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3a follow up > Psych > Flashcards

Psych Flashcards

1
Q

First rank symptoms of schizophrenia?

A

Auditory hallucinations
Delusional perception
Passivity phenomena
Thought abnormalities

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2
Q

Positive symptoms of schizophrenia?

A

Hallucinations, thought abnormalities, delusional perception, passivity, ideas of reference, persecutory delusions

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3
Q

Negative signs of schizophrenia?

A

Alogia/poverty of speech
Anhedonia
Affective blunting
Avolition (reduced motivation)

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4
Q

Monitoring for Clozapine?

A

FBC, Blood clozapine, lipids, weight, fasting glucose

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5
Q

Treatment for tardive dyskinesia?

A

Tetrabenazine

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6
Q

What is preferred over chlordiazepoxide for patients with liver cirrhosis?

A

Lorazepam

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7
Q

What if miss clozapine doses for 48 hours?

A

Re-titrate the dose

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8
Q

Example of tardive dyskinesia?

A

Lip smacking

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9
Q

Example of acute dystonia?

A

Oculogyric crisis

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10
Q

Treatment for acute dystonia?

A

Procyclidine

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11
Q

What is Akathisia?

A

Restlessness

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12
Q

Treatment for akathisia?

A

Propranolol

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13
Q

Features of voices in schizophrenia?

A

Third person, hearing her own thoughts spoken aloud, running commentary

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14
Q

Non blood test monitoring of Olanzapine?

A

Weight
BMI
Waist size
ECG
BP

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15
Q

Blood tests for alcohol dependence?

A

GGT - gamma glutamyl transpeptidase
MCV
CDT - carbohydrate deficient transferrin

All raised

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16
Q

Diagnosis of panic disorder?

A

Symptoms for 1 month

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17
Q

First and second line sedation for delirium on the wards?

A

1st - Haloperidol IM/PO
2nd - Lorazepam PO/IM/IV

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18
Q

Reversible causes of dementia?

A

DEMENTIA
Drugs
Emotional - depression
Metabolic - COPD, CKD, OSA
Endocrine - thyroid/parathyroid, hyponatraemia
Nutrition - B12 deficiency
Trauma - chronic SDH
Infection - UTI, sepsis
Arterial - vascular

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19
Q

Which questionnaire screens for alcohol misuse?

A

AUDIT

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20
Q

Which AUDIT score indicates harmful use?

A

8 or more

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21
Q

Which questions can quickly screen for harmful alcohol use?

A

CAGE
Cut down?
Annoyed?
Guilty?
Eye opener?

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22
Q

PHQ-9 scores and classifications?

A

5-9 = mild depression
10-14 = moderate depression
15-19 = moderately severe depression
20-27 = severe depression

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23
Q

GAD-7 scores and classifications?

A

5-9 = mild anxiety
10-14 = moderate anxiety
15-21 = severe anxiety

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24
Q

Which drugs may cause reversible dementia?

A

Benzodiazepines
Anticholinergics
Opioids

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25
Q

What is Capgras delusion?

A

C = C
Someone replaced by exact clone

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26
Q

What is Fregoli delusion?

A

Fregoli = Faces
Everyone they meet is actually the same person

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27
Q

What is Ekbom delusion?

A

Ek = Ik
Infested with parasites, crawling on skin

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28
Q

What is Cotard delusion?

A

COtard = COld
Belief that they are dead, non-existent, or rotting

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29
Q

What is a Koro delusion?

A

Delusion that penis is shrinking/retracting and will dissapear

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30
Q

What is De Clerambault delusion?

A

De Clera = Declare
Delusions of being the object of love

31
Q

What is Charless Bonnet syndrome?

A

Visual hallucinations due to visual impairment

32
Q

What is Othello’s syndrome?

A

Belief their partner is cheating on them without any real proof&raquo_space; pathological jealousy

33
Q

Common side effects of Lithium?

A

N+V+D
FINE tremor
Nephrotoxicity
Hypothyroidism
Weight gain
IIH
Leucocytosis

34
Q

Side effects of SSRIs in the first trimester?

A

Congenital heart defects

35
Q

Side effects of SSRIs in the third trimester?

A

Persistent pulmonary hypertension

36
Q

Korsakoff syndrome symptoms?

A

Anterograde amnesia (inability to acquire new memories)
Retrograde amnesia
Confabulation

37
Q

SSRIs with ECT?

A

Reduce to lowest possible dose before ECT

38
Q

Which antipsychotic lowers seizure threshold?

A

Clozapine

39
Q

Which antidepressants cause hyponatraemia?

A

SSRIs

40
Q

Section 2 of the MHA?

A

Admission for 28 days
Cannot be renewed
AMHP + 2 doctors

41
Q

Section 3 of the MHA?

A

Admission for max period of 6 months
Can be renewed
AMHP + 2 doctors

42
Q

Section 4 of the MHA?

A

72 hour assessment order
AMHP + 1 doctor

43
Q

Section 5(2) of the MHA?

A

Voluntary patient in hospital detained for 72 hours

44
Q

Section 5(4) of the MHA?

A

Nurse can detain patient who is voluntarily in hospital for 6 hours

45
Q

Section 135 of MHA?

A

Police can remove person from private property to a place of safety (court order needed)

46
Q

Section 136 of MHA?

A

Police remove someone from a public place to a place of safety for 24 hours

47
Q

Symptoms of neuroleptic malignant syndrome?

A

Pyrexia
Muscle rigidity
Agitated delirium with confusion
Autonomic lability = hypertension, tachycardia and tachypnoea

48
Q

Symptoms of serotonin syndrome?

A

Hyperreflexia
Myoclonus
Rigidity
Hyperthermia
Sweating
Confusion

49
Q

Which PHQ-9 score should be offered antidepressant along with CBT first line?

A

if >16

50
Q

Onset of symptoms/seizure/delirium tremens from alcohol withdrawal?

A

Symptoms: 6-12 hours
Seizures: 36 hours
Delirium tremens: 72 hours

51
Q

When should patients starting new antidepressants be reviewed?

A

2 weeks
UNLESS under 25 - 1 week

52
Q

Physical signs of anorexia?

A

Lanugo hair
Parotidomegaly

53
Q

Physical signs of bulimia?

A

Russel’s sign - calluses on knuckles/backs of hand

54
Q

Symptoms of opioid withdrawal?

A

N+V
Myalgia
Sweating/Chills/Tremors
Anxiety/irritability/low mood
Watery eyes/rhinorrhoea
Diarrhoea
Goosebumps

55
Q

Features of frontotemporal dementia?

A

Disinhibition
Personality changes
Pick bodies

56
Q

Histological findings in Lewy body dementia?

A

Alpha-synuclein cytoplasmic inclusions (Lewy bodies
In the substantia nigra and paralimbic areas

57
Q

1st line treatment for mild-mod Alzheimers?

A

Acetylcholinesterase inhibitors
e.g. Donepezil, Galantamine, Rivastigmine

58
Q

Treatment for severe Alzheimers?

A

NMDA receptor antagonist
e.g. Memantine

59
Q

How to treat severe lithium toxicity?

A

Haemodialysis

60
Q

Blood results in anorexia?

A

Hypercholesterolaemia
High growth hormone
Low U+Es
Low testosterone

61
Q

Antidepressant used in those taking warfarin?

A

Mirtazapine

62
Q

Antidote for paracetamol overdose?

A

Acetylcysteine

63
Q

Antidote for benzodiazepenes?

A

Flumazenil

64
Q

Antidote for beta blockers?

A

Glucagon/atropine

65
Q

Antidote for calcium channel blockers?

A

Calcium chloride/gluconate

66
Q

Antidote for cocaine?

A

Diazepam

67
Q

Antidote for cyanide?

A

Dicobalt acetate

68
Q

Antidote for carbon monoxide?

A

100% oxygen

69
Q

Antidote for methanol/ethylene glycol?

A

Fomepizole/ethanol

70
Q

Bloods findings in neuroleptic malignant syndrome?

A

Increased CK and increased WCC

71
Q

What are the different pathways responsible for?

A

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

72
Q

Scale for classifying OCD?

A

Y-BOCS

73
Q

Mechanism of action of disulfiram in alcohol dependence?

A

Inhibits aldehyde dehydrogenase

74
Q

Definition for opioid use disorder?

A

Harmful pattern of use is evident over 12 months or at least 1 month if use is continuous

3a follow up (7 decks)

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