Psych Flashcards
Stepwise dementia
vascular
dementia- mri shows infarcts and white matter changes
vascular
treatment for vascular dementia
no specific
Dementia recent memories affected
alzheimers
Alzheimers rx
mild-mod- AChEi (donepezil, rivastigmine, galantamine)
Severe/adjunct/second line- memantine
Are antidepressants recommended in alzheimers
no
Donepezil c/i and side effect (one of each)
not in bradycardia
Can = insomnia
Can you give antipsychotic in alzheimers
yes if agitated ++
2 types of frontotemporal dementia
behavioural variant (50%)
Primary progressive aphasia (has subtypes)
dementia where behaviour change noticed before memory change
frontotemporal
dementia with personality change and impulsiveness
frontotemporal
frontotemporal rx
no drug therapy
can use SSRI/benzo/antipsychotic (as last resort for antipsych)
EArly impairment in attention or function dementia
LBD
Fluctuating cognition dementia
Visual hallucinations
LBD
LBD leads to what
parkinsonism
Diagnosis of LBD
SPECT
Treatment of LBD
AChEi or memantine similar to alzheimers
AVOID neuroleptics as can cause parkinsonism
3 treatments for parkinsons
Levodopa (for motor primarily)
MOAi (rasagiline, seslegiline)
Dopamine agonist
What type of medication is not first line in parkinsons
Ergot derived dopamine agonists- bromocriptine, cabergoline
3 complications of parkinsons
autonomic dysfunction (constipation, urinary freq, postural hypotension)
falls
cognitive impairment
When can you define it as parkinsons dementia
onset after >1yr parkinsons (before 1y would be LBD)
SSRI of choice in children/adolescent?
Fluoxetine
Best antidepressant post MI
sertraline
Which SSRI has QT risk
citalopram
First line for GAD
sertraline
how to taper off benzos when addicted
switch to equivalent diazepam dose then taper over 2 months
biggest risk factor for schizophrenia
family history
Dizziness, electric shock sensations and anxiety are symptoms of discontinuing what class of medication
SSRIs
What PHQ-9 score is more severe depression (as opposed to ‘less severe’) and what is first line rx
PHQ-9 score of ≥ 16
CBT AND antidepressant medication
What are the first rank symptom (categories) of schizophrenia?
auditory hallucinations
thought disorder
passivity phenomena
delusional perceptions
Cotard syndrome
believes they are dead
Capgras syndrome
believes friend/family has been replaced by an imposter
Erotomania
believe someone is in love with them, stalking
Factors associated with poor prognosis in schizophrenia
strong family history
gradual onset
low IQ
prodromal phase of social withdrawal
lack of obvious precipitant
what is an eponymous sign to see if paralysis if non-organic
Hoover’s sign (pressure is felt under the paretic leg when lifting the non-paretic leg against pressure, this is due to involuntary contralateral hip extension)
Conversion syndrome
typically involves loss of motor or sensory function
Somatisation syndrome
multiple physical SYMPTOMS present for at least 2 years, refuses to accept negative tests or reassurance
