Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

My notes - med > Psych > Flashcards

Psych Flashcards

1
Q

Tool for ADHD children

A

Conners Comprehensive Behavioural Scale (CRBS)- academic, behavioural and social issues

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

Tool for ADHD adults

A

Adult ADHD Self-Report Scale (ASRS) - current sx

Wendler Utah Rating Scale (WURS) - retrospective rating of childhood

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

ADHD stats

A

m:f 3:1
heritable
8-12% worldwide, 20-50% first degree relative

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

ADHD pathophys

A

disregulation of dopamine and noradrenaline in prefrontal cortex
Frontal lobe hypoperfusion and lower frontal lobe metabolic rates
Enviro: mom smoker or substance use in preg, low birth weight, premature, getal hypoxia

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

ADHD MSE

A

Overfamiliar + impatient
Good eye contact
Rapport reasonable but redirection + reassurance needed
Speech normal rate/rhythm/tone, slight increased volume
Thought content ok
Self describe as happy, no self harm, no psychotic
Attention reduced
Insight ok, realises he has an issue

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

ADHD tx

A
  • Parental support/teaching
  • Psychoeducation, social skills training, impulse control interventions, neurofeedback, CBT, classroom SNAssistant
  • Diet: minimise additives, lots of protein and vitamin rich food.
  • Meds: stims –>methylphenidate , amphetamine, dextroamphetamine, dexmethylphenidate, non stims –>atomoxetine, guanfacine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Methylphenidate

A

ADHD stimulant
Increase dopamine and noradrenaline levels in prefrontal cortex
Increases fine and gross motor control + cog performance and executive function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Methylphenidate SE

A

ADHD
N, abdo pain, headache, anxiety, sleep troubles, appetite and weight reduction, growth retardation
Increase HR and BP, monitor this
Suicidal thoughts, dysphoria, mood lability, psychosis
Tics

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

Non stim ADHD meds

A

atomoxetine

guanfacine

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

Atomoxetine

A 
ADHD non stim
Noradrenlaine reup inhib
SE: N, dry mouth, anorexia, insomnia
Irritability, behavioural changes, suicide thoughts
Liver damage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Guanfacine

A

ADHD non stim
Stims alpha 2 adrenergic receptors to enhance noradren neurotransmission
SE: fatigue, headache, GI

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

Symptoms of depression

A 
SIG-E-CAPS
Sleep changes
Interest low
Guilt (worthlessness)
Energy down
Cognition/Concentration low
Appetite low
Psychomotor depression or agitation
Suicide/death preoccupation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Criteria for Mild Depression

A

2 of main 3 sx + 2 other for >2weeks

Distressed but continues working/social functioning

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

Criteria for moderate depression

A

2 of main 3 + 3 other, >2w

Difficulty continuing normal social/work

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

Criteria major depression

A

3 main sx + 4 other, >2w
Can have psychosis or severe dep
Severe distress/agitation

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

Tools for depression

A

HAD (hospital anxiety and depression)–> score out of 21, <7 norm, 8-10 borderline, >11 positive
PHQ-9 (patient health question) –> <4 norm, 5-9 mild, 10-14 mod, 15-19 mod sev, 20-27 sev

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

DSM depression criteria

A

*1 depressed most of day most days
*2 v. diminished interest or pleasure in most/all activities most days
*3 sig weigh loss/gain
4 insomnia/hypersomnia most days
5 psychomotor agit/retard most days
6 fatigue/loss of energy most days
7 worthless/guilt most d
8 low concentration most d
9 recurrent thoughts of death, suicidal ideation w/ plan or w attempt or plan

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

Duloxetine MOA

A

Depression, GAD, social anx, panic, menopause sx

SNRI

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

Venlafaxine MOA

A

Depression, GAD, social anx, panic, menopause sx

SNRI

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

Typical antipsychotic eg

A

Haloperidol

Chlorpromazine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Haloperidol MOA

A

Typical

D2 receptor antagonist, blocks dop transmission in mesolimbic pathways

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

Haloperidol SE

A

Extrapyramidal SE and hyperprolactinemia

Long QT

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

Chlorpromazine SE

A

Extrapyramidal SE and hyperprolactinemia

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

Chlorpromazine MOA

A

Typical

D2 receptor antagonist, blocks dop transmission in mesolimbic pathways

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Extrapyramidal SE's
Parkinsonism Acute dystonia (sustained muscle contraction --> procyclidine) Akathisia (restless) Tardive dyskinesia
26
Tx for acute dystonia
procyclidine
27
Atypical antispychotic eg
Clozapine Risperidone Olanzapine
28
Clozapine, Risperidone, Olanzapine MOA
D2, D3, D4, 5HT
29
Clozapine, Risperidone, Olanzapine SE
Metabolic effects | ESPS + Hyperprolactinemia less common
30
Antipsychotic rare side effect
neuroleptic malignant syndrome
31
Antipsychotics in elderly se:
stroke | VTE
32
Typical antipsychotic se
``` Antimuscarinic (dry mouth, blurred vision, urinary retention, contipation Sedation, weight gain Raised prolactin (galactorrhea) Impaired glucose tolerance Neuroleptic malignant syndrome Reduced seizure threshold Prolonged QT (haloperidol) ```
33
Neuroleptic malignant syndrome
Antipsychotics Pyrexia + muscle stiffness altered mental state, rigidity, fluctuating BP, high temp
34
Alcohol withdrawal tx
decreasing doses chlordiazepoxide or diazepam **lorazepam if acute liver failure Carbamazepine can be effective
35
Chronic alcohol on brain
enhanced GABA mediated inhibition of CNS, inhibits NMDA glutamate receptors
36
Alcohol withdrawal on brain
decreased inhibition of GABA and increased NMDA glutamate transmission
37
Alcohol withdrawal 6-12hr
tremors, sweating, tachy, anxiety
38
Alcohol withdrawal 36h
seizures
39
Alcohol withdrawal 48-72h
DTs: coarse tremor, confusion, delusions, aud/vis hallucinations, fever, tachy
40
Schneider's 1st rank sx
``` Auditory hallucinations (2+ voices discussing patient, thought echo, voices commending on pt behav) Thought disorders (insertion, withdrawal, broadcasting) Passivity (body sensations being controlled by external, actions/impulses/feelings imposed on pt by others) Delusional perceptions (normal object perceived then sudden intense delusional insight into its meaning for pt.) ```
41
Auditory hallucinations - Schneider's
2+ voices discussing patient in 3rd person thought echo voices commending on pt behaviour
42
Thought disorder - Schneider's
Insertion, withdrawal, broadcasting
43
Passivity phenomenon - Schneider's
Bodily sensations controlled by external influence | Actions/impulses/feelings imposed on patient or influenced by others
44
Delusions -Schneider's
first a normal object is percieved, then there is sudden intense delusional insight into objects meaning for patient
45
Ft of schizophrenia
Schneider's: auditory hallucination, thought disorder, passivity, delusions Other: impaired insight blunt affect/incongruous Decreased speech neologisms - made up words Catatonia Negative sx: blunting of affect, anhedonia, alogia, avolition
46
Negative sx schizo
Incongruity/blunting of affects Anhedonia (no pleasure) Alogia (poverty of speech) Avolition (low motivation)
47
Anxiety ddx
hyperthyroid cardiac disease medication-induced anx (salbutamol theophylline, steroids, antidepressant, caffeine)
48
GAD mgmt
1: education + active monitor 2: psychoeducation groupts, self-help 3: CBT, meds 4: highly specialist input
49
GAD drugs
1st: Sertraline (SSRI) 2nd: another SSRI or SNRI (duloxetine, venlafaxine) 3rd: pregabalin * * <30y warn of suicidal thinking and self harm
50
Panic disorder mgmt:
1: recognise + dx 2: primary care tx 3: review + alternative tx 4: refer to specialist 5: admit
51
Panic disorder tx
CBT SSRI x 12 w no resp: imipramine or clomipramie (TCA)
52
Weight gain antipsychotics
atypical antipsychotics
53
Clozapine risk
``` agranulocytosis - monitor FBC neutropenia reduced seizure threshold constipation myocarditis hypersalivation Only use after failure of 2 other drugs ```
54
Olanzapine
atypical | Obesity, dyslipidemia
55
Clozapine
atypical not first line agranulocytosis
56
Risperidone
atypical
57
Quetiapine
atypical
58
Amisulpride
atypical
59
Aripiprazole
Atypical
60
Erotomania
delusion of famous person being in love with them Absence of other psychotic sx De Clerambeault's
61
Schizotypal PD
odd beliefs bizarre behaviours No delusional convistions
62
Narcissistic PD
long term pattern of inflated self importance, excessive need for admiration, lack of empathy
63
Histrionic PD
excessively attention seeking
64
Lithium checks
1w after dose change/initiation and weekly until stable check 12h post dose Once stable - 3 monthly, 6monthly after 1 y ***thyroid, renal tests 6 monthly
65
Lithium therapeutic range
0.4-1.0
66
Lithium uses
bipolar | adjunct in refractory depression
67
Lithium SE
``` N/V/D Fine tremor Nephrotoxic: polyuria from nephrogenic diabetes insipidus Thyroid enlargement - hypothyroid ECG: t wave flatten/inversion Weight gain Idiopathic intracranial HTN Leucocytosis Hyperparathyroid + hypercalcemia ```
68
ECT side effects
Short term: headache, nausea, ST memory, memory loss of events prior to tx, cardiac arrythmia. LT: impaired memory
69
Unexplained symptoms:
Somatisation -- Symptoms | hypoCondria -- Cancer
70
Pt concerned about persistent (>2y), unexplained sx, no accepting reassurance of negative tests
somatisation
71
pt concerneed about an underlying diagnosis
hypocondria
72
intentional production of sx
muchausen/factitious
73
Somatisation
Pt concerned about persistent (>2y), unexplained sx, | no accepting reassurance of negative tests
74
Illness anxiety disorder/hypocondria
belief in underlying serious disease | refusal to accept negative test results
75
Conversion disorder
loss of motor/sensory function (amnesia, fugue, stupor) | not conscious of them not being real
76
seeking material/financial gain from simulation or exaggeration of symptoms
malingering
77
Dissociative disorder
separating certain memories from normal consciousness
78
Anorexia Criteria
1) restriction of energy intake relative to requirements leading to sig low body weight in context of age/sex/development/health 2) intense fear of gaining weight or becoming fat, even through underweight 3) disturbance in exeperience of won body weight/shape, undue influence of body weight or shape on self eval, denial of seriousness of current low body weight
79
Anorexia mgmt
CBT | Family focused therapy
80
Paroxetine
SSRI
81
Paroxetine in preg
avoid - risk of congenital malformations (1st tri and heart defects) 3rd tri: pulm HTN baby
82
SSRIs
Citalopram Dluoxetine Sertraline
83
First line depression
Citalopram or Fluoxetine (SSRI)
84
Depression meds post MI
Sertraline (SSRI)
85
Antidepressant for children/ado
Fluoxetine (SSRI)
86
SSRI SE
GI Hyponatremia in elderly increased risk GI bleed, give PPI if giving NSAID Can cause increased anxiety/agitation at frst
87
Citalopram
SSRI | Dose dependent QT prolongation - dont use in those w congenital QT, pre existing QT, or in combo with other QT drugs
88
Citalopram max dose
40mg/d adults | 20mg/d over 65 or hepatic impair
89
SSRI interactions
``` NSAID (give PPI) Warfarin/heparin (mirtazapine instead) Aspirin Triptans (serotonin syndrome) MAOis (serotonin syndrome) ```
90
SSRI discontinuation sx
``` Continue 6mo after remission, reduce over 4 weeks Increased mood change restlessness difficulty sleeping unsteadiness sweating GI paresthesia ```
91
SSRI + Preg
1st tri: congenital heart 3rd tri: pulm HTN Paroxetine bad
92
Stones, bones abdo moans and psychic groans
hypercalcemia
93
Schizoid
Doesnt want or enjoy close relationships (fam included) Chooses colitary activities Little interest in sex Pleasure in v few activities Lacks close friends/confidants Indifferent to praise or criticism Emotional coldness/detachment, flattened affect
94
Emotionally labile, severe sudden mood swings, rages, self harm, jealousy
borderline PD
95
rely on reassurance of others, others to make decisions
dependent PD
96
dont trust anyone, including partner, fear of people lying or harming them
paranoid PD
97
PD tx
dialectical behavioural therapy
98
Antisocial ft
Failure to conform to social norms - repeatedly performing acts that are grounds for arrest Men>women Deception, lying, use of alias, conning for profit or pleasure Impulsive or failure to plan Irritable, aggressive, fights/assaults Reckless disregard for others safety Consistent irresponsibility Lack of remorse/indifferent to hurting/stealing/mistreating
99
Avoidant PD
Avoid occupational activities involving significant interpersonal contact due to fear of criticism or rejection Unwilling to be involved unless certain of being liked Preoccupied w ideas of being criticized/rejected in social situations Restraint in intimate relationships for fear of ridicule Reluctance to take risks for fear of embarrassment Views self as inept/inferior Social isolation but craves social contact
100
Borderline PD
``` Avoid real/imagined abandonment Unstable interpersonal relationships that alternate between idealization and evaluation Unstable self image Impulsive in self damaging areas (sex, $, substances) Recurrent suicidal behaviour Affective instability Chronic feeling of empty Hard to control temper Quasi psychotic thoughts ```
101
Dependent PD
Can't make decisions without excessive reassurance from others Need for others to assume responsibility for major areas of life Hard to express disagreement with others cuz scared to lose support Lack of initiative Unrealistic fears of being left to care for self Urgent search for another relationship after one ends Need to obtain support from others Unrealistic feelings that they cant care for themselves
102
Histrionic PD
Inappropriately sexual Need to be centre of attention Rapidly shifting and shallow expression of emotion Suggestibility Dresses for attention Self dramatization Considers relationships more intimate than they are
103
Narcissistic PD
``` Grandise sense of self importance Preocc w fantasies of unlimited success, power, beaty Sense of entitlement Lack of empathy Take advantage of others for own needs Excessive need for admiration Chronic envy Arrogant/hauty ```
104
Obsessive compulsive PD
Occupied with details, rules lists, order, organization or agenda to the point that they key part of activity is gone Perfectionism that hampers completion of tasks Dedicated to work and efficiency with eliinationof spare time activities Meticulous, scrupulous, rigis re etiquette of morality, ethics, values Not capable of getting rif of indignificant things even when they dont have meaning Unwilling to pass on tasts or work unless done their way Stingy spending towards self and others, stiff, stubborn
105
Paranoid PD
Hypersensitivity and unforgiving attitude when insulted Unwarranted tendency to question loyalty of friends Reluctant to confide in others Preocc with conspirational beliefs and hidden meanings Parceiev attacks on their character
106
Schizoid PD
``` Indifference to praise/criticism Prefers solitary activities Lack of interest in sex Lack of interest in companion Emotional coldness Few interetss Few friends/confidants ```
107
Schizotypal PD
``` Ideas of reference Odd beliefs, magical thinking Unusual perceptual distubances Paranoid ideation, suspiscious Odd, eccentric behaviour Lack of close friends other than fam Inappropriate affect Odd speech but not incoherent ```
108
SE after LT use of antipsychotics
tardive dyskinesia
109
SE shortly after starting antipsychotics
neuroleptic malignant syndrome | Acute dystonia
110
Serotonin syndrome
``` Agitation Hyperthermia Hyperreflexia Sweating Dilated pupils ```
111
repeating the same words/answers.
perseveration
112
repeating exactly what someone has said
echolalia
113
making up new words
neologism
114
disorganised speech, sentences that do not make sense
word salad
115
difficulty putting together words. Often develops following a stroke
expressive dysphagia
116
Alogia
little info in speech
117
tangentiality
diverge from topic and dont return
118
clanging
linking words by sound/rhyme not meaning
119
Benzos MOA
enhance effect of GABA (main inhibitory NT) by increasing freq of chloride channels "FRENdodiazepines increase FREquency"
120
How to stop Benzos
Steps of 1/8 daily dose every 14d | If having trouble, switch them to equiv dose diazepam, reduce this every 2-3w by 2 or 2.5mg
121
Benzo withdrawal
``` Up to 3 weeks after stopping Insomnia Irritability Anxiety Tremor Loss of appetite Tinnitus Perspiration Perceptual disturbances Seizures ```
122
Barbituates
Increase DURATION of chloride channel | "barbiDURATes increase DURATion"
123
Zoplicone SE
``` Agitation Bitter taste in mouth Constipation Decreased muscle tone Dizziness Dry mouth Increased risk of falls ```
124
LT SE of ECT
``` apathy anhedonia difficulty concentrating loss of emotional responses difficulty learning new info ```
125
OCD
either obsessions or compulsions causing significant impairment and/or distress
126
Obsession
unwanted intrusive through, image or urge that repeatedly enters mind
127
Compulsion
repetitive behaviours or mental acts that you feel driven to perform
128
OCD mgmt
mild: CBT/ERP +/- SSRI Mod: SSRI or intensive CBT Sev: SSRI + CBT *if SSRI works, keep for at least 12mo
129
body dysmorphic disorder tx
fluoxetine
130
Oculogyric crisis
Sustained upward deviation of eyes Clenched jaw Hyperextension of back/neck with torticollis
131
Othello syndrome
delusional/pathological jealousy | Can be isolated or secondary to schizophrenia or a PD
132
Psych Conditions with psychotic sx
``` Schizophrenia Depression Bipolar Peuperal psychosis Brief psychotic disorder ```
133
Non psych conditions with psychotic sx
Neuro conditions (Parkinsons, Huntingtons) Corticosteroids Cannabis, phencyclidine
134
Schizophrenia poor prognosis
``` Pre morbid social withdrawal Low IQ Fam Hx schizo Gradual onset of sx Lack of obvious precipitant ```
135
PTSD features
``` >1 month re experiencing (flashback, nightmare) avoidance (people/situations) hyperarousal (hypervigilance, sleep problems) emotional numbing ```
136
PTSD mgmt
<4 w - watchful wait CBT, Eye movement desensitization and reprocessing Venlafaxine or SSRI (sertraline) Severe - risperidone
137
Commonest electrolyte abnormality in anorexia
hypokalemia
138
Anorexia ft
reduced BMI Bradycardia Hypotension Enlarges salivary glands
139
Anorexia physiological abnormalities
``` Hypokalemia Low FSH, LH, estrogen, testos Raised cortisol, GH Impaired glucose tolerance Hypercholesterolemia Hypercarotenemia Low T3 ```
140
Catatonia
stopping of voluntary movement | Staying in unusual position
141
Abnormal grief response
>6mo
142
RF for schizophrenia
``` Fam w schizo = strongest (RR7.5) Twin (50%) Parent (10-15%) Sibling (10%) No relatives (1%) Black caribbean (5.4) Migration (2.9) Urban enviro (2.4) Cannabis (1.4) ```
143
Meds + ECT
reduce dose but dont stop
144
Clozapine bad SE
``` agranulocytosis neutropenia reduced seizure threshold myocarditis constipation/intestinal obs ```
145
Olanzapine SE
Weight gain dyslipidemia Diabetes Sedation
146
Quetiapine SE
postural hypotension weight gain dyslipidemia
147
Risperidone SE
EPSPs Postural hypotension ED
148
GAD tx, first SSRI doesnt work
If first SSRI doesnt work, try a different one
149
Clomipramine
TCA | Depression , OCD
150
Benzos SE
anterograde amnesia - recall and creation of new memories impaired
151
Anorexia: raised
``` MOST thing low but G's and C's raised: Growth hormone Glucose salivary Glands Cortisol Cholesterol Carotenemia ```
152
Grief rxn stages
``` Denial - numb, pseudohallucinations, make meals for them Anger - against family and docs Bargaining Depression Acceptance ```
153
Atypical grief rxn ft
Delayed - when 2+ weeks have passed | Prolonged - hard to define...>12m?
154
SSRI discontinuation
Gradual over 4 w | except fluoxetine
155
Things that change clozapine blood levels
Smoking: lowers levels, cessation will increase levels Alcohol: low alcohol will reduce levels, binges will increase
156
Suicide risk factors
``` SAD PERSONS Sex (M>F) Age (35-49) Depression/mental illness Prev attempts Ethanol/Drugs Rational thinking Social support (loss of job, friends/support) Organized plan No spouse (single/div/widdow) Sickness (pain, chronic illness) ```
157
Increased risk of future successful suicide after this attempt
``` Efforts to avoid discovery Planning Leaving a note Final acts Violent method ```
158
Protective factors for suicide
Family support Children Religion
159
Mirtazapine
Noradrenergic and Specific Serotonergic Antidepressant (NaSSA) SE: sedation + increased appetite
160
TCA side effects
``` dry mouth, blurred vision, urinary retention, drowsiness weight gain Constipation mydriasis Long QT ```
161
TCA eg
``` Amitriptyline Clomipramine Trazodone Dosulepin Imipramine ```
162
Most dangerous TCA for OD
amitriptyline | Dosulepin
163
Least dangerous TCA for OD
Lofepramine
164
TCA for headache/migrain
low dose amitriptyline
165
ECT indications
catatonia prolonged severe mania severe life threatening depression
166
Circumstantiality
inability to answer question without giving excessive, unnecessary detail, eventually returns to the point
167
Knight's move thinking
loosening of associations, unexpected and illogical leaps from one idea to another - schizophrenia.
168
Flight of ideas
leaps from one topic to another with links between them
169
Mania
>1w severe functional impairment in social/work can require hospitalization for risk of harm to self or others Can have psychotic sx
170
Hypomania
<7days - usually 3-4 Can be high functioning, doesnt impair functional capacity in society No hospitalization no psychotic sx
171
Mania/Hyponaia ft
Mood: elevated, irritable Speech/thought: pressured, flight of ideas, poor attn Behaviour: insomnia, loss of inhibitions, increased appetite
172
Acute stress disorder
<4w after trauma | Intrusive thoughts, dissociation, negative mood, avoidance, arousal
173
Acute stress disorder tx
CBT | Benzos for acute sx (agitation, sleep disturbance)
174
Agoraphobia
situations where escape is difficult or help unavailable
175
Panic disorder
random panic attacks on a background OF NO ANXIETY

My notes - med (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions