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Phase 3a > Psych 3 - Behaviour > Flashcards

Psych 3 - Behaviour Flashcards

1
Q

What are the characteristics of anorexia nervosa?

A

Marked distortion of body image
Pathological desire for thinness (over-valued idea)
Self-induced weight loss

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2
Q

Give three risk factors for anorexia nervosa and bulimia nervosa

A

Low self-esteem
Family history of mental health conditions
Poor family relationships

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3
Q

What are the physical consequences of anorexia nervosa?

A 
Hypotension and bradycardia
Arrhythmias
Infertility
Arrested growth and delayed puberty
Dry scaly skin
Anaemia, leucopenia, thrombocytopenia
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4
Q

What causes amenorrhoea in anorexia nervosa?

A

Low FSH and LH due to hypothalamic dysfunction, despite low oestrogen

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5
Q

Give three physical signs of anorexia nervosa

A

Decreased muscle mass
Peripheral cyanosis
Russell sign - calloused skin over interphalangeal joints

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6
Q 
What occurs in the following blood tests in anorexia nervosa:
Thyroid function:
Cholesterol:
Growth hormone:
UEs:
A

Thyroid: low T3/T4
Cholesterol: high due to starvation
GH: Increased
UEs: Increased urea and creatinine (dehydration)
Metabolic alkalosis if vomiting, metabolic acidosis if laxative abuse. Decreased ions

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7
Q

What are the risks of re-feeding in anorexia nervosa?

A

Cardiac decompensation

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8
Q

What is bulimia nervosa?

A

Recurrent episodes of binge eating, with compensatory behaviours
Over-valued ideas about body shape and weight

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9
Q

How do the physical signs of bulimia nervosa compare to the physical signs of anorexia nervosa?

A

Similar, but less severe

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10
Q

What complications of bulimia nervosa relate specifically to purging?

A 
Oesophageal erosions/perforation
Gastric ulcers
Dental erosion
Pancreatitis
Steatorrhoea
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11
Q

What is the treatment of anorexia nervosa and bulimia nervosa in children?

A

First line: AN-FT or BN-FT

2nd line: ED-CBT

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12
Q

What is the criteria for diagnosis of insomnia?

A

Insufficient quantity or quality of sleep for at least 3 days a week, for one month

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13
Q

What are three risk factors for insomnia?

A

Shiftwork
Pregnancy
Anxiety

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14
Q

What is sleep hygiene?

A 
Preventative strategy for insomnia:
Comfortable bed
Low light and noise level
Regular daytime exercise
Realistic expectation of sleep length
Get up if can't sleep after 20 mins
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15
Q

How is insomnia managed?

A

Sleep hygiene and regular exercise

Short term: short course of hypnotic drug
Long term: refer to IAPT and a sleep clinic, possibly melatonin

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16
Q

What is the disorder characterized by sleep occurring at times out of synchrony with the environment and social cues?

A

Circadian rhythm disorder

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17
Q

What are the three types of Circadian rhythm disorder?

A

Delayed sleep phase syndrome (asleep at 2am)
Advanced sleep phase syndrome (asleep at 7pm)
Irregular sleep wake pattern
Non-entrained type

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18
Q

How can bright light therapy help Circadian rhythm disorders?

A

DSPS: early morning
ASPS: before bedtime to delay
Suppresses melatonin

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19
Q

What hormones must be taken in gender dysphoria if transitioning?

A

MTF: ethinylestradiol, finasteride
FTM: testosterone injection or gel

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20
Q

What are the negative side effects of gender dysphoria hormonal treatments?

A

MTF: increased risk of thromboembolic disease and breast cancer
FTM: Polycythaemia and osteoporosis
Both: abnormal liver function

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21
Q

What are the tree types of Munchausen’s syndrome?

A

Wandering, non-wandering, by proxy

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22
Q

How is Munchausen’s syndrome managed?

A

Reduce iatrogenic harm - no inappropriate treatments

Direct or indirect challenges

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23
Q

What is meant by a personality disorder?

A

The enduring characteristics of an individual cause distress/difficulties for themselves or in their relationships with others.

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24
Q

Define affect

A

Range, intensity, and appropriateness of emotional response

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25
Q

Give three characteristics of paranoid personality disorder

A

Sensitive
Suspicious
Jealous
Distrust

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26
Q

Which PD is associated with emotional coldness, detachment, lack of interest, shyness, and excessive introspection?

A

Schizoid

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27
Q

A history of what is common in patients with dissocial/antisocial PD?

A

Childhood conduct disorder

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28
Q

What are the characteristics of antisocial PD?

A

Callous lack of concern for others
Irresponsible
Aggressive

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29
Q

What are the characteristics of anankastic/obsessive-compulsive PD?

A

Preoccupation with orderliness and control
Pedantic
Perfectionism
Doubtful

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30
Q

How is OCPD different to OCD?

A

No resistance in the personality disorder

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31
Q

Which PD is characterized by insecurity, timidness, and social discomfort

A

Anxious/avoidant

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32
Q

What are the characteristics of dependant PD?

A 
Clinging
Submissive
Excess need for care
Resourcelessness
Individuals develop a passive role to life
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33
Q

What are the characteristics of borderline PD?

A

Unclear identity
Unpredictable affect
Impulsivity

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34
Q

Which PD is characterized by an inability to control anger/plan, unpredictable affect, and episodic loss of control of aggressive impulses?

A

Impulsive

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35
Q

What are the characteristics of histrionic PD?

A

Self-dramatization
Shallow affect
Attention seeking
Manipulative

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36
Q

Give three characteristics of psychopathy

A

Lack of remorse
Manipulative
Superficial charm

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37
Q

What EEG finding is present in psychopaths?

A

Posterior temporal slow waves

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38
Q

How are personality disorders managed?

A

Treat comorbid psych conditions

DBT

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39
Q

Define learning disability

A

A condition of arrested or incomplete development of the mind, characterised by impairments of skills manifested in the developmental period.

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40
Q

What are the four classifications of learning disability?

A

Mild (IQ under 70), moderate, severe, profound

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41
Q

Give some genetic causes of LD

A

Down syndrome
Neural tube defects
MERRF

42
Q

Give some pre and perinatal causes of LD

A

Pre - infection, exposure to alcohol/drugs, maternal illness

Peri - neonatal illness, asphyxia in delivery

43
Q

Give some postnatal causes of LD

A

CNS infection

Head injury

44
Q

What is a conduct disorder?

A

A repetitive and persistent pattern of anti-social, aggressive, or defiant behaviours

45
Q

What are the risk factors for conduct disorder?

A

Social disadvantage
Parental criminality
Parental psychiatric disorder
Low IQ

46
Q

Give three symptoms of conduct disorder

A

Aggression and cruelty
Deceitfulness
Disobedience

47
Q

What conditions are associated with conduct disorder?

A

ADHD
Learning difficulties
Anxiety

48
Q

What is the management of conduct disorder?

A

Refer to CAMHS

Parent training programmes

49
Q

What is oppositional defiant disorder?

A

An enduring pattern of negative/defiant behaviour without the serious violation of societal norms or the rights of others
May occur in only one situation e.g. home

50
Q

What condition is characterized by an effect on social and communication skills, and a restricted, stereotypes repertoire of interests and activities?

A

Autism spectrum

51
Q

What are the risk factors for autism spectrum disorder?

A

Genetic - sibling risk
Low birth weight and asphyxia
Prenatal and postnatal infection

52
Q

Give three symptoms of autism

A

Limited empathy
Lack of awareness of social rules
Obsessively pursued and unusual interests and routines

53
Q

What is the pharmacological management of autism?

A

Sleep disturbance - melatonin

Aggression - risperidone

54
Q

How does Asperger’s syndrome compare with autism spectrum disorders?

A

IQ and language are normal or superior

55
Q

For how long do motor and vocal tics have to be present for a diagnosis of Tourette’s syndrome?

A

At least 1 year

56
Q

At what age does Tourette’s syndrome present?

A

5-6 years

57
Q

What is a tic?

A

Sudden, purposeless, repetitive, stereotyped movement or vocalisation

58
Q

Give one reason for an exacerbation of Tourette’s syndrome

A

Emotional stress

59
Q

What other features are seen in Tourette’s syndrome?

A

Copralalia and coprapraxia
Echolalia and echopraxia
Difficult concentrating

60
Q

What is the treatment of Tourette’s syndrome?

A

Habit reversal training
ERP
If severe: refer to a specialist, low dose antipsychotic monotherapy - risperidone; stereotactic surgery

61
Q

What is a risk factor for separation anxiety?

A

Anxious, inconsistent, or over-involved parenting

62
Q

What are the three subtypes of ADHD?

A

Combined - ADHD
Inattentive - ADD
Hyperactive-impulsive

63
Q

What are the features of ADHD?

A 
Poor organization
Poor concentration
Fidgeting
Interrupts
Talks excessively
Forgetful
Easily distracted
64
Q

What is the drug treatment of ADHD?

A

Stimulants - methylphenidate over 6y

2nd line - lisdexamfetamine

65
Q

What are the side effects of methylphenidate?

A

Dry mouth

Nausea and vomiting

66
Q

What is the genetic cause of Down Syndrome?

A

95% trisomy 21

5% Robertson translocation

67
Q

What are the signs of Down’s syndrome?

A

Hypotonia and short stature
Brachycephaly, epicanthic fold, eyes close together, low set ears, protruding tongue, strabismus
Single palmar crease
Sensorineural deafness
Hypothyroidism
Delayed puberty in males, ovulation problems in females

68
Q

What grey spots can be seen on the iris in Down’s syndrome?

A

Brushfield spots

69
Q

What congenital conditions are common in Down’s syndrome?

A

CV - ASD, VSD, PDA
Hirschprung’s disease
Hernias

70
Q

What are the common causes of death in Down’s syndrome?

A

Dementia

Childhood leukaemia

71
Q

What is the genetic abnormality in Fragile X syndrome?

A

Expansion of CGG triplet repeat within fragile X Mental Retardation gene on X-chromosome

72
Q

What is the learning disability in Fragile X syndrome?

A

IQ less than 70, borderline to profound

73
Q

What are the physical signs of Fragile X syndrome?

A 
Large testicles
High forehead
Hand flapping
Mannerisms
Hyper-extensible fingers
74
Q

What mutation causes Prader-Willi syndrome?

A

15q 11.2-13 microdeletion

75
Q

What are the signs and symptoms of Prader-Willi syndrome?

A

Hyperhagia, excessive eating and food seeking, obesity

Hypogenitalism, LD, hypotonia, speech disorder

76
Q

What is the treatment of Prader-Willi syndrome?

A

Growth hormone

77
Q

How are genetic learning difficulty syndromes diagnosed?

A

Fluorescence in-situ hybridization (FISH)

78
Q

Which syndrome is the complement to Prader Willi syndrome (same microdeletion)?

A

Angelman syndrome (happy puppet)

79
Q

What gene is lacking in the brain, in Prader-Willi, and Angelman syndromes?

A

UBE3A

80
Q

What are the symptoms of Angleman syndrome?

A 
Happy demeanour and laughter
Developmental delay
Short attention span
Decreased speech
Affinity for water
81
Q

What syndrome is caused by a partial deletion of the short arm of chromosome 5 (5p-)?

A

Cri-du-chat

82
Q

What are the symptoms of Cri-du-chat syndrome?

A

“cat-like” cry, LD, feeding difficulties, microcephaly and micrognathia, gentle and affectionate, hypotonia

83
Q

What is the deletion associated with DiGeorge syndrome?

A

22q11.2

84
Q

What are the symptoms of DiGeorge Syndrome?

A 
C - cardiac abnormalities
A - abnormal facies
T - thymic hypoplasia
C - cleft palate
H - hypocalcaemia secondary to hypoparathyroidism

Also - LD

85
Q

Which deletion is associated with William’s syndrome?

A

7q11.23

86
Q

What are the stand-out features of William’s syndrome?

A

Hoarse voice
Premature sagging and wrinkling of the skin
Hypercalcaemia

87
Q

The syndrome associated with a port wine stain on the forehead and eyelids is known as?

A

Sturge-Weber syndrome

88
Q

What mutation causes von-Hippel Lindau syndrome?

A

VHL tumour suppressor gene on chromosome 3p

89
Q

What tumours are found in patients with VHL syndrome?

A

Angiomas, renal/pancreatic carcinomas, phaeochromocytoma

90
Q

What symptoms are seen in Rett syndrome?

A 
Hand wringing
Loss of spoken language between 1-4 years
Stereotyped hand movements
Worsening gait
Seizures and muscle weakness`
91
Q

Which SSRI has the lowest risk of drug interactions?

A

Sertraline

92
Q

When is urgent medical admission needed in eating disorders?

A

HR<40
BMI<15
Severe infection or electrolyte disturbances

93
Q

Which SSRI is the drug of choice in children and adolescents?

A

Fluoxetine

94
Q

What is erotomania?

A

Delusion of a famous person being in love with the patient

95
Q

What is a common side effect of atypical anti-psychotics?

A

Weight gain

96
Q

When are personality disorders allowed to be diagnosed?

A

Over the age of 18

97
Q

What is an abnormal grief reaction?

A

Grief that lasts longer than 6 months

98
Q

What is Othello syndrome?

A

Delusional jealousy/unfaithfulness

99
Q

What is the risk of developing schizophrenia if one monozygotic twin, and one parent has it?

A

50% - twin

10-15% - parent/sibling

100
Q

What is the treatment of bulimia or anorexia in adults?

A

First line anorexia: CBT-ED, MANTRA or SSCM

First line bulimia: CBT-ED

101
Q

Name some extra-pyramidal side effects associated with atypical anti-psychotics?

A

Parkinsonism
Acute dystonia (sustained muscle contraction)
Akathisia - severe restlessness
Tardive dyskinesia - choreoathetoid movements.

Phase 3a (18 decks)

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