Psych Flashcards
First rank symptoms of schizophrenia?
Auditory hallucinations
Delusional perception
Passivity phenomena
Thought abnormalities
Positive symptoms of schizophrenia?
Hallucinations, thought abnormalities, delusional perception, passivity, ideas of reference, persecutory delusions
Negative signs of schizophrenia?
Alogia/poverty of speech
Anhedonia
Affective blunting
Avolition (reduced motivation)
Monitoring for Clozapine?
FBC, Blood clozapine, lipids, weight, fasting glucose
Treatment for tardive dyskinesia?
Tetrabenazine
What is preferred over chlordiazepoxide for patients with liver cirrhosis?
Lorazepam
What if miss clozapine doses for 48 hours?
Re-titrate the dose
Example of tardive dyskinesia?
Lip smacking
Example of acute dystonia?
Oculogyric crisis
Treatment for acute dystonia?
Procyclidine
What is Akathisia?
Restlessness
Treatment for akathisia?
Propranolol
Features of voices in schizophrenia?
Third person, hearing her own thoughts spoken aloud, running commentary
Non blood test monitoring of Olanzapine?
Weight
BMI
Waist size
ECG
BP
Blood tests for alcohol dependence?
GGT - gamma glutamyl transpeptidase
MCV
CDT - carbohydrate deficient transferrin
All raised
Diagnosis of panic disorder?
Symptoms for 1 month
First and second line sedation for delirium on the wards?
1st - Haloperidol IM/PO
2nd - Lorazepam PO/IM/IV
Reversible causes of dementia?
DEMENTIA
Drugs
Emotional - depression
Metabolic - COPD, CKD, OSA
Endocrine - thyroid/parathyroid, hyponatraemia
Nutrition - B12 deficiency
Trauma - chronic SDH
Infection - UTI, sepsis
Arterial - vascular
Which questionnaire screens for alcohol misuse?
AUDIT
Which AUDIT score indicates harmful use?
8 or more
Which questions can quickly screen for harmful alcohol use?
CAGE
Cut down?
Annoyed?
Guilty?
Eye opener?
PHQ-9 scores and classifications?
5-9 = mild depression
10-14 = moderate depression
15-19 = moderately severe depression
20-27 = severe depression
GAD-7 scores and classifications?
5-9 = mild anxiety
10-14 = moderate anxiety
15-21 = severe anxiety
Which drugs may cause reversible dementia?
Benzodiazepines
Anticholinergics
Opioids
What is Capgras delusion?
C = C
Someone replaced by exact clone
What is Fregoli delusion?
Fregoli = Faces
Everyone they meet is actually the same person
What is Ekbom delusion?
Ek = Ik
Infested with parasites, crawling on skin
What is Cotard delusion?
COtard = COld
Belief that they are dead, non-existent, or rotting
What is a Koro delusion?
Delusion that penis is shrinking/retracting and will dissapear
What is De Clerambault delusion?
De Clera = Declare
Delusions of being the object of love
What is Charless Bonnet syndrome?
Visual hallucinations due to visual impairment
What is Othello’s syndrome?
Belief their partner is cheating on them without any real proof»_space; pathological jealousy
Common side effects of Lithium?
N+V+D
FINE tremor
Nephrotoxicity
Hypothyroidism
Weight gain
IIH
Leucocytosis
Side effects of SSRIs in the first trimester?
Congenital heart defects
Side effects of SSRIs in the third trimester?
Persistent pulmonary hypertension
Korsakoff syndrome symptoms?
Anterograde amnesia (inability to acquire new memories)
Retrograde amnesia
Confabulation
SSRIs with ECT?
Reduce to lowest possible dose before ECT
Which antipsychotic lowers seizure threshold?
Clozapine
Which antidepressants cause hyponatraemia?
SSRIs
Section 2 of the MHA?
Admission for 28 days
Cannot be renewed
AMHP + 2 doctors
Section 3 of the MHA?
Admission for max period of 6 months
Can be renewed
AMHP + 2 doctors
Section 4 of the MHA?
72 hour assessment order
AMHP + 1 doctor
Section 5(2) of the MHA?
Voluntary patient in hospital detained for 72 hours
Section 5(4) of the MHA?
Nurse can detain patient who is voluntarily in hospital for 6 hours
Section 135 of MHA?
Police can remove person from private property to a place of safety (court order needed)
Section 136 of MHA?
Police remove someone from a public place to a place of safety for 24 hours
Symptoms of neuroleptic malignant syndrome?
Pyrexia
Muscle rigidity
Agitated delirium with confusion
Autonomic lability = hypertension, tachycardia and tachypnoea
Symptoms of serotonin syndrome?
Hyperreflexia
Myoclonus
Rigidity
Hyperthermia
Sweating
Confusion
Which PHQ-9 score should be offered antidepressant along with CBT first line?
if >16
Onset of symptoms/seizure/delirium tremens from alcohol withdrawal?
Symptoms: 6-12 hours
Seizures: 36 hours
Delirium tremens: 72 hours
When should patients starting new antidepressants be reviewed?
2 weeks
UNLESS under 25 - 1 week
Physical signs of anorexia?
Lanugo hair
Parotidomegaly
Physical signs of bulimia?
Russel’s sign - calluses on knuckles/backs of hand
Symptoms of opioid withdrawal?
N+V
Myalgia
Sweating/Chills/Tremors
Anxiety/irritability/low mood
Watery eyes/rhinorrhoea
Diarrhoea
Goosebumps
Features of frontotemporal dementia?
Disinhibition
Personality changes
Pick bodies
Histological findings in Lewy body dementia?
Alpha-synuclein cytoplasmic inclusions (Lewy bodies
In the substantia nigra and paralimbic areas
1st line treatment for mild-mod Alzheimers?
Acetylcholinesterase inhibitors
e.g. Donepezil, Galantamine, Rivastigmine
Treatment for severe Alzheimers?
NMDA receptor antagonist
e.g. Memantine
How to treat severe lithium toxicity?
Haemodialysis
Blood results in anorexia?
Hypercholesterolaemia
High growth hormone
Low U+Es
Low testosterone
Antidepressant used in those taking warfarin?
Mirtazapine
Antidote for paracetamol overdose?
Acetylcysteine
Antidote for benzodiazepenes?
Flumazenil
Antidote for beta blockers?
Glucagon/atropine
Antidote for calcium channel blockers?
Calcium chloride/gluconate
Antidote for cocaine?
Diazepam
Antidote for cyanide?
Dicobalt acetate
Antidote for carbon monoxide?
100% oxygen
Antidote for methanol/ethylene glycol?
Fomepizole/ethanol
Bloods findings in neuroleptic malignant syndrome?
Increased CK and increased WCC
What are the different pathways responsible for?
Mesolimbic = pleasure + positive sx of psychosis
Mesocortical = cognitive/emotional regulation + negative sx of psychosis
Nigrostriatal = voluntary movements + EPSE’s
Tuberoinfundibular = hormone release from pituitary gland + hyperprolactinaemia
Scale for classifying OCD?
Y-BOCS
Mechanism of action of disulfiram in alcohol dependence?
Inhibits aldehyde dehydrogenase
Definition for opioid use disorder?
Harmful pattern of use is evident over 12 months or at least 1 month if use is continuous