Psych Flashcards

1
Q

Delirium Tremens

A

ETOH withdrawal

low serum B12

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2
Q

Acute delirium

A

Mx - Cause, otehrwise haloperidol

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3
Q

Pharm causes of depression

A

Prednisolone

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4
Q

Frontal lobe injury

A

Px - Hyperphagia, lability&irritability, hypersexuality, inappropriate affect

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5
Q

Wilson’s

A

Ax - Cu accumulation

Px - jaundice, KF rings, Psych=aggression, disinhibition

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6
Q

Huntington’s

A

Ax - chromosome 4p triplet repeat. Cell loss in basal ganglia, sunstantia nigra and verebellum
Px movement disorder, choreiod and athetoid movements dementia, personality changes

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7
Q

Stroke psych complications

A

Depression

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8
Q

Schizophrenia subtypes

A

Hebephrenic/disorganized: predominance of thought disorder and affective symptoms. social withdrawal, fatuous affect, negative symptoms develop rapidly
Catatonic: psychomotor disturbances or catatonic behaviour, waxy flexibility, negativism, aversion
Paranoid: delusions and hallucinations
Residual: +ve Sx are replaced by -ve Sx
Simple: insidious development of oddities of conduct, inability to meet demands of society and decline in total performance
Lifetime risk is 0.4% twins 50%

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9
Q

Neuroleptic malignant syndrome

A

Emergency
Ax - complicaiton of antipsychotics dopamine blockage.
Px - Confused, dec GCS, extra-pyramidal Sx, fever, hypotension, tachycardia
Mx - stop antipsychotic

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10
Q

Aripiprazole

A

Newer antipsychotic, less SE’s

SE: Nausea, insomnia

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11
Q

Olanzapine

A

2nd gen antipsychotic
Treating +ve Sx
SE: wt gain and diabteic control

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12
Q

Clozapine

A

Treatment resistant schizophrenia

SE: Neutropenia or agranulocytosis

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13
Q

Sertraline

A

SSRI antidepressant

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14
Q

Section 3

A

Detain for 6 mnths, when the person is known to mental health services

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15
Q

Section 2

A

Detain for 28 days, initial assessment

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16
Q

Section 135

A

Warrant permitting police to search premises and remove pts from those premises

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17
Q

Section 4

A

Detained for 72hrs, emergency, should be converted to section 2. 1 medical recommendation

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18
Q

Section 5(2)

A

(Dr) Detain for 72hrs on inpts for a full mental health assessment

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19
Q

Lewy body dementia

A

Second most common after Alzheimer’s
Day to day fluctuation of cognition, visual hallucinations, parkinsonian
Antipsychotics avoided

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20
Q

Normal pressure hydrocephalus

A

Gait, urinary incontinence, dementia

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21
Q

Hippocampal atrophy on MRI

A

Alzheimer’s

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22
Q

MOA of drugs targeting cognitive symptoms of dementia

A

Drugs that Inc ACh i.e. ACh esterase inhibitors

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23
Q

Day to day fluctuating consciousness, visual hallucinations, Parkinsonism

A

Lewy body dementia

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24
Q

Excessive worry over memory loss in old people.

A

Depression

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25
Q

Somatization is a common presentation of ……… in old age

A

Depression

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26
Q

Partition delusions ‘radiation through ceiling’

A

VLOSP

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27
Q

Body fat in elderly increases/decreases

Fat soluble drugs will have a longer/shorter duration of effect in older people

A

Increases

Longer

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28
Q

Px - pyrexia, rigidity, tachycardia, raised WCC, raised CK, fluctuating consciousness, younger male pts
Ax - antipsychotics
Mx - stop antipsychotics, IV fluids (bromocriptine/dopamine agonist may be used)

A

Neuroleptic malignant syndrome

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29
Q

Wake up screaming w/ no recollection the next day

A

Night terror

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30
Q

Wake up screaming w/ recollection

A

Nightmares

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31
Q

Suicide RF’s

A
Male
45
divorced, single, widowed
unemployed
psych illness
prev episode of self harm
chronic physical illness
adverse life events
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32
Q

Annual rsk of suicide

Annual incidence of self-harm

A

1 in 10,000

3-1000

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33
Q

Delusional psychosis infected w/ parasites

A

Ekbom’s

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34
Q

Nihilistic delusion that one is dead, does not exist, is decaying etc

A

Cotard syndrome

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35
Q

Delusional belief that someone of a higher social status is in love with you

A

De Clerambault’s

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36
Q

Mimicking ideas of crazy w/ approximate answers showing understanding of underlying Q
Prison inmates before trial

A

Ganser’s

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37
Q

Delusion that persecutor can change form

A

Fregoli’s

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38
Q

Delusional jealousy

A

Othello syndrome

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39
Q

Px - >2years of multiple, variable physical Sx of no underlying cause, refusal to accept Dr’s reassurance, impairment of social function, Sx not intentionally produced,

A

Somatization disorder

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40
Q

Px - dazed and inability to process external stimuli after exceptional physical or mentally stressful stimuli

A

Acute stress reaction

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41
Q

Restless legs

A

Akathisia

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42
Q

Px - Lip smacking, sucking, chewing

Ax - extrapyramidal SE of antipsychotics e.g. haloperidol

A

Tardive dyskinesia

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43
Q
Atypical antipsychotics (2)
MOA
A

Olanzapine, Clozapine

Block dopamine D1+D4 receptors

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44
Q

Px - severe HTN, tachycardia, pyrexia, hyperreflexia, SSRI + St Johns Wort

A

Serotonin syndrome

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45
Q

Snapshot low mood

A

Dysphoria

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46
Q

Snapshot exaggerated high mood

A

Euphoria

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47
Q

Distorted recall of past experiences

A

Paramnesia

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48
Q

Inability to recall past experiences

A

Amnesia

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49
Q

Exaggerated retention of detail in past recall

A

Hypermnesia

50
Q

Copying movements

A

Echopraxia

51
Q

Repeated non goal directed movements

A

Sterotypies

52
Q

Motionless resistance to commands and attempts to be moved

A

Negativism

53
Q

Pt remains motionless but allows their posture to be manipulated, the limbs remain in the new posture

A

Waxy flexibility

54
Q

Bizarre body posture adopted for inappropriately long time

A

Posturing

55
Q

Tentative incomplete movements i.e. when shaking hands

A

Ambitendency

56
Q

Px - Auditory hallucinations, Thought disorder, passivity, delusion

A

Schizophrenia
Auditory hallucinations - running commentary third person auditory hallucination
Though disorders - insertion, withdrawal, broadcasting
Passivity - movement/emotion/sensation being controlled by external influences
Delusion - fixed belief despite evidence to the contrary

57
Q

Px - Mood disorder + schizophrenic Sx. Classified into manic and depressive

A

Schizoaffective disorder

58
Q

Delusion that parts of the body are rotting away

A

Psychotic depression ?Cotard

59
Q

Px - Stupor, excitement, posturing, negativism, rigidity,

A

Catatonic Schizophrenia

60
Q

Px - predominantly positive Sx’s (delusions and hallucinations), w/ inc suicide risk

A

Paranoid schizophrenia

61
Q

Px - earlier age, mainly negative Sx’s (thought disorders and incongruent affect)

A

Hebephrenic schizophrenia

62
Q

Px - gradual decline in functioning, negative w/o positive

A

Simple Schizophrenia

63
Q

Cluster A

A

Paranoid/schizoid

64
Q

Cluster B

A

Histrionic, emotionally unstable, dissocial

65
Q

Cluster C

A

Anankastic, anxious, dependent

66
Q

Sensitive, Unforgiving, Suspicious, Possesive and jealous of partners, Excessive self-importance, Conspiracy theories, Tenacious sense of rights

A

Paranoid PD

67
Q

Anhedonic, Limited emotional range, Little sexual interest, Apparent indifference to praise/criticism, Lacks close relationships, One-player activities, Normal social conventions ignored, Excessive fantasy worlds

A

Schizoid PD

68
Q

Attention seeking, Concerned with own appearance, Theatrical, Open to suggestion, Racy and seductive, Shallow affect

A

Histrionic PD

69
Q

Affective instability, Expolsive behaviour, Impulsive, Outbursts of anger, Unable to plan or consider consequences

A

Emotionally unstable personality disorder

70
Q

Doubtful, Excessive detail, Tasks not completed, Adheres to rules, Inflexible, Likes own way, Excludes pleasure and relationships, Dominated by intrusive thoughts

A

Anankastic

71
Q

Carbemazepine
Lamotrigine
Lithium carbonate
Sodium valproate

A

Mood stabilizers

72
Q

Chlorpromazine

A

1st gen antipsychotics

Potent anti-cholinergic effects

73
Q

Trimipramine

A

TCAD

risk of inducing manic episode in BPAD

74
Q

Quetiapine

A

2nd gen/atypical antipsychotic

75
Q

Donepezil

A

Acetylcholinesterase inhibitor

Cognitive and non-cognitive Sx’s of dementia

76
Q

Haloperidol

A

Antipsychotic dopamine antagonist

77
Q

Procyclidine

A

Antimuscarinic agent

Parkinson’s, parkinsonian/extra pyramidal SE Tx

78
Q

Mild depression 1st line

A

CBT

79
Q

Severe depressive illness Tx

A

ECT

80
Q

Fluoxetine

A

SSRI 1st line depression medication

SE: GI, insomnia, sexual dysfunction

81
Q

Resistant depression, mania prophylaxis,

SE: fine tremor, dry mouth, metallic taste, wt gain

A

Lithium

82
Q

TCA

SE: drowsiness, wt gain, dry mouth, blurred vision

A

Amitriptyline

83
Q

Malaysian man runs around killing people and takes own life

A

Amok

84
Q

Assian men w/ retracting penis

A

Koro

85
Q

Arctic circle, violence, hysteria and bizarre behaviour followed by amnesia

A

Piblokto

86
Q

Indian, masturbation bad, semen+vital fluid

A

Dhat

87
Q

North African women, exaggerated startle response, echolocia, obeying comands

A

Latah

88
Q

South american, severe depressive episode, separation of soul from the body

A

Susto

89
Q

North American tribes, cannibalism, possessed

A

Windigo

90
Q

Section 136

A

Allows police to detain a Pt in a public place

91
Q

Section 5 (4)

A

Nurses holding power lasts 6 hrs on inPts

92
Q

TCAD SE’s

A
Drowsiness
Dry mouth
Blurred vision
Constipation
Urinary retention
93
Q

Eye movement desensitization and reprocessing therapy

A

PTSD

94
Q

Severe depression criteria

A
Decreased concentration
Reduced self-esteem
Guilt
Pessimism about the future
Self-harm ideation
Disturbed sleep
Reduced appetite
95
Q

poor memory, difficulty in word finding and difficulty in planning

A

Alzheimer’s

96
Q

management of an unconscious patient without capacity to consent to surgery

A

The involvement of close family members in decision-making is crucial in such cases.

97
Q

Citalopram

A

SSRI

SE: Insomnia, GI

98
Q

Mirtazapine

A

NSSRI

Indication Warfarin

99
Q

Delusions congruent w/ pt mood

A

Mania

100
Q

Bullimia BMI

A

> 18

101
Q

Anorexia BMI

A

<17.5

102
Q

Episode of self harm after suicide attempt % (1 yr)

A

20%

103
Q

Heroin withdrawal Sx

A

Dilated pupils sweaty runny nose

104
Q

Non-identical twin risk of schizophrenia lifetime rsk

A

10%

105
Q

Clinical depression inpts

A

25%

106
Q

Scizophrenia young full recovery %

A

20%

107
Q

Who can make the application for section2+3

A

Approved social worker

108
Q

Wernicke’s Sx

A

Opthalmoplegia, ataxia (heel-toe), confusion

109
Q

Korsakoff’s Sx

A

Confabulation, amnesia

110
Q

Acute dystonia

A

Procylidine

111
Q

Tardive dyskinesia

A

Stop depot start Olanzepine

112
Q

Anorexia Mx

A

Specialist diet clinic, nutritional advice, individual+family therapy

113
Q

PD criteria

A
REPORT
Relationship affected
Enduring 
Pervasive
Onset since childhood
Results in distress
Trouble in  occupation/social life
114
Q

Hebephrenc

A

Young and mood

115
Q

MMSE 25-20

A

Mild = Donepezil

116
Q

MMSE 20-10

A

Moderate = Donepezil or straight to memantine

117
Q

MMse <10

A

Severe = Memantine

118
Q

Care programme approach

A

Key worker

119
Q

Hypothyroidsim

A

Lithium

120
Q

Extra-pyramidal

A

Typical antipsychotics

121
Q

Benzo overdose

A

Flumazanil

122
Q

Previous failed inpt detox

A

Outpt detox