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Finals > Psych additional > Flashcards

Psych additional Flashcards

1
Q

alcohol withdrawal sx and times

A

symptoms: 6-12 hours
seizures: 36 hours
delirium tremens: 72 hours

sx- tremor, tachycardia, sweating, anxiety

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2
Q

Factors associated with poor prognosis of schizophrenia

A
  • strong family history
  • gradual onset
  • low IQ
  • prodromal phase of social withdrawal
  • lack of obvious precipitant
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3
Q

Schneider’s first rank sx for schizophrenia

A
  • Delusions
  • Auditory hallucinations
  • Thought disorder: insertion, withdrawal, broadcasting
  • Passivity phenomena
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4
Q

what is schizoid personality disorder

A

tendency towards solitariness, lack of interest in social relationships, and emotional detachment

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5
Q

what is schizotypal PD

A
  • Ideas of reference (differ from delusions in that some insight is retained)
  • Odd beliefs and magical thinking
  • Unusual perceptual disturbances
  • Paranoid ideation and suspiciousness
  • Odd, eccentric behaviour
  • Lack of close friends other than family members
  • Inappropriate affect
  • Odd speech without being incoherent
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6
Q

difference between schizoid and schizotypal

A

Schizoid = AVOID
Schizotypal = type of schizophrenia (has weird thoughts)

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7
Q

personality disorder clusters

A
  • Cluster A (MAD): - ‘odd or eccentric’ - paranoid, schizoid, schizotypal
  • Cluster B (BAD): ‘dramatic, erratic or emotional’ - histrionic, emotionally unstable(/borderline), dissocial, narcissistic
  • CLuster C (SAD): ‘anxious and fearful’: anankastic, anxious (avoidant) and dependent.
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8
Q

What is Russell’s sign?

A

calluses on the knuckles or back of the hand due to repeated self-induced vomiting
bulimia

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9
Q

purging behaviours

A

vomiting
laxative
exercise
diuretics

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10
Q

schizoaffective disorder

A

combination of psychotic symptoms and prominent mood symptoms (e.g., mania or depression).

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11
Q

What are the main approaches to managing OCD?

A
  • CBT (exposure and response prevention)
  • SSRIs (most commonly fluoxetine)
  • 3rd line: clomipramine (TCA)
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12
Q

discontinuitation sx of SSRIs

A
  • increased mood change
  • restlessness
  • difficulty sleeping
  • unsteadiness
  • sweating
  • GI sxs: pain: cramps, diarrhoea, vomiting, paraesthesia
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13
Q

Duloxetine mechanism of action

A

serotonin and noradrenaline reuptake inhibitor

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14
Q

What is the most appropriate action to take with regards to SSRIs prior to ECT treatment for this patient?

A

Antidepressant medication should be reduced but not stopped when a patient is about to commence ECT treatment

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15
Q

What is Charles Bonnet syndrome?

A

A phenomenon in which patients with severe visual impairment report vivid hallucinations

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16
Q

What is Othello syndrome?

A

Also known as delusional jealousy, is a delusional disorder with male preponderance in which patients hold a firmly held belief that their partner is unfaithful, in the absence of proof.

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17
Q

what is acute dystonia?

A

sudden involuntary muscle contractions and spasms, often affecting the neck (torticollis), jaw, and tongue.

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18
Q

what is tardive dyskinesia?

A

rhythmic involuntary movements e.g. grimace, chewing, sucking movements (mainly facial)

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19
Q

what is parkinsonism?

A

tremor,rigidity,bradykinesia

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20
Q

mx of parkinsonism

A

change the drug/dose,
sometimes anticholinergics like procyclidine can help

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21
Q

what is akathisia

A

unpleasant feeling of restlessness

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22
Q

mx of akathisia

A

change drug/dose, or give
propranolol, benzos

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23
Q

examples of typical antipsychotics

A

haloperidol
Chlorpromazine

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24
Q

examples of atypical antipsychotics

A

aripiprazole
Clozapine
Risperidone
Olanzapine

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25
Q

examples of EPSEs

A
  • acute dystonia
  • akathisia
  • parkinsonism
  • tardive dyskinesia
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26
Q

What is the most appropriate medication choice to prevent further seizures in alcohol withdrawal?

A

chlordiazepoxide

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27
Q

side effects of mirtazapine

A
  • increased appetite
  • increased sleep
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28
Q

first line medication for GAD

A

sertraline

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29
Q

difference between knight’s move and flight of ideas

A
  • Knight’s move= thinking there are illogical leaps from one idea to another
  • Flight of ideas there are discernible links between ideas
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30
Q

what food to avoid on SSRI

A

Grapefruit juice is a CYP inhibitor and can increase serum levels of SSRIs

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31
Q

what is conversion disorder

A

loss of motor and sensory function, which typically arises during periods of stress

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32
Q

drug itneraction that can cause serotonin syndrome

A

SSRIs and MAOIs so never co-prescribe

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33
Q

what are side effects of clomipramine (TCAs)

A

Dry mouth (anticholinergic) and weight gain (antihistaminic)

34
Q

what medication can precipitate a benign leucocytosis

A

lithium

35
Q

Most appropriate antidepressant to start post MI

A

sertraline

36
Q

features of anorexia

A
  • most things low
  • G’s and C’s raised: growth hormone, glucose, salivary glands, cortisol, cholesterol, carotinaemia
37
Q

unexplained sx

A

Somatisation = Symptoms
hypoChondria = Cancer

38
Q

delusional parasitosis

A

Patient with a fixed, false belief (delusion) that they are infested by ‘bugs’

39
Q

side effect of steroid use

A

steroid-induced psychosis

40
Q

Metabolic side effects of antipsychotics

A
  • dysglycaemia
  • dyslipidaemia
  • diabetes mellitus
41
Q

What pattern of memory loss is characteristic for severe depression

A

global memory loss, can mimic dementia but is pseudodementia

42
Q

most effective antipsychotic for dealing with negative symptoms

A

clozapine

43
Q

short term side effects of ECT

A
  • headache
  • nausea
  • short term memory impairment (retrograde amnesia more common than anterograde amnesia)
  • memory loss of events prior to ECT
  • cardiac arrhythmia
44
Q

RF for GAD

A
  • Aged 35- 54
  • Being divorced or separated
  • Living alone
  • Being a lone parent
45
Q

what happens when a pt takes disulfiram

A

Within twenty to thirty minutes of alcohol consumption results in unpleasant symptoms, including facial flushing and nausea and vomiting

46
Q

what is korsakoff syndrome

A
  • complication of wernicke’s encephalopathy
  • It’s features include: anterograde amnesia, retrograde amnesia, and confabulation
47
Q

triad for wernicke’s encephalopathy

A
  • ophthalmoplegia (often a lateral rectus palsy and/or horizontal nystagmus)
  • confusion
  • ataxia (though any cerebellar signs can be present)
48
Q

what is Erotomania (De Clerambault’s syndrome)

A

The presence of a delusion that a famous is in love with them, with the absence of other psychotic symptoms

49
Q

differing demographic in antisocial PD and borderline PD

A

Antisocial personality disorder more often affects men than it does women,
Borderline personality disorder affects more women than men.

50
Q

What is formication

A

a type of paraesthesia in which it feels like insects are crawling on the skin

51
Q

where does heroin act in the brain

A

mu opiate agonist stimulates brain and spinal cord receptors which are normally acted on by
endogenous endorphins (reduce pain

52
Q

presentation of heroin use

A
  • pinpoint pupils
  • Intense rush/buzz, feelings of euphoria
  • anorexia
  • decreased libido
53
Q

antidote for opiate overdose

A

naloxone

54
Q

sx of opiate withdrawal

A
  • peaks 36-48hrs
  • dysphoria, nausea, insomnia, agitation
  • flu like sx
  • ‘Everything runs’: diarrhoea, vomiting, lacrimation, rhinorrhoea
  • gooseflesh ‘cold turkey’
55
Q

signs of benzo withdrawal

A
  • insomnia
  • tremor
  • agitation
  • loss of appetite
  • excessive sweating
  • tinnitus
  • seizures
56
Q

antidote to benzo overdose

A

flumazenil

57
Q

medication for alcohol dependence

A
  • Disulfiram (aversive)
  • Acamprosate (anti-craving)
  • Naltrexone (anti-craving)
58
Q

antidote to paracetamol overdose

A

N-acetylcysteine
activated charcoal if presenting within the first hour

59
Q

where in the brain is affected by Alzheimer’s

A
  • hippocampus affected early: new learning and visuospatial skills
  • temporal and parietal lobes later
60
Q

What is Alzheimer’s

A

increased B-amyloid
F>M
Age biggest RF

4As
Amnesia
Agnosia- recognition problems
Aphasia
Apraxia- inability to carry out skilled tasks despite normal motor function

61
Q

what is vascular dementia

A

dementia due to infarcts causes by thromboembolism or atherosclerosis

62
Q

presentation of vascular dementia

A

Stepwise progression - each step representing a sudden deterioration as an infarct occurs

63
Q

what is lewy body dementia

A

Lewy bodies - eosinophilic intracytoplasmic neuronal structures composed from a-synuclein with ubiquitin
found in cingulate nucleus and neocortex

64
Q

presentation of lewy body dementia

A

2/3 should alert possibility of DLB:
1. bradykinesia, rigidity, tremor
2. fluctuating confusion with variation in awareness
3. vivid visual hallucination- little men or animals

65
Q

how to diagnose neuroleptic malignant syndrome

A

Serum creatine kinase (CK), which is a muscle enzyme that can be elevated in NMS.

66
Q

mx of mania

A

antipsychotic e.g. olanzapine

67
Q

mx of dystonia

A

anticholinergic e.g. benztropine or diphenydramine

68
Q

mx of alzheimers and lewy body dementia

A
  • 3 acetylcholinesterase inhibitors (donepezil, galantamine and rivastigmine) for mild to moderate
  • memantine (NMDA receptor antagonist) 2nd line
69
Q

how to differentiate between delirium and dementia

A
  • One of the main factors favouring delirium is impairment of consciousness,
  • fluctuating sx and hallucinations = delirium
70
Q

Section 2

A
  • admission for assessment for up to 28 days, not renewable
  • made by an Approved Mental Health Professional (AMHP) on behalf of 2 doctors
  • one of the doctors should be ‘approved’ under Section 12(2) of the Mental Health Act (usually a consultant psychiatrist)
71
Q

section 3

A
  • for up to 6 months, can be renewed
72
Q

section 4

A
  • 72 hour assessment order
    used as an emergency
  • a GP and an AMHP or NR
    often changed to a section 2 upon arrival at hospital
73
Q

section 5(2)

A

a patient who is a voluntary patient in hospital can be legally detained by a doctor for 72 hours
F1 can do

74
Q

section 5(4)

A

similar to section 5(2), allows a nurse to detain a patient who is voluntarily in hospital for 6 hours

75
Q

section 135

A

a court order can be obtained to allow the police to break into a property to remove a person to a Place of Safety

76
Q

section 136

A

someone found in a public place who appears to have a mental disorder can be taken by the police to a Place of Safety
can only be used for up to 24 hours, whilst a Mental Health Act assessment is arranged

77
Q

Naltrexone use

A

similar to acamprosate
used for anti-craving in alcohol dependence

78
Q

what is disulfiram

A

anti-eversive in alcohol dependence. makes you go red and feel hungover

79
Q

mx of acute dystonia

A

procyclidine (anti-cholinergic)

80
Q

Mx of tardive dyskinesia

A

tetrabenzine

81
Q

signs of TCA overdose (e.g. amitriptylline)

A
  • dry mouth
  • dilated pupils
  • arrhythmias
  • seizures
  • metabolic acidosis
  • coma

ECG
- sinus tachycardia
- widening of QRS
- prolongation of QT interval

Finals (26 decks)

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