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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
Q

SSRI in pregnancy 1st n3rd tri

A

1st; small inc risk of congenital heart defects

3rd; persistatnt pul htn in newborn

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25
Q

lithium on renal

A

nephrotoxic polyurias, secondaru to nephrogenic diabetes insipidus

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26
Q

lithum ecg

A

t wave flattening/inversion

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27
Q

when should sample be taken when checking lithium level

A

12 hour post dose

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28
Q

lithiumwhen to check

A

when starting or changing dose. weekly until stabilised
then 3 mnthtly

thyroid and renal every 6mths

29
Q

mania vs hypomania

A

mania = 7 days
psychotic sx

hypomania <week (3-4days)
no psychotic sx

30
Q

section 135

A

police enter home
sectioned for 24 hrs (extended to 36 if not assesed in time)

31
Q

section 136

A

police detain in public place
24 hrs (also extended to 36 if no asses)

32
Q

section 5(4)

A

nurses ability to detain someone in hospital (ie stop them leaving) until dr assesses to see if need 5(2)
6 hrs

33
Q

section 5(2)

A

doctors ability to detain in hospital for 72 hrs in order to receive assessment for detention under mental health act

34
Q

section 2 MHA

A

up to 28 days

35
Q

section 3 MHA

A

6 months

36
Q

mania sx DIG FASTER

A

distractibilty
insominia
grandiosity

flight of ideas
agitation
sexual exploits
talkative
elevated mood
racing thoughts

37
Q

bipolar tx

A

mood stabiliser =lithium (2nd valp)

mania: stop SSRI, antipsychotic ie olanzapine or haloperidol

38
Q

comorbidities w bipolar

A

2-3 inc risk if diabetes CVD and copd

39
Q

chronic insomnia

A

atleast 3 nights a week for more than 3 mnths

40
Q

protective suicide factors

A

family support
having children at home
religious beliefs

41
Q

factors with increased risk of completed suicde at later date post first attempt

A

efforts to avoid discovery
planning
leaving a written note
final acts ie sorting finances
violent method

42
Q

charles bonet syndrome

A

hallucinations (visual/auditory) occuring in clear consciencness on background of visual impairment (age related mac degen (MC), glucouma, cataract)

43
Q

risk factors for charles bonnet

A

advancing age
peripheral visual impairment
social isolation
senspry deprivation
early cog impairment

44
Q

moai example

A

selegiline

45
Q

cluster A odd or ecentric PD

A

paarnoid
schizoid
schizotypal

46
Q

cluster B ‘dramatic, emotional, erratic’

A

antisocial
borderline
histrionic
narcissistic

47
Q

cluster C ‘anxious nd fearful’

A

obsessive compulsive
avoidant
dependant

48
Q

when do sx start in alcohol withdrawal

A

6-12hrs: tremor, sweating, tachycardia, anxiety

49
Q

peak incidence of seizures alcohol withdrawal

A

36 hrs

50
Q

peak incidence of delirium tremens

A

48-72hrs
course tremor
confusion
delusions
auditory and visual hallucinations, fever, tachy

51
Q

negative sx of schizophrenia

A

incongruity/blunting of affect
anhedonia
alogia (poverty of speech)
avolition (poor motivation)
social withdrawal

52
Q

suicide risk factors

A

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
Q

somatisation disorder

A

multiple physical sx present for atleast 2 yrs

pt refuses to accept reassurance or negative test results

54
Q

illness anxiety (hypochondriasis)

A

persisant belief that they have underlying DISEASE eg cancer
refuses to accept reassurance or test results

55
Q

funcitional neuro disorder (conversion)

A

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
Q

dissociative disorder

A

seperate off certain memories from normal consciousness
involves psychiatric sx ie amnesia fugue stupor

57
Q

factitious disorder

A

munchausens
intentional production of physical/pscyho sx

58
Q

malingering

A

fraudulent simulation/exaccergation of sx for financial or other gain

59
Q

clag associations

A

words and ideas only related bc sound similar eg

my mini mouse might make me mumble

60
Q

cotard

A

believing they are dead

60
Q

anorexia fx

A

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
Q

clozapine adverse affects

A

agranulocytosis n neutropenia
reduces seizure threshold
constipation
hypersalivation
myocarditis - take baseline ecg

62
Q

dx causes of mania

A

anti depressants
cocaine amphetamines
corticosteroids
levodopa
procylidine

63
Q

tests be lithium

A

TFT
FBC
U&E

ECG

64
Q

+ves of HAD/PHQ

A

diagnostic
monitering of sx
research

65
Q

-ves had/phq

A

significantly diff scores between different populations and cultures

only validated in hospitals not for general pop

66
Q

other things to screen for w depression

A

mental - anxiety bipolar shizophrenia

medical - hypothyroid addisions perimenopause

67
Q

mirtazapine class

A

noradrenergic and specific serotonergic antidepressant

inc release of neurotransmitters by blocking alpha 2 adrenoreceptors

68
Q
A

finals (28 decks)

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