Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

3a Notes AC > Psych 3a > Flashcards

Psych 3a Flashcards

1
Q

Treating Depression

Medical

A

Adults: SSRI (Sertraline) SNRI (Venlafaxine)
Children: SSRI (Fluoxetine)
Elderly: Mirtazapine - also given to Warfarin Pts

SSRIS: citalopram, paroxetine SNRIS: duloxetine. Careful with Fluoxetin

When starting SSRI, prescribe for 6mths at least, avoid triptans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Medical treatments

Non Medical Treatments for Depression

A

Non medical 1st line: CBT, IAPT Fam therapy in CAMHS
Encourage resuming old activities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Side FX SSRIs

Sertraline, Citalopram, Fluoxetine

SSRI can increase risk of suicide so double check

A

GI symptoms (most common)
Sexual Impotence
Hyponatremia
Agitation, Weight gain
Upon Discontinuation: Restless, Sweating, Parasthesia, GI symptoms

Interactions: NSAID (Give PPI), Sumatriptan, Warfarin/Heparin

Fluoxetine and Paroxetine risks of interactions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Medical treatments

Other Treatments for Depression

other than SSRi and SNRI

Generally avoided

A

MAOI - Tranylcypromine, phenelzine Side FX: HTN crisis when taken with cheese, pickles etc.
TCAs - Amitriptyline Side Fx: Urinary retention, dry mouth, lethargy, blurry QT interval increased

These both are avoided due to side fx profile

MAOI treate atypical depression TCA commonly used for neuropathic pain and chronic TTH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Assesment and management Frontal Lobe Syndrome

Hx

A
  • Developmental, Trauma & Social Hx
  • Check B12. TFT, Syphilis screen
    Management
  • General Supportive Care
  • Speech therapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Treatment Acute Mania

A
  • Stop Anti-Depressants
  • 1st line antipsychotics

Haloperidol, Olanzapine, Queitapine, Risperidone

Li can be used short term & Benzodiazepnes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Chronic Management of Bipolar Disorder

A
  • CBT
  • Mood stabilisers: Lithium
  • 2nd Line: Na Valporate, Carbamezipine Olanzipine

Pregnancy use antipsychotic: Haloperidol

Lithium is teratogenic causing Ebsteins Foetal Anomaly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Treating Depression in Bipolar

A
  • Avoid antidepressant (Can cause Mania)
  • 1st line Antipsychotic: Quietapine
    If you are to prescribe SSRI such as Fluoxetine then prescribe Mood stabiliser alongside it

Olanzapine can be used as Mood Stabiliser although it is a antipsychotic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Side FX Lithium

Due to narrow Therapeutic Index you must check LI bloods evry wk for 3w

Then check every 3m

A

Leukoytosis (Excess WBC)
Insipidus Diabetes
Tremors
Hydration (Dehydrates)
Increased GI motility
Underactive thyroid
Metallic Taste

Long-term lithium use can result in hyperparathyroidism and resultant hypercalcaemia (stones,bones, abdominal moans & psychic groans)

Wt gain, hypoparathyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Think of a drunk man

Lithium Toxicity

Conc of LI in blood above 1.5mM

NEPHROTOXICITY

A

Reduced renal function due to Li accumulation leading to

  • Dehydration
  • D&V
  • Sleepy
  • Motor signs: Coarse Tremor + Hyperflexia
  • Neuro: Confusion, seizures

Mild Toxicity: Stop Li & Rehydrate

Avoid with Li: NSAIDS, THiazide diuretics, ACEi, ARBs, metronidazole

Severe: Haemodialysis, Gastric Lavage, Diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is Dysthymia?

Not severe enough to be classed as something (Hint)

Treated with SSRI (Sertraline) + CBT

A

Chronic, midly depressed mood and diminished enjoyment
Presence of low grade symptoms for around 2y

Not severe enough to be classified as severe illness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is Alogia

poverty of speech.

A

Refers to difficulty with speaking or the tendency to speak little due to brain impairment.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Treatment Schizophrenia

Antipsychotics

Extrapyramidal Side Fx caued by Typical Antipsychotics

A

1st line: Atypical (Quietapine, Olanzapine, Risperidone)
2nd Line: Typical (Haloperidol, Chlopromazine)
3rd Line: Clozapine
Treatment steps: 6mths -> 5Y -> Lifelong

Regular monitoring of: Wt, Lipids, Glucose, & ECG

Psycho: CBT Social: Housing, Financial Advice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

4 Extra Pyramidal side Fx of Typical antipsychotics

Haloperidol Chlorpromazine

Increased risk of stroke and VTE

A
  1. Acute Dystonic Rxn (Hours)
    Muscle spasms, acute torticolis, Eyes rolling back
  2. Parkinsonism (Days)
    Tremor, bradykinesia
  3. Akathisia (Days to weeks)
    Inner restlessness, agitation, suicide risk in young
  4. Tardive Dyskinesia (Months to Years)
    Grimacing, tongue protrusion, lip smacking

Difficult to treat Tardive Dyskinesia as Dr Receptors upregulated

Torticolis: Neck spasms Bradykinesia: slow movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Side Fx Profile Antipsychotics

Apart from Extrapyramidal

Atypical (Clozapine, Queitapine, Olanzapine, Aripiprazole, Risperidone)
Typical (Haloperidol, Chlorpromazine)

A

Typical : Dry mouth, Galactorrhoea, Urinary retention, blurred vision, constipation, QT interval increase
Clozapine: Agranulocytosis
Olanzapine: Dyslipidaemia, Hyperlipidaemia

Agranulocytosis: Severe reduction in the number of white blood cells
Monitor clozapine evry week for 18wks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Treatment for Extrapyramidal Symptoms

Caused by Typical Antipsychotics like Haloperidol and Chlorpromazine

A

Procyclidine for Acute Dystonic Rxn

Tetrabenazine may be used to treat moderate/severe tardive dyskinesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Young Age Dementia

Define Frontal Lobe Syndrome & Causes

fronto-temporal dementia

A
  • Damage to prefrontal regions of frontal lobe
    important in Motivation, planning, social behaviours, speech production
  • Damage leads to speech problems, reduced attention and abstract thoughts

Ubiquitin Deposits

Causes: Head Injury, CVA, Infection, Picks Disease (neurosyphillis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Endocrine disorders causing Psych symptoms

DM, Thyroid, Parathyroid, Adrenal

A
  • T1DM: Anorexia, Bulimia
  • T2DM Bipolar, Schizo
  • HyperThy: GAD, Depression, Thyroid storm -> Mania
  • HypoThy: Depression, Myoxydema -> Psychosis
  • HyperCalc: Depression, apathy, irritation
  • HypoCalc: Anxiety, mania
  • Cushings: Depression, anxiety, mania
  • Addisons: Fatigue

Cushings: hyperaldosteronism: More cortisol
Addisons is opposite

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Panic Disorder Vs GAD

generalised anxiety disorder

A

GAD: Constant worry with external stimulus of particular thing
Panic: Discreet episodes of anxiety w/out stimulus (spontaneous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

RF for OCD

A
  • FH
  • Parental Overprotection
  • PANDAS (Paediatric neuropsychiatric disorders associated with strep infection)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Dopamine

Pathophysiology of Schizophrenia

4 main dopaminergic pathways in the brain

A
  1. Mesolimbic Reward, excess dopamine here leads to +ve symptoms (Delusions, Hallucinations etc)
  2. Mesocortical Pre Frontal: low dopamine here -> -ve symptoms (anhedonia, blunted effect, alogia)
  3. Nigostriatal Basal Ganglia: excess dopamine -> motor movements
  4. Tuberoinfundibular: Excess dopamine -> rise in PRL (nipple leaks)

3 & 4 refer to Sid Fx of Antipsychotics

Dopamine in mesocortical needed for executive functioning such as emotion, speech

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

ALCOHOLISM

Investigation & Treatment for Drinking problem

Questionaiire

A

CAGE questionaire
- Have you ever tried to CUT down
- Have you been ANNOYED at the fact that you may have alcoholism
- Have you ever felt GUILTY
- Have you ever had an EYE OPENER first thing in morning
Alcohol dependence treatment
- Acute detox
- Psycho therapies
- Meds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Stepwise Detoxification from Alcohol

Alcohol dependence 4 drugs

A
  • Benzos (Diazepam, Lorezepam, Chlordiazepoxide)
  • Rehydration with correct electrolytes
  • Thiamine
    Disulfram - Prevents alcohol metabolism - causes nausea if you drink
    Acamprostate - Reduce cravings
    Naltrexone - Opiod antagonist
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Treatment for Delirium Tremens

Acute withdrawal from alcohol

A

First line: Lorezepam or chlordiazepoxide

Treat with Thiamine
or Antipsychotics (Haloperidol)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Treatment for Delirium Tremens

Acute withdrawal from alcohol

A

Treat with Thiamine
Lorezepam or Antipsychotics (Haloperidol)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is Korkasoff

Think Thiamine

Due to Alcohol misuse

A
  • Short term memory loss + Cofabulation
    Thiamine deficiency due to alcohol misuse
    Damage to hypothalamus mamiliary bodies

Other Cause: Head Injury, Post anasthesia, Encephalitis CO poisoning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Treatment for Korkasoff Psychosis

A
  • Oral Thiamine replacement therapy for up to 2Y
  • Treat psychiatric co morbidities
  • Cognitive Rehab
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Caused by Thiamine B1 deficiency

Triad of Wernickes Encephalopathy

& Treatment

Develops further on from Korkasoff

A
  • Opthalmoplegia (eye muscle paralysis)
  • Ataxia
  • Confusion

High risk Pts: prophylactic vit(s)

Treat with IV Pabrinex (vit)

Can also present alongside Korkasoff: Wernicke’s Korkasoff

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Delirium Screening & Symptoms

A
  • 4 AT assesment
    Symptoms
  • Confusion
  • Disorientation
  • Hallucinations
  • Agrresion
  • Labile mood (yoyo)

ICD 10: cognitive, attention disturbance over short period of time

Delirium: evidence of physical cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

4A’s of Alzheimers

A
  1. Amnesia; Poor recent memory
  2. Apraxia: unable to button up
  3. Agnosia: unable to recognise body parts
  4. Aphasia: Struggle with language
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Diagnosing Alzheimer’s

A

CT
- Brain atrophy, sulcul widening, large ventricles
- Amyloid Plaques
- Neurofibilary tangles
- Shrinkage of cortex
- Alzheimer’s disease causes widespread cerebral atrophy mainly involving the cortex and hippocampus

Use ACE III for diagnosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Medical Management Alzheimer’s

Non Pharm:

Acitivities promoting wellbeing & group cognitive simulation therapy

A

1st: Ach inhibs: Donepezil, Rivastigmine, Galantamine
2nd NMDA antagonist: **Memantine ** (when 1st line contraindicated)
Mild-Moderate AD: 1st
Severe AD: 1st + 2nd line

Donepezil: insomnia, contraindicated bradycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Related to Parkinsonism

Lewy Body Dementia Features

Common in 50-80y

Same Treatment as AD

A
  • Caused by Lewy bodies (alpha-synuclein cytoplasmic inclusions) in the substantia nigra
  • Early impairments in attention and executive function rather than memory
  • Parkinsonism
  • Visual Hallucinations
  • Fluctuating cognition (Confused for delirium)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Baby Blues

1st

A
  • 60-70% women
  • 3-7 days post birth
  • Anxiety & Fearful

Treatment: Reassurance from Health Visitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Post Natal Depression

2nd

A
  • 10% Women
  • Start at 1m peak at 3m
  • Symptoms of Depression
  • Reassurance + CBT
  • SSRI (Sertraline)

SSRI can come in breast milk so be mindful

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Puerperal Psychosis

3rd (most critical of the lot)

A
  • 0.2% of Women
  • 2wk Post Partum
  • Bipolar 1 - Mania
  • Disordered Perceptions
  • Psych emergency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is ECT?

What treatment is it used in?

Catatonia: a disorder that disrupts a person’s awareness of the world around them

A
  • Treatment in Depression with catatonia
  • +/- Psychotic Symptoms
  • contraindicated in Raised ICP

Side Fx: Headache, nausea, arrythmias. Long term: Impaired memory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Schizoid Personality

Cluster A

A
  • Indifferent to praise and criticism
  • Prefers solitary activities
  • No interest in sex
  • cold
  • few friends
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What are the four Ps

A
  1. Predisposing
  2. Precipitating
  3. Perceptuating
  4. Protective

e.g. 1. Genetics 2.Particular event 3. Drinking 4. Support network

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Depression and its Core 3 symptoms

Other symptoms: Sleep deprived, apetitie change, agitation, labile mood

A
  • Pervasive Lowering of mood
    1. Anhedonia
    2. Low of mood
    3. Loss of energy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

ICD classification for Depression

Time frame + mild/moderate/severe

A
  • At least 2/3 core symptoms
  • over 2wks
    Mild: Core + 2/3 symptoms
    Moderate: Core +4 symptoms
    Severe: Several symptoms +/- Suicide risk
    also marked loss of functioning
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Signs & Investigations of Depression

Hx, Risk Assesment

A
  • Wt loss
  • Psychomotor retardation
  • Lack of eye contact
  • Slow + Quiet
    Take a full Hx and blood test
    Risk Assesment: Self neglect/harm, suicidal thoughts
43
Q

RF & DD For depression

A

RF: FH, History of Abuse, Socio-economic status, Drugs and alcohol, trauma
DD: Bereavement, Schizophrenia, Substance Withdrawal

44
Q

RF & DD For depression

A

RF: FH, History of Abuse, Socio-economic status, Drugs and alcohol, trauma
DD: Bereavement, Schizophrenia, Substance Withdrawal

45
Q

Downsides of Antidepressants

Time, Symptoms, Exacerbation of other symtoms

A
  1. Take time to work - 4wks
  2. Can initially increase suicide tendencies
  3. Improve some symptoms but not all

Important to assess Pts after 2wks and 1wk if they have suicide risk

46
Q

Define Bipolar Affective Disorder

And Risk factors

A

Recurrent episodes of altered mood and activity
- Hypomania/Mania + Depression
- Onset early 20s
- M:F 1:1
RF
- FH
- Trauma
- Sleep deprivation
- Cannabis use in adolescence
- BAME
- History of Abuse

47
Q

What is Cyclothymia

Think Bipolar

A

Chronic Mood fluctuations over last 2 years
Episodes of Depresssion and Hypomania
Rapid Cycling lasting only a few days

48
Q

Bipolar 1 vs Bipolar 2

A

Bipolar 1: Most common: Mania + Depression
Bipolar 2: More symptoms of Depression + Mild Hypomania

Bipolar 2 is often harder to spot

49
Q

Hypomania Symptoms

Lasts 4 days

A
  • Elevated mood
  • Increased Energy & Talkativeness
  • Poor concentration
  • Mild Reckless behaviour (Overspending)
  • Increase in Libido and confidence
  • Little need for sleep
  • Change in apetite

No Psychotic Symptoms

50
Q

Psychotic Symptoms

Mania Symptoms

Last >7days

A
  • Extreme uncontrollable reaction
  • overactivity
  • pressure of speech
  • impaired judgement
  • Very reckless (Spending spree, Jumping buildings)
  • Social Disinhibition
  • Increase in Self esteem and Gradiosity
  • Absent insight - Hallucinations
51
Q

Psychotic Symptoms

Mania Symptoms

Last >7days

A
  • Extreme uncontrollable reaction
  • overactivity
  • pressure of speech
  • impaired judgement
  • Very reckless (Spending spree, Jumping buildings)
  • Social Disinhibition
  • Increase in Self esteem and Gradiosity
  • Absent insight - Hallucinations

pressure of speech: words can’t get out quick enough

52
Q

DD Bipolar Disorder

A
  • Substance Abuse (Amphetamines, Cocaine)
  • Endocrine Disease (Cushings - Steroid Induced Psychosis)
  • Schizophrenia
  • Schizoaffective disorder
  • ADHD
  • Personality disorder
53
Q

Investigations & Signs for Bipolar

History and Signs

A

Perform Full History and MSE
Signs

  • Pressure of speech
  • Restlessness
  • Flight of ideas

Look out for endocrine signs like purple striae (Cushings)

54
Q

Define Schizophrenia

A
  • A spiltting/dissociation of thoughts
  • Loss of contact with reality
  • Affects person’s thoughts and perceptions

Most common type is paranoid schizophrenia

55
Q

RF for Schizophrenia

In order of strongest to weakest

A
  • FH (Twin>Parent>Sibling)
  • Black ethnicity
  • Migration
  • smoking ganga in youth
  • adverse life event
  • bullying
56
Q

1st Rank Symptoms

Schizophrenia

A
  • 3rd person auditory hallucinations
  • Thought disorders
  • Passivity phenomena (somebody controlling thoughts)
  • Delusional perceptions
57
Q

Second Rank Symptoms

Schizophrenia

A
  • Delusions
  • 2nd Person Auditory hallucinations
  • Formal thought disoder (FMD)
  • Catanoic behaviour
  • -ve Symptoms

FMD: When words come out wrong because of muddled up thoughts

58
Q

Diagnosing Schizophrenia

Rank Symptoms

A
  • 1 first rank symptoms
    or
  • 2 second rank symptoms

For at least a month

59
Q

+ve Symptoms

A

Delusions Persecutory (think they’re being watched)
Delusions of Reference (Things being placed in a certain way to highlight they are evil)
Hallucinations
Thought Disorders

60
Q

-ve Symptoms

A

Poverty of speech
Flat affect
Poor motivation
Social Withdrawal

61
Q

Treatment Acute Transient Psychosis

A
  • Haloperidol

Typical Antipsychotics

62
Q

Charles Bonnet Hallucinations

Akhaaaaaa

A

Visual Hallucinations in a person with partial or severe blindness
Visual impairtments promote sensory deafferentiation leading to disinhibition thus resulting in sudden neural findings of the visual cortical regions

63
Q

Cotard Syndrome

maree gaya

A

False belief of death

Dangerous as Pts may no longer eat or drink thinking they are dead

64
Q

De Clerambault’s Syndrome

Erotomania

A

Seen in young women
Falsely believing that a famous person has fallen in love with them

65
Q

Othello’s

A

Pt believes spouse is being unfathful without any solid proof

66
Q

Folie a Deux

A

Symptoms of delusional belief transmitted from one individual to another

67
Q

Schizoaffective disorder

A

Schizophrenia symptoms plus depression

Treat with antpsychotics, mood stabilisers etc

68
Q

GAD

Generalised Anxiety Disorder

A
  • Persistent worry (excessive)
  • About a nr of events (School, work, bills)
  • Individualised; find it difficult to control worry
  • 3mths ICD 10
  • 6mths DSM
69
Q

RF for GAD

A
  • Alcohol
  • Benzo use
  • Co-existing depression
  • FH
  • History of abuse
  • Pushy parents
    *

Excessive salbutamol use is also another factor

70
Q

Symptoms GAD

A
  • Unpleasant emotional state
  • bodily discomfort
  • palpitations
  • chest pain
  • tachycardia
  • tremor
  • insomnia
  • increased vigilance
71
Q

Treatment for GAD

Bio Psycho Social

A

Bio: SSRI, Pregablin, Benzo
Psycho: CBT, Relaxation therapy
Social: arrange for housing etc

Beno used in acute settings

Sertraline is SSRI of choice

72
Q

Agoraphobia Vs Social Phobia

Both Very similar

Treatment: CBT, Exposure therapy

A

Agoraphobia: Fear of crowded places & places without easy escape route
Social Phobia: Fear of situastions (social) where individual isn’t familiar with the people around them

73
Q

Obsessive Compulsion Disorder

Obsessions which lead to compulsive behaviour

A

Obsessions: reflected by intrusive, unwelcome, unpleasant thoughts/images doubts
Compulsions: A repetitive, purposeful, physical or mental behaviour performed in response to obsession

74
Q

Presentation & Investigations OCD

A

P/ Time consuming obsessions present most days for 2 weeks
Distressing & interferes with daily life
I/-Detailed History + MSE

75
Q

Treatment OCD

A

PsychoEducation
CBT
SSRI

76
Q

Somatisation Disorder

Leads to needless surgeries

Common in Females

A
  • Physical Symptoms without physical explanation
  • Persistent for 2Y
  • Common in Women
  • GI & Skin Related

Important to rule out organic causes using detailed history

77
Q

Conversion Disorder

Neuro

A

Pt presents with neurological signs such as: Paralysis, Weakness, Amnesia
- Examination is inconsistent
- Pt is not faking it

78
Q

Alcohol Abuse

Alcohol dependence Syndrome

A
  • Regular binge consumption of alcohol
  • Sufficient to cause physical, neuro, social damage
  • Alcohol dependence Syndrome inability to control intake of substance, oft used to avoid withdrawals
79
Q

Signs of Alchol dependence

CANT STOP

A

Compulsion to drink
Aware of harm but persists
Neglect of ther activities
Tolerance to alcohol
Stopping causes withdrawal
Time preoccuppied with alcohol
Out of control use
Persistent

80
Q

medical emergency

Delirium Tremens

A
  • Acute confusional state secondary to alcohol withdrawal
  • Occurs 1-7 days after last drink
  • Clouding of consciousness
  • disorientation
  • amnesia of recent events
  • psychomotor agitation
  • tremors
  • visual, auditory + tactile hallucinations
  • Risk of CVD collapse
81
Q

Causes of Delirium

Delirium: Acute confusional state

Infection, Toxic, Vasc, Metabolic, Meds, Vit

A

Infection: UTI, Septicaemia
Toxic:Substance misuse,opiods
Vascular: Stroke, Head trauma
Metabolic: Thryoid, Diabetes, Hypoxia
Meds Anticholinergics, benzo, polypharmacy
Vitamin Deficiency

82
Q

Symptom of Delirium

Hypoactive Vs Hyperactive

A

Hypoactive:Withdrawn, sleepy, quiet behaviour, (less likely to be recognised so dangerous)
Hyperactive: Restless, Agitated, aggresive

management: treat cause + hydration & nutrition

83
Q

Dementia

Define, late onset vs early onset

A
  • Decline in higher cortical function
  • no clouding of consciousness (Delirium)
  • Usually irreversible
  • Deterioration present for 6mths
  • Decrease in memory, orientation, language, comprehension
  • Resulting in impairment in activities of daily living
  • Late onset: >65Y
  • Early onset: <65Y
84
Q

Most common form of Demetia

Alzheimer’s Disease

genes involved different in early v late onset

Unknown Aeitiology

A
  • Insidious onset of dementia due to deterioraton of brain
  • Early Onset: APP gene, Preslin 1+2
  • Late Onset: Apoliprotein E

50% off Downsyndrome Pts develop AD

85
Q

2nd Most common form of dementia

Vascular Dementia

A

Dementia caused by infarction(s) in the white matter
- Stroke related VD
- Subcortical VD (Small vessel disease)
- Mixed Dementia (VD+AD)
VD can be inherited: CADASIL

Sudden stepwise deterioration of cognition : NINDS-AIREN criteria

86
Q

PTSD Vs Acute Stress Disorder

Time, Symptoms, Treatment

A

PTSD Symptoms: >1mth Flashbacks, nightmares, avoid certain people or situations. Treatment: CBT & EMD
ASD Symptoms: within 4 wks, same as above. Treatment: CBT, Benzodiazepene

87
Q

Histrionic Personality type

Cluster B

A
  • Inappropriate sexual seductiveness
  • centre of attention
  • impressionistic spech lacking detail
  • self dramatization
  • Relationships considered more intimate than they are
88
Q

Narcisstic Personality type

Cluster B

A
  • Grandoise sense of self importance
  • Arrogant and lack empathy
  • Pre-occupied wuth fantasy of self power
  • taking advantage of others
89
Q

Schizotypal Personality

Cluster A

A
  • Idead of Reference Odd beliefs + magical thinking
  • Unusual perceptual disturbance
  • paranoid
  • Odd eccentric behaviour
  • Odd speech
  • Inappropriate affect
90
Q

Paranoid Personality

Cluster A

A
  • Hypersensitivity and unforgiving
  • Question loyalty of friends
  • Reluctance to confide
  • Conspiratorial
91
Q

Antisocial Personality

Cluster B

A
  • Common in Men
  • Disrespectful of Law
  • Lying deceipt, conning, assault, irresponsible all common traits
  • Lack of remorse
92
Q

Borderline

Emotionally unstable personality disorder

A
  • Unstable relationships alternating b/ween idealization and devaluation
  • Unstable self image
  • Impulsive and suicidal
  • Feel empty
93
Q

Learning Disabilty

Different to Learning Difficulty

A

IQ Below 70
Intelectually delayed in every aspect of life.
Onset before the age of 18.

94
Q

Downsyndrome

goes hand in hand with AD

A
  • Trisomy 21
  • RF Mother above 40
  • Characteristics: Short, fat with hypotonia
  • Congenital Heart Defects very common
95
Q

Fragile X Syndrome Features

A
  • Common in men
  • Large testes, ears, etc
  • CGG triplet defect
96
Q

Symptoms of common LDs

Aspergers Rett’s Heller’s Tourettes Enuresis

A

Aspergers: Autisim spectrum disorder
Rett’s: Affects brain develpment common in girls
Heller’s: Similar to autism
Tourettes: Motor and vocal tics
Enuresis: Involuntary urination

97
Q

Excess Serotonin in body

Serotonin Syndrome

Treated using Chlorpromazine

A
  • Caused by SSRI. MAOI, Ecstasy, psycho active stimulants
  • Rapid onset
  • Increased Reflexes, Clonus, Dilated pupiils
  • Youn Pts, Tachycardia, Hypertensive, Pyrexia, Diaphoresis (sweating)
98
Q

Lifethereatening reaction to Antipsychotics

Neuroleptic Malignant Syndrome

Treatment: Dantrolene (muscle relaxant)

A
  • Slow onset
  • Decrease reflexes, rigidity, diaphoresis (sweating) confusion
  • Normal pupils
99
Q

Eating Disorder

Anorexia Nervosa Features

Suicide affects 1/5 mortality due to AN

MARSIPAN used to treat sick patients from AN

A
  • Least common in adults
  • most common in children
  • Failure to gain weight/ weight loss
  • overvaluead ideation regarding weight/shape
  • Lagune hair common symptom
    Two types
    1. Anorexia Nervosa Restricting
    Consumption of less than 500kcals daily
    2. Anorexia Nervosa Binge purging
    Low wt but engages in binge eating/purging
100
Q

Bulimia Nervosa Features

A
  • Recurrent binge eating followed by compensatory behaviour to avoid wt gain
  • at least once a week for 3mths
  • Self induced vomitting, laxatives, diuretics
  • Look out for cavities from vomit acid damage and marks on knuckels/hands
101
Q

Binge Eating Disorder

Different to Bulimia as no compensatory mechanisms

A
  • BED episode once a week for 3mths
102
Q

OFSED

Other specified feeding and eating disorder

A

Features of all three: AN, BN and BED

103
Q

ARFID syndrome

Eating

A

Avoid certain foods due to sensitiveity to particular foods i.e. might not like texture of one food so will avoid or PTSD of a choking incident
- Seen often in autistic children
- general disinterest in food

3a Notes AC (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions