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MEDICINE FINALS > PSYCH > Flashcards

PSYCH Flashcards

1
Q

When does delirium tremens present?

A

2-3 days post alcohol consumption

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2
Q

What symptoms do you get with delirium tremens? (5)

A
  1. delirium -> fluctuating consciousness/aggression
  2. hallucinations
  3. coarse tremor
  4. fever
  5. tachycardia
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3
Q

How do you treat delirium tremens?

A

Chlordiazepoxide
+ thiamine

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4
Q

When is the peak incidence of seizures post alcohol withdrawal?

A

36 hour

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5
Q

When would symptoms of alcohol withdrawal first start?

A

6-12 hours after last drink

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6
Q

What are the symptoms of Wernicke’s encephalopathy?

A

confusion
ophthalmoplegia
ataxia

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7
Q

What are the symptoms of Korsakoff’s psychosis?

A

Retrograde amnesia
Anterograde amnesia
Confabulation

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8
Q

How would you screen for alcohol misuse?

A

CAGE
C - have you felt that you should cut down?
A - do you get annoyed when people tell you to stop?
G - do you ever feel guilty
E - do you ever need an eyeopener in the morning?

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9
Q

What are 3 pharmacological drugs that help to maintain alcohol abstinence?

A
  • Disulfiram →
    unpleasant reaction if drink, doesn’t stop craving
    – Acamprosate → reduces cravings
    – Naltrexone → decreases
    pleasurable effects of drinking alcohol
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10
Q

What is the ICD-10 criteria for diagnosing mild/moderate/severe depression?

A

mild = 4 symptoms
moderate = 5-6 symptoms
severe= 7+ symptoms

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11
Q

What are the 3 main features of depression?

A

low mood
anhedonia
anergia

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12
Q

Give 4 common side effects of SSRIs?

A
  • nausea/vomiting
  • loss of appetite
  • agitation
  • loss of libido
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13
Q

Give 4 common side effects of TCA

A
  • dry mouth
  • constipation
  • drowsiness
  • weight gain
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14
Q

Give 4 withdrawal symptoms of antidepressants

A
  • restlessness/agitation
  • altered feeling ( irritable/anxious/panic)
  • altered sensation (electric shock)
  • dizzy
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15
Q

What is generalised anxiety disorder?

A

Excessive anxiety and worry, more days than not, for at least 6 months about multiple different aspects

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16
Q

Give 4 symptoms of GAD?

A
  • restlessness
  • easily fatigued
  • sleep disturbance
  • difficulty concentrating
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17
Q

What is panic disorder?

A

Sudden onset anxiety + at least 4 symptoms of:
- SOB
- palpitations
- shakiness
- nausea
- fear of dying

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18
Q

How is panic disorder treated?

A

Propranolol 40mg OD

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19
Q

What scoring system is used to assess for depression/anxiety?

A

Depression - PHQ-9
Anxiety - GAD-7

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20
Q

What is the difference between mania and hypomania?

A

Mania = symptoms <7days, elevated mood, irritability + PSYCHOSIS
Hypomania = symptoms ,4 days, no marked impairment in social functioning, no psychosis

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21
Q

How would you manage an acute episode of mania?

A
  1. therapeutic trial of oral antipsychotic
  2. if ineffective trial different antipsychotic
  3. lithium
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22
Q

What are the side effects of lithium?

A

LITHIUM
Lethargy
Insipidus (diabetes)
Tremor
Hypothyroidism
Insides (GI)
Urine (decreased)
Metallic taste

23
Q

Give 4 drugs that should not be prescribed alongside lithium

A

ACE-i/ARB
diuretics
NSAIDs

24
Q

Which factors might precipitate lithium toxicity?

A

dehydration
renal failure
diuretics/ACEi/ARB/NSAIDs/metronidazole

25
Q

Give 5 symptoms of lithium toxicity

A
  • coarse tremor
  • hyperreflexia
  • acute confusion
  • seizure
  • polyuria
26
Q

How do you treat lithium toxicity?

A

mild-moderate = volume resuscitation with normal saline
severe = haemodialysis

27
Q

Give 3 psychotic symptoms?

A

hallucinations
delusions
thought disorder

28
Q

Give 4 examples of psychosis with negative symptoms

A

emotional blunting
reduced speech
loss of motivation
self-neglect

29
Q

what is knights move thinking?

A

no links between sentences

30
Q

Which antipsychotic drugs can you NOT prescribe in pregnancy?

A

carbamazepine
clozapine
lithium

31
Q

What is the criteria for a diagnosis of schizophrenia?

A

1 month history of
<1 :
- 3rd person auditory hallucinations
- thought disorder
- passivity
- delusional perceptions
<2 :
- persistent hallucinations
- catatonic behaviours
- negative psychosis
- social withdrawal

32
Q

What is schizoaffective disorder?

A

bipolar + schizophrenia

33
Q

Give 2 examples of typical antipsychotics

A

haloperidol
chlorpromazine

34
Q

Give 4 examples of atypical antipsychotics

A

risperidone
aripiprazole
clozapine
olanzapine

35
Q

Give 4 examples of extrapyramidal side-effects

A
  1. Parkinsonism
  2. Acute dystonia
  3. Akathisia
  4. Tardive dyskinesia
36
Q

What is the mechanism of action of typical antipsychotics?

A

dopamine receptor antagonist (D2)

37
Q

Which psych drugs can you not take whilst breast feeding?

A
  • carbamazepine
  • clozapine
  • lithium
38
Q

Which side effect causes involuntarily repetitive movements?

A

Tardive dyskinesia

39
Q

How is tardive dyskinesia treated?

A

tetrabenazine

40
Q

What is acute dystonia and how is it treated?

A

Sustained, painful, involuntary muscle contraction
treated - procyclidine

41
Q

What is the treatment for OCD?

A
  1. low intensity CBT including ERP
  2. SSRI
  3. clomipramine
42
Q

What are the triad of symptoms for PTSD?

A
  1. hyperarousal
  2. avoidance
  3. re-experiencing
43
Q

How is PTSD treated?

A
  1. trauma focused CBT +/- EMDR
  2. venlafaxine/SSRI
44
Q

what clinical signs might you see in someone with anorexia?

A
  • bradycardia
  • enlarged salivary glands
  • hypotension
  • proximal myopathy (squat test)
45
Q

What blood results would you see in someone with anorexia nervosa?

A
  • hypOkalaemia
  • raised cortisol, growth hormone, cholesterol
  • impaired glucose tolerance
46
Q

What are the complications of anorexia nervosa?

A
  • pancreatitis
  • constipation
  • refeeding syndrome
47
Q

What is the management for someone with anorexia nervosa ?

A
  1. CBT (with family)
  2. monitor U&Es and ECG
  3. oral supplements to correct electrolyte imbalance
  4. dentist + DEXA scan
48
Q

What is section 2 of MHA?

A
  • used for assessment
  • 28 days (can’t be renewed)
  • need 2 drs and AMHP
49
Q

What is section 3 of MHA?

A
  • 6 months
  • used for treatment (CAN be renewed)
  • need 2 drs and AMHP
50
Q

What is section 4 of MHA?

A
  • 72 hours
  • Used in emergency
  • not enough time for 2nd dr
  • 1 dr and 1 AMHP
51
Q

What is section 5 (4) of MHA?

A

Detains pt for 6 hours
- used by nurses to stop pt leaving

52
Q

What is section 5 (2) of MHA?

A

72 hours holding power for Dr

53
Q

What is section 135 of MHA?

A

police - used to take to or keep you at place of
safety (need a warrant to enter your home)

54
Q

What is section 136 of MHA?

A

police - used to enter your house without warrant

MEDICINE FINALS (19 decks)

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