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Psych Flashcards

1
Q

Which markers are low and which are high in anorexia?

A

Most biochemical markers are low

High: growth hormone, salivary glands, cortisol, cholesterol, carotinaemia

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2
Q

How does treatment for anorexia differ between adults and children?

A

Adults: CBT
Children: anorexia focussed family therapy

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3
Q

What frequency of binge/purge behaviour must be seen before diagnosing bulimia?

A

At least once a week for 3 months

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4
Q

How to manage a paracetamol overdose that has taken place over 15 hours?

A

Immediate N-acetylcysteine

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5
Q

How to manage a paracetamol overdose that has taken place during a single incident?

A

Take a paracetamol level 4-15hrs after the incident and treat with NAC based on level

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6
Q

What dementia treatment is contraindicated in patients with cardiac arrhythmia?

A

Anti-cholinesterase inhibitor such as donepezil

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7
Q

What investigation is important to carry out in anorexic patients?

A

ECG

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8
Q

Treatment for frontotemporal dementia?

A

No treatment, can only provide social support

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9
Q

What electrolyte disturbances are seen in refeeding syndrome?

A

Low potassium, low magnesium, low phosphate

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10
Q

Side effects of SSRI?

A
  • Sexual dysfunction
  • Hyponatraemia
  • N&V
  • Headache
  • Anxiety
  • Increased suicide risk at first (review after 1-2 weeks of starting)
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11
Q

Features of serotonin syndrome

A
  • Hyperthermia
  • Confusion
  • Tremor
  • Diarrhoea
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12
Q

How to avoid serotonin discontinuation syndrome?

A

Taper off medication over 4 weeks

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13
Q

Symptoms of discontinuation syndrome?

A
  • Diarrhoea
  • Shivering
  • Anxiety
  • Dizziness
  • Headache&nausea
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14
Q

Examples of SNRI? What side effect must be monitored?

A

Venlafaxine, duloxetine

Hypertension

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15
Q

What class is mirtazapine? What are its side effects?

A

NaSSA

-Sedation and weight gain, agranulocytosis

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16
Q

Side effects of lithium?

A
  • N&V
  • Diarrhoea
  • Polyuria, thirst
  • Fine tremor
  • Hypothyroidism
  • Weight gain
  • Leucocytosis
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17
Q

Symptoms of lithium toxicity?

A
  • Coarse tremor
  • Hyperreflexia
  • Acute confusion
  • Vomiting
  • Seizure
  • Coma
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18
Q

How to monitor lithium levels?

A

Levels should be taken weekly until stable. Once stable, check every 3 months. The levels should be checked 12 hours after a dose is taken

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19
Q

Which antipsychotics are most effect in the management of mania?

A

Quetiapine/olanzapine

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20
Q

How long must someone be suffering from symptoms to be diagnosed with depression?

A

2 weeks

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21
Q

Which test must be done to rule out other causes of depression?

A

TFT - hypothyroidism is a known cause of depression

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22
Q

After treating depression, how long should patients continue to take SSRIs? Why?

A

another 6 months to prevent relapse

23
Q

Cluster A personality disorders?

A

Paranoid, schizoid, schizotypal

24
Q

Cluster B personality disorders?

A

Narcissistic, histrionic, anti-social, borderline

25
Q

Cluster C personality disorders?

A

Obsessive compulsive, avoidant, dependant

26
Q

What are delusions of persecution, reference, misidentification?

A

Persecution - people conspiring against you

Reference - unrelated and normal occurrences are somehow significant for you

Misidentification - thinking people and objects are something else

27
Q

What is the definition of 1 unit of alcohol?

A

10ml of pure alcohol

28
Q

How to calculate units of alcohol from ABV?

A

(ABV x volume) / 1000

29
Q

When do alcohol withdrawal symptoms occur and what are the symptoms?

A

Occur 6-12 hrs after last drink

  • Coarse tremor
  • Sweating
  • Insomnia
  • N&V
  • Hallucination
30
Q

When is the onset of seizures in alcohol withdrawal?

A

36hrs after last drink

31
Q

When is the onset of delirium tremens in alcohol withdrawal? What are the symptoms?

A

72hrs after last drink

  • Autonomic instability (hypertension, tachycardia, sweating, pyrexia)
  • Visual/auditory hallucination
  • Paranoia
  • Disorientation
  • Altered consciousness
32
Q

What is the triad for Wernicke’s encephalopathy?

A
  • Ataxia
  • Confusion
  • Ophthalmoplegia/nystagmus
33
Q

How does Korsakoff syndrome occur?

A

If Wernicke’s encephalopathy is not treated

34
Q

What 3 symptoms characterises Korsakoff?

A
  • Anterograde and retrograde amnesia
  • Confabulation
  • Behaviour change
35
Q

What is given to treat withdrawal symptoms?

A

-Benzodiazepines (chlordiazepoxide)

36
Q

Symptoms of opiate withdrawal?

A
  • Chills/fever
  • Body ache
  • Insomnia
  • Diarrhoea
  • Tiredness
  • Sweating
  • Depression
  • Anxiety
37
Q

What are the positive and negative symptoms of schizophrenia?

A

Positive: delusion, hallucination, thought disorder

Negative: Impaired volition&motivation, flattened mood, social withdrawal, blunt affect, anhedonia

38
Q

What are the 1st rank symptoms of schizophrenia?

A
  • Auditory hallucination
  • Delusions
  • Thought disorder
  • Passivity phenomena (thoughts and actions are being controlled by an external influence)
39
Q

Side effects of typical antipsychotics?

A
  • Parkinsonism
  • Dystonia
  • Tardive dyskinesia
  • Akathisia
40
Q

How is acute dystonia managed?

A

Procyclidine

41
Q

How is tardive dyskinesia managed?

A

Tetrabenazine

42
Q

When would clozapine be considered?

A

When schizophrenia persists after use of 2 antipsychotics

43
Q

Side effects of olanzapine?

A
  • Dyslipidaemia

- Obesity

44
Q

Side effects of risperidone?

A

Hyperprolactinaemia

45
Q

Cardiac side effect of anti-psychotics?

A

Torsades de pointes

46
Q

Side effects of aripiprazole?

A

Generally has a good side effect profile with less weight gain and hyperprolactinaemia

47
Q

Side effects of clozapine?

A
  • Agranulocytosis
  • Neutropaenia
  • Reduced seizure threshold
  • Myocarditis
  • Hypersalivation
  • Constipation
48
Q

What monitoring needs to be done for clozapine?

A

FBC for agranulocytosis

49
Q

General monitoring tests for antipsychotic use?

A
  • FBC, U&E, LFT
  • Lipids and weight
  • ECG
  • Blood pressre
  • Glucose, prolactin
50
Q

Symptoms of neuroleptic malignant syndrome?

A

4 main features:
-Rigidity
-Hyperthermia
-Autonomic instability (hypotension, tachycardia)
-Confusion
NB can also have raised CK due to rhabdomyolysis

51
Q

What questions should you ask in a CAGE assessment of alcoholism?

A
  • Do you feel like you should cut down on alcohol?
  • Have you ever become annoyed by criticisms of your drinking?
  • Do you feel guilty about your drinking?
  • Do you need a drink first thing in the morning to get you through the day? (eye opener)
52
Q

What ECG changes are seen in anorexia nervosa?

A

-Bradycardia, arrhythmia, QT prolongation

53
Q

Risk factors for anorexia?

A
  • Caucasian
  • Female
  • Higher socioeconomic background
  • Higher family education

Revision all topics (11 decks)

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