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psych Flashcards

1
Q

OCD severity scale

A

Y-BOCS scale

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2
Q

example of severe ocd

A

spends >3 hrs a day on obsessions/compulsions

seevre intereference /distress

very little control/resistance

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3
Q

body dysmorphic ssri

A

fluoxetine

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4
Q

ocd tx

A

mild functional impairment: CBT including ERP

mod: SSRI CBT ERP

SSRI CI = offer clomipramine

severe = refere 2ndry care in meantime offer the above

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5
Q

ptsd features

A

re-experiencung
aavoidance
hyperarousal
emotional numbing

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6
Q

ptsd vs acute stress disorder

A

ptsd>month
asd <month

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7
Q

ptsd tx

A

watch and wait if sx less than 4 weeks

trauma focucsed CBT
EMDR

dx not 1st line but if used = venlafaxine or ssri eg sert

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8
Q

less severe depression

A

PHQ-9 <16

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9
Q

more severe depression

A

PHQ-9 = 16+

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10
Q

2 depression screening qs

A

‘During the last month, have you often been bothered by feeling down, depressed or hopeless?’

‘During the last month, have you often been bothered by having little interest or pleasure in doing things?’

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11
Q

major depressive disorder criteria (DSM-5)

A

Low mood OR loss of interest (anhedonia)
and
2+ weeks
and 5 of following: SIG-E-CAPS

Sleep
interest
Guilt
Energy
Concentration
appetite
psychomotor
suicidal

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12
Q

switching from fluoxetine to another SSRI

A

taper then gap 4-7days (long half life) then titrate

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13
Q

switching SSRI to TCA

A

cross taper

EXCEPT fluoxetine = withdraw before starting TCA

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14
Q

switching from SSRI (not fluox) to venlafaxine

A

cross taper cautiously
start ven 37.5mg daily n increase v slowly

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15
Q

switch fluox to venla

A

withdraw then start 37.5mg daily and v slow increase

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16
Q

SSRI post MI

A

sertraline

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17
Q

SSRI in kids and teens

A

be careful when indicated = fluox

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18
Q

SSRI SE

A

GI Sx
inc risk of GI bleed (PPI if on nsaid)
counsell for inc anxiety and agitation after starting

fluox and paroxetine higher propesity for drug interactions

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19
Q

citalopram and escitalopram SE

max dose

A

long QT

40mg for adults

20mg: >65 or hepatic impairment

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20
Q

triptans and SSRI

A

serotonin syndrome

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20
Q

antidepressant w pt on warfarin/heparin

A

avoid ssri
use mirtazapine

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21
Q

MAOIs n ssri

A

serotonin syndrome

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22
Q

continue antidepressants how long

A

6mths post remission

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23
Q

paroxetine in pregnancy

A

increased risk of congen malformations esp in first tri

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24
SSRI in pregnancy 1st n3rd tri
1st; small inc risk of congenital heart defects 3rd; persistatnt pul htn in newborn
25
lithium on renal
nephrotoxic polyurias, secondaru to nephrogenic diabetes insipidus
26
lithum ecg
t wave flattening/inversion
27
when should sample be taken when checking lithium level
12 hour post dose
28
lithiumwhen to check
when starting or changing dose. weekly until stabilised then 3 mnthtly thyroid and renal every 6mths
29
mania vs hypomania
mania = 7 days psychotic sx hypomania
30
section 135
police enter home sectioned for 24 hrs (extended to 36 if not assesed in time)
31
section 136
police detain in public place 24 hrs (also extended to 36 if no asses)
32
section 5(4)
nurses ability to detain someone in hospital (ie stop them leaving) until dr assesses to see if need 5(2) 6 hrs
33
section 5(2)
doctors ability to detain in hospital for 72 hrs in order to receive assessment for detention under mental health act
34
section 2 MHA
up to 28 days
35
section 3 MHA
6 months
36
mania sx DIG FASTER
distractibilty insominia grandiosity flight of ideas agitation sexual exploits talkative elevated mood racing thoughts
37
bipolar tx
mood stabiliser =lithium (2nd valp) mania: stop SSRI, antipsychotic ie olanzapine or haloperidol
38
comorbidities w bipolar
2-3 inc risk if diabetes CVD and copd
39
chronic insomnia
atleast 3 nights a week for more than 3 mnths
40
protective suicide factors
family support having children at home religious beliefs
41
factors with increased risk of completed suicde at later date post first attempt
efforts to avoid discovery planning leaving a written note final acts ie sorting finances violent method
42
charles bonet syndrome
hallucinations (visual/auditory) occuring in clear consciencness on background of visual impairment (age related mac degen (MC), glucouma, cataract)
43
risk factors for charles bonnet
advancing age peripheral visual impairment social isolation senspry deprivation early cog impairment
44
moai example
selegiline
45
cluster A odd or ecentric PD
paarnoid schizoid schizotypal
46
cluster B 'dramatic, emotional, erratic'
antisocial borderline histrionic narcissistic
47
cluster C 'anxious nd fearful'
obsessive compulsive avoidant dependant
48
when do sx start in alcohol withdrawal
6-12hrs: tremor, sweating, tachycardia, anxiety
49
peak incidence of seizures alcohol withdrawal
36 hrs
50
peak incidence of delirium tremens
48-72hrs course tremor confusion delusions auditory and visual hallucinations, fever, tachy
51
negative sx of schizophrenia
incongruity/blunting of affect anhedonia alogia (poverty of speech) avolition (poor motivation) social withdrawal
52
suicide risk factors
male hx of self harm alcohol/drug misuse hx of mental illness hx of chronic disease advancing age unemployment or social isolation ie live alone unmarried, divorced, widowed
53
somatisation disorder
multiple physical sx present for atleast 2 yrs pt refuses to accept reassurance or negative test results
54
illness anxiety (hypochondriasis)
persisant belief that they have underlying DISEASE eg cancer refuses to accept reassurance or test results
55
funcitional neuro disorder (conversion)
loss of motor or sensory function pt not consciously feign sx or seek matieral gain pt may be indifferent to disorder (la belle indifference)
56
dissociative disorder
seperate off certain memories from normal consciousness involves psychiatric sx ie amnesia fugue stupor
57
factitious disorder
munchausens intentional production of physical/pscyho sx
58
malingering
fraudulent simulation/exaccergation of sx for financial or other gain
59
clag associations
words and ideas only related bc sound similar eg my mini mouse might make me mumble
60
cotard
believing they are dead
60
anorexia fx
most things low ie low t3, LH,FSH, oest, prog, test, hypokalaemia Gs and Cs raised: growth hormone glucose salivary glands cortisol cholesterol carotinamia
61
clozapine adverse affects
agranulocytosis n neutropenia reduces seizure threshold constipation hypersalivation myocarditis - take baseline ecg
62
dx causes of mania
anti depressants cocaine amphetamines corticosteroids levodopa procylidine
63
tests be lithium
TFT FBC U&E ECG
64
+ves of HAD/PHQ
diagnostic monitering of sx research
65
-ves had/phq
significantly diff scores between different populations and cultures only validated in hospitals not for general pop
66
other things to screen for w depression
mental - anxiety bipolar shizophrenia medical - hypothyroid addisions perimenopause
67
mirtazapine class
noradrenergic and specific serotonergic antidepressant inc release of neurotransmitters by blocking alpha 2 adrenoreceptors
68

finals (28 decks)

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