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Essie Year 5 > Psych > Flashcards

Psych Flashcards

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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
parkinsonism tx
procyclidine
26
when would you give NaSSA over SSRI
when there are particular issues with sleep / appetite, eg mirtazapine
27
benzodiazpeine wtihdrawal sx + mx
sx - insomnia, tremor, anxiety, sweating, tinnitus, nausea, vomiting, perceptual disturbances mx - switch from short acting benzos to long acting (diazepam), then dose gradually reduced
28
extracampine hallucinations
things outside normal sensory field eg hearing alien voices
29
paraideolic illusion
seeing meaningful images in vague stimulus (eg seeing face in a fire)
30
OCD tx
exposure response prevention therapy SSRIs (fluoxetine preferred, paroxetine, sertraline) for 12 months, if no improvement can switch to alternative SSRI / clomipramine (TCA)
31
learning difficulties by IQ
mild 50-70 moderate 35-49 severe 20-34 profound <20
32
insomnia mx
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
questionnaire for social phobia
SPIN
34
questionnaire for depression
PHQ9
35
safest SSRI in people with hx of ischemic heart disease
sertraline
36
types of schizoaffective disorder
manic | depressive
37
knight's move thinking is assoc. w/ ...
schizophrenia | psychosis
38
ICD10 anorexia criteria
restrictive/purging behaviour designed to reduce calorie intake body dysmoprhia/fear of gaining weight/being fat BMI < 18.5
39
risk factors of eating disorder
being previously overweight family hx occupation (model, dancer) T2DM
40
anorexia complications
``` electrolyte abnormalities --> arrhythmias dehydration hypoglycaemia multi organ failure death risk of self harm + suicide ```
41
when is inpatient tx necessary in eating disorder
BMI < 13 rapid weight loss high suicide risk serious physical complications
42
what MMSE score indicates cognitive impairment
< 25 / 30
43
what MMSE score indicated normal cognition
> 27 / 30
44
ECT indications
catatonia neuroleptic malignant syndrome mania
45
Section 4
allows emergency admission to hospital when there is not enough to arrange section 2 its duration is 72h
46
TCA overdose
``` dilated pupils urinary retention dry mouth tachycardia agitation blurred vision constipation prolonged QT ```
47
lithium overdose
``` coarse tremor hyperreflexia confusion polyuria seizure coma ```
48
vascular dementia medical mx
aspirin + manage CVS risk factors
49
formication
feeling of insects crawling over/under skin due to stimulant intoxication/withdrawal (MDMA, cocaine, amphetamines) or alcohol withdrawal
50
SSRI side effects
``` increased agitation/suicidal thoughts at the start GI upset increased risk of GI bleeding loss of libido / erectile dysfunction hyponatremia ```
51
SSRI discontinuation sx
FIRM STOP Flu like sx Insomnia Restlessness Mood swings Sweating Tummy problems Off balance (ataxia) Paresthesia
52
Time needed for GAD dx
6 months
53
at least 3 of the following sx are needed for GAD dx
SPINE FM ``` Sleep disturbance Poor sleep Irritability Nervousness/restlessness Easily Fatigued Muscle tension ```
54
GAD tx
SSRI --> alternative SSRI --> SNRI --> pregabalin
55
Lithium toxicity
``` Coarse tremor Hyperreflexia Nystagmus Seizures Ataxia ```
56
when is community based alcohol detox offered
if drinking >15 units / day | or AUDIT score > 15
57
when is inpatient alcohol detox offered
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
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?
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
drug classes where you may get prolonged QT
TCAs antipsychotics citalopram
60
what to check before starting atypical antipsychotics
check BMI, pulse, BP, fasting blood glucose or HbA1c, | lipid profile
61
atypical grief reaction
delayed grief reaction = when > 2 weeks passes before grieving begins prolonged grief reaction = difficult to define
62
opioid detox
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
Wernicke's encephalopathy triad
confusion ataxia nystagmus
64
Korsakoff's triad
anterograde amnesia retrograde amnesia confabulation
65
serotonin syndrome in a patient who is taking an SSRI and a concurrent medication?
concurrent medication likely to be MAOi or triptan
66
what drugs should not be taken at the same time as taking an SSRI
``` heparin/warfarin NSAIDs aspirin triptans MAOi ```
67
patient has a good response to SSRI and now wants to discontinue it. What advice should be given?
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
most likely SSRI to cause torsades de pointes
citalopram
69
chronic insomnia definition
struggling to sleep more than 3 nights a week for more than 3 months
70
Dizziness, electric shock sensations, GI upset, restlessness, sweating, difficulty sleeping after discontinuing medication?
SSRI discontinuation syndrome
71
What should be monitored at initiation and dose titration of venlafaxine?
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
formication vs delusional parasitosis
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
in which type of antipsychotic is hyperprolactinaemia more common
typical antipsychotics
74
murmur in Ebstein's anomaly
pansystolic murmur
75
depression tx
1) SSRI 2) if fails, alternative SSRI 3) if fails, SNRI 4) others
76
mx for benzo overdose
flumezanil

Essie Year 5 (4 decks)

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