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Phase 3a > Psych 2 > Flashcards

Psych 2 Flashcards

1
Q

Describe the features of antisocial personality disorder. what cluster?

A

-Cluster B -disregard moral values & social norms -little empathy -poor impulse control - drug abuse -over represented in prison populations

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2
Q

Describe the features of borderline personality disorder. What cluster?

A

Cluster B -unstable moods - rapid change from intense joy to intense rage -split things - completely good or completely bad -threaten suicide or self harm - fear of people leaving them

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3
Q

Describe the features of histrionic personality disorder. what cluster?

A

Cluster B -attention seeking behaviour -intense emotionality -manipulate to draw attention -many friends few close friends as seen as shallow and flighty

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4
Q

Describe the features of narissitic personality disorder. What cluster?

A

Cluster B -Grandiose image -I’m the best/deserve the best -poor at seeing other ideas as valid -fragile self esteem -come across as pretentious, self centred and entitled -lack empathy.

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5
Q

what treatment would you give for a person with a cluster B personality disorder?

A

Dialect behavioural therapy

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6
Q

What are the 3 cluster A personality disorders?

A
  • paranoid - delusional
  • Schizoid - socially withdrawn
  • Schizotypal - distorted reality
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7
Q

Describe the features of paranoid personality disorder. what cluster?

A

Cluster A -very sensitive -suspicious -distrusts loyalty -holds grudges -combative sense of personal rights -self referential

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8
Q

Describe the features of schizoid personality disorder. What cluster?

A

Cluster A -no pleasure from activities -emotional coldness or flattened affect -limited capacity to express -indifferent to praise or criticism -little interest in sexual experience -solitary -fantasize and introspective

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9
Q

Describe the features of Schizotypal personality disorder. What cluster?

A

Cluster A -social and interpersonal defecits -magical thinking -vague -suspiciousness -excess social anxiety

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10
Q

What’s a helpful pneumonic for personality disorders?

A

-ABC WWW -weird, wild and worried

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11
Q

Describe the features of Avoidant personality disorder. what cluster?

A

Cluster C -seeks social relationship but avoids social situations -hypersensitive to rejection

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12
Q

Describe the features of Obsessive-Compulsive personality disorder. what cluster?

A

Cluster C -inflexible but inefficient -can be happy with how they are or not

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13
Q

describe the features of a Dependent personality disorder. what cluster?

A

Cluster C -reliance on others to make decisions -feelings of helplessness & incompetence -tendency to transfer responsibility

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14
Q

What are the 3 emergency psychiatric conditions?

A
  • Acute dystonic reaction
  • Neuroleptic Malignant Syndrome
  • Serotonin syndrome
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15
Q

What causes an Acute Dystonic Reaction?

A
  • happens within a week or starting/increasing dose of an antipsychotic
  • usually within first few hours
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16
Q

How may an acute dystonic reaction present?

A

-affects mainly head and neck muscles -torticollis - shortening of one SCM -forceful tongue protrusion -grimacing -blepharospasm

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17
Q

How do you manage an acute dystonic reaction?

A

-Discontinue causative agent -IM anticholinergic - Procyclidine

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18
Q

How does Neuroleptic Malignant Syndrome present? What causes it?

A
  • life threatening complication of an antipsychotic medication
  • within 2 weeks of the first dose
  • Hyperthermia (>38deg), muscle rigidity, altered mental state, autonomic dysfunction.
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19
Q

What blood test may help confirm neuroleptic malignant syndrome?

A

-elevated CK

20
Q

How would you manage neuroleptic malignant syndrome?

A
  • ABCDE
  • Stop causative agent
  • IV benzos for agitation
  • Cooling devices/antipyretics
  • treat rhabdomyolysis
  • Dantrolene for muscle relaxation
  • Bromocriptine for D2 agonism
21
Q

What is the pneumonic for depression symptoms?

A

DEAD SWAMP Depressed mood Energy reduced Anhedonia Disturbed sleep Suicidal ideation Worthlessness Appetite changes Mentation decreased (poor concentration) Psychomotor retardation

22
Q

What’s the first line medication treatment for depression?

A

SSRI - sertraline, fluoxetine, citalopram

23
Q

Give an example of an SNRI? are there any side effects?

A

-Venlafaxine - Arrhythmias -Duloxetine

24
Q

Give an example of a MAO inhibitor? and what substance in foods must you swerve if on them?

A

-Phenelzine -tyramine containing foods such as cheese -HTN crisis if not

25
Q

What pneumonic helps you remember symptoms of mania present in Bipolar?

A

I DIG FAST

Irritability/elevated mood

Distractibility

Inhibition lost

Grandiosity

Flight of ideas

Activity increased

Sleep not needed

Talkative

26
Q

What mood stabilisers are there for Bipolar disorder?

A
  • Lithium
  • Sodium Valproate
  • Lamotrigine

+/- antipsychotic

27
Q

What side effects can lithium cause?

A
  • tremor
  • anorexia
  • D+V
  • Ataxia
  • Dysarthria
  • Delirium
  • Fasciculations
  • hypotension
  • arrhythmias
  • Seizures
  • Coma
28
Q

How can you tell the difference between Mania and Hypomania?

A
  • Mania may present with psychotic symptoms and hypomania won’t
  • Hypomania also lasts for 3-4 days and mania has to have bene for greater than 7 days
  • Hypomania may not affect ADL
29
Q

What’s an example of a tricyclic antidepressant? some side effects?

A

-Amitriptyline -anticholinergic effects Can’t pee Can’t see Can’t spit Can’t shit

30
Q

What’s the acronym for remembering suicide risk factors?

A

SAD PERSONS

Sex - male

Age (<20->44)

Depression

Previous suicide attempt

Ethanol abuse

Rational thinking loss (psychosis)

Social support LACKING

Organised suicide plan: do they have means? did they write a note?

No spouse

Sickness

31
Q

What are the 4 types of antidepressants we need to know about? Give an example of each.

A

MOAi - phenelzine

TCA - amytriptiline

SSRIs - fluoxetine

SNRIs - Veneflexine

32
Q

What sort of drug is phenelzine? What are it’s potential side effect?

A
  • MOAi
  • cheese effect - tyramine rish foods can cause V high blood pressure
  • severe drug interactins - can cause serotonin syndrome when taken with other Anti-Ds
33
Q

What sort of drug is amytriptilline? What are it’s side effects?

A
  • Tricyclic antidepressant
  • anticholinergic effects - can’t pee, can’t see, can’t spit can’t shit
  • overdose can cause seizures
34
Q

What type of drug is fluoxetine? What are some side effects?

A
  • Selective Serotonin Reuptake Inhibitor
  • Nausea, headache, GI upset
  • Agitation, akathisia, anxiety
  • Sexual dysfunction
  • insomnia
  • hyponatraemia
  • increase risk of suicidal ideation on initiation of treatment
35
Q

Do antidepressants actually work? (according to the lecture slide - not recent metaanalysis)

A

STAR*D 37% initial remission

67% overall

36
Q

How long do antidepressants take to work?

A
  • 2 weeks
  • longer in elederly
  • shorter in children
37
Q

How long do you need to be taking Antidepressants for?

A
  • 6-9 months if first episode
  • 2 years if recurfrent depressice disorder, very severe episode, major relapse factors present
38
Q

What is the classical tirad of Serotonin Syndrome?

A

CAN

  • cognitive dysfunction - altered mental state
  • Automonic dysfunction - tachycardia, sweating, nausea, vomiting
  • Neuromuscular dysfunction - rigidity, hyperreflexia, myoclonus, hyperthermia
39
Q

What is the treatment for serotonin syndrome?

A
  • depends on presentatino severity
  • supportive and stopping medication
  • Cyproheptadine (5-HT2 antagonist)
40
Q

Name 4 atypical antipsychotics? how do they work?

A
  • haloperidol, clozapine, resperidone, onlazapine
  • partial anatagonists to dopamine recpetors
41
Q

How does the dopamine hypothesis pertain to positive and negative symptoms in schizophrenia?

A
  • postive Sx = overactivity of the Meso-Limbic pathway
  • negative Sx = relative underactivity in Mesocortical pathway
42
Q

What are some side effects of atypical antipsychotics?

A
  • increased apetite and WEIGHT GAIN
  • pronlonged QT syndrome
  • headaches and dizziness
  • sleeping problems/extreme tiredness
  • weakness
43
Q

how long shoud a patient remain on antipsychotics?

A

risk of relapse continues up until 18 months post remission

44
Q

When is clozapin indicated? What precautions should be taken?

A
  • offered in psychosis when 2 or more treatments have been tried unsuccessfully
  • FBC monitoring due to the risk of agranulocytosis
  • also can cause hypersalivation and constipation
45
Q

How quickly do antipsychotics take effect?

A
  • within 24 hours
  • most improvement seen within first 2 weeks compared to any other 2 weeks
  • reduction in behavioural impact of symptoms and preocupation
  • perspective and conviction reducing later

Phase 3a (15 decks)

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