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BRS 2 > psych > Flashcards

psych Flashcards

1
Q

what is an adjustment reaction?

A

distress/emotional disturbance interfering with social functioning arising in a period of adaptation to significant change

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2
Q

what is organisational delusional disorder?

A

persistent/recurrent delusions dominant

±hallucinations

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3
Q

how does post-stroke psychosis usually present?

A

delusions (persecutory, jealousy, environment)
hallucinations
more common in right hemisphere strokes

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4
Q

what mental illnesses can thyrotoxicosis lead to?

A

anxiety

mania

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5
Q

what mental illnesses can hypothyroidism lead to?

A

dementia

depression

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6
Q

what is delirium?

A

organic cerebral syndrome
acute confusional state
psychiatric manifestation of a physical illness

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7
Q

why is delirium a problem in hospital patients?

A

delays discharge and increases mortality

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8
Q

what can cause delirium?

A 
infection 
change in environment 
medication
alcohol withdrawal
surgery
pain 
constipation
dehydration
urine retention
stroke
organ impairment
hypoxia
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9
Q

risk factors for delirium?

A 
age
dementia
immobility
sensory impairment
catheterization
malnutrition 
alcohol
depression
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10
Q

3 types of stigma?

A

interpersonal - internalised discrimination
intrapersonal - friends, family, colleagues
structural - poor resources and funding, lack of access to care

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11
Q

what is psychosis?

A

difficulty interpreting and perceiving reality

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12
Q

what are the 3 symptom domains in pyshcoiss?

A

postive & negative symptoms, disorganisation

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13
Q

what are positiver symptoms?

A

hallucinations - percepts in absence of stimulus

delusions - fixed false beliefs out of keeping with social background

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14
Q

what are negative symptoms?

A

alogia - poverty of speech
anhedonia -
aversion/apathy- poor self care/motivation
affective flattening

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15
Q

what are disorganisation symptoms?

A

bizzarre behaviour

thought disorder

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16
Q

what is assess in the mental state exam?

A 
appearance & behaviour
insight
cognition 
speech
mood
thoughts
perceptions
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17
Q

2 types of delusions?

A

primary - occur suddenly

secondary - arise from previous idea/experience

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18
Q

name for delusion shared between people?

A

folie a deux

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19
Q

what is an illusion?

A

misconception of real external sitmulus

20
Q

types of hallucinations?

A 
hypnagogic (when falling asleep)
hypnopompic (when waking up)
auditory
visual
olfactory
gustatory
tactile
21
Q

what is Charles bonnet syndrome?

A

visual hallunctions when one starts to lose eyesight

22
Q

what is a hallucination?

A

perception ion absence of external stimulus

23
Q

management options for psychosis?

A

meidctaion - antipsychotics
psychological - CBT
social support

24
Q

what is the commonest class of antipsychotic?

A

dopamine antagonist

25
Q

what is the pathophysiology for psychosis?

A

increased presynaptic dopamine in striatum

26
Q

what main side effects can dopamine antagonists cause?

A

extrapyradimal side effects

  • parkinsonism = rigidity, slow gait, lack of arm swing, pill-rolling tremor
  • dystonia = increased motor tone
  • tardive dyskinesia = repetitive oral, facial movements
  • akathisia = inner restlessness
27
Q

difference between typical and atypical antipsychotics?

A

typical more likely to causes EPSEs

28
Q

other side effects ion antipsychotics?

A 
sedation
constipation
agranulocytosis, neutropenia
↑prolactin
↑ appetite , weight gain
diabetes
dysrhytmia
29
Q

diagnostic criteria for a dpressive episode?

A 
low mood for at least 2 weeks
PLUS 4+ :
anhedonia
low energy
sleep disturbances
appetite changes
↓ concentration
guilt
agitation/retardation 
suicidal thoughts
30
Q

diagnostic criteria for major depressive disorder?

A

prolonged major depressive episode

no previous manic/hypomanic episodes

31
Q

subtypes of MDD?

A

atypical
psychotic
melancholic

32
Q

core symptoms of depression?

A

low mood
low energy/anergia
anhedonia

33
Q

diagnostic criteria for manic episode?

A 
euphoric/irritable mood 
PLUS 3+
decrease sleep need with increased energy
distractibility
grandiosity
racing thoughts/ideas
↑talking 
↑goal-directed activities
impulse behaviour
34
Q

diagnostic criteria for a type I bipolar?

A

manic episode for minimum 1 week with notable functional impairment

35
Q

diagnostic criteria for a hypomanic episode?

A

manic episode symptoms present for minimum 4 days without functional impairment

36
Q

diagnostic criteria for a type II bipolar?

A

only hypomanic episodes with at least one major depressive episode

37
Q

diagnostic criteria for unspecified bipolar disorder?

A

manic symptoms for less than 4 days or other thresholds not met for manic/hypomanic episodes

38
Q

can psychotic features present in hypomania?

A

no because these indicate functional impairment

39
Q

hospitliztaion indicates what type of mania?

A

manic episode NOT hypomanic (irrespective of duration of either symptoms)

40
Q

difference between mania and depression?

A

insight maintained in depression

41
Q

what kind of biases are seen I. depression?

A

attention - prolonged focus on negative stimuli
memory - preferential recall of negative memories
perceptual - increased recognition of unhappy faces

42
Q

what brain regions are seponsible for the attention bias seen in depression?

A

amygdala

prefrontal cortex - anterior cingulate cortex & lateral inferior frontal cortex

43
Q

what is the monamine deficiency hypothesis?

A

depressive symptoms arise from insufficient monoamine transmitters

44
Q

what are the monamine transmitters?

A

dopamine
serotonin
noradrenaline

45
Q

gold standard for measuring receptors and transmitters in the brain?

A

PET scan using radioactive tracers

46
Q

why is it important to distinguish between bipolar and unipolar?

A

therapeutics - more ineffective in bipolar depression and can cause mania/hypomania and can worsen rapid-cycling cases

BRS 2 (12 decks)

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