Psych Flashcards

1
Q

How do you test someone’s delusions? What must you avoid?

A
  • DO NOT GIVE SOMEONE A REASON TO MISTRUST YOU
  • how did you come to know this?
  • can you explain why you feel this way to me?
  • what if someone was to say it was for (logical reasoning)
  • seems to be a good understanding, but I’m a little confused, can you tell me a little bit more?
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2
Q

What is a framework for treating psych conditions? Can you apply it to mood disorders?

A
  • Biopsychosocial model, in the short term, medium term and long term.
  • Depression treatment:
    • ST - bio - med titration/diagnosis, psycho - Risk assessment/psychoeducation, social - admitted under MHA?
    • MT - bio - med titration, psycho - community services/case worker, social - employment, accomodation, finances
    • LT - bio - monitor CVD RFs, fetility impact of hyperprolactinemia, psycho - continued therapy, social - empower about MHA, and encourage to participate in community.
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3
Q

What are the 5 side effects of SSRI Initiation?

A

5xSAD

  • SiADH
  • Suicide
  • Sex
  • serotonin syndrome
  • Anticholinergic (anti-SLUD)
  • Diarrhoea
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4
Q

What is NMS?

A

Neuroleptic malignant syndrome: antipsychotic drug

FEVER:

  • fever
  • encephalopathy
  • vital sign instability
  • elevated CPK/WBC
  • rigidity
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5
Q

What is antidepressant discontinuation syndrome? What signs and symptoms do you get?

A
  • FINISH:
    • flu-like
    • insomnia
    • nausea
    • imbalance
    • sensory disturbance (l’hermitte’s sign)
    • hyperarousal
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6
Q

What is serotonin syndrome?

A

HARMED:

  • hyperthermia
  • autonomic instability
  • rigidity
  • myoclonus
  • encephalopathy
  • diaphoresis
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7
Q

How do you counsel someone about a treatment or drug?

A
  • explore why? (what is the treatment for, do they understand?)
  • drug counselling:
    • what are you taking?
    • why?
    • how to take it?
    • how to stop?
    • don’t with with what?
    • side effects?
    • how long will it take to work?
  • opportunity for questions
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8
Q

What is CAGE acronym?

A
  • cut down (get symptoms?)
  • annoyed when people tell you to cut down?
  • guilt?
  • eye-opener
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9
Q

What is an acronym you can use for MSE?

A
  • ASPETIC
    • apperance/behaviour
    • speech
    • emotions/affect
    • perception (hallucinations)
    • thought
    • insight/judgement (risk assessment)
    • cognition
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10
Q

What different psychological therapies are there?

A
  • CBT - anxiety
  • ERP (exposure response prevention therapy) - OCD
  • family based therapy - eating disorders
  • ACT - acceptance and commitment therapy
  • group therapy
  • mindfullness
  • social skills training - schizophrenia
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11
Q

What are the 4Ps of Formulation for a risk assessment? What are some risks of suicide?

A
  • Predisposing (development, occupation)
  • Precipitating
  • Perpetuating
  • Protective (family, relevant negatives, family history)

SAD PERSONS for risk:

  • S= sex = male
  • A - age <19 >45
  • D - depression
  • P - previous attempts
  • E - excess alcohol/substances
  • R - rational thinking lost
  • S - no spouse
  • O - organised plan
  • N - no social supports
  • S - sickness
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12
Q

What is an acronym for depression?

A

SIG E CAPS + mood

  • Sleep
  • Lost interest
  • Guilt (hopelessness/worthlessness)
  • Energy low
  • Concentration low/indecision
  • Appetite change
  • Psychomotor retardation/agitation
  • Suicidal ideation

rule out manic/hypomanic, rule out grief (preserved self esteem, + memories), substance use and other conditions.

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13
Q

What is the diagnostic criteria for Bipolar affective disorder?

A
  • GST PAID
    • grandiosity
    • reduced sleep need
    • increased talking (pressured speech)
    • painful consequences
    • activity increased (goal directed +/- psychomotor)
    • ideas - flight of
    • distractibility

need a moof stabiliser

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14
Q

What is an acronym for GAD? What should you consider?

A
  • excessive anxiety/worry for >6months
  • >3 of
    • BE SKIM:
      • blank mind
      • reduced energy
      • sleep disturbance
      • keyed up/on edge/restless
      • muscle tension
  • think of substance use - caffience/nicotine/EtOH and triggers
  • initial increase in symptoms when starting SSRIs (higher dose)
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15
Q

What is PTSD?

A
  • adults + children >6 years
    • C- TRAUMA
      • cognition change (negative)
      • trauma - real, threatened, violence, injury
      • re-exposure
      • avoidance
      • unable to function
      • 1 month at least
      • arousal/reactivity.
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16
Q

What are the features of schizophrenia?

A
  • >2 for >1mths:
    • delusions
    • hallucinations
    • disorganised speech
    • disorganised behaviour
    • negative symptoms (4As - blunted affect, anhedonia, avolition, apathy, impoverished though)
17
Q

What is the criteria for anorexia? how is it classified and treated?

A

DSM5 criteria:

  • restricted intake with significant weight loss
  • intense fear of gaining weight
  • body dysmorphia/failure to recognise decreased weight

classified:

  • mild <17
  • mod 15-17
  • severe 15-16
  • extreme <15

Admission?

  • medical - HR <40, BP <90, serum changes temp <36
  • behavioural - suicidal
  • restore healthy weight - target, nutritional rehb + refeeding syndrome (Mg, Phos, K, thiamine). Insulin spike drived metabolites into cells (arrhythmias, rhabdo, serizures 3-4 days after).
  • psychotherapy - family based therapy, CBTE
18
Q

What is bullimia nervosa?

A
  • recurrent binge-purge cycles
    • compensatory behaviours = purge
    • bonge - no control over eating
  • >1week in the last 3 months
  • more common in BPD, childhood obesity, childhood assault
19
Q

What are the signs of alcohol withdrawal? How do you control it?

A
  • 6-8hours after heavy drinking
    1. tremors/shakes/agitation/anorexia/cramps/diarrhoea
    2. seziures
    3. hallucinations
    4. delirium tremens
  • wernickes = ataxia, CN6 palsy (nystagmus), confusion
  • Korsakoff’s = retrograde amnesia, confabulation, not acute delirium

Treatment:

  • diazepam - first (prevent seizure)
  • thiamine - before glucose
  • haloperidol + diazepam fordelirium (consider benztropine for EPSE)
  • long term - try disulfiram, acamprosate and natrexone (suboxone - combo with buprenorphine).
20
Q

What is the acronym for BPD?

A
  • IDESPAIRR
    • identity disturbance
    • dissociation
    • emptiness
    • suicidal behaviour
    • paranoid ideation
    • abandoment (fear of)
    • impulsivity (>2 self-damaging areas)
    • relationships (unstable/splitting)
    • rage