PSYCH 2

Question 1

schizophrenia strongest RF
lifetime risk 
positive symptoms 
negative symptoms 
first rank symptoms

Answer 1

family history
delusions, hallucination, thought disorder

apathy, lack of violation, social withdrawal, cognitive impairment

auditory hallucination, delusional perceptions, thought abnormalities

Question 2

schizophrenia diagnosis 1 of
2 of
good prognosis
bad prognosis

Answer 2

thought interference, passivity phenomenon, running comenteray hallucination, impossible persistent delusions

frontal thought disorder, catatonic behaviour, neg symptoms, loss of interest, self absorbed attitude, social withdrawal or at least 1 month

older age onset, F, marked mood disturbance, FH of mood disorders

longer duration of untreated psychosis, poor premorbid adjustment, early onset, insidious onset, enlarged ventricles, decreased IQ, strong FH

Question 3

schizophrenia treatment

paranoia schizophrenia caused by what and treatment

Answer 3

risperidone, olanzapine, clozapine
CBT, CDV risk assessment

stimulant drugs (amphetamine, coke) make schizophrenia symptoms worse and cause psychotic symptoms

1. Risperidone/aripropazole
2. chlorpromazine or clozapine

Question 4

anorexia nervosa diagnosis A-D

in who

Answer 4

A. weight loss 15% below normal/expected. in children - lack of weight gain
B. weight loss induced by avoiding fatty foods
C. self perception of being too fat with intrusive thoughts of fattness
D. endocrine disorders. Amen n F. M = loss of sexual interest and potency

F>M. usually 18yo

Question 5

anorexia nervosa risk assessment

some complications

Answer 5

low BMI 17.5 - 16
mod 16-15
high 14.9 - 13
v high <13

CNS, decreased k, NA, glucose, calcium, anaemia. decreased testosterone, oestrogen, gonadotrophins, increased cortisol, increased GH
swollen salivary glands, delayed gastric emptying, constipation

Question 6

treatment anorexia nervosa

Answer 6

CBT. MANTRA. SSCM.

children and young adults 1 anorexia focused family therapy 2. CBT

Question 7

bullimia nervosa A-D
on examination
complications
treatment 1. 2.

Answer 7

recurrent episodes of operating two times a week over 3 months
persistent pre occupation with over eating and food
attempt to counteract food by self induced nom, self induced purg, alt periods of starvation
self perception of being too fat with intrusive dread of fastness

Brussels sign. parotid hypertrophy. dental

oesophageal reflux, erosion/tears/ruptures, decrease K/NA, subconjunctival haem, dehydration, seizures, pancreatitis

BN focused guided self help. CI/ineffective after 4 w
CBT
in children - 1. family therapy BN focused

Question 8

what is a binge eating episode 
what happens during an episode 
marked what present 
when 
not assoc with what

Answer 8

eating a lot in a short amount of time feeling a lack of control over eating
eating more rapidly until uncomfortably full
large amounts when not hungry
eating alone
feeling disgusted/guilty afterwards
marked distress
at least once a week
not assoc w inappropriate compensatory behaviour

Question 9

traumatic event 48h
up to 1 month
unto 3 months 
>3 months 
when should there be watching airing and review

Answer 9

acute stress reaction
acute stress disorder
PTSD acute
chronic PTSD

if trauma symp mild and present for under 4 weeks

Question 10

acute stress disorder when
symptoms
treatment

Answer 10

occurring with 1 month of trauma and lasting at least 2 days

dissociative symptoms - emotional numbing, depersonalisation, derealisation, detachment, amnesia
persistent re experiencing - intrusions, nightmares
increased arousal - anxiety, alertness, poor sleep

practical support. brief CBT

Question 11

complex PTSD happens when
symptoms
treatment

Answer 11

develops after prolonged exposure to trauma

cognitive disturbance, emotional dysregulation, dissociative identity disturbance, intrusive thoughts, tension decreasing activities: binge eating, self mutilation

trauma focused CBT

Question 12

PTSD cause
triggers
symptoms (just list them 8)

Answer 12

acute, combat, war, torture, crime, terrorism, bombing, kidnapping, riots, acts of nature

visual, auditory, smell, tone, kinetic

flashbacks, nightmares, avoidance, increased arousal, emotional numbing, dissociation, re-enactment, alcohol misuse (may be a symptom or long term complication)

Question 13

diagnosis of PTSD

Answer 13

exposure to stressful event or situation
persistent remembering or reliving
actual or preferred avoidance of circumstances
inability to recall some or all aspects of period of exposure to stress OR persistent symptoms not present before

B, C and D all occur within 6 months of stressful event or the end of a period of stress

Question 14

treatment of PTSD

Answer 14

trauma focused CBT
eye movement and desensitisation and representing therapy
anti dep - paroxetine
mirtazipine, amitrip, phenalzine, BZDs: bromazepam, clonazepam,
gabapentin, prcegablin, olanzapine