

Tricyclic antidepressants

42
Q

What is the general threshold age for personality disorder diagnosis?

A

18 years old

43
Q

If CBT or EMDR are ineffective in PTSD, what drug treatments are first line?

A

Venlafaxine or an SNRI

44
Q

What drug classes increase the risk of serotonin syndrome when taking an SSRI

A

MAOIs

Triptans

45
Q

What is tardive kinesia?

How does it present?

A

A late onset extrapyramidal side effect of long term antipsychotic use.

Presents with chewing, jaw pouting, excessive blinking

46
Q

What do you need to check before starting someone on venlafaxine?

A

Blood pressure, SNRIs are associated with development of hypertension

47
Q

What should be monitored before starting citalopram?

A

ECG due to an increased risk of QT prolongation / ventricular arrhythmias

48
Q

What is an electrolyte abnormality seen in SSRI usage

A

Hyponatraemia

49
Q

What is the risk of SSRIs in the 1st trimester?

A

Congenital heart defects

50
Q

What is the risk of SSRIs in the 3rd trimester?

A

Persistent pulmonary hypertension of the newborn

51
Q

What is the peak incidence of seizures after alcohol withdrawal?

A

36 hours

52
Q

What is the peak incidence of DT after alcohol withdrawal

A

72 hrs

53
Q

What is the 1st line treatment for delirium?

A

Haloperidol 0.5mg (or olanzepine)

Except for in Parkinson’s

54
Q

What is the 1st line treatment for delirium in Parkinson’s?

A

Low dose lorazepam

Haloperidol can worsen parkinson symptoms

55
Q

What drug can be used to treat tardive dyskinesia?

A

Tetrabenazine

56
Q

What class of drug can cause urinary retention?

A

Tricyclic antidepressants e.g. amitryptyline

57
Q

What is the hallmark sign of refeeding syndrome?

A

Hypophosphataemia

58
Q

What is section 135 of the MHA?

A

Section 135 is an order allowing the police to forcefully enter a property of a person believed to be mentally ill, in order to allow a mental health assessment.

59
Q

What is section 136 of the MHA?

A

allowing the police to remove a person from a public place who is believed to be mentally ill, to take them to a “place of safety” for a mental health assessment.

60
Q

What is 1st line in those seeking to maintain abstinence from alcohol?

A

Acamprosate

61
Q

What happens to cortisol and GH in anorexia nervosa?

A

They are raised

62
Q

What is cholesterol like in anorexia nervosa

A

Raised

63
Q

What are the 1st rank symptoms of schizophrenia?

A

Delusional perceptions
Auditory hallucinations
Delusions of thought
Passivity phenomenon

Passmed Flashcards (10 decks)

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