Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

3b specialties > Psych > Flashcards

Psych Flashcards

1
Q

Give 4 risk factors for depression

A

Female, family history, past history, alcohol, adverse events, psychical comorbidities, lack of social support, low SES

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

4 cognitive symptoms of depression

A

Feelings of guilt/worthlessness/hopelessness, lack of concentration, negative thoughts, suicidal ideation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Type of hallucinations in psychotic depression?

2 types of delusions you might get?

A

2nd person derogatory auditory hallucinations

Persecutory, hypochondriacal, guilt, nihilistic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is Beck’s cognitive triad?

A

Negative thoughts about the self, the world, the future

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How to define mild/mod/severe/psychotic depression?

A

Mild = 2 core Sx + 2 others
Mod = 2 core + 3-4 others
Severe = 3 core + >=4 others
Severe psychotic = above + psychosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Give a biopsychosocial management plan for depression

A

Bio = SSRI
Psycho = CBT
Social = Social support groups
Suicide risk assessment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

4 indications for psych referral for depression?

A
  • Severe depression
  • Suicide risk is high
  • Recurrent depression
  • Initial treatments have failed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When to stop SSRI following recovery of depression

A

Continued for 6 months after resolution of depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Definiton of bipolar affective disorder?

A

A chronic episodic mood disorder characterised by at least one episode of mania, and another episode of either mania or depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is BAD type 2?

A

1+ depressive episode with at least hypomanic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

4 risk factors for BAD?

A

Age in early 20s, anxiety disorders, after depression

Substance misuse, strong FHx, stressful life events

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

3 features of a hypomanic episode?

A
  • > =4 days of mildly elevated mood or irritability
  • manic symptoms but to a lesser extent
  • Inters with work/social life but not severe disruption
  • Partial insight
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How long do symptoms of mania have to last for it to be a manic episode?

A

> 1 week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

When to suspect mania with psychosis?

A

Psychotic features e.g. grandiose/persecutory delusions, auditory hallucinations (mood congruent), aggression, suspicion.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Definitoin of rapid cycling?

A

> 4 mood swings in 12 months with no asymptomatic period between

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Give stepwise pharmacological management of a manic episode.

A

1) Antipsychotic e.g. olanzapine, risperidone, quetiapine. If first isn’t effective, try a different one.
2) Lithium (or valproate)
3) Benzos
4) Rapid tranq e.g. haloperidol, lorazepam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Treatment options for bipolar depression?

A

Olanzapine + fluoxetine/olanzapine/quetiapine
Or mood stabiliser e.g. lamotrigine, lithium
CBT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Biopsychosocial approach to bipolar?

A

Bio = mood stabilisers, antipsychotics, benzos, ECT if severe uncontrolled mania
Psycho = psychoeducation, CBT
Social = social support groups, self help groups, calming activities.
Full risk assessment, ask about driving

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is used first line for long term management of bipolar to prevent relapses?
How long after resolution of an acute episode should you start it?
What are alternative options?

A

Lithium, start 4 weeks following resolution

Other options = valproate, olanzapine, quetiapine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

4 possible indications for hospitalisation with bipolar?

A
  • Reckless behaviour causing risk to self or others
  • Significant psychotic sx
  • Impaired judgement
  • Psychomotor agitation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

4 tests to do before starting lithium?

A

U&Es, pregnancy test, TFTs, ECG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Give 5 signs of lithium toxicity

A

N+V, coarse tremor, muscle weakness, ataxia, nystagmus, hypereflexia, convulsions, coma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

3 things to monitor during lithium therapy and how often?

A

Lithium levels - every 3 months once established
U&Es - every 6 months
TFTs - every 12 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Define a delusion

A

A fixed, false belief, that is firmly held despite evidence to the contrary, and goes against a person’s normal social and cultural belief system.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Define a hallucination

A

A perception in the absence of an external stimulus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is schizoaffective disorder?

A

depressive illness/manic episode + 1/2 classical schizophrenia symptoms, at the same time. Schizophrenia + a mood disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is persistent delusional disorder?

A

A delusion or group of delusions held for at least 3m. Delusion is the only/most prominent symptom

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Give 3 different types of schizophrenia and their characteristics

A 
Paranoid = most common, dominated by positive sx (hallucinations, delusions)
Hebephrenic = thought disorder predominates
Catatonic = 1 or more catatonic symptoms
Simple = rare, negative sx without positive
Residual = 1 year of chronic neg sx preceded by psychotic episode
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are Schneider’s first rank sx of schizophrenia?

A

3rd person auditory hallucinations
Delusional perception
Thought interference
Passivity phenomenon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What are 4 negative sx of schizophrenia?

A 
The As:
Anhedonia
Avolition (not motivated)
Alogia
Asocial
Attention/cognitive deficit
Affect blunted
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is the ICD-10 diagnostic criteria for schizophrenia?

A

At least 1 grp A sx (Schneider 1st rank) or 2+ group B (other hallucinations, neologisms/loosening of assoc/incoherence, catatonic sx, negative sx)
For at least 1 month
No organic brain disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Give 4 organic causes of psychosis?

A 
Drug induced e.g. alc, cocaine, methamphetamine
Iatrogenic e.g. levodopa
Huntington's
SLE
Syphilis
Vit B12 deficiency
Complex partial epilepsy
Delirium and dementia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Management of first episode of psychosis?

Biopsychosocial

A

Early intervention in psychosis team
Bio = antipsychotic, benzos, ECT
Psycho = CBT (NICE strongly recommends), psychoeducation, family education, art therapy
Social = Rethink, peer support, supported employment programmes
Risk assessment and may need MHA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What type of antipsychotics are first line for schizophrenia? Give 2 drug examples.

Which antipsychotic is used for treatment resistant schizophrenia?

A

Atypical antipsychotics e.g. risperidone, olanzapine

Clozapine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Definition of GAD?

A

ongoing, widespread, uncontrollable worry, not restricted to certain situations, pt recognises as excessive and inappropriate. Sx present on most days for at least 6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is the ICD-10 criteria for GAD?

A 
A = 6m with prominent tension, worry, feelings of apprehension
B = At least 4 symptoms, with at least 1 of autonomic arousal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Give 4 symptoms of autonomic arousal in anxiety

And 4 other symptoms.

A 
AA = palpitations, sweating, tremor, dry mouth
Other = tight chest, difficulty breathing, chest pain, N, diarrhoea, dizzy, derealisation/depersonalisation, headache, muscle tension, concentration difficulty, fear of dying/losing control, insomnia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Name 3 questionnaires that could aid diagnosis of generalised anxiety?

A

GAD-2, GAD-7, HADS, Beck’s anxiety inventory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Biopsychosocial approach to managing GAD?

A

Bio = SSRI (sertraline), then SNRI. Pregabalin if neither work.
Psycho = psychoeducation, CBT, applied relaxation techniques
Social = self help methods, support groups, exercise.
Screen for depression and substance misuse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Definition of phobia?

A

Intense irrational fear of a person, object, place, situation that is recognised as excessive or unreasonable.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What are the characteristic features of phobias that are used to define them in ICD-10?

A
  • Marked fear/avoidance of …
  • Anxiety symptoms (at least 2)
  • Recognised as excessive/unreasonable
  • Causes emotional distress
  • Sx restricted to that situ/predominate there
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Phobia often causes tachycardia. Give 3 psychological symptoms of phobia?

A

Fear of dying
Anticipatory anxiety
Need to avoid the situation
Inability to relax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What are the 3 features that separate phobia from GAD?

A

SS AA AA
Specific situations
Anticipatory anxiety
Attempted avoidance of situations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Outline the management for the following:
Agoraphobia
Social phobia
Specific phobia

A

Agora = CBT w graded exposure, SSRI

Social = CBT w graded exposure, SSRI (or venlafaxine). Psychodynamic psychotherapy if they refuse the above.

Specific = CBT w graded exposure. Benzos short term

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

ICD-10 criteria for panic disorder

A

A - recurrent panic attacks, not consistently associated with a specific thing, occur spontaneously
B - All of the following: intense fear/discomfort, starts abruptly, reaches crescendo in few mins and lasts minutes, at least 1 sx of autonomic arousal, other symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

3 organic DDx of panic disorder?

A

Phaeochromocytoma, hyperthyroid, alc/drug withdrawal, carcinoid syndrome, hypoglycaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

1st and 2nd line pharmacotherapy for panic disorder?

What not to prescribe?

A

1st - SSRI
2nd - TCAs e.g. imipramine (if no improvement after 12 weeks)

Don’t prescribe benzos!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Biopsychosocial approach to panic disorder?

A

Bio - SSRI
Psycho - CBT
Social - support groups, self help exercise classes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What is the ICD-10 classification of PTSD?

A

Experience of extremely stressful event
Persistent reliving
Avoidance of similar situations
Either inability to recall certain aspects or hyperarousal
All occur within 6 months of an event. Sx last >1 month

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

2 other symptoms of PTSD not in the ICD10 definition?

A

Social withdrawal, emotional numbing, irritability/outburts, difficulty sleeping, difficulty concentrating, distress in similar circumstances, excessive rumination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Normal bereavement shouldn’t extend over ?? months. If it does, should consider which 2 disorders?

A

6 months

Abnormal bereavement or adjustment disorder

52
Q

Stages of grief?

A

DABDA

Denial, Anger, Bargaining, Depression, Acceptance

53
Q

2 questionnaires for PTSD?

A

Trauma screening questionnaire

Post-traumatic diagnostic scale

54
Q

For mild PTSD symptoms <4 weeks long, what approach may be suitable?

A

Watchful waiting

55
Q

Outline the biopsycho social management of PTSD

A

Bio = Venlafaxine (drug treatments aren’t 1st line) (or mirtazepine).
Psycho = trauma-focused CBT or EMDR
Social = employment support
Risk assess for neglect and SI

56
Q

What is an obsession?

A

Unwanted intrusive urges, thoughts, images that repeatedly enter the mind. Cause distress to the pt who tries to resist them and recognises them as absurd and a product of their mind.

57
Q

What is a compulsion?

A

Repetitive stereotyped behaviours or mental acts that a person feels driven into doing. May be overt or covert

58
Q

ICD-10 classification of OCD?

A 
A = O and/or C on most days for at least 2 weeks 
B = O and C share a number of features, all must be present
C = O/C cause distress and interfere with functioning
59
Q

Mnemonic to remember features of obsessions and compulsions?

A 
FORD Car 
Failure to resist
Originate from the pts mind 
Repetitive and Distressing
Carrying out thought/action isn't pleasurable but relieves anxiety
60
Q

What’s the OCD cycle?

A

Obsession – anxiety – compulsion – relief – obsession

61
Q

Give 3 common obsessions and 3 compulsions

A

O - contamination, fear of harm, order/symmetry, sex

C - checking, cleaning, counting, mental compulsions

62
Q

Questionnaire to find severity of OCD?

A

Yale Brown obsessive compulsive scale

63
Q

Biopsychosocial method for OCD?

A 
Bio = SSRI e.g. fluox, sertraline, citalopram
Psycho = Psychoeducation, distracting techniques, CBT - exposure response prevention
Social = self-help books, support groups
64
Q

OCD has a strong association with which other disorder?

A

Depression (30%)

65
Q

ICD-10 criteria for anorexia nervosa?

A

FEEDD
Fear of weight gain
Endocrine disturbance e.g. amenorrhoea
Emaciated (>15% below expected weight or BMI<17.5)
Deliberate weight loss (reduced intake or increased exercise)
Distorted body image.

Features present for 3 month. Absence of recurrent binging or obsession about eating.

66
Q

5 other symptoms of anorexia nervosa?

A

Lanugo hair, fatigue, headaches, hypothermia, bradycardia, arrhythmias, peripheral oedema (hypoalbuminaemia), social isolation, depressive sx

67
Q

Give 5 investigations to do for AN

A 
FBC, U&Es, LFTs, TFTs, glucose, vit B12/folate, lipids, cortisol, sex hormones, amylase
VBG
DEXA scan
ECG
Questionnaires e.g. EAT
68
Q

Biopsychosocial model for AN?

A

Bio = Treat medical problems, SSRI if depressed
Psycho = family therapy, CBT-ED, IPT, CAT, psychoeducation
Social = voluntary organisations, self-help groups
Risk assessment for suicide and medical complications is vital
May need hospitalisation and use of MHA

69
Q

Aim of weight gain for AN :

a) Inpatient
b) outpatient?

A

a) 0.5-1kg/wk

b) 0.5kg/wk

70
Q

5 disorders that BN commonly is assoc with?

A 
Depression
Anxiety
Substance misuse
Self-harm
EUPD
71
Q

ICD-10 criteria for BN?

A

Bulimia Patients Fear Obesity
Behaviours to compensate - exercise, laxatives, vomiting
Preoccupation with eating
Fear of fatness
Overeating - at least twice a week for 3 months

72
Q

Potentially life threatening complication of vomiting?

A

Hypokalaemia

73
Q

3 complications of repeated vomiting that may be seen in a patient with BN?

A

Russell’s sign (calluses on back of hand)
Dental erosion
Bilateral parotid swelling

74
Q

Biopsychosocial model for BN?

A

Bio = fluoxetine, treat medical complications
Psycho = Psychoeducation, CBT-BN, IPT
Social = support groups, self-help programmes, food diary, eat with others
Risk assess for suicide and screen for comorbid conditions
May need hospitalisation, unlikely to need MHA as usually have insight and are motivated to change

75
Q

Recovery % from BN vs AN?

A

50% vs 20% full recovery

76
Q

Mnemonic to remember substance dependence features?

A 
Drugs Probably Will Continue To Harm
Desire/craving
Preoccupation with substance
Withdrawal if stop/reduce
Can't control use
Tolerance
Harmful effects don't stop use
Need 3 or more, lasting for at least 1 month
77
Q

How to divide history of substance misuse in an OSCE?

A 
Current use - TRAP
Signs of dependency
Risk assessment - suicide, self harm, needle sharing
Possible triggers
Past substance use
Physical, psycho, social impact of use
Coping mechanisms
78
Q

5 investigations to do for substance misuse?

A

LFTs, clotting, U&Es, drug blood levels, HIV, Hep B and C, TB.
Urinalysis
ECG
ECHO if suspecting infective endocarditis

79
Q

Biopsychosocial approach for substance misuse?

A 
Bio = hep B immunisation, treat any medical complications e.g. infection. 
Psycho = motivational interviewing, CBT
Social = keyworker assigned to each patient, support groups e.g. narcotics anonymous, help with employment/housing/finance
80
Q

First and second line drugs for opioid detox and maintenance?

A

Methadone

Buprenorphine

81
Q

What is the Edward and Goss criteria for alcohol dependence?

A 
SAW DRIN(k)
Subjective experience of craving 
Avoidance/relief of withdrawal sx by drinking 
Withdrawal symptoms
Drink-seeking behaviour predominates
Reinstatement after abstinence
Increased tolerance 
Narrowing of repertoire
82
Q

When is peak incidence of seizures following alcohol withdrawal?
Peak incidence of delirium tremens?

A

36 hours

72 hours

83
Q

Investigations to do for a patient with alcohol misuse?

A

FBC, U&Es, LFTs and clotting, B12/folate, TFTs, blood alcohol concentration, amylase, glucose
ECG if arrhythmias
CT head if head injury

84
Q

3 questionnaires that can be used for alcohol abuse?

A

AUDIT
SADQ
FAST

85
Q

Equation to work out how many units of alcohol a drink is?

A

[% strength x volume (ml)]/ 1000

86
Q

What is the biopsychosocial approach to managing alcohol abuse?

A 
Bio = chlordiazepoxide and thiamine. Then disulfiram/naltrexone/acamprosate. Treat medical/psych comps
Psycho = Motivational interviewing + CBT. 
Social = AA, family support
87
Q

Give 3 indications for inpatient alcohol withdrawal

A
  • High suicide risk
  • Previous severe withdrawal symptoms
  • poor social support
88
Q

5 characteristic features of delirium tremens?

A
  • Perceptual abnormalities e.g. hallucinations
  • Paranoid delusions
  • Autonomic arousal
  • Tremor
  • Cognitive impairment
89
Q

What are the 3 clusters of personality disorders and give 3 PDs in each type.

A

1) Odd/eccentric - schizoid, schizotypal, paranoid
2) Dramatic/emotional - EUPD, histrionic, dissocial
3) Anxious/fearful - anankastic, anxious avoidant, dependent

(Weird, wild, worriers)

90
Q

Give 5 features of EUPD?

A 
Self-harm and suicide behaviours 
Intense, unstable relationships
Mood instability
Fear of abandonment 
Impulsivity
Disturbed sense of self 
Chronic feelings of emptiness

Often there is a history of abuse as a child

91
Q

How to differentiate cluster A personality disorders and schizophrenia/psychotic disorders?

A

Hallucinations and true delusions are absent in personality disorders

92
Q

2 questionnaires/tests to look for personality disorders?

A

Personality diagnostic questionnaire, Eysenck personality questionnaire, Minnesota Multiphasic personality inventory

93
Q

What are 3 general management principles for patients with personality disorders?
What is the biopsychosocial approach to management

A
  • Education and support for family and friends
  • Written crisis plan and may need input from crisis team
  • Manage co-existing psychiatric or substance misuse problems.

Bio - antidepressants/mood stabilisers in EUPD. Antipsychotics if ideas of reference, impulsivity.
Psycho - CBT, DBT (EUPD), psychodynamic psychotherapy, psychoeducation
Social - Support groups, substance misuse services

94
Q

What is self harm?

A

A deliberate act of self-injury/poisoning regardless of the intent/motivation

95
Q

4 risk factors for self-harm?

A 
Alcohol
Divorced/single/live alone
<35 yrs old 
History of child abuse 
Stressful life events 
psychiatric illness e.g. depression
Chronic physical health problems
96
Q

What are the 5 key motives behind self harm?

A

DRIPS
Death wish
Relief
Influence others (e.g. to change a decision)
Punishment of self
Seeking attention (expression of emotional distress)

97
Q

Biopsychosocial management of self harm?

What is mandatory in the management of self harm?

A 
Bio = antidote for poisoning, sutures, SSRI if depressed
Psycho = counselling, CBT, psychodynamic psychotherapy if PD
Social = social services input, voluntary organisations (Samaritans, MIND)

Risk assessment is mandatory may need Crisis team/hospitalisation +/- MHA
Ensure follow up 48hrs after discharge from hospital

98
Q

What antidote is used in overdose of:

a) Benzodiazepines
b) beta blockers
c) TCAs

A

a) Flumazenil
b) Glucagon
c) Sodium bicarbonate

99
Q

Give 5 risk factors for suicide

A

Male, middle-aged, unemployed, mental health problems e.g. depression, previous attempts at suicide/DSH, alcohol use, lack of social support, lives alone, psychically disabling or painful illness.

100
Q

What mnemonic helps to remember how to assess risk of suicide following DSH?

A

Note Planned Attempts Are Very Frightening

Note left, Planned attempt, Attempts to avoid discovery, Avoided seeking help, Violent methods, Final acts (finances, wills etc)

101
Q

2 questionnaires for assessing suicide risk?

A

Tool for Assessment of Suicide Risk (TASR)

Beck suicide intent scale

102
Q

Outline the management following a suicide attempt

A
  • Ensure safety and medically stablised
  • Risk assessment, then depending on risk may manage in hospital (may need MHA) or in community
  • Psychiatric treatment for depression or psychosis
  • Crisis Resolution and Home Treatment Team involvement
103
Q

Give 3 macroscopic changes seen in Alzheimer’s

A
  • Widened sulci
  • Cortical atrophy (particularly hippocampal)
  • Enlarged ventricles
104
Q

What are 3 genes associated with early onset AD?
Before what age is classed early onset?
What is the susceptibility gene that predisposes to late onset AD?

A

Presenilin 1 and 2, and amyloid precursor protein
65 yrs
ApoE-4

105
Q

ICD-10 classification of dementia?

A 
A = a decline in memory, a decline in other cognitive functions
B = preserved awareness of environment for A to be evident
C = decline in emotional control/motivation/change in behaviour e.g. irritability, lability, apathy, coarsening of behaviour
D = A present for at least 6 months
106
Q

5 cognitive areas impaired by dementia?

A

My Cat Loves Eating Pigeons

Memory, cognition, language, executive functioning, personality

107
Q

3 indications for brain imaging in dementia?

A

Early onset, rapid decline, focal CNS signs, monitor disease progression

108
Q

Gve 3 examples of a frontal lobe test

A

Clock drawing exercise
Similarities e.g. in what way are these two objects similar
Luria 3 step hand test
Ask for as many words starting with S in a minute

109
Q

ICD-10 criteria for diagnosis of autism?

A
  • Abnormalities noted before the age of 3
  • Abnormalities in social interaction
  • Abnormalities in communication
  • Restrictive, repetitive and stereotyped patterns of behaviour, activity and interests
110
Q

Give 5 symptoms you may see in autism?

A

Lack of eye contact, inability to pick up on social cues, lack of interest in others, upset when change to daily routine, obsessively pursued interests, repetitive behaviours e.g. banging head, waving arms, echolalia, distorted and delayed speech

111
Q

Who may be involved in an MDT for and austistic child?

A

Paediatricians, psychiatrists, educational psychologist, SALT, occupational therapists

112
Q

Biopsychosocial approach to autism?

A 
Bio = treat co-existing disorders e.g. methylphenidate for hyperkinetic disorder, may use melatonin for sleep disorders 
Psycho = Psychoeducation for families/carers, may use CBT
Social = support groups (NAS), modify environmental factors, social-communication intervention, special schooling
113
Q

What are the 3 core features of ADHD?

A

Hyperactivity, inattention and impulsivity

114
Q

ICD-10 criteria for the 3 core features of ADHD?

A
  • Present in more than one setting e.g. school and home
  • Directly observed
  • Out of keeping of development
  • Lasting at least 6 months
  • Onset before age of 7
  • IQ above 50
115
Q

Give 3 symptoms for each of the core features of ADHD

A

Inattention - not listening, losing things, lots of easy mistakes in homework, highly distractible
Hyperactivity - restlessness, excessive running/jumping on things, excessive talking, recklessness, inability to do quiet activities.
Impulsivity - interrupts people talking, blurts out answer prematurely, inability to await turn, disobedient, runs into street without looking

116
Q

Biopsychosocial management of ADHD?

A 
Bio = methylphenidate, atomoxetine, dexamphetamine (if severe and at school)
Psycho = Parent training and psychoeducation (first line!). For school goers- psychoeducation, CBT
Social = support groups (add+up), school support
117
Q

What triad must exist to constitute a learning disability?

A

1) Intellectual impairment (IQ <70)
2) Onset from birth or early childhood
3) Wide range of functional impairment

118
Q

What is the commonest cause of LD?

Second commonest?

A

Down syndrome

Fragile X

119
Q

What are 4 common psychiatric comorbidities in patients with LD?

A 
Depression, anxiety
Alzheimer's
Schizophrenia
Eating disorders
Autism/ADHD
Personality disorders
120
Q

Biopsychosocial approach to LD?

A 
Bio = GP involved in managing health conditions. Antipsychotics for challenging behaviour (but overused)
Psycho = family education, positive behaviour support,  CBT
Social = support groups, social worker, school support
121
Q

4 criteria for gambling addiction in ICD-10?

A
  • Impaired control over gambling
  • Priority given to gambling so it takes precedence over other activities
  • Continuation despite negative consequences
    For 12+ months, with significant impairment in personal/social/occupational functioning.
122
Q

DSM-V diagnosis of gambling addiction requires 4+ symptoms. Give the possible symptoms

A

Spending increasing money for same excitement
Restless/irritable when trying to cut down
Unsuccessful attempts to stop
Preoccupied by gambling
Lies to conceal extent
Jeopardized a relationship/job
Borrows money to relieve financial situation
Goes back to get even after loss

123
Q

Management of gambling addiction?

A

Motivational interviewing, CBT, gamblers anonymous

124
Q

What is the treatment for:

a) acute dystonia
b) akathisia
c) tardive dyskinesia

A

a) procyclidine
b) propranolol
c) tetrabenazine

125
Q

Features of neuroleptic malignant syndrome?

Treatment of neuroleptic malignant syndrome?

A

Pyrexia, rigidity, hypertension, tachycardia, agitated delirium with confusion, hyporeflexia

Stop antipsychotic, IV fluids, severe - dantrolene, bromocriptine

126
Q

What is the triad of serotonin syndrome?

Treatment?

A

Altered mental state, autonomic nervous system stimulation, neuromuscular abnormalities (hyperreflexia, clonus, rigidity)

Stop serotonergic drugs, IV fluids, benzos, severe- cyproheptadine/chlorpromazine

127
Q

Timing of onset of neuroleptic malignant syndrome vs serotonin syndrome?

A

Neuroleptic is slower e.g. hours- days, serotonin syndrome is within hours

3b specialties (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions