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BRS High Yield errors > Psych > Flashcards

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
Q

<div>Gender distribution in Type 1, 2 Bipolar + MDD</div>

A

<p>M = F in <strong>bipolar type 1</strong></p>

<p>F>M in <strong>bipolar type 2</strong> <strong>+ MDD</strong></p>

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26
Q

<div>Depression symptoms (and time period)</div>

A

<p><strong>2 weeks + 4/8 symptoms WITH depressed mood</strong></p>

<p><span><strong>S</strong></span>leep changes: increase during day or decreased sleep at night</p>

<p><span><strong>I</strong></span>nterest (loss): of interest in activities that used to interest them</p>

<p><span><strong>G</strong></span>uilt (worthless): depressed elderly tend to devalue themselves</p>

<p><span><strong>E</strong></span>nergy (lack): common presenting symptom (fatigue)</p>

<p><span><strong>C</strong></span>ognition/<span><strong>C</strong></span>oncentration: reduced cognition &/or difficulty concentrating</p>

<p><span><strong>A</strong></span>ppetite (wt. loss); usually declined, occasionally increased</p>

<p><span><strong>P</strong></span>sychomotor: agitation (anxiety) or retardations (lethargic)</p>

<p><span><strong>S</strong></span>uicide/death preocp.</p>

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27
Q

<div>What to do if someone no longer wants SSRI?</div>

A

<p>Taper</p>

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28
Q

<div>Triad of symptoms in Depression</div>

A

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

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29
Q

<div>Symptoms in mania (and time range for hypo/mania)</div>

A

<p><strong>3/7 (4 days or more: hypomania, 1 week or more: mania)</strong></p>

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

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30
Q

<div>Hypomania for less than 4 days with depression?</div>

A

<p>Unspecified Bipolar Disorder</p>

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31
Q

<div>Which area of the brain is switched on during negative stimuli?</div>

A

<p>Amygdala</p>

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32
Q

<div>Which area of the brain is responsible for mediating negative attention bias?</div>

A

<p>Perigenual Anterior Cingulate Cortex</p>

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33
Q

<div>Amygdala has a bias towards what type of detecting?</div>

A

<p>Detecting fear</p>

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34
Q

<div>Amygdala function?</div>

A

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

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35
Q

<div>Which receptors are theorised to be low in those with depression?</div>

A

<p>5-ht1a + 5-ht4</p>

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36
Q

<div>Explain the method of measuring serotonin in the brain</div>

A

<p><strong>AMPHETAMINE CHALLENGE</strong></p>

<ol><li>Give a ligand of dopamine receptor and measure with PET</li></ol>

<ol><li>Then give pharma challenge + ligand and measure with PET</li></ol>

<p>Subtract 1-2 and we can see dopamine levels</p>

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37
Q

<div>Are agonist or antagonist tracers more sensitive?</div>

A

<p>Agonist</p>

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38
Q

<div>Which receptor do psychedelics bind to?</div>

A

<p><strong>Serotonin 2A receptor.</strong></p>

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39
Q

<div>What particular differential to MDD might be relevant in asking about suicide?</div>

A

<p><strong>Borderline Personality Disorder/Bipolar Affective Disorder</strong></p>

<ul><li>How could you tell between these?<ol><li>Life events/environment affects BPD</li></ol><ol><li>Emptiness or sadness typically more BPD</li></ol><ol><li>History of Bipolar in heritages!</li></ol></li></ul>

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40
Q

<div>Rude, lack of self-awareness, CEO-mindset are indicators of what?</div>

A

<p><strong>Narcisstic Personality Disorder</strong></p>

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41
Q

<div>What are some disorders that belong in Cluster B?</div>

A

<p><strong>Histrionic, Borderline, Narcisstic + Antisocial</strong></p>

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42
Q

<div>Physical attacks, rude behaviour and other non-civil behaviours are all signs of what?</div>

A

<p><strong>Antisocial Behaviour Disorders</strong></p>

<p></p>

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43
Q

<div>Blood tests for which vitamins should be run when MDD is suspected?</div>

A

<p>B12/Folic acid</p>

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44
Q

<div>Why might we run an MRI on depressed individual patients?</div>

A

<p><strong>White Matter Hyperintensities</strong> - Vascular Depression</p>

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45
Q

<div>What are the criteria for dependence syndrome?</div>

A

<p><em>THIS WC 🏟</em></p>

<ol><li><strong>S</strong> Strong desire/compulsion to take substances</li></ol>

<ol><li><strong>C </strong>Difficulty controlling</li></ol>

<ol><li><strong>W </strong>‘Withdrawal state’</li></ol>

<ol><li><strong>T </strong>Tolerance evidence (need to take more to get same effects)</li></ol>

<ol><li><strong>I </strong>Neglect of other interest</li></ol>

<ol><li><strong>H </strong>Despite harmful sustances, persist with usage</li></ol>

<ul><li>How do you ask about control?<p><strong>Who has control (you or the drug?)/when did you last have the drug?</strong></p></li></ul>

<p></p>

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46
Q

<div>How many symptoms in the last period of time must you have to qualify for dependence syndrome?</div>

A

<p>3/6 in the last 12 months</p>

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47
Q

<div>Difference between <strong>dependence</strong> and <strong>addiction?</strong></div>

A

<p><strong>Addiction</strong>: Use despite harmful consequences, can’t stop drug, affects life + tolerance and withdrawal.</p>

<p><strong>Dependence</strong>: A physical adaptation.</p>

48
Q

<div>Can you be dependent but not addicted?</div>

A

<p><strong>Yes</strong></p>

49
Q

<div>Can you be addicted but not dependent</div>

A

<p><strong>No</strong></p>

50
Q

<div>How to differentiate hazardous substance use from harmful substance use?</div>

A

<p>There should be prior damage done to either <strong>physical</strong> or <strong>mental</strong> health caused by the substance.</p>

<p><em>eg. hangovers occuring regularly.</em></p>

51
Q

<div>Which order do the following tend to occur: hazardous + harmful + addiction + dependence?</div>

A

<p>Hazardous → Harmful → Dependence (→ <strong>Addicition</strong>)</p>

<p></p>

52
Q

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

A

<p>Quantity + Consequences + Pattern</p>

53
Q

<div>What are some factors involved in drug usage?</div>

A

<p>Social/environmental/personal + drug</p>

54
Q

<div>Which receptors are involved in the inhibitory and excitatory systems?</div>

A

<p><strong>E</strong> - NMDA</p>

<p><strong>I</strong> - GABA-A</p>

55
Q

<div>What happens to these receptors in the presence of alcohol?</div>

A

<p><strong>NMDA increases receptors</strong></p>

<p><strong>GABA have reduced sensitivity</strong></p>

<p></p>

56
Q

<div>How to treat withdrawal?</div>

A

<p>Benzo’s → reduce glutamate and increase GABA</p>

57
Q

<div>Which ion is increased when NMDA is upregulated in withdrawal?</div>

A

<p>Calcium 2+</p>

58
Q

<div>How does acamprosate work, in contrast to benzo treatment?</div>

A

<p>Benzo: increases GABA</p>

<p>Acamprosate: decreases NMDA</p>

59
Q

<div>Why do we give acamprosate ∴?</div>

A

<p>Support abstinence + provide neuroprotection from excessive NMDA overactivation</p>

60
Q

<div>Drugs increase the level of which neurotransmitter?</div>

A

<p>Dopamine</p>

61
Q

<div>Addiction has been known to be a reward \_\_\_\_\_ state.</div>

A

<p>Deficient</p>

62
Q

<div>Neurones involved in the reward pathway (implicated in addiction) go from where → where?</div>

A

<p>Ventral Tegmental area - Ventral Striatum</p>

63
Q

<div>Which opioid subtype is involved with pleasure effects?</div>

A

<p>Mu Opioid</p>

64
Q

<div>Which opioid subtype is involved with stress effects?</div>

A

<p>Kappa opioid</p>

65
Q

<div>How do amphetamine drugs work?</div>

A

<p>Release Dopamine - REMEMBER AMPHETAMINE CHALLENGE 😯</p>

66
Q

<div>How do opioids work?</div>

A

<p>Increase dopamine neuronal firing rates in ventral tegmental area.</p>

67
Q

<div>How do we use fMRI to explain addiction?</div>

A

<p>Provide money-incentive game and measure dopamine levels (D2 receptor).</p>

<p>Those with problematic drug use, have lower dopmaine levels in striatum.</p>

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

68
Q

<div>Change from positive - negative reinforcement occurs through addiction/dependence - T or F?</div>

A

<p><strong>True</strong></p>

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

69
Q

<div>In the transition from <strong>voluntary</strong> drug use to <strong>compulsive</strong> drug habits name the <strong>2</strong> key changes in brain areas where activity occurs?</div>

A

<ol><li>Prefrontal → Striatum</li></ol>

<ol><li>Ventral → Doral</li></ol>

<p><em>essentially front to back</em></p>

70
Q

<div>∴ from above what brain part is most active in alcoholics who remain abstinent?</div>

A

<p>Prefrontal cortex.</p>

71
Q

<div>How to calculate units of alcohol</div>

A

<p>(% x volume/ml) <strong>DIV</strong> 1000</p>

72
Q

<div>Recommended limit of alcohol per week</div>

A

<p>14</p>

73
Q

<div>Excretion rate of alcohol</div>

A

<p>1 unit per hours</p>

74
Q

<div>Which screening test is used to monitor signs of harm in alcohol use?</div>

A

<p>CAGE</p>

75
Q

<div>Features of opioid withdrawal</div>

A

<p>Tachycardia, Dilated pupils, Sweating</p>

76
Q

<div>Signs of alcohol abuse on examination?</div>

A

<p>Oedema, jaundice, anaemia, clubbing, lymphadenopathy</p>

77
Q

<div>Track marks are a sign of \_\_\_\_\_\_\_\_</div>

A

<p>Opioid use</p>

78
Q

<div>What are signs of opioid use?</div>

A

<p>Track marks, endocarditis, skin abscesses, hep, pnuemonia + HIV</p>

79
Q

<div>Alcohol vs opioid withdrawal - more dangerous?</div>

A

<p><strong>Alcohol</strong></p>

80
Q

<div>How long does alcohol withdrawal start from + what’s the latest sign?</div>

A

<p><strong>6 hours + delirium tremens</strong></p>

81
Q

<div>2 functions of opioids</div>

A

<p><strong>Analgesia/Euphoria</strong></p>

82
Q

<div>Opioid overdose medication</div>

A

<p><strong>Naloxone IM in the arm/thigh or nasally</strong></p>

<p>Support airways!!!!!</p>

83
Q

<div>G drugs</div>

A

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

84
Q

<div>Presentation of MDMA</div>

A

<p><strong>SIMILAR TO SEROTONIN OVERDOSE</strong></p>

<p>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.</p>

85
Q

<div>Lithium binds to enzyme/receptor/neurotransmitter reuptake channel/MAOIs</div>

A

<p><strong>Enzymes (glycogen kinase)</strong></p>

86
Q

<div>Most treatments are agonists/antagonists</div>

A

<p><strong>Antagonists</strong></p>

87
Q

<div>Two agonistic treatments</div>

A

<p><strong>Benzodiazepines and Guanfacine</strong></p>

88
Q

<div>Three antagonistic treatments (drug + illnesses)</div>

A

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

89
Q

<div>Which antidepressant blocks NA reuptake channels?</div>

A

<p><strong>Desipramine</strong></p>

90
Q

<div>Which antidepressant blocks dopamine reuptake inhibitor?</div>

A

<p><strong>Methylphenidate</strong></p>

91
Q

<div>How does amfetamine work?</div>

A

<p>Activates GABA reuptake channels <strong>- ADHD</strong></p>

92
Q

<div>Most treatments activate/block reuptake channels?</div>

A

<p>Block</p>

93
Q

<div>How does citalopram work and how does a psychedelic work since both bind to the same neurone?</div>

A

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

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

94
Q

<div>How do gabapentin & pregabalin work?</div>

A

<p><strong>Block calcium channels (epilepsy stabilisations</strong></p>

95
Q

<div>GABA or Glutamate?</div>

A

<ul><li>Which are higher number?<p><strong>Glutamate 80% & GABA 15%</strong></p></li></ul>

<ul><li>Which cells do each occur throughout?<p><strong>Glutamate (Pyramidal) & GABA (Inter-neurones)</strong></p></li></ul>

<ul><li>Function of both?<p><strong>Memory, Vision & Movements</strong></p></li></ul>

96
Q

<div>Apart from the two most common type of neurotransmitters above, what are the remainders?</div>

A

<p>Slow acting (ser, nor, dop)</p>

97
Q

<div>What are the above responsible for?</div>

A

<p>Emotions, Drives, Valence of memories</p>

98
Q

<div>Excess glutamate causes which disease + what’s the treatment?</div>

A

<p><strong>Epilepsy, Alcoholism (perampanel + acramprosate, ketamine)</strong></p>

99
Q

<div>Excess dopamine causes which disease + what’s the treatment?</div>

A

<p><strong>Psychosis (Dopamine receptor blockers)</strong></p>

100
Q

<div>Excess noradrenaline causes which disease + what’s the treatment?</div>

A

<p><strong>Nightmares (Prazosin)</strong></p>

101
Q

<div>Deficient GABA causes which disease + what’s the treatment?</div>

A

<p><strong>Anxiety (Benzodiazepines)</strong></p>

102
Q

<div>Deficient serotonin causes which disease + what’s the treatment?</div>

A

<p> <strong>Depression, Anxiety (SSRIs + MAOIs)</strong></p>

103
Q

<div>Deficient acetylcholine causes which disease + what’s the treatment?</div>

A

<p><strong>Impaired memory, Dementia (Acetylcholine esterase enzyme blockers (inhibitors))</strong></p>

104
Q

<div>What are partial agonist alternatives to heroin, haloperidol and nicotine?</div>

A

<p><strong>Buprenorphine, ariprozole + varenicline</strong></p>

105
Q

<div>Label 1 & 2</div>

A

<a><img></img></a><ul class="toggle"><li>Answer<p class>1 : <strong>Antagonist</strong></p><p class>2 : <strong>Inverse agonist</strong></p></li></ul>

106
Q

<div>What are orthosteric drugs?</div>

A

<p><strong>Drugs that bind to same receptor as endogenous neurotransmitters</strong>.</p>

107
Q

<div>What are the 4 factors that dispose someone to mental health conditions?</div>

A

<p><strong>Perpetuating, Precipitating, Perpetuating + Protective</strong></p>

108
Q

<div>What development order is used to monitor psychosocial development?</div>

A

<p><strong>Erikson’s Stages of Psychosocial development.</strong></p>

109
Q

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

A

<p><strong>The limbic lobe (matures earlier) and cortical areas. </strong></p>

<p><strong>FRONTAL LOBE TAKES AGES TO MATURE.</strong></p>

110
Q

<div>What are the peak age of onset of anxiety, OCD, depression, ADHD, eating disorders and substance misuse?</div>

A

<p><strong>Anxiety: 5.5</strong></p>

<p><strong>ADHD: 9.5</strong></p>

<p><strong>OCD: 14.5</strong></p>

<p><strong>Eating Disorders: 15.5</strong></p>

<p><strong>Depression: 19.5</strong></p>

<p><strong>Substance Misuse: 19/5</strong></p>

111
Q

<div>ADHD diagnosis criteria?</div>

A

<p><strong>At least 6/9 symptoms for 6 months</strong></p>

112
Q

<div>What are some environmental risk factors of ADHD?</div>

A

<p><strong>Low birth weight, premature birth weight & prevent tobacco exposure</strong></p>

113
Q

<div>Simple forgetfulness, some vocab problems and little bit of loneliness indicates what type of AD?</div>

A

<p><strong>Early AD</strong></p>

114
Q

<div>Significant vocab issues, problematic memory issues and some inital psychotic symptoms indicates what type of AD?</div>

A

<p><strong>Advanced Alzheimer’s</strong></p>

115
Q

<div>Significant psychosis, monosyllabic voice and urine or bladder problems indicate what type of AD?</div>

A

<p><strong>Severe Alzheimer’s.</strong></p>

BRS High Yield errors (4 decks)

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