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Finals > Psych > Flashcards

Psych Flashcards

1
Q

Stages of change

A 
Preparation
Action
Relapse
(Precontemplation)
Contemplation
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2
Q

Transitional model of stress

A

STRESSORS (life events, daily hassles, chronic stressors) interact with RESOURCES (personality, social support, coping skills) resulting in APPRAISAL which may or may not produce a STRESS RESPONSE

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3
Q

Motivational interviewing stages

A
  1. Expressing empathy
  2. Avoiding argument
  3. Supporting self-efficacy
  4. Rolling with resistance
  5. Developing discrepancy
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4
Q

Antipsychotic extrapyramidal side effects (4)

A
  1. Parkinsonism -intention tremor
  2. Acute dystopia - totricollis, oculogyric crisis
  3. Akathisia - severe restlessness
  4. Tardive dyskinesia -chewing, pouting
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5
Q

Side effects of antipsychotics not including extrapyramidal effects (6)

A
  1. Increased VTE and strike risk in the elderly
  2. Antimuscarinic effects e.g. dry mouth, urinary retention, blurred vision, constipation
  3. Sedation
  4. Weight gain
  5. Raised prolactin - galactorrhea
  6. Neuroleptic malignant syndrome
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6
Q

Side effects of typical vs. atypical antipsychotics

A

Typical - more extrapyramidal side effects

Atypical- more metabolic side effects

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7
Q

SSRI Interactions (3)

A
  1. NSAIDs and Asprin - increased GI bleeding, avoid or co-prescribe PPI
  2. Warfarin/Heprin - avoid SSRI, use mirtazapine instead
  3. Triptans- use a different class
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8
Q

Prognostic indicators of schizophrenia (5)

A
  1. Strong family Hx
  2. Gradual onset
  3. Low IQ
  4. Premorbid Hx of social withdrawal
  5. Lack of obvious precipitant
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9
Q

Side effects of ECT
Short term x5
Long term x1

A

Short term- headache, nausea, short-term memory impairment, memory loss of events prior to ECT, cardiac arrhythmia
Long term - memory impairment

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10
Q

Benzodiazepine withdrawal symptoms
Neuro x3
Psychological x5
Other x1

A

Neuro: tinnitus, tremor, seizures
Psychological: insomnia, irritability, anxiety, perceptual disturbance, decreases appetite
Other: perspiration

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11
Q

3x features of somatisation

A

Multiple physical symptoms, more than two years, patient won’t accept reassurance or negative test results

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12
Q

2x Key features of hypochondriac disorder

A

Persistent belief in underlying disease, won’t accept negative test results

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13
Q

3x key features of conversion disorder

A

Loss of motor/sensory skill
Not feigned
Not seeking material gain

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14
Q

3x key features of dissociative disorder

A

Separating memories from normal consciousness
Psychiatric symptoms such as amnesia, fugue, stupor
Worst form is dissociative identity disorder

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15
Q

What is munchausen’s disorder

A

AKA factious disorder, intentional production of symptoms. May be by proxy e.g. when a parent reports or produces symptoms in their child

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16
Q

What is malingering?

A

Fraudulent stimulation or exaggeration of symptoms for material gain

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17
Q

Physiological abnormalities in anorexia nervous (6 low and 5 high)

A

Low: potassium, reproductive hormones, T3, hypotension, bradycardia, BMI
High: cortisol, growth hormone, glucose, cholesterol, carotin

18
Q

How long should you reduce dose of SSRI before discontinuing

A

4 weeks

19
Q

Which SSRI doesn’t require dose reduction on discontinuation

A

Fluoxetine

20
Q

Which SSRI has a higher rate of discontinuation symptoms?

A

Paroxetine

21
Q

What are SSRI discontinuation symptoms?

A

Increased mood change, restlessness, difficulty sleeping, unsteadiness, sweating, GI disturbance, parasthesia

22
Q

When should you consider reducing SSRI dose or stopping therapy?

A

6 months after remission if symptoms

23
Q

Neurotransmitter mechanism in alcohol withdrawal

A

Chronic alcoholism causes increase in GABA and decrease in NMDA type glutamate receptors.

Withdrawal causes decrease in GABA and an increase in NMDA glutamate receptors

24
Q

Features of alcohol withdrawal with associated time scale

A

6-12 hours: sweating, tachycardia, tremor, anxiety
36 hours: seizures
72 hours (delirium tremens): coarse tremor, confusion, delusions, auditory and visual hallucinations, fever, tachycardia

25
Q

Management of alcohol withdrawal

A

Chlordiazepoxide with a gradually reducing dose, carbamezamine if seizures

26
Q

Management of depression by classification

A

Suspected: Assessment, support, active monitoring, psychoeducation
Mild-moderate: psychosocial intervention, medication, referral
Moderate-severe: medication, high intensity psychosocial intervention, collaborative care and referral
Severe and complex: ECT, crisis support, inpatient management

27
Q

Management of anxiety

A

Psychological: self help, CBT, psychological therapy
Medication: SSRIs, short term benzodiazepines or propranolol for palpitations

28
Q

Gate control theory of pain

A

Neural relays, ‘gates’ are located in the dorsal horn of the spinal cord and the degree to which they’re open controls how many pain signals are sent to the brain

29
Q

What class is Mirtazipine?

A

Noradrenergic and specific serotonergic antidepressant

30
Q

what to do with antidepressant when starting patient on ECT?

A

reduce to minimum dose gradually

31
Q

What is dysthymia?

A

mild depressive symptoms over more than 2 years

32
Q

Main risk of antipsychotic use in the elderly

A

Stroke and VTE

33
Q

management of extra-pyramidal side effects

A

procyclidine

34
Q

side effects of clozapine (5)

A 
agranulocytosis (1%), neutropaenia (3%)
reduced seizure threshold 
constipation
myocarditis: a baseline ECG 
hypersalivation
35
Q

What is catatonia?

A

Stopping of voluntary movement or staying still in an unusual position

36
Q

physiological features of anorexia nervosa

A 
hypokalaemia
low FSH, LH, oestrogens and testosterone
raised cortisol and growth hormone
impaired glucose tolerance
hypercholesterolaemia
hypercarotinaemia
low T3
37
Q

venlafaxine MOA

A

serotonin and noradrenaline reuptake inhibitor

38
Q

lithium side effects (10)

A

nausea/vomiting, diarrhoea
fine tremor
nephrotoxicity: polyuria, secondary to nephrogenic diabetes insipidus
thyroid enlargement, may lead to hypothyroidism
hyperparathyroidism and resultant hypercalcaemia
ECG: T wave flattening/inversion
weight gain
idiopathic intracranial hypertension
leucocytosis

39
Q

what is tardive dyskinesia?

A

chewing, jaw pouting or excessive blinking

40
Q

features of sleep paralysis

A

paralysis - this occurs after waking up or shortly before falling asleep
hallucinations - images or speaking that appear during the paralysis

41
Q

How long must symptoms be present for a diagnosis of PTSD?

A

1 month

Finals (34 decks)

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