Psych Flashcards
RFs for developing generalised anxiety disorder
- Aged 35- 54
- Being divorced or separated
- Living alone
- Being a lone parent
What is delusional disorder
- fixed, false belief that persists despite a lack of evidence
- The belief is non-bizarre, but there’s no substantial evidence, and the patient’s overall functioning is relatively intact
Contraindications to bupropion
- epilepsy: reduces seizure threshold
- pregnancy
- breastfeeding
How can OCD be differentiated from psychosis
level of insight into their actions
What should be monitored at initiation and dose titration of SNRIs
Blood pressure: SNRIs are associated with the development of hypertension
In an elderly patient with sudden onset psychosis, what investigation should be ordered to rule out an organic cause
CT head scan
which healthcare professionals must be involved to
validate a section 3 under the MHA
2 doctors and an approved mental health professional
First rank symptoms of schizophrenia
- Thought disorders
- delusional disorder
- Hallucinations
- passivity phenomenon
Side effects of atypical antipsychotics
Weight gain / Hyperprolactinemia / Nipple discharge / Impaired glucose tolerance
Differentials of depression
Bipolar disorder, Psychotic disorders, Premenstrual syndrome, Substance misuse, Hypothyroidism, Anaemia
Screening tools to help confirm diagnosis of depression
- PHQ-9
- HADS - Hospital Anxiety and Depression Scale
- BDI-II - Beck’s Depression Inventory
Magical thinking and delusions are characteristic of which personality disorder
Schizotypal
Examples of monoamine oxidase inhibitors
- phenelzine
- selegiline
- Isocarboxazid
Lithium toxicity generally occurs following concentrations over what value
> 1.5 mmol/L
Examples of stimulant drugs
- Cocaine
- methamphetamine * MDMA - ecstasy
- khat
- nicotine
management of insomnia
- short-acting benzodiazepines
- non-benzodiazepines (zopiclone, zolpidem and zaleplon)
Investigation results of neuroleptic malignant syndrome
- Raised CK (creatine kinase) –> due to muscle rigidity
● Raised white cell count
● Deranged LFT’s
● Acute renal failure –> abnormal U&E’s
● Metabolic acidosis –> low pH, low HCO
What type of urinary incontinence is associated with TCAs
overflow incontinence
Define knight’s move thinking
a phenomenon where a patient’s thoughts move from one topic to another, without any logical connection between them
Define circumstantiality
describes a phenomenon where a patient’s thoughts are connected, but they include unnecessary details and go off-topic before returning to the original subject
If patients with OCD has minimal improvement after having trialled a combination of SSRI and exposure response prevention CBT for at least 12 weeks, what is the next step
should either try a different SSRI or switch the SSRI
to clomipramine
A capacity assessment regarding a specific decision involves four features. State them
the ability to understand, weigh-up, retain and communicate the decision made
4 medications associated with drug induced delirium
- furosemide
- oxybutynin
- propranolol
- ranitidine
When a patient is first commenced on clozapine, what is the initial blood monitoring requirements
blood test every week for 18 weeks
withdrawal symptoms from cocaine use
- increased hunger/ cravings
- anxiety
- fatigue
- lack of motivation
- irritability
How long can a person be detained under section 5(4) of the mental health act
6 hours
What section allows a police office to section a person suspected of having a mental disorder in a public
place
Section 136
How long can someone be held under section 136
72 hours and should be seen by a doctor or AMHP
When is activated charcoal used in the management of an overdose
if the overdose was within an hour ago
mechanism of action of memantine
NMDA receptor antagonist
What parameters should be monitored for someone taking lithium
- weight
- urea and electrolytes
- eGFR
- Calcium
- thyroid functions tests
every 6 months
What type of hallucination is most suggestive of delirium tremens
Lilliputian - seeing lots of small people
Ina patient presenting with low mood and fatigue, what is the most appropriate next step in management
- ask them to fill out the PHQ-9 questionnaire: assess risk of having depression
- PHQ-9 low: FBC and thyroid function tests would be useful to explore alternative diagnoses
When is sumatriptan contraindicated
history of coronary artery disease
