Psych Flashcards

1
Q

how long after dose should lithium be checked

A

12 hours

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2
Q

when stopping one SSRI and starting another, how long after stopping the first do you start the second

A

4-7 days (long half life)

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3
Q

How long after stopping alcohol do you get withdrawal symptoms

A

12 hours

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4
Q

How long after stopping alcohol do you get seizures

A

36 hours

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5
Q

How long after stopping alcohol do you get delerium tremens

A

48-72 hours

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6
Q

Which SSRI is used after an MI

A

sertraline

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7
Q

which drug class increases the risk of stroke/VTE in elderly patients

A

atypical antipsychotics (clozapine, risperidone, olanzapine)

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8
Q

When starting a patient on Electroconvulsive therapy, what should you do to the sertraline dose

A

Reduce but not stop

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9
Q

Neuroleptic malignant syndrome symptoms

A

Rigidity, hyperthermia, autonomic instability (hypotension, tachycardia) and altered mental status

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10
Q

Amitriptyline side effects

A

Can’t see (blurred vision)
can’t pee (urinary retention)
can’t sit (dizziness)
can’t shit (constipation)

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11
Q

Coronary prone behaviour pattern

A

Highly competitive, highly stressed

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12
Q

Schneider’s first rank symptoms

A

3rd person auditory hallucinations
Somatic hallucination
Delusional perception
Thought alienation

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13
Q

Wernicke’s encephalopathy treatment

A

IV pabrinex - IV thiamine replacement

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14
Q

Medication/drugs that cause mania

A

Antidepressant
amphetamines
cocaine

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15
Q

before prescribing lithium test

A

U+E - nephrotoxic
TFT - may cause hypothyroid
ECG - long QT

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16
Q

Lithium toxicity symptoms

A

Tremor
convulsions
renal failure
coma

nausea/diarrhoea/vomiting

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17
Q

Which neurotransmitter primarily causes major depressive disorder

A

Serotonin

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18
Q

Which receptors do opioids act on

A

Mew opioid peptide receptors

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19
Q

Negative symptoms of schizophrenia

A

Blunting of affect
Poverty of speech
Anhedonia
Lack of motivation

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20
Q

Clozapine monitoring

A

FBC
Blood clozapine
Lipids
Weight
Fasting glucose

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21
Q

Face twitching
Rapid blinking
Repeated hand movement

A

Tardive dyskinesia

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22
Q

Tardive dyskinesia symptoms

A

Extra pyramidal side effects
Face twitching
Repeated hand movements
Hand shaking
Rapid blinking

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23
Q

Tardive dyskinesia treatment

A

Tetrabenazine

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24
Q

Amitriptyline/tricyclic antidepressant overdose management under 1hr or 1hr +

A

under 1 hour activated charcoal
over IV sodium bicarbonate

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25
Q

tricyclic antidepressant overdose first investigation + main complication

A

ECG - QRS prolongation

26
Q

Tricyclic antidepressant overdose main complication

A

QRS prolongation/cardiac issue

27
Q

which receptors does LSD act on

A

5ht2a

28
Q

Schizophrenia pathogenesis hypothesis

A

neurotransmitter - increased mesolimbic/decreased mesocortical

Neurodevelopmental (HIE/autism)

29
Q

Which lobe of brain is most commonly affected in schizophrenia

A

temporal

30
Q

Which ssri can prolong qt interval

A

Citalopram

31
Q

Which ssri is preferred in young people

A

Fluoxetine

32
Q

Ssri side effects

A

Constipation/diarrhoea
Sexual dysfunction
Hyponatremia

33
Q

Conversion disorder/functional neurological disorder definition

A

Patient doesn’t consciously feign symptoms and is not seeking material gain.

Motor or sensory loss due to stress/emotional distress

34
Q

Which antipsychotic lower seizure threshold

A

Clozapine

35
Q

Clozapine side effects

A

S - seizures
C - constipation
A - agranulocytosis
M - myocarditis

36
Q

Alcohol withdrawal treatment

A

1 - chlordiazepoxide - long acting bezodiazipine

2 - diazepam - long acting

If cirrhosis - lorazepam - short acting bezodiazipine

37
Q

Alcohol withdrawal mechanism

A

Gaba causes inhibition. Alcohol enhances gaba. When alcohol is stopped brain is over stimulated

38
Q

Emotional unstable personality disorder treatment

A

Dialectical behavioural therapy

39
Q

PTSD symptoms

A

Flashbacks
Hypervigilance
Avoidance
Emotional numbing/dissociation

40
Q

Which antipsychotic has the best side effects profile for hyperprolactinaemia

A

Aripiprazole

41
Q

What monitoring is done for Lithium

A

BMI
UandE
eGFR
Calcium
Thyroid

Every 6 months

42
Q

Which antipsychotic causes worst prolactin symptoms

A

Risperidone

43
Q

Acamprostrate use and mechanism

A

Alcohol abstinence
GABA
Gaba agonist

44
Q

Sign of bulimia on hands

A

Russels sign

45
Q

When do you get hallucinations after alcohol

A

12-24 hours

46
Q

Ssri to which antidepressant is a direct switch

A

Venlefaxine

47
Q

ADHD medication

A

First: Methylphenidate
Then: Lisdexamphetimine
Then atomoxetine

48
Q

Which medication decreases pleasure while drinking alcohol

A

Disulfiram - inhibits acetaldehyde dehydrogenase causing a build of of acetaldehyde - causes flushing nausea and palpitations

49
Q

What audit score indicates harmful drinking

A

8

50
Q

What audit score indicates dependence

A

20+

51
Q

Which receptors does haloperidol act on

A

D2 antagonist

52
Q

Which SSRI is safe in breastfeeding

A

Sertraline

53
Q

What type of memory loss does electroconvulsive therapy cause

A

Retrograde amnesia

54
Q

SSRI discontinuation syndrome symptoms

A

Flu-like sx (headache, myalgia, lethargy)
Imbalance (vertigo, lightheadedness)
Nausea (vomiting, diarrhoea)
Insomnia
Sensory disturbances (electric shocks, paraesthesia, numbness)
Hyperarousal (agitation, tremor).

55
Q

what is first line management for those wishing to stop abusing substances

A

motivational intervention

56
Q

Which pharmacological treatment would be the first line to manage acute disturbance in a young schizophrenia patient

A

oral lorazepam

57
Q

Which is the main hypnotic mechanism of zopiclone?

A

gaba agonist

58
Q

schizophrenia auditory hallucination features

A

3rd person
running commentary
thoughts spoken aloud

59
Q

psychological treatments for psychosis

A

hearing voices group, CBT, family intervention, psychoeduction

60
Q

alcohol dependence blood test

A

raised gamma glutamyl transpeptidase (GGT)
raised MCV (red blood cell mean corpustular volume)
raised carbohydrate deficient transferrin

61
Q

Wernicke’s encephalopathy symptoms

A

Confusion
Ataxia
Nystagmus

Ophthamoplegia
PEripheral
Neuropathy