psych cards Flashcards by L P

ED screening questionnaire?

SCOFF
sick, controll, one, fat, full. 2+ = ED

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Shizophrenia 1st rank?
positive
negative sx?

1st rank: thought insertion/ withdrawal/ echo/broadcasting
delusions of control/ passivity/ delusions of perseption, auditory hallucinations talking about person in 3rd perosn
positive:hallucinations, disrupted speech, delusions
negativie: social withdrawal, self neglect, flat affect, demotivation

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Munchausen vs malingering?
somatisation vs hypochondria?
conversion disorder?
dissociation disorder?

munhausen - for attention, malingering - for external gain,
somatisation - multiple sx, conscious, no gain, hypochondria - belief that there is serious underlying condition. both refuse to accept reassurance or negative result

conversion: loss of sensory/ motor function result of psychological conflict. not conscious. keep conflict internal
dissociation - involves psychiatric sx eg amnesia, depersonalisation

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CAGE qs?

cut down, annoyed, guilty, eye opener (first thing in day)

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Medical emergency ED red flag?

WL 1kg/ week for 2weeks, BMI <14/ <70 in <18YO, dehydrated, U+Es altered, daily self harm/ laxitive abuse, <30.5kg (M), <17.5 (F), QTC 450+ )F/430+M. BP postural sx SBP 20 drop.

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BPD, increased reflexes, ataxia, tremour, flat t waves,

lithium
mild sx: GCS low, diarrhoea, low co-ordination, muscle weak at Li <2
severe: T wave flat, ataxia, tinnitus, blurred vision, large UO dilute at levels 3+
normal: 0.5-1.2 perform 12 hrs after dose. 5 days after started tx

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aripiprazole tox?

lethargy, HTN, N+V, tachycardia, somnolence,diarrhoea

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vaporate toxicity?

low Ca, Low BM, high Na, lactic acidosis , tahcycardia, hypotension,

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CI lithium therapy?

renal imp, cardiac, untreated hypothyroid, addisions with low Na
pregnancy - CI 1st, only use with nec with 2nd and 3rd
risk renal/ low Na with acei, diruetics (thiazides), SSRI, NSAID

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Monitoring lithium therapy?

levels 5 days after starting, then weekly until stable then 3 monthly and during any illness.
TFTs, U+Es, urine dip, Ca, creatiine (6 monthsly and initial)check goitre, ECg, weight pulse, BP

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common lithium SE?

metallic taste, thirst, polyuria, weight gain, oedema, abdo pain, nausea,
less commonL hypothyroid, diabetes insipidus (nephro), high PTH, high Ca, acne, cognitive impairment, high MG,m

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monitoring clozapine?

tx resistant shizophrenia.
weekly FBC for 18 weeks then fortnightly 34 weeks then monthly. risk reduces the longer the therapy

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8YO boy staring into space/ daydreaming?

abscent seizurr

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60YO F, derranged LFTs, acutely confused, ataxic gait, B/Lhorizontal nystagmus. CTH petechial haemorrhages

Glucose infusion with chronic thiamine deficiency precipitating wernickes

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Features of borderline personality disorder?

emotional instability, intense and unstable relationships, impulsive behaviour, disturbed patterns of thinking/perception

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risk of suicide?
most concerning intent?

male, self harm, physical health issues, express suicidal intent

most concerning: detailed planning of event

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3 month HX low mood, suicide, hallucinating dead mother, 21YO

depression.
bereavement usually within 2-3 weeks. psychotic sx unlikely in uncomplicated bereavement

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Breastfeeding safe SSRI?

paroxitine/ sertraline

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When is mirtazipine/ trazadone/ reboxetine best to start in depression with chronic illness?

if patient is on NSAID/ warfarin/ aspirin, triptans, ci: selegiline/ rasagiline (MAO-B),

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best antidepressant for patient on anti-epileptics?

Sertraline

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What can you not prescribe with amoxetine?

SSRIs: fluoxetine, peroxetine, citalopram, escitalopram

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antidepressent for patient taking clozapine/ methadone/theophylline?

sertraline

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antidepressents with dedating effects?

mirtazipine, trazadone, lofepramine

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antidepressent discontinuation sx?

dizzy, nausea, anxiety, diarrhoea, flu sx, headache, diarrhoea

SNRI names and risk?

venlafaxine- CI arrythmias, HTN, recent MI. likely discontinuation sx duloxetine- CI HTNhepatic/ renal impariemnt

SSRI - names and risks? weight gain? torsade? best for HF/ MI? other SE?

paroxetine - WG, high disontnuation sx Citalopram/ escitalopram - QT Sertraline - good for MI/HF, risks hepatic impairment SE: bleeding, ED, SIADH, GI, headaches, anxiety/suicide CI: mania, poorly controlled epilepsy

Which anti-depressents class give anti cholinergic sx and bad for bundle branch block/ heart issues?

TCAs - amitryptiline/ nortryptiline SE: dry mouth, urine retention, blurred vision, cognitive impairement, constipation

antidepressent better for erectile dysfunction/ elderly?

mirtazipine - sedation, weight gain, increased appetite (CI MAOi)

19YO lively, flirty, enthusiastic, inappropriate sexually provocative, influenced by others?

histrionic

detatched, cold, indifferent to praise, social norms, little pleasure in activities, limited capacity to express emotions, lack of sexual desire

shizoid

surgeon who dedicates life to distract herself from inadequate family?

compensation - cope with inferiority

stressed GP, acts out at home is aggressive?

displacement - redirects negative emotion to less threatening opponent

Med student drinking like rugby player?

identification - make themselves like someone else

Well dressed presented to ED 1000miles from home with amnesia?

dissociative fugue

newly started risperidone, has lower limb restlessness but able to sleep fine?

akasthisia. restless legs - effects sleep

belief that famous person is in love with you?

de clerambault's

belief that familiar person is identified in strangers?

fregoli

shizophrenia negative sx?

lack of motivation, oncongruity, blunting affect, depresison, povert of speech,h

shizophrenia positive sx?

thought disorder, delusions, auditory hallucinations

TCAS less sedative?

lofepramine, imipramind, nortypriptiline

amitryptiline type of incontinence?

overflow incontinent

paresis of left leg. asked patient to SLR right leg. pressure under heel of left leg felt?

hoover's sign. positive in conversion disorder (non organic cx of leg paresis)

most things in anorexia low except Gs and Cx?

G's and C's raised: growth hormone, glucose, salivary glands, cortisol, cholesterol, carotinaemia

Extra pyramidal SE? extra potato?

Extra pyramidal effects - Parkinsonism, Oculogyric crisis, TArdive dyskinesia,TOrticollis (dystonia),

short term low mood and stress began in response to a clear external stressor (job loss)

adjustment disorder

delusional disorder?

fixed, false belief (being spied on by his neighbours) that persists despite a lack of evidence. The belief is non-bizarre, meaning it could happen in reality, but there is no substantial evidence, and the patient’s overall functioning is relatively intact

How do benzos and barbiturates work? Frequently Bend - During Barbeque

Benzos increased frequency of chloride ion channels, icnrease GABA effect. barbiturates increase duration of chloride channels

Poor prognosis factors for shizophrenia?

strong family history gradual onset low IQ prodromal phase of social withdrawal lack of obvious precipitant

tx for severe depression, life threatening with catatonia?

ECT

Alcohol withdrawal - time to reach sx/ seizures/ delerium tremens?

sx - 6-12 hrs seziures 36 hrs delerium tremens 72 hrs

difference between OCD and OCPD?

OCD - intrusive thoughts and unwanted behaviours OCPD - rational and desirable thoughts

TX GAD drugs?

sertraline, then alternate SSRI/ SNRI then pregablin. if no response for 12 weeks, try imipramine/ chloropramine

wandering from a topic without returning to it.

tangetiality

new word formations, which might include the combining of two words

neologisms

ideas are related to each other only by the fact they sound similar or rhyme.

clang associations

loosening of associations, where there are unexpected and illogical leaps from one idea to another. It is a feature of schizophrenia.

knight's move associations

leaps from one topic to another but with discernible links between them.

flight of ideas

repetition of ideas or words despite an attempt to change the topic

perservation