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4th Year SB > Psych > Flashcards

Psych Flashcards

1
Q

what does emergency detention cover

A
  • up to 72 hours
  • for assessment only, NOT treatment
  • must be done by a fully registered doctor,
  • preferably also a mental health officer also present
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2
Q

what does short term detention cover

A
  • for assessment and treatment
  • 28 days
  • need a psychiatrist and MHO to approve it
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3
Q

what does a Compulsory treatment order cover

A
  • lasts for 6 months, can be extended by 6 months again if required
  • must be approved by a tribunal
  • application = two medical professionals
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4
Q

what are most common side effects of SSRIs

A

insomnia
nausea
reduced libido
headache

GI sx
“emotional numbness”
agitation

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5
Q

what SSRI is safest in epilepsy

A

citalopram

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6
Q

what SSRI is safest in cardiac problems

A

sertraline

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7
Q

what SSRI is associated with long QT syndrome

A

ciralopram

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8
Q

what is an example of a NaSSA and when is it useful

A

mirtazepine

patients with insomnia and reduced appetite

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9
Q

what are side effects of mirtazepine

A

weight gain [due to increased appetite]

sedation
constipation
dizziness
GI upset with alcohol

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10
Q

common side effects of TCA

A

Sedation, cardiotoxicity, tremor

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11
Q

what are the anti-muscarinic effects of TCAs

A

dry mouth, constipation, urinary retention, impotence, visual disturbance

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12
Q

most lethal anti-depressant in overdose

A

TCAs

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13
Q

safest SSRI in MI Hx

A

sertraline

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14
Q

due to GI upset, what classes of drugs should SSRI be avoided co-prescribed with

A

NSAIDs, Warfarin, Aspirin, Triptans

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15
Q

how do SSRI work

A

selective pre-synaptic blockade of serotonin re-uptake pumps

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16
Q

how do TCAs work

A

pre-synaptic blockage of both noradrenaline and serotonin reuptake pumps

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17
Q

Side effects of TCA

A

sedation
weight gain
dry mouth, nose, urinary retention
postural hypotension

tachycardia
arrhythmia
heart block

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18
Q

what changes on an ECG can be seen with TCAs

A

prolonged QT interval

ST segment elevation

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19
Q

contraindications to TCAs

A 
recent MI
arrhythmia 
severe liver disease
mania 
high risk of over dose
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20
Q

what is phenelzine an example of and what is it MOI

A

MOAI

inhibition of monoamine oxidase A and B

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21
Q

when is a MOAI used

A

atypical depression, anxiety disorders

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22
Q

SE of MOAI

A

can cause hypertensive crisis if mixed with foods containing tyramine

Sx = flushing, headache, increased BP, CVA

Tx = alpha blocker

If used with another anti-depressant can cause = serotonin syndrome

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23
Q

contraindications of MOAI use

A

phaechromocytoma
cerebrovascular disease
hepatic impairment
mania

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24
Q

what are examples of SNRI

A

venaflaxine, duloxetine

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25
Q

what are examples of NaSSA and MOI

A

mirtazapine

presynapatic alpha 2 receptor blockade

[get extra pyramidal SE]

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26
Q

what should not be prescribed in patients on lithium

A

NSAIDs
ACEi
Diuretics

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27
Q

lithium - contraindications

A 
pregnancy 
breastfeeding 
impaired renal function 
thyroid disease
cardiac conditions 
neurological conditions
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28
Q

lithium - side effects general

A 
confusion, headache, concentration problems
constipation 
dry mouth, thirst 
fine tremor 
hypothyroid 
weight gain
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29
Q

lithium - side effects toxicity

A 
diarrhoea, N+v
decreased potassium
ataxia, myoclonus 
coarse tremor 
convulsions, coma
30
Q

lamotrigine - side effects

A

N/V, diarrhoea

skin rash - steven johnson syndrome

31
Q

carbamazepine - side effects

A

agranulocytosis
aplastic anaemia
hyponatramia , fluid retention

32
Q

what are the two categories of anti psychotics

A

1st gen = typical [haloperidol, chlorpromazine]

2nd gen = atypical [clozapine, olanzapine, quitiapine, risperidone]

33
Q

general side effects of anti psychotic

A

dry mouth, constipation, urinary retention
postural hypotension
sedation, weight gain

prolonged QT interval
arrhythmia

galactorrhea
gynaecomastia 
amenorrhoea 
infertility 
sexual dysfunction
34
Q

how should extra-pyramidal side effects and acute dystonia cause by anti-psychotics be treated

A

anticholinergics e.g. procyclidine

35
Q

what time frame does acute dystonia appear after starting anti-psychotic and what is it

A

72 hours

involuntary sustained muscular contractions

36
Q

what is akathisia, when does it appear and how can it be treated

A

restless legs, feel need to move around
6-10 days
propanolol or short term BZDs

37
Q

what is tardive dyskinesia

A

rhythmic involuntary movements of head, limbs, trunk

38
Q

what disease is clozapine reserved for due to its side effects

A

treatment resistant schizophrenia

39
Q

inheritance of huntingtons

A

autosomal dominant

40
Q

types of dementia

A 
vascular
alzheimers
dementia with lewy bodies 
fronto-temporal dementia 
alcohol related 
parkinsons related
41
Q

1st line Tx of alzheimers

A

cholinesterase inhibitor i.e. donepezil, rivastigmine

42
Q

what cannot be given in dementia with lewy body

A

haloperidol = can cause parkinsons

43
Q

what are the parkinsonisms Sx

A

muscular rigidity
bradykinesia
resting tremor

44
Q

how else can thiamine be written

A

B1

45
Q

what is the effect of anorexia on blood results

A

G’s and C’s raised
= GH, Glucose, Cortisol, Cholesterol

Low FSH

46
Q

1st line treatment for anorexia in kids

A

‘anorexia focused family therapy’

47
Q

treatment of GAD

A

1st line = SSRI
2nd line = SNRI

18 month treatment

[panic disorder/phobias only 6 months]

48
Q

how is GAD often described

A

free floating

49
Q

time frame for acute stress response, acute stress disorder, acute PTSD, chronic PTSD

A

acute stress response = 48 hours
acute stress disorder = 4 weeks
acute PTSD = 4 weeks - 3 months
chronic PTSD = more than 3 months

50
Q

Tx of PTSD

A

Psychological
- EMDR [eye movement desensitisation and reprocessing]

Medication
1st line = SSRI
2nd line = SNRI or BZDs
3rd line = anticonvulsants

duration of treatment = 12 months

51
Q

Tx of OCD

A

Psychological
- ERP > 20 hours [exposure and response prevention]

Medication
1st line = SSRI
2nd line = SNRI or BZDs

52
Q

positive sx of schizophrenia

A

delusions = bizarre, paranoid, grandiose, nihilistic
persecutory ideas

hallucinations = auditory; 3rd person, running commentary, discussing patient

passivity phenomena

though broadcasting, withdrawal, insertion, interference

53
Q

negative sx of schizophrenia

A

apathy
lack of motivation
social withdrawal
cognitive impairment
blunting of affect [limited range of emotion]
incongruent affect [laughing at sad story]
catatonia

54
Q

tx for schizophrenia

A

1st line = risperidone
2nd line = Aripiprazole

treatment resistant = clozapine

55
Q

hallmarks of delirium

A

acute and fluctuating
inattention
altered level of consciousness
disorganized thinking

56
Q

tx for delirium

A

haloperidol 1-10mg [0.5mg in elderly]

if alcohol failure = BZDs i.e. Lorazapem [also use in patients with parkinsons]

57
Q

what is conversion disorder

A

loss of sensory or motor function

58
Q

what is somatoform disorder

A

physical symptoms suggestion a physical disorder with no evidence of organic disease

59
Q

what are the cluster A PD and what harry potter character are they

A

Cluster A = weird

Paranoid = mad-eye moody
- distrust and suspicious

Schizoid = snape
- detachment from social relationships, restricted emotions

Schizotypical

60
Q

what are the cluster B PD and what harry potter character are they

A

Cluster B = wild

Antisocial = bellatrix
- disregard for others, occuring since age 15

Borderline/Emotionally Unstable = lavender brown
- unstable inter-personal relationships, self-image, marked impulse, associated with ADHD, learning difficulties

Histrionic = draco
- excessive emotion, attention seeking, inappropriately sexual behavior

61
Q

what are the cluster C PD and what harry potter character are they

A

Cluster C = worried

Avoidant = neville longbottom
- feeling adequate, hypersensitive to negative feedback

Dependant = ron weasley
- need to be taken care of, clingy, submissive

Obsessive-Compulsive = Umbridge
- inflexible to change, preoccupied with perfection

62
Q

learning disability cutoffs IQs

A

Mild = 50-69
Moderate = 35-49
Severe = 20-34
Profound < 20

63
Q

triad of Sx in autism

A

abnormal social interaction
communication impairment
rigid/restrictive or repetitive behavior

64
Q

ICD-10 criteria for dependence

A
  • strong desire to take
  • difficulty in controlling
  • physiological withdrawal state
  • increasing tolerance [need a higher dose]
  • neglect of alternative pleasures
  • persistence despite evidence of harm
65
Q

pyscotherapy developed by frued and jung

A

psychoanalysis

66
Q

what can CBT be used for

A 
personality disorders - psychopathy
generalised anxiety disorder
panic disorder
phobias
acute stress disorder
67
Q

neurotransmitter affected in schizo, depression and anxiety

A 
depression = serotonin 
schizo = dopamine 
anxiety = GABA
68
Q

list the panic disorders

A 
panic disorder
panic attack
agoraphobia [fear of leaving house]
specific phobia
social phobia
69
Q

what are the components of capacity

A

1) Understand and retain relevant information
2) Use and weigh that information to make a decision
3) Communicate that decision

70
Q

what section of the adults w/ incapacity act can authorise treatment of a physical disorder in someone without capacity to consent to that treatment

A

section 47

71
Q

what are the different sub headings of AWI act

A

Power of Attorney - grant when you have capacity

Guardianship

Section 47 certificate of incapacity

4th Year SB (22 decks)

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