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Psych Flashcards

1
Q

Front

A

Back

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2
Q

<div>Time range for adjustment disorder?</div>

A

<p><strong>1 - 6 months</strong></p>

<p>Symptoms of depression should occur within the first <strong>3</strong> months</p>

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3
Q

<div>Common delusional themes in post-stroke psychosis?</div>

A

<p>Persecutory, Jealousy + Environmental</p>

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4
Q

<div>What psychiatric disorders are associated with CVR disease, diabetes, COPD + MSK diseases</div>

A

<a><img></img></a><p class></p>

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5
Q

<div>What psychiatric disorders are caused by Thyrotoxicosis, Cushing’s Disease, Thyroid deficiency, Infections, Cancer and Parkinson’s?</div>

A

<a><img></img></a>

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6
Q

<div>What are some things that affect accurate diagnosis of psychiatric diseases?</div>

A

<a><img></img></a>

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7
Q

<div>Where are most delirium patients found?</div>

A

<p>ICU</p>

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8
Q

<div>Which sudden onset psychiatric disorder is found in <strong>up to 30% of elderly inpatients?</strong></div>

A

<p>Delirium</p>

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9
Q

<div>A <strong>fluctuating</strong> or <strong>waxing/waning</strong> or <strong>cyclical</strong> appearance of going crazy - This is indicative of which psychiatric condition?</div>

A

<p><strong>Delirium - If a patient goess crazy then normal then delirium is a contender.</strong></p>

<p><em>Twelve hours later, his temperature is 101.8°F (38.8°C), he demands that he be allowed to return home, and he gets agitated when the nurse does not allow him to leave his bed. He starts complaining about a parrot in his bathroom. One hour later he politely asks when he will receive lunch. </em></p>

<p></p>

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10
Q

<div>3 categories of psychosis symptoms</div>

A

<ol><li>Positive</li></ol>

<ol><li>Negative</li></ol>

<ol><li>Disorganisation</li></ol>

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11
Q

<div>All the negative symptoms of Psychosis</div>

A

<p><strong>Anhedonia, Alogia, Avolition + Affective Flattening</strong></p>

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12
Q

<div>All of the disorganisation symptoms of Psychosis</div>

A

<p><strong>Bizarre Behvaiour, Thought disorder</strong></p>

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13
Q

<div>Components of the MSE</div>

A

<p>🧴<strong>ASEPTIC</strong></p>

<p><strong>A</strong>ppearance + Behaviour</p>

<p><strong>S</strong>peech</p>

<p><strong>E</strong>motion + Mood</p>

<p><strong>P</strong>erception</p>

<p><strong>T</strong>houghts</p>

<p><strong>I</strong>nsight</p>

<p><strong>C</strong>ognition</p>

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14
Q

<div>Repetitive movements of lip smacking, pouting or wrist circumduction are examples of what psychological symptom?</div>

A

<p>Tardive Dyskinesia</p>

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15
Q

<div>What 4 things do you measure in speech with the MSE?</div>

A

<ol><li>Rate</li></ol>

<ol><li>Quantity</li></ol>

<ol><li>Spontaneity</li></ol>

<ol><li>Volume</li></ol>

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16
Q

<div>Order of MSE</div>

A

<p>A Sorry Man Thought Psychiatry Could Imply</p>

<blockquote>Appearance & Behaviour</blockquote>

<blockquote>Speech</blockquote>

<blockquote>Mood & Affect</blockquote>

<blockquote>Thoughts (control & content)</blockquote>

<blockquote>Perception</blockquote>

<blockquote>Cognition</blockquote>

<blockquote>Insight</blockquote>

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17
Q

<div>What term is given to shared delusions?</div>

A

<p>Folie a deux</p>

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18
Q

<div>Hypangogic vs Hypnopompic</div>

A

<a><img></img></a>

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19
Q

<div>What’s a Charles Bonnet syndrome?</div>

A

<p>When a person losing their sight starts having visual hallucination.</p>

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20
Q

<div>What’s acute dystonia?</div>

A

<p>Increased motor tone</p>

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21
Q

<div>What’s akathisia?</div>

A

<p>Inner ‘restlessness (commonly in legs)</p>

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22
Q

<div>Sore throat with antipsychotics.....</div>

A

<p>Agranulocytosis</p>

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23
Q

<div>Milky white discharge w/ antipsychotics.....</div>

A

<p>Galactorrhea</p>

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24
Q

<div>2 types of bipolar disorder?</div>

A

<ul><li>type I disorder: mania and depression (most common)</li></ul>

<ul><li>type II disorder: hypomania and depression</li></ul>

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25
Gender distribution in Type 1, 2 Bipolar + MDD

M = F in bipolar type 1

F>M in bipolar type 2 + MDD

26
Depression symptoms (and time period)

2 weeks + 4/8 symptoms WITH depressed mood

S leep changes: increase during day or decreased sleep at night

I nterest (loss): of interest in activities that used to interest them

G uilt (worthless):  depressed elderly tend to devalue themselves

E nergy (lack): common presenting symptom (fatigue)

C ognition/C oncentration: reduced cognition &/or difficulty concentrating

A ppetite (wt. loss); usually declined, occasionally increased

P sychomotor: agitation (anxiety) or retardations (lethargic)

S uicide/death preocp.

27
What to do if someone no longer wants SSRI?

Taper

28
Triad of symptoms in Depression
29
Symptoms in mania (and time range for hypo/mania)

3/7 (4 days or more: hypomania, 1 week or more: mania)

30
Hypomania for less than 4 days with depression?

Unspecified Bipolar Disorder

31
Which area of the brain is switched on during negative stimuli?

Amygdala

32
Which area of the brain is responsible for mediating negative attention bias?

Perigenual Anterior Cingulate Cortex

33
Amygdala has a bias towards what type of detecting?

Detecting fear

34
Amygdala function?

Medial Temporal lobe is the area and involved in perception and encoding of stimuli and translating to goals (reward system, facial expression & emotions)

35
Which receptors are theorised to be low in those with depression?

5-ht1a + 5-ht4

36
Explain the method of measuring serotonin in the brain

AMPHETAMINE CHALLENGE

  1. Give a ligand of dopamine receptor and measure with PET
  1. Then give pharma challenge + ligand and measure with PET

Subtract 1-2 and we can see dopamine levels

37
Are agonist or antagonist tracers more sensitive?

Agonist

38
Which receptor do psychedelics bind to?

Serotonin 2A receptor.

39
What particular differential to MDD might be relevant in asking about suicide?

Borderline Personality Disorder/Bipolar Affective Disorder

  • How could you tell between these?
    1. Life events/environment affects BPD
    1. Emptiness or sadness typically more BPD
    1. History of Bipolar in heritages!
40
Rude, lack of self-awareness, CEO-mindset are indicators of what?

Narcisstic Personality Disorder

41
What are some disorders that belong in Cluster B?

Histrionic, Borderline, Narcisstic + Antisocial

42
Physical attacks, rude behaviour and other non-civil behaviours are all signs of what?

Antisocial Behaviour Disorders

43
Blood tests for which vitamins should be run when MDD is suspected?

B12/Folic acid

44
Why might we run an MRI on depressed individual patients?

White Matter Hyperintensities - Vascular Depression

45
What are the criteria for dependence syndrome?

THIS WC 🏟

  1. S Strong desire/compulsion to take substances
  1. C Difficulty controlling
  1. W ‘Withdrawal state’
  1. T Tolerance evidence (need to take more to get same effects)
  1. I Neglect of other interest
  1. H Despite harmful sustances, persist with usage
  • How do you ask about control?

    Who has control (you or the drug?)/when did you last have the drug?

46
How many symptoms in the last period of time must you have to qualify for dependence syndrome?

3/6 in the last 12 months

47
Difference between dependence and addiction?

Addiction: Use despite harmful consequences, can’t stop drug, affects life + tolerance and withdrawal.

Dependence: A physical adaptation.

48
Can you be dependent but not addicted?

Yes

49
Can you be addicted but not dependent

No

50
How to differentiate hazardous substance use from harmful substance use?

There should be prior damage done to either physical or mental health caused by the substance.

eg. hangovers occuring regularly.

51
Which order do the following tend to occur: hazardous + harmful + addiction + dependence?

Hazardous → Harmful → Dependence (→ Addicition)

52
What 3 things do you look for to quantify whether behaviour falls into hazardous, addictive/dependent + harmful behaviour?

Quantity + Consequences + Pattern

53
What are some factors involved in drug usage?

Social/environmental/personal + drug

54
Which receptors are involved in the inhibitory and excitatory systems?

E - NMDA

I - GABA-A

55
What happens to these receptors in the presence of alcohol?

NMDA increases receptors

GABA have reduced sensitivity

56
How to treat withdrawal?

Benzo’s → reduce glutamate and increase GABA

57
Which ion is increased when NMDA is upregulated in withdrawal?

Calcium 2+

58
How does acamprosate work, in contrast to benzo treatment?

Benzo: increases GABA

Acamprosate: decreases NMDA

59
Why do we give acamprosate ∴?

Support abstinence + provide neuroprotection from excessive NMDA overactivation

60
Drugs increase the level of which neurotransmitter?

Dopamine

61
Addiction has been known to be a reward _____ state.

Deficient

62
Neurones involved in the reward pathway (implicated in addiction) go from where → where?

Ventral Tegmental area - Ventral Striatum

63
Which opioid subtype is involved with pleasure effects?

Mu Opioid

64
Which opioid subtype is involved with stress effects?

Kappa opioid

65
How do amphetamine drugs work?

Release Dopamine - REMEMBER AMPHETAMINE CHALLENGE 😯

66
How do opioids work?

Increase dopamine neuronal firing rates in ventral tegmental area.

67
How do we use fMRI to explain addiction?

Provide money-incentive game and measure dopamine levels (D2 receptor).

Those with problematic drug use, have lower dopmaine levels in striatum.

68
Change from positive - negative reinforcement occurs through addiction/dependence - T or F?

True

69
In the transition from voluntary drug use to compulsive drug habits name the 2 key changes in brain areas where activity occurs?
  1. Prefrontal → Striatum
  1. Ventral → Doral

essentially front to back

70
∴ from above what brain part is most active in alcoholics who remain abstinent?

Prefrontal cortex.

71
How to calculate units of alcohol

(% x volume/ml) DIV 1000

72
Recommended limit of alcohol per week

14

73
Excretion rate of alcohol

1 unit per hours

74
Which screening test is used to monitor signs of harm in alcohol use?

CAGE

75
Features of opioid withdrawal

Tachycardia, Dilated pupils, Sweating

76
Signs of alcohol abuse on examination?

Oedema, jaundice, anaemia, clubbing, lymphadenopathy

77
Track marks are a sign of ________

Opioid use

78
What are signs of opioid use?

Track marks, endocarditis, skin abscesses, hep, pnuemonia + HIV

79
Alcohol vs opioid withdrawal - more dangerous?

Alcohol

80
How long does alcohol withdrawal start from + what’s the latest sign?

6 hours + delirium tremens

81
2 functions of opioids

Analgesia/Euphoria

82
Opioid overdose medication

Naloxone IM in the arm/thigh or nasally

Support airways!!!!!

83
G drugs

Odourless white liquid (ecstasy) aka gamma hydroxybutyrate/butyrolactone that’s highly addictive, anti-depressive effect!

84
Presentation of MDMA

SIMILAR TO SEROTONIN OVERDOSE

MDMA, also known as "Molly" or "ecstasy" is a recreational drug with sympathomimetic properties accomplished by its increase release of endogenous catecholamine and inhibition of catecholamine re-uptake. It also increases serotonin levels. Patients can present with hyperthermia, hypertension, and tachycardia; as well as, increased alertness and feelings of increased physical and mental powers. Patients may be hyponatremic due to their increased water intake and, in some patients, persistent anti-diuretic hormone release.

85
Lithium binds to enzyme/receptor/neurotransmitter reuptake channel/MAOIs

Enzymes (glycogen kinase)

86
Most treatments are agonists/antagonists

Antagonists

87
Two agonistic treatments

Benzodiazepines and Guanfacine

88
Three antagonistic treatments (drug + illnesses)
89
Which antidepressant blocks NA reuptake channels?

Desipramine

90
Which antidepressant blocks dopamine reuptake inhibitor?

Methylphenidate

91
How does amfetamine work?

Activates GABA reuptake channels - ADHD

92
Most treatments activate/block reuptake channels?

Block

93
How does citalopram work and how does a psychedelic work since both bind to the same neurone?

Citalopram can bind to reuptake channels → increase serotonin concentration which bind to 5HT-1a receptors which are inhibitory and thus reduces neuronal activity (helpful for depression + anxiety)

Psychedelic can bind to 5HT-2a receptors which are activatory and thus cause mind-alterations and thus cause hallucinations (involved in schizo, eat, sleep)

94
How do gabapentin & pregabalin work?

Block calcium channels (epilepsy stabilisations

95
GABA or Glutamate?
  • Which are higher number?

    Glutamate 80% & GABA 15%

  • Which cells do each occur throughout?

    Glutamate (Pyramidal) & GABA (Inter-neurones)

  • Function of both?

    Memory, Vision & Movements

96
Apart from the two most common type of neurotransmitters above, what are the remainders?

Slow acting (ser, nor, dop)

97
What are the above responsible for?

Emotions, Drives, Valence of memories

98
Excess glutamate causes which disease + what’s the treatment?

Epilepsy, Alcoholism (perampanel + acramprosate, ketamine)

99
Excess dopamine causes which disease + what’s the treatment?

Psychosis (Dopamine receptor blockers)

100
Excess noradrenaline causes which disease + what’s the treatment?

Nightmares (Prazosin)

101
Deficient GABA causes which disease + what’s the treatment?

Anxiety (Benzodiazepines)

102
Deficient serotonin causes which disease + what’s the treatment?

Depression, Anxiety (SSRIs + MAOIs)

103
Deficient acetylcholine causes which disease + what’s the treatment?

Impaired memory, Dementia (Acetylcholine esterase enzyme blockers (inhibitors))

104
What are partial agonist alternatives to heroin, haloperidol and nicotine?

Buprenorphine, ariprozole + varenicline

105
Label 1 & 2
  • Answer

    1 : Antagonist

    2 : Inverse agonist

106
What are orthosteric drugs?

Drugs that bind to same receptor as endogenous neurotransmitters.

107
What are the 4 factors that dispose someone to mental health conditions?

Perpetuating, Precipitating, Perpetuating + Protective

108
What development order is used to monitor psychosocial development?

Erikson’s Stages of Psychosocial development.

109
During adolesence, in emotional situations, which areas of the brain are more likely to take precedent over decisions?

The limbic lobe (matures earlier) and cortical areas.

FRONTAL LOBE TAKES AGES TO MATURE.

110
What are the peak age of onset of anxiety, OCD, depression, ADHD, eating disorders and substance misuse?

Anxiety: 5.5

ADHD: 9.5

OCD: 14.5

Eating Disorders: 15.5

Depression: 19.5

Substance Misuse: 19/5

111
ADHD diagnosis criteria?

At least 6/9 symptoms for 6 months

112
What are some environmental risk factors of ADHD?

Low birth weight, premature birth weight & prevent tobacco exposure

113
Simple forgetfulness, some vocab problems and little bit of loneliness indicates what type of AD?

Early AD

114
Significant vocab issues, problematic memory issues and some inital psychotic symptoms indicates what type of AD?

Advanced Alzheimer’s

115
Significant psychosis, monosyllabic voice and urine or bladder problems indicate what type of AD?

Severe Alzheimer’s.

BRS High Yield errors (4 decks)

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