Psych Flashcards
how long after dose should lithium be checked
12 hours
when stopping one SSRI and starting another, how long after stopping the first do you start the second
4-7 days (long half life)
How long after stopping alcohol do you get withdrawal symptoms
12 hours
How long after stopping alcohol do you get seizures
36 hours
How long after stopping alcohol do you get delerium tremens
48-72 hours
Which SSRI is used after an MI
sertraline
which drug class increases the risk of stroke/VTE in elderly patients
atypical antipsychotics (clozapine, risperidone, olanzapine)
When starting a patient on Electroconvulsive therapy, what should you do to the sertraline dose
Reduce but not stop
Neuroleptic malignant syndrome symptoms
Rigidity, hyperthermia, autonomic instability (hypotension, tachycardia) and altered mental status
Amitriptyline side effects
Can’t see (blurred vision)
can’t pee (urinary retention)
can’t sit (dizziness)
can’t shit (constipation)
Coronary prone behaviour pattern
Highly competitive, highly stressed
Schneider’s first rank symptoms
3rd person auditory hallucinations
Somatic hallucination
Delusional perception
Thought alienation
Wernicke’s encephalopathy treatment
IV pabrinex - IV thiamine replacement
Medication/drugs that cause mania
Antidepressant
amphetamines
cocaine
before prescribing lithium test
U+E - nephrotoxic
TFT - may cause hypothyroid
ECG - long QT
Lithium toxicity symptoms
Tremor
convulsions
renal failure
coma
nausea/diarrhoea/vomiting
Which neurotransmitter primarily causes major depressive disorder
Serotonin
Which receptors do opioids act on
Mew opioid peptide receptors
Negative symptoms of schizophrenia
Blunting of affect
Poverty of speech
Anhedonia
Lack of motivation
Clozapine monitoring
FBC
Blood clozapine
Lipids
Weight
Fasting glucose
Face twitching
Rapid blinking
Repeated hand movement
Tardive dyskinesia
Tardive dyskinesia symptoms
Extra pyramidal side effects
Face twitching
Repeated hand movements
Hand shaking
Rapid blinking
Tardive dyskinesia treatment
Tetrabenazine
Amitriptyline/tricyclic antidepressant overdose management under 1hr or 1hr +
under 1 hour activated charcoal
over IV sodium bicarbonate
tricyclic antidepressant overdose first investigation + main complication
ECG - QRS prolongation
Tricyclic antidepressant overdose main complication
QRS prolongation/cardiac issue
which receptors does LSD act on
5ht2a
Schizophrenia pathogenesis hypothesis
neurotransmitter - increased mesolimbic/decreased mesocortical
Neurodevelopmental (HIE/autism)
Which lobe of brain is most commonly affected in schizophrenia
temporal
Which ssri can prolong qt interval
Citalopram
Which ssri is preferred in young people
Fluoxetine
Ssri side effects
Constipation/diarrhoea
Sexual dysfunction
Hyponatremia
Conversion disorder/functional neurological disorder definition
Patient doesn’t consciously feign symptoms and is not seeking material gain.
Motor or sensory loss due to stress/emotional distress
Which antipsychotic lower seizure threshold
Clozapine
Clozapine side effects
S - seizures
C - constipation
A - agranulocytosis
M - myocarditis
Alcohol withdrawal treatment
1 - chlordiazepoxide - long acting bezodiazipine
2 - diazepam - long acting
If cirrhosis - lorazepam - short acting bezodiazipine
Alcohol withdrawal mechanism
Gaba causes inhibition. Alcohol enhances gaba. When alcohol is stopped brain is over stimulated
Emotional unstable personality disorder treatment
Dialectical behavioural therapy
PTSD symptoms
Flashbacks
Hypervigilance
Avoidance
Emotional numbing/dissociation
Which antipsychotic has the best side effects profile for hyperprolactinaemia
Aripiprazole
What monitoring is done for Lithium
BMI
UandE
eGFR
Calcium
Thyroid
Every 6 months
Which antipsychotic causes worst prolactin symptoms
Risperidone
Acamprostrate use and mechanism
Alcohol abstinence
GABA
Gaba agonist
Sign of bulimia on hands
Russels sign
When do you get hallucinations after alcohol
12-24 hours
Ssri to which antidepressant is a direct switch
Venlefaxine
ADHD medication
First: Methylphenidate
Then: Lisdexamphetimine
Then atomoxetine
Which medication decreases pleasure while drinking alcohol
Disulfiram - inhibits acetaldehyde dehydrogenase causing a build of of acetaldehyde - causes flushing nausea and palpitations
What audit score indicates harmful drinking
8
What audit score indicates dependence
20+
Which receptors does haloperidol act on
D2 antagonist
Which SSRI is safe in breastfeeding
Sertraline
What type of memory loss does electroconvulsive therapy cause
Retrograde amnesia
SSRI discontinuation syndrome symptoms
Flu-like sx (headache, myalgia, lethargy)
Imbalance (vertigo, lightheadedness)
Nausea (vomiting, diarrhoea)
Insomnia
Sensory disturbances (electric shocks, paraesthesia, numbness)
Hyperarousal (agitation, tremor).
what is first line management for those wishing to stop abusing substances
motivational intervention
Which pharmacological treatment would be the first line to manage acute disturbance in a young schizophrenia patient
oral lorazepam
Which is the main hypnotic mechanism of zopiclone?
gaba agonist
schizophrenia auditory hallucination features
3rd person
running commentary
thoughts spoken aloud
psychological treatments for psychosis
hearing voices group, CBT, family intervention, psychoeduction
alcohol dependence blood test
raised gamma glutamyl transpeptidase (GGT)
raised MCV (red blood cell mean corpustular volume)
raised carbohydrate deficient transferrin
Wernicke’s encephalopathy symptoms
Confusion
Ataxia
Nystagmus
Ophthamoplegia
PEripheral
Neuropathy
