Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Sheff 3a > Psych - 10th Nov > Flashcards

Psych - 10th Nov Flashcards

1
Q

3 major and name a few of the 7 minor sx of depression

A

Low mood, anhedonia, fatigue / low energy

Disturbed sleep, appetite change, poor concentration, low self esteem, guilt, suicidal thoughts, bleak and pessimistic thought of future

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Diagnosis of depression?

A

> 1major sx present most of every day

Mild - 4 sx but still mostly functioning
Moderate - 5/6 and impact on normal functioning
Severe - 7 or more sx and severe impact on social functioning

Psychotic - severe + psychotic sx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Management of mild, moderate, and severe depression?

A

ALWAYS assess suicide risk
Mild - low intensity psychological Eg CBT self help, active monitoring

Moderate- medication, psychosocial interventions

Severe - medication, inpatient care, ECT if catatonic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Some sx of mania

A 
Elated mood and increased energy
Feeling of mental and psychical well-being
Reduced need for sleep
Loss of social inhibition
Over-spending
Increased sexual energy
Pressure of speech
Increased self esteem, grandiosity
Insight is usually lost
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Diagnosis of mania

A

Sx for >1wk
Impact on normal functioning
Social rejection due to bizarre behaviour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Usual time of episodes of bipolar? How long do manic / depressive episodes usually last?

A

Following stressful life events
Manic - 4 months
Depressive - 6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Management of manic? Depressive? Maintenance of bipolar?

A

Manic - don’t make important decisions until better

  • antipsychotics
  • mood stabilisers can be used 2nd line acutely

Depressive - fluoxetine + antipsychotic

Maintenance - lithium / sodium valproate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

3 clusters of personality disorders

A 
Cluster A ‘Odd or eccentric’ (MAD)
Schizoid
Schizotypal
Paranoid
Cluster B ‘Dramatic, emotional or erratic’ (BAD)
Antisocial/Dissocial
Emotionally unstable/Borderline
Histrionic
Narcissistic
Cluster C ‘anxious or fearful’ (SAD)
Anankastic
Anxious/Avoidant
Dependant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Talk about schitzoid ? Eg of who ?

A

emotionally ‘cold’
don’t like contact with other people, often uninterested in sexual contact
have a rich fantasy world
day dream a lot

Sheldon Big Bang theory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Schitzotypal features ? Eg of who?

A

eccentric behaviour
odd ideas
difficulties with thinking
lack of emotion, or inappropriate emotional reactions
see or hear strange things
You wonder if they are psychotic
sometimes related to schizophrenia, the mental illness

David tennant in doctor who

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Paranoid personality disorder features? Eg?

A

suspicious
feel that other people are being nasty to you (even when evidence shows this isn’t true)
feel easily rejected
tend to hold grudges

The husband who always thinks his wife in cheating on him

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Antisocial personality disorder features? EG?

A

don’t care much about the feelings of others
easily get frustrated
tend to be aggressive
commit crimes
find it difficult to makeclose relationships
impulsive - do things on the spur of the moment without thinking about them
don’t feel guilty about things you’ve done

The joker from batman

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Features of borderline / emotionally unstable? Eg?

A 
find it hard to control your emotions
feel bad about yourself
often self-harm, and use it as a threat
make relationships quickly, but easily lose them
can feel paranoid or depressed
clingy, falls in love easily

A certain person post break up

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Features of histrionic ? Eg?

A

over-dramatise events
self-centered, attention seeking behaviour
have strong emotions which change quickly and don’t last long
can be suggestible
worry a lot about your appearance
crave new things and excitement
can be seductive, sexually promiscuous

Reality TV stars

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Features of narcissistic? Eg?

A

Sense of self importance
Dream of unlimited success, power and intellectual brilliance
Crave attention, but show few warm feelings in return
Asks for favours but doesn’t like doing them

Kanye west

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Features of Anankastic (obsessive compulsive) Eg?

A 
Worry and doubt 
Perfectionist 
Cautious - pre occupied with detail 
Worry about doing the wrong thing 
Find it hard to adapt to new situations 
High moral standards 
Judgemental 
Sensitive to criticism 
Obsessional thoughts

Eg behrouz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Features of avoidant ? Eg?

A 
Anxious and tense 
Worry a lot 
Insecure and inferior 
Have to be liked and accepted 
Sensitive to criticism 
Avoid people due to feeling

Eg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Features of dependant

A 
Passive
Rely on other to make your decisions 
Do what other people want you to 
Find it hard to cope with daily chores 
Hopeless and incompetent feeling 
Feel easily abandoned
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Define hallucination / delusion

A

Delusion
a belief that is held with strong conviction despite superior evidence to the contrary
Hallucination
an experience involving the apparent perception of something not present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Parts of the mental state examination? Mnemonic

A 
ASEPTIC 
Appearance and behaviour 
Speech 
Emotion 
Perceptions 
Thoughts 
Insights 
Cognition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Diagnosis of schitzophrenia

A

ICD 10
1 clear 1st rank symptom
Or at least 2 other symptoms
For > 1 month

1st rank symptoms
Thought echo, insertion, withdrawal or broadcasting
Delusions of control
 3rd Person auditory hallucinations
Delusions of perception
Other symptoms
Persistent delusions in other modalities
Breaks in train of thought
Catatonic behaviour
-ve symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Features of paranoid schitz

A

Most common form

(a) delusions of persecution, reference, exalted birth, special mission, bodily change, or jealousy;
(b) hallucinatory voices that threaten the patient or give commands, or auditory hallucinations without verbal form, such as whistling, humming, or laughing;
(c) hallucinations of smell or taste, or of sexual or other bodily sensations; visual hallucinations may occur but are rarely predominant.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Features of Hebephrenic schitz

A

Affective changes prominent

Hallucinations fleeting
Behaviour is irresponsible and unpredictable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Features of catatonic schitz

A

(a)stupor (marked decrease in reactivity to the environment and in spontaneous movements and activity) or mutism;
(b)excitement (apparently purposeless motor activity, not influenced by external stimuli);
(c)posturing (voluntary assumption and maintenance of inappropriate or bizarre postures);
(d)negativism (an apparently motiveless resistance to all instructions or attempts to be moved,
or movement in the opposite direction);(e)rigidity (maintenance of a rigid posture against efforts to be moved);(f)waxy flexibility (maintenance of limbs and body in externally imposed positions)
(g)other symptoms such as command automatism (automatic compliance with instructions),
and perseveration of words and phrases

25
Features of residual schitz
- (a)prominent "negative" schizophrenic symptoms, i.e. psychomotor slowing, underactivity, blunting of affect, passivity and lack of initiative, poverty of quantity or content of speech, poor nonverbal communication by facial expression, eye contact, voice modulation, and posture, poor self-care and social performance; (b) evidence in the past of at least one clear-cut psychotic episode meeting the diagnostic criteria for schizophrenia; (c) a period of at least 1 year during which the intensity and frequency of florid symptoms such as delusions and hallucinations have been minimal or substantially reduced and the "negative" schizophrenic syndrome has been present; (d) absence of dementia or other organic brain disease or disorder, and of chronic depression or institutionalism sufficient to explain the negative impairments.
26
What is a schitzoaffective disorder? Types?
Features schitz and affective symptoms at the same time But does not meet the criteria for schitz, mania or depression Manic type Depressive type Mixed type
27
How is monitoring of clozapine? How does it work
Weekly for 18 weeks, then fortnightly for 1 year then monthly Titration with initiation as an inpatient Missing 2 days -> re initiation of treatment
28
Neuroleptic malignant syndrome What is it? Who does it affec? Diagnostic features? Complications? What drug can you use
What is it? Imbalance of dopaminergic neurotransmitters following neuroleptic drug use Who does it affect? ≈ 0.5% patients ≈ 10% mortality Diagnostic features Muscular rigidity Hyperthermia 5 of: Altered mental status, tachycardia, Unstable BP, tremor, sweating, incontinence, ∆CPK, metabolic acidosis, leukocytosis Complications Rhabdomyolysis, Renal/hepatic failure, CV collapse Bromocriptine
29
Risk factors for suicide ? Mnemonic
``` SAD PERSONS S - sex (male) A - <19, >45 D - Depression P – Previous Attempt E - ETOH R – Rational thinking loss S – social support lacking O – Organised plan N – No spouse S - sickness ```
30
20yo girl presents to A&E saying she took 18 paracetamol and 500ml vodka. She broke up with her bf 2 weeks ago. Has previously seen GP for low mood. Has evidence of superficial cuts on arms. Name 4 blood tests Name 4 risk factors in this patient for repeated self harm Treatment for paracetamol overdose She was assessed by a psychiatrist on the ward. Which section of the mental health act should be implemented?
U&E, LFTS, Clotting, glucose Young, alcohol, life stressor, previous self harm Acetylecistine A&E doesn’t count as hospital -> Section 2
31
3 types of anxiety?
Generalised AD Panic disorder Phobic anxiety
32
Definition of GAD ? Needed for diagnosis?
A period of at least 6 months with prominent tension, feelings of apprehension about everyday events and problems ``` At least 4 of the following Palpitations Sweating Trembling and shaking Dry mouth Difficulty inhaling Chest pain or discomfort Sensation of lump in throat, difficulty swa[llowing, choking Feeling of nausea or abdominal distress Dizzy, unsteady, faint, light headed Numbness or tingling sensation Tinnitus Muscle tension/ aches and pains Restlessness Feeling on edge ``` Does not meet criteria for phobic anxiety, panic disorder, OCD, hypochondriacal disorder Not sustained by physical disorder- hypothyroidism or psychoactive substance use
33
GAD risk factors? Precipitating factors? Predisposing? Perpetuating? Protective?
35-54, separated / divorced, living alone, lone parent Stressful events especially threatening eg employment, relationships, ill health Genetic, childhood, anxious/avoidant personality Stressful events / ways of thinking Age 16-24, married, cohabiting
34
Panic disorder definition ? What is a panic attack? Moderate / severe panic disorder?
Recurrent panic attacks that are not associated with a specific situation, and often occur spontaneously. They are not related to marked exertion or exposure to dangerous events A panic attack is a Discrete episode of intense fear or discomfort Start abruptly Reaches crescendo within a few minutes and last few minutes 4 symptoms from the list of generalised anxiety disorder Moderate- 4 attacks in a 4 week period Severe- 4 attacks per week in a 4 week period
35
3 common types of phobia ?
Acrophobia (heights) Social phobia Specific isolated phobia Agoraphobia (places that’s hard to escape / no help)
36
Questionnaire for GAD?
GAD-7 Over the last 2 weeks, how often have you been bothered by any of the following problems (not at all, several days, more than half the days, nearly everyday) Feeling anxious, nervous, on edge Not being able to stop or control worrying Worrying too much about different things Having trouble relaxing Being so restless that it is hard to sit still Becoming easily annoyed or irritable Feeling afraid as if something scary might happen
37
Mx of anxiety disorders? (3 categories) when do you refer?
Conservative Education and active monitoring Low intensity psychological - individual self help High intensity - CBT , applied relaxation Pharmacological SSRI (sertraline) Pregabalin Referral to specialist mental health service With risk of self harm / suicide Significant co-morbidity - substance misuse, complex physical illness, personality disorder Self neglect Inadequate response to psych / pharma interventions
38
Which psychotic features can indicate psychotic depression
Delusions, hallucinations Catatonic (depressive stupor) - motionless, mute, refuses to eat or drink
39
What tool is used to monitor the severity of depression and response to treatment in GP?
PHQ-9 (patient health questionnaire)
40
Most important complication of bipolar? Others?
The most important complication of bipolar disorder is suicide and deliberate self-harm. Other consequences of acute episodes are: Financial ruin arising from overspending. Traumatic injuries and accidents. Damage to reputation, occupation, and relationships. Self-neglect, exhaustion, and dehydration. Exploitation by others. Alcohol and substance misuse. Harm to others from: Neglect. Depressive or paranoid delusions.
41
Difference between mania and hypomania ? How long do they last? How long does depressive episode have to last?
Hypomania has no psychotic features Mania must be present for 7 days Hypomania only 4 Depressive at least 2 weeks
42
Bipolar treatment of mania
Trail of haloperidol, olanzapine, quetiapine, or risperidone Ineffective / not tolerated -> another one offered Ineffective / not tolerated -> add lithium (if not suitable -> sodium valproate) Stop antidepressants if develop mania
43
Options for treatment of depression in bipolar
Quetiapine alone, or Fluoxetine combined with olanzapine, or Olanzapine alone, or Lamotrigine alone.
44
Complications of schitz
Suicide and accidents Physical disorders - CVD: stress, genetic, lifestyle, antipsychotics - T2DM: lifestyle, antipsychotics - COPD: lifestyle - infections: HIV HCV, TB Social disability - due to negative sx Substance misuse
45
Diagnosis of schitz
Sx present for most of the time for at least 1 month One or more of the following features if they are clear-cut (1st rank symptoms) 3rd person auditory hallucinations Thought alienation :thought echo, withdrawal or broadcasting Passivity phenomena: delusions of control or passivity Delusional perception: persistent delusions that are culturally inappropriate and completely impossible (superpowers) Or any 2 of the following (secondary symptoms) Persistent hallucinations in any form: includes 2nd person auditory hallucination Breaks in train of thought, resulting in incoherence Negative symptoms: apathy, emotional blunting, social withdrawal
46
What interventions would you use to prevent psychosis ? What would you not do ?
Individual CBT / those for anxiety, substance misuse ... Not antipsychotic
47
How should you manage first episode of psychosis
Offer oral antipsychotic AND | Psychological interventions
48
What should you do if a patient (1st episode of psychosis) does not want oral medication?
Offer family intervention and CBT Agree a time (within a month) for a review of treatment options Monitor sx and functioning regularly
49
What criteria before MHA can be applied? Exclusions?
Patient has a mental disorder Detained for their own safety / safety of others Nature of mental disorder warrants the detention of a patient in hospital Informal admission / community assessment not appropriate (Eg refusal of treatment) Learning disability - unless abnormally aggressive Drug/alcohol dependance
50
``` Tricyclic Eg? Mechanism ? Effects? Side effects? ```
Amitriptyline Blocks resp take of 5HT and NA. Also affects histamine and muscarinic receptors Effects - drowsiness, confusion, motor in coordination but these resolve when anti depressive effects develop in 1-2 weeks Side effects Anticholinergic - dry eyes, mouth, burred vision, constipation, urinary retention ∂ receptor blocker - Drowsiness, postural hypotension, sexual dysfunction CVS - tachycardia, hypotension, conduction defects CNS - sedation, seizures Other - Weight gain
51
SSRIs Eg? Mechanism? Side effects?
Sertraline, citalopram, fluoxetine Inhibits 5HT reuptake Side effects - may increase suicidal ideation as it is a stimulant -> motivation to take own life GI - nausea, anorexia, diarrhoea, GI bleed (long term use) CNS - insomnia, restlessness, irritability, agitation, headache, tremor GU - ejaculatory delay, anorgasmia CVS - conduction defects -> long QT
52
``` MAOI Eg? Mechanism? Would you use it first line? S/E? ```
Iproniazid, phenelzine Regulates the free intraneuronal concentration of 5HT -> release of these transmitters Not first line use ``` Hypotension, central stimulation (tremor, excitement, insomnia, convulsions) Weight gain from appetite Anticholinergic Hepatotoxic Tyramine reaction ```
53
Triad of serotonin syndrome? Mx?
1: Cognitive impairment - agitation, headache, confusion, delirium, pressure of speech 2: Autonomic - shivering, sweating 3: Neuromuscular dysfunction - Akathisia ``` Mx Stop drug Give charcoal IV fluid + benzo ABCDE 5HT block - chlorpromazine Severe-> Cyproheptadine (prevents serotonin production) ```
54
Lithium blood levels - how long to decrease?
Half of oral is excreted in 12 hours | Remainder taken up by cells and excreted over 1-2 weeks
55
When is lithium dangerous?>
Dehydration, sodium depletion, thiazide, renal disease
56
When should you monitor litmus levels?
12 hours after last dose and 4-7 days after starting drugs
57
What level of lithium is toxic? Signs/sx? Management?
>1.5mmol/l Coarse tremor, nausea / vomiting / diarrhoea, ataxia, muscle twitching, hyperreflexia, renal failure, confusion/coma/convulsions Mx Stop lithium, check levels, refer for urgent assessment If severe - admit as emergency for total bowel irrigation
58
Want to start tricyclic in 75yo man - what investigation need to do firsT?
ECG

Sheff 3a (30 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions