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Psych Flashcards

1
Q

Depression

  1. 3 major sx
  2. 7 minor sx
  3. Diagnosis
A
  1. Low mood, anhedonia, fatiuge
  2. EMW, appetite change, poor conc., low self esteem, guilt, suicide, pessimistic
  3. > 1major sx most of every day for 2w
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2
Q

Mx of depression

A
  • assess risk of suicide
    Mild - low intensity psychological eg CBT
    Moderate - medication, psychosocial intervention
    Severe - medication, admit, ECT if catatonia
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3
Q

Sx of mania

A

Elated mood, increased energy, reduced sleep, disinhibition, over spending, hypersexual, pressure of speech, grandiosity
loss of insight

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4
Q

Dx of mania

A

Sx for >1w
Impact on function
Social rejection - bizarre behaviour

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5
Q
  1. When do episodes of bipolar occur?
  2. Length of manic episode?
  3. Length of depressive episode?
A
  1. following life stress
  2. 4m
  3. 6m
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6
Q
  1. Mx of mania

2. maintenance of BPD

A
  1. antipsychotic

2. Lithium

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7
Q

Personality disorders egs of each cluster?

  1. A
  2. B
  3. C
A
  1. MAD ‘odd/eccentric’ (schizoid, schizotypal, paranoid)
  2. BAD ‘dramatic, emotional, erratic’ (antisocial, emotionally-unstable, histrionic, narcissistic)
  3. SAD ‘anxious/fearful’ (anankastic, anxious, dependent)
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8
Q

Schizoid PD

  1. typical behaviours
  2. character eg
A
  1. emotionally cold, withdrawn, asexual, fantasy world

2. Sheldon from BBT

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9
Q

Schizotypal PD

  1. typical behaviours
  2. character eg
A
  1. eccentric, odd ideas, difficulty thinking, lack of emotion, ?psychotic
  2. david tennant Dr Who
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10
Q

Paranoid PD

  1. typical behaviours
  2. character eg
A
  1. suspicious, conspiracies, hold grudges

2. husband always thinks wife is cheating on him

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11
Q

Antisocial PD

  1. typical behaviours
  2. character eg
A
  1. dont care about others feelings, easily frustrate, aggressive, crimes, impulsive, no guilt
  2. millseh king of grime
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12
Q

Emotionally Unstable PD

  1. Typical behaviours
  2. character eg
A
  1. hard to control emotions, low self esteem, DSH, lose relationships, clingy
  2. jodie
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13
Q

Histrionic PD

  1. typical behaviours
  2. character eg
A
  1. over dramatic, self centred, attention seeking, strong labile emotions, seductive
  2. stu
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14
Q

Narcissistic PD

  1. typical behaviour
  2. character eg
A
  1. self-important, dreams of power, crave attention, ask for favours,
  2. hodge lol / trump
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15
Q

Anankastic (OC) PD

  1. typical behaviour
  2. character eg
A
  1. worry and doubt, perfectionist, cautious, judgemental, sensitive to criticism
  2. laurence at school
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16
Q

Avoidant PD

  1. typical behaviours
  2. character eg
A
  1. anxious, worrier, insecure, avoids

2. recluse

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17
Q

Dependant PD

  1. typical behaviours
  2. character eg
A
  1. passive, relies on others, hopeless, abandoned

2. fincheh

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18
Q

Define:

  1. hallucination

2. delusion

A
  1. perception in the absence of external stimulus

2. fixed, firm belief despite evidence to contrary

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19
Q

Parts of MMSE

A

ASEPTIC

  • Appearance +behaviour
  • Speech
  • Emotion
  • Perceptions
  • Thoughts
  • Insights
  • Cognition
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20
Q

Schizophrenia

  1. 1st rank sx
  2. other sx
  3. criteria
A
  1. 3rd person auditory hallucination, thought disorder, passivity phenomena, delusional perception
  2. incongruity, breaks in train of thought, -ve sx, neologisms, catatonia
  3. 1 clear 1st rank sx for >1m
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21
Q

Features of Paranoid schizophrenia

A
  • Most common type
  • Delusions of persecution, reference, special mission, jealousy
  • hallucinatory voices threatening
22
Q

Features of Hebephrenic schizophrenia

A
  • Affective changes prominent

- Behaviour irresponsible and unpredictable

23
Q

Features of catatonic schizophrenia

A
  • Stupor/mutism
  • excitement (purposeless motor activity)
  • posturing
  • negativism
  • rigidity
  • waxy flexibility
  • automatism
24
Q

Features of residual schizophrenia

A
  • negative symptoms (slowing, under activity, blunt affect, passivity, poverty of speech, no eye contact, poor self care)
  • positive symptoms decline in freq
25
Q

Schizoaffective disorder

  1. what is it
  2. types
A
  1. Schizophrenia and affective sx at same time
    • manic
      - depressive
      - mixed
26
Q

Clozapine

  1. monitoring?
  2. why?
  3. missed dose rule?
A
  1. Titrate dose as inpatient. Weekly for 18w, fortnightly for 1y then monthly
  2. agranulocytosis
  3. miss 2 days then must reinitiate treatment
27
Q

Neuoroleptic malignant syndrome

  1. what
  2. who
  3. dx features
  4. comps
  5. mx
A
  1. imbalance of dopaminergic neurotransmitters following initiation of drugs
  2. 0.5% of pts, usually young men. First 10d of treatment
  3. hyperthermia, rigidity, tachycardia, delirium, autonom instab
  4. rhabdomyolysis (measure CK), renal/liver failure, CV collapse
  5. bromocriptine
28
Q

RFs for suicide?

A 
SAD PERSONS
Sex (M)
Age <19 / >45
Depression
Prev attempt
EtOH
Rational thought loss
Social support lack
Organised plan
No spouse
Sick
29
Q

pcm OD

  1. ix
  2. RFs for rpt
  3. mx
A
  1. U&Es, LFTs, clotting, glucose,
  2. young, alcohol, life stress, prev self harm
  3. NAC
30
Q

anxiety

1. 3 types

A
  • GAD
  • Panic
  • Phobic
31
Q

GAD

  1. dx (GAD-7)
  2. RFs
  3. precipitant
  4. perpetuating
  5. protective
A
  1. > 6m prominent tension, worry + [palp, sweating, tremble, dry mouth, chest pain, nausea, dizzy, numbness, restlessness, on edge]
  2. middle age, separated, lonely
  3. stressful event
  4. anxious personality, ways of thinking
  5. young, married, cohabit
32
Q

Panic disorder

  1. what
  2. panic attack?
  3. severity
A
  1. Recurrent spontaneous panic attacks occuring in any situation
  2. Discrete episode of fear lasting a few minutes
  3. Mod = 4 attacks in 4 weeks
    Severe = 4 attacks per week in 4 weeks
33
Q
  1. Mx of anxiety disorders

2. when to refer

A
  1. -Conservative (education and monitoring)
    - Psychological (self help, cbt, relaxation)
    - Pharma (SSRI, pregabalin, BB)
  2. risk of suicide, self neglect
34
Q

Bipolar disorder

  1. main complication
  2. other
A
  1. suicide/DSH

2. self neglect, exploitation, substance misuse

35
Q

Mania vs hypomania

A
  • Mania >7d

- Hypomania 4d and no psychotic features

36
Q

Bipolar management

A

SGA
lithium
if manic episode –> stop antidepressants

37
Q

1st episode of psychosis mx

A

SGA + psychological intervention

38
Q

Criteria for MHA

A
  • Patient has mental disorder
  • Detained for their safety / of others
  • Nature of disorder warrants detention in hospital
39
Q

TCA

  1. eg
  2. mechanism
  3. effects
  4. se
A
  1. amityptilline
  2. blocks reuptake of 5HT + NA.
  3. drowsy, confusion,
  4. anticholinergic (dry eyes, mouth, blurred vision, retention)
    tachycardia, sedation, wt gain
40
Q

SSRI

  1. eg
  2. mechanism
  3. se
A
  1. sertraline, citalopram, fluoxetine
  2. inhibits 5HT reuptake
  3. can increase suicidal ideation, nausea, diarrhoea, restless, tremor, anorgasmia
41
Q

Serotonin syndrome

  1. triad
  2. mx
A
  1. cognitive impairment (agitation, confusion); autonomic (shiver/sweat); neuromus dysfunction (akathisia)
  2. STOP DRUG + ABCDE
    give charcoal, IV fluids + benzo
    5HT block –> chlorpromzine
42
Q

Lithium toxicity

  1. sx
  2. ix
  3. mx
A
  1. coarse tremor, N+V, diarrhoea, muscle twitching, renal failure, confusion
  2. Li > 1.5mmol/l
  3. STOP LITHIUM
    IV fluids, total bowel irrigation
43
Q

Circumstantiality

  1. what
  2. seen in
A
  1. trivial details when answering, eventually gets to point

2. anxiety disorders

44
Q

Loosening of assos

  1. what
  2. egs
A
  1. breakdown in assos between topics, random chain of thoughs
  2. knights move
45
Q

OCD

  1. obsession
  2. compulsion
  3. dx
A
  1. stereotyped, purposeless words/phrases -OWN thoughts (intrusive + nonsensical)
  2. senseless, repeated rituals done to reduce stress of obsessions
  3. > 2w, OWN thoughts, intrusive + unpleasant,
46
Q

Negative sx of schizophrenia

A
  • poverty of speech
  • blunt affect
  • social withdrawal
  • lack of motivation
  • self neglect
47
Q

PTSD

  1. what
  2. sx
  3. assos
  4. mx
A
  1. delayed response to severe traumatic event (>6m duration)
  2. flashbacks, hypervigilance, disturbed sleep, autonom reaction
  3. substance misuse, depression, aggression
  4. CBT, EMDR
48
Q

Alcohol withdrawal

  1. sx of dependence
  2. questionairre
  3. signs of withdrawla
  4. mx
A
  1. tolerance, withdrawal, narrow rep
  2. CAGE
  3. delirium tremens - tremor, fits, hallucinations
  4. chlordiazepoxide
    + pabrinex
49
Q

Egs of thought disorders + what they are

A
  • Echolalia –> repeating exactly what someone said
  • Word salad –> disorganised speech, sentences dont make sense
  • Perseveration –> repeating the same words/answers
  • Neologism–> making up new words
  • Expressive dysphasia –> difficulty putting together words
  • Tangentiality
  • Clang assos
50
Q

egs of thought delusion

A
  • insertion
  • withdrawal
  • broadcast
51
Q

Unexplained symptoms egs (5 disorders)

A
  • Somatisation (multiple symptoms, refuses negative results)
  • Hypochondrial (persistent belief of underlying serious disease)
  • Conversion (loss of motor/sensory function, not consciuosly feigned. often stress induced)
  • Dissociative
  • Factitious (aka Munchausen’s)
52
Q

Side effects of Lithium

A 
Leukocytosis
Insipidus
Tremor (coarse)
Hydration (dry mouth, diarrhoea, thirst)
Increased GI, skin and memory problems
Underactive thyroid, decreased TSH
Mums beware (Ebstein's)

Finals (20 decks)

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