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Pass Med > PSYCH > Flashcards

PSYCH Flashcards

1
Q

ECT

A

Useful for patients with severe depression refractory to medicine or those with psychotic symptoms.

Only CI is increased intracranial pressure

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2
Q

ECT S/E

A

Headache
Nausea
Short term memory impairment
Cardiac arrhythmia

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3
Q

Causes of unexplained symptoms

A 
Somatisation disorder
Hypochondriac disorder
Conversion disorder
Dissociative disorder
Munchausens syndrome
Malingering
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4
Q

Malingering

A

Fraud claims or exaggeration of symptoms with the intention of financial or other gain

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5
Q

Munchausens syndrome

A

Intentional production of physical or psychological symptoms

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6
Q

Dissociative disorder

A

Separating off cetain memories from normal consciousness
Involves psychiatric symptoms
Most severe form is dissociate identity disorder

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7
Q

Conversion disorder

A

Loss of motor or sensory function
Doesn’t consciously feign symptoms or seek material gain
May be indifferent to their apparent disorder

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8
Q

Hypochondriac disorder

A

Persistent belief in the presence of an underlying disease

Refuse to accept reassurance or neg test results

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9
Q

Somatisation disorder

A

Multiple physical symptoms present for at least 2 years

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10
Q

Body dysmorphic disorder

A

Condition where patients have a significantly distorted body image

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11
Q

SSRI + NSAID

A

GIVE PPI

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12
Q

First choice SSRI in patient with a CVS history

A

Sertraline

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13
Q

S/E SSRI

A

GI symtoms
Increased risk of GI bleeding
Increased risk of more severe anxiety/ depression initially

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14
Q

QT prolongation

A

Escitaopram and citalopram should not be used if present

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15
Q

SSRI discontinuation syndrome

A

Unsteadiness
Sweating
GI symptoms
Parenthesia

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16
Q

Clozapine

A 
NOT FIRST LINE- must try at least 2 other drugs first
Used in treatment of drug resistant schizophrenia 
Very effective but serious side effects
Weight gain
Excessive salivation
Agranulocytosis 
Neutropenia
Myocarditis 
Arrhythmia
17
Q

Schizophrenia mgmt

A

Oral atypical antipsychotics
CBT to be offered to all patients
Close attention to CVS risk factor modification

18
Q

Alcohol withdrawal mechanism

A

Chronic alcohol consumption enhances GABA mediated inhibition in the CNS and inhibit NMDA type glutamate receptors
Alcohol withdrawal is thought to be lead to the opposite- decreased inhibitory GABA and increased NMDA glutamate transmission

19
Q

Features of alcohol withdrawal

A

Start at 6012 hours; tremor, sweating, tachycardia and anxiety
Peak incidence of seizures at 26hours
DT is peaked at 48-72hours ; coarse tremor, confusion, delusion and auditory and visual hallucinations, fever and tachycardia

20
Q

Mmgmt of alcohol withdrawal

A

First line- benzodiazepines,

Carbamazepine

21
Q

Schizophrenia epidemiology

A

Monozygotic twin has it - 50%
Parent has it - 10-15%
Sibling - 10%
No relatives- 1%

22
Q

Schizophrenia features

A

Auditory hallucinations; two or more voices discussing the patient in the third person
Though echo
Voices commenting on the patients behaviour

Though disorder
Insertion
Withdrawal
Broadcasting

Passivity phenomena
Body sensations being controlled by external influence

Delusional perceptions

Impaired insight 
Blunting of affect
Decreased speech 
Neologism 
Catatonic
23
Q

Negative symptoms

A

Incongruity
Ahedonia
Alogia
Avolition

24
Q

SSRI of choice in children and adolescents

A

Fluoxetine

25
Q

Anorexia features

A

Most things low
G’s and C’s raised

Growth hormone, glucose, salivary glands, cortisol, cholesterol, carotinaemia

26
Q

Anorexia nervousness features

A

Reduced BMI
Bradycardia
Hypotension
Enlarged salivary glands

27
Q

Physiological abnormalities in AN

A 
Hypokalemia 
Low FSH, lH, Estrogen and testosterone 
Raised cortisol and GH
Impaired glucose tolerance 
Low T3
28
Q

Grief reaction - abnormal

A

More likely to occur in women
If death was sudden or unexpected

Delayed Grief- 2 weeks after death
Prolonged grief - hard to define

29
Q

SAD

A

Depression that occurs around the winter months
Should be treated the same way as depression
Don’t give a sleeping tablet - this can make them worse
Evidence for light therapy is limited- should not be routinely recommended

30
Q

PTSD

A

Can develop in people of any age following a traumatic event

Symptoms must be present for over a month

31
Q

Anti psychotics - extrapyramidal s/e

A

Parkinsonism
Acute dystopia
Aka this is
Tardive dyskinesia

In elderly - increased with of stroke and venous thromboembolism

32
Q

Anti psychotics - other side effects

A

Anti mus- dry mouth, blurred vision, urinary rentention, constipation
Sedation
Weight gain
Resided prolactin- galactorrrhoea impaired glucose tolerance
Neuroleptic malignant syndrome- pyrexia, muscle stiffness
Prolong QT interval

33
Q

Atypical antipsychotics

A

First line in patients with schizophrenia

S/e eight gain,

Pass Med (8 decks)

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