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4th year written > Psych > Flashcards

Psych Flashcards

1
Q

anorexia nervosa red flags

A

SUSS
bradycardia <50
(orthostatic) hypotension

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2
Q

tests to screen for unidentifiable causes of confusion

A

FBC, ESR, CRP, U&E, Ca, HbA1c, LFTs, TFTs, serum B12 and folate

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3
Q

tricyclic antidepressants urinary SEs

A

overflow incontinence

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4
Q

why is Ca checked in lithium use

A

hyperpara

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5
Q

anorexia nervosa ECG

A

prominent U waves - hypokalaemia

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6
Q

long term lithium use can lead to

A

hyperparathyroidism –> hypercalcaemia

(lower back pain, constipation, difficulty concentrating, low mood, headache)

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7
Q

differentiate depression from AD

A

depression has shorter history and rapid onset

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8
Q

SSRIs can be associated with which electrolyte abnormality

A

hyponatraemia esp fluoxetine

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9
Q

cardiac defect caused by lithium

A

ebstein’s anomaly

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10
Q

mania whilst on depression meds (sertraline) mx

A

stop sertraline & add olanzapine –> ++ lithium

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11
Q

mirtazapine mechanism

A

noradrenergic and specific serotonergic antidepressant which increases release of neurotramsitters by blocking alpha2 adrenoreceptors

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12
Q

how gradually should SSRIs be withdrawn

A

over 4 weeks

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13
Q

SSRIs risk in 1st vs 3rd trimester

A

1st –> congenital heart defects
3rd –> pulmonary hypertension

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14
Q

TCAs cause ….. incontinence

A

overflow incontinence

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15
Q

normal FBC changes with lithium

A

benign leucocytosis

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16
Q

antipsychotics side effects timeline

A

Neuroleptic malignant syndrome and acute dystonia - days/weeks

tardive dyskinaesia - years

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17
Q

peak age 1st episode psychosis

A

15-30 years

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18
Q

tyramine containing foods (e.g. cheese) + monoamine oxidase inhibitors –>

A

hypertensive crisis

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19
Q

antidepressant that causes large increase in appetite

A

mitrazapine

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20
Q

chronic metabolic side effect MDMA/ecstasy

A

hyponatraemia 2ry to water intoxication

21
Q

substance misuse that causes massive increase in serotonin

A

LSD

22
Q

distinguish narcissistic from histrionic

A

Narcissistic - lack empathy & entitled

histrionic - attention seeking & inappropriate behaviour

23
Q

a note on tx delusional disorders

A

medication + psychotherapy (highly resistant to medication alone)

24
Q

class A drugs

A

MDMA/ecstasy
LSD
Heroin
Cocaine
injectable amphetamine

25
Q

class B drugs

A

amphetamine
cannabis
ketamine

26
Q

2 forms to assess cognition

A

MOCA & ACE-III

27
Q

CBT for depression

A

behavioural activation

28
Q

CBT for OCD

A

exposure & response prevention

29
Q

art therapy is useful in

A

schizophrenia

30
Q

motivational interviewing is useful in

A

addictions

31
Q

75 year old woman with 18 month history ofmemory problems, gradually worsening. She has noother past medical history. She score 67 on ACE-IIIand her CT shows marked atrophy, especially in themedial temporal lobes. What medication

A

acetylcholine (acetylcholinesterase inhibitors)

32
Q

75 year old woman with 18 month history ofmemory problems, gradually worsening. She has ahistory of bradycardia, gastric ulcer disease(including a confirmed ulcer) and several recentfalls. She score 67 on ACE-III and her CT showsmarked atrophy, especially in the medial temporallobes. what medication

A

memantine (NMDA receptor antagonist that blocks glutamate receptor)

33
Q

A 55 year old woman presents with recurrent thoughts about crashing her car when she drives with passengers. They come into her mind and distress her so that she has stopped driving. She tries to stop the thoughts but they keep recurring

A

SSRI

34
Q

summarise NaSSa (metrazapine) SEs

A

sedative // weight gain // agranulocytosis

35
Q

neurotransmitter implicated in psychosis // depression

A

dopamine // monoamines

36
Q

pre-lithium tests

A

Weight, U&E, TFT, Ca 2+, ECG, pregnancy test

37
Q

dementia screen

A

B12, folate, TFTs

38
Q

tests before antipsychotics

A

FBC, U&Es, LFTs, ECG, prolactin, lipids & cholesterol, HbA1C, weight, BP, pulse

39
Q

tests before valproate

A

LFTs, amylase, FBC, pregnancy

40
Q

drugs that can lead to lithium toxicity

A

NSAIDS // diuretics

41
Q

A 42 year old man dependent on alcohol presents wanting to detoxify. He has been drinking three 3L bottles of cider per day for over two years. He has had no previous attempts at stopping using alcohol and does not wish to be admitted

A

chlordiazepoxide

42
Q

A 50 year old woman presents asking to come off her medication. She has a long history of anxiety and depression. She is currently on lorazepam which was, started for panic attacks several years ago. She now takes doses above BNF recommended maximum limits.

A

diazepam

43
Q

A man who is prescribed diazepam is found collapsed and unresponsive. He has a respiratory rate of 8 breaths per minute and a bradycardia. His pupils are slightly dilated but reactive. He has written a suicide note saying he wants to end his life

A

flumazenil

44
Q

which section can run back to back

A

section 3

45
Q

duration of section 2 // 3 // 5(2) // 5(4)

A

2: 28 days
3: 6m
5(2): 72hrs (FY2 holding powers)
5(4): 6hrs (nurse holding powers)

46
Q

sections that can be appealed

A

section 2 & 3

47
Q

difference between 135 & 136

A

135: power to enter property
136: remove from public area

48
Q

the three players of assessing for sectioning

A

1 Dr section 12 approved
1 Dr prior knowledge of patient
1 AMHP (makes decision)

49
Q

Elderly patient with delirium, requires IVantibiotics but is refusing to remain on the medical ward as needs to “get back to school for class”. what bit of the law to use to treat him

A

treat in hospital under MCA

4th year written (5 decks)

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