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Essie Year 5 > Psych > Flashcards

Psych Flashcards

1
Q

1st and 2nd line Mx in OCD

A

1) SSRI - fluoxetine 2) if 12 months of SSRI does not work, try alternative SSRI or clomipramine (TCA)

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2
Q

NMS Vs serotonin syndrome

A

NMS - lead pipe rigidity

Serotonin syndrome - hyperreflexia, myoclonus

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3
Q

questionnaire for GAD

A

GAD-7

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4
Q

core symptoms of ptsd

A

flashbacks
nightmares
hyperarousal / startle response
avoidance

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5
Q

1st rank sx of schizophrenia

A

auditory hallucinations
delusional perceptions
thought disorder - broadcasting, withdrawal, insertion
passivity

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6
Q

when is interpersonal therapy used

A

depression

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7
Q

baseline Ix for lithium

A

measure BMI, FBC, U&Es, TFTs, ECG before starting

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8
Q

ix when starting antipsychotics

A

FBC, U&Es, LFTs, prolactin, fasting blood glucose,
BP, lipids, weight
+ ECG !

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9
Q

monitoring when on antipsychotics

A

FBC, U&Es, LFTs, prolactin, fasting blood glucose,
BP, lipids, weight
+ cardiovascular risk assessment !

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10
Q

special tests for IVDUsers

A

physical exam for track marks
screen for hep B/hep C/HIV
blood cultures

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11
Q

section 17

A

allows leave for a specified amount of time from a current section

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12
Q

post partum psychosis mx

A

admission to mother and baby unit (allows breastfeeding, healthy development of attachment between mother + baby, maintains mother’s confidence in being a mother)
MDT approach - perinatal psychologist, psychiatrist, GP, nurses, health visitor, social services
antipsychotics - olanzapine/risperidone/quetiapine
talking therapies
education

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13
Q

long term complications of turner’s

A

htn
dm
infertility

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14
Q

mx of turner’s

A

further ix - echo for cardiac abnormalities, renal USS + DMSA for renal abnormalities, opthamology for visual disturbances, annual checks for BP, HbA1c, etc
MDT !!!!!! = paeds endocrinologist, psychologist, gynae, nephro, cardio, specialist nurses
can consider GH therapy for growth + oestrogen for induction of puberty
psychological support
support groups

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15
Q

piloerection

A

opiate withdrawal

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16
Q

derealisation

A

episodes when you feel that you are not real, seen in acute stress reaction

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17
Q

temporal lobe

A

memory

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18
Q

ECT C/I

A

no absolute C/I

relative C/I include: recent MI/stroke, increased ICP, severe HTN

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19
Q

OCD criteria

A

> 2 weeks of recurring unpleasant/intrusive thoughts or mental images or repetitive acts/mental operations

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20
Q

lewy body dementia onset

A

insidious

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21
Q

frontotemporal dementia onset

A

insidious, rapid progression

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22
Q

tardive dyskinesia tx

A

tetrabenazine

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23
Q

akasthesia tx

A

propanolol / lorazepam

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24
Q

dystonia tx

A

procyclidine

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25
Q

parkinsonism tx

A

procyclidine

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26
Q

when would you give NaSSA over SSRI

A

when there are particular issues with sleep / appetite, eg mirtazapine

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27
Q

benzodiazpeine wtihdrawal sx + mx

A

sx - insomnia, tremor, anxiety, sweating, tinnitus, nausea, vomiting, perceptual disturbances

mx - switch from short acting benzos to long acting (diazepam), then dose gradually reduced

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28
Q

extracampine hallucinations

A

things outside normal sensory field eg hearing alien voices

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29
Q

paraideolic illusion

A

seeing meaningful images in vague stimulus (eg seeing face in a fire)

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30
Q

OCD tx

A

exposure response prevention therapy
SSRIs (fluoxetine preferred, paroxetine, sertraline) for 12 months, if no improvement can switch to alternative SSRI / clomipramine (TCA)

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31
Q

learning difficulties by IQ

A

mild 50-70
moderate 35-49
severe 20-34
profound <20

32
Q

insomnia mx

A

short term <4week mx:
sleep hygiene advice
if there is significant daytime impairment, prescribe short-acting benzos or Z drugs
review in 2 weeks

long term >4week mx:
sleep hygiene advice
prescribe short-acting benzos or Z drugs to take for up to 4 weeks
refer to CBT

33
Q

questionnaire for social phobia

A

SPIN

34
Q

questionnaire for depression

A

PHQ9

35
Q

safest SSRI in people with hx of ischemic heart disease

A

sertraline

36
Q

types of schizoaffective disorder

A

manic

depressive

37
Q

knight’s move thinking is assoc. w/ …

A

schizophrenia

psychosis

38
Q

ICD10 anorexia criteria

A

restrictive/purging behaviour designed to reduce calorie intake
body dysmoprhia/fear of gaining weight/being fat
BMI < 18.5

39
Q

risk factors of eating disorder

A

being previously overweight
family hx
occupation (model, dancer)
T2DM

40
Q

anorexia complications

A 
electrolyte abnormalities --> arrhythmias
dehydration
hypoglycaemia
multi organ failure
death 
risk of self harm + suicide
41
Q

when is inpatient tx necessary in eating disorder

A

BMI < 13
rapid weight loss
high suicide risk
serious physical complications

42
Q

what MMSE score indicates cognitive impairment

A

< 25 / 30

43
Q

what MMSE score indicated normal cognition

A

> 27 / 30

44
Q

ECT indications

A

catatonia
neuroleptic malignant syndrome
mania

45
Q

Section 4

A

allows emergency admission to hospital when there is not enough to arrange section 2
its duration is 72h

46
Q

TCA overdose

A 
dilated pupils
urinary retention
dry mouth
tachycardia
agitation
blurred vision
constipation
prolonged QT
47
Q

lithium overdose

A 
coarse tremor
hyperreflexia
confusion
polyuria
seizure
coma
48
Q

vascular dementia medical mx

A

aspirin + manage CVS risk factors

49
Q

formication

A

feeling of insects crawling over/under skin due to stimulant intoxication/withdrawal (MDMA, cocaine, amphetamines) or alcohol withdrawal

50
Q

SSRI side effects

A 
increased agitation/suicidal thoughts at the start
GI upset
increased risk of GI bleeding
loss of libido / erectile dysfunction
hyponatremia
51
Q

SSRI discontinuation sx

A

FIRM STOP

Flu like sx
Insomnia
Restlessness
Mood swings

Sweating
Tummy problems
Off balance (ataxia)
Paresthesia

52
Q

Time needed for GAD dx

A

6 months

53
Q

at least 3 of the following sx are needed for GAD dx

A

SPINE FM

Sleep disturbance
Poor sleep
Irritability
Nervousness/restlessness
Easily Fatigued
Muscle tension
54
Q

GAD tx

A

SSRI –> alternative SSRI –> SNRI –> pregabalin

55
Q

Lithium toxicity

A 
Coarse tremor 
Hyperreflexia 
Nystagmus
Seizures
Ataxia
56
Q

when is community based alcohol detox offered

A

if drinking >15 units / day

or AUDIT score > 15

57
Q

when is inpatient alcohol detox offered

A

if drinking > 30 units/day
or SADQ score of 30+
or hx of epilepsy, delirium tremens, seizures following withdrawal
or significant psychiatric comorbidity / learning disability
or vulnerable social background (eg child, homeless)

58
Q

A 46 year old male inpatient has recently been initiated on clozapine following relapse
of paranoid schizophrenia. He reports chest pain and tachycardia. ECG demonstrates
ST elevation. Which is the most likely diagnosis?

A

myocarditis
- one of the adverse effects of clozapine is myocarditis so a baseline ECG should be done before prescribing. Sx include chest pain, SOB, arrhythmias

59
Q

drug classes where you may get prolonged QT

A

TCAs
antipsychotics
citalopram

60
Q

what to check before starting atypical antipsychotics

A

check BMI, pulse, BP, fasting blood glucose or HbA1c,

lipid profile

61
Q

atypical grief reaction

A

delayed grief reaction = when > 2 weeks passes before grieving begins
prolonged grief reaction = difficult to define

62
Q

opioid detox

A

tx = liquid methadone or sublingual buprenorphine (decision up to personal preference), clonidine + lofexidine can help sx

given inpatient for up to 4 weeks
given in community for up to 12 weeks

63
Q

Wernicke’s encephalopathy triad

A

confusion
ataxia
nystagmus

64
Q

Korsakoff’s triad

A

anterograde amnesia
retrograde amnesia
confabulation

65
Q

serotonin syndrome in a patient who is taking an SSRI and a concurrent medication?

A

concurrent medication likely to be MAOi or triptan

66
Q

what drugs should not be taken at the same time as taking an SSRI

A 
heparin/warfarin
NSAIDs
aspirin
triptans
MAOi
67
Q

patient has a good response to SSRI and now wants to discontinue it. What advice should be given?

A

if the patient has had a good response, they should take the SSRI for 6 months before discontinuation as there is a higher risk of relapse if discontinued early.

68
Q

most likely SSRI to cause torsades de pointes

A

citalopram

69
Q

chronic insomnia definition

A

struggling to sleep more than 3 nights a week for more than 3 months

70
Q

Dizziness, electric shock sensations, GI upset, restlessness, sweating, difficulty sleeping after discontinuing medication?

A

SSRI discontinuation syndrome

71
Q

What should be monitored at initiation and dose titration of venlafaxine?

A

BP
venlafaxine and other SNRIs can lead to development of hypertension. if the patient is found to be hypertensive before starting venlafaxine, then a reduced dose should be considered.

72
Q

formication vs delusional parasitosis

A

Delusions of parasitosis are distinct from formication.

Formication involves the cutaneous sensation of crawling, biting, and stinging.

Formication does not involve the fixed conception that skin sensations are induced by parasites. Patients with this condition can accept proof that they do not have an infestation.

73
Q

in which type of antipsychotic is hyperprolactinaemia more common

A

typical antipsychotics

74
Q

murmur in Ebstein’s anomaly

A

pansystolic murmur

75
Q

depression tx

A

1) SSRI
2) if fails, alternative SSRI
3) if fails, SNRI
4) others

76
Q

mx for benzo overdose

A

flumezanil

Essie Year 5 (4 decks)

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