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3B + Finals > Psych COPY > Flashcards

Psych COPY Flashcards

1
Q

Negative symptoms of psychosis

A

Anhedonia
alogia
asocial
avolition

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2
Q

+ symptoms of psychosis

A

Hallucinations
delusions
thought disorder

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3
Q

Alcohol Withdrawal a management

A

Benzodiazepine (chlordiazepoxide)
Psychosis -> Haloperidol
Thiamine deficiency -> Pabinex

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4
Q

Alcohol withdrawal symptoms

A 
Delerium 
dehydration 
cognitive impairment 
Paranoid delusions 
Tremor 
Autonomic arousal
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5
Q

Mx of substance misuse

A

Hep B vaccine
CBT + Movitational interviewing
Social support

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6
Q

Management of PTSD presenting <3 months from event

A

Watchful waiting
Trauma focussed CBT
Sleep disturbance managed with zopiclone

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7
Q

4 clinical features of PTSD

A

reliving
Avoidance
Hyperarousal
Emotional Numbing

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8
Q

Management of anxiety

A

SSRI -sertraline

SNRI - venlafaxine

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9
Q

ICD-10 diagnosis of anxiety

A

4 symptoms

at least one is of autonomic arousal eg palpitations, dry mouth, sweating, tremor

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10
Q

Bloods done for alcohol dependancy

A 
FBC - anaemia (microcytic)
U/E - Dehydration, renal failure 
LFT
B12/folate 
Amylase
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11
Q

Organic causes of schizophrenia

A

Drugs (alcohol, cannabis, MDMA, levodopa)
Huntingtons disease
dementia
syphilis

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12
Q

Alcohol depednance long term medical treatment

A

Disulfam - increase acetaldehyde when you drink
Acomprosate - increase GABA, decreasing craving
Naltrexame - Blocks opioid receptors, prevents reward

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13
Q

Kosakoffs psychosis?

A

Irreversable memory loss + confabulation and disorientation

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14
Q

Two theories for the development of alcohol dependancy

A

Social learning theory - copy friends and parents

Operant conditioning - positive negative reinforcement.

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15
Q

Antidepressant for children and adults first line

A 
Child = fluoxetine 
Adult = sertraline then venlafaxine or mirtazipine (if insomnia)
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16
Q

Inx for dementia

A

MMSE
AMT
Addenbrookes cognitive exam
Montreal cognitive assessment

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17
Q

Alzheimers management

A

AchE inhibitors (rivastigmine)

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18
Q

2 typical and 2 atypical antipsychotics

A

Atypical - Rispiridone Clozapine olanzepine

Typical - Halloperidol Fluphenazine

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19
Q

Extrapyramidal Side effects of antipsychotics

A

Parkinsonism
Akathisia (feeling restless)
Dystonia
Tardive dyskinesia (abnormal involuntary movements)

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20
Q

Side effects of antidepressants

A

Antimuscarinic (functional incontinence)
Antihistaminic - sedation and weight gain
Increased weight
prolonged QT

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21
Q

Indications for ECT

A

severe depression
Catatonia
Fucking off the walls with mania

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22
Q

Issues with smoking in patients with schizophrenia

A

If the patient is on clozapine

Smoking cessation can increase blood levels of clozapine

23
Q

4 Problems with SSRIs

A 
GI upset (also common in SSRI discontinuation syndrome) 
Sexual dysfunction 
Tremor 
Avoid in epileptics and mania
24
Q

Extra-pyramidal side effects of Anti-psychotics

A

Parkinsonism - bradykinesia, tremor, Rigidity
Akethesia - restlessness
Dystonia
Tardative dyskinesia

25
Q

3 Side effects of TCAs

A

Anti-cholenergic
Increased appetite and weight gain
Arrhythmias postural hypotension

26
Q

Risk for elderly patients on antipsychotics

A

VE

27
Q

Section 5(4) and 5(2) of MHA?

A

4 = Nurse holding power. Lasts 6 hours. Medications can not be given

28
Q

Section 2 of MHA

A

28 days for assessment and treatment
2 doctors, + AMHP
On s12 doctor

29
Q

Section 3

A

6 months for treatment
2 doctors + AMHP
One s12 doctor

30
Q

Section 4

A

Emergency order
72 hrs
1 doctor + 1 AMHP

31
Q

1dt and 2nd Mx for insomnia

A

1 - CBT

2 - Benzodiazepine

32
Q

Causes of neuroleptic malignant syndrome

A

Anti-psychotics

Dopaminergic drugs

33
Q

How to stop and SSRI

A

over a 4 week period reduce the dosage

34
Q

What is serotonin syndrome

A 
comes on shortly after starting and SSRI
Increased serotonin 
Headache, agitation, hypothermia 
Autonomic defects - shivering, sweating
Myoclonus and increased reflexes
35
Q

Suicide RF

A 
Male 
Hx of self harm 
alcohol and drug misuse 
Mental illness
Old age 
chronic disease
36
Q

Risk of successful suicide

A 
Planning 
Effort to avoid discovery 
Leaving a note
final acts (finances) 
Violent method
37
Q

Anti-psychotic that reduces seizure threshold the most

A

Clozapine

38
Q

5 drugs in mx of alcoholism (short term and long)

A 
Chlordiazeperoxide (treats/prevent DTs)
Thiamine (wernickes encephalopathy) 
IV pabrinex (as above)
Disulfiran - makes hangovers worse
Acomprosate (decrease GABA so decrease  cravings)
Naltrexene - blocks opioid receptors
39
Q

Lithium side effects

A 
Leukocytosis
Increased reflexes 
Tremor 
Hypothyoidism 
Impaired renal function 
Urine (polyuria)
Metallic taste
40
Q

1) What is the safest SSRI to prescribe post MI
2) You start a 22yo man on Citalopram - what should you a) Screen for b) counsel the patient about c) follow up
3) SSRi to use in children an young people

A

1) Sertraline
2) Suicide risk. Agitation and anxiety when starting. Follow up appt in 2 weeks
3) Fluoxetine

41
Q

Safest antidepressants to use in pregnancy and breast feeding

A

Sertraline and fluoxetine in pregnancy, as well as amitriptyline (TCA)
Paroxetine and sertraline in breast feeding

42
Q

A patient has difficulty sleeping and is tired all the time and depressed. They are often off their food and as a result have lost 8 kilos.
What is the best antidepressant to start them on and why?

A

Mirtazipine

Improves insomnia - increases appetite and weight gain.

43
Q

Pt presents to A&E with a headache, confusions, hallucinations, sweating and high BP. On the SCS you see yesterday they saw their GP regarding depression

1) What is the likely cause of their symptoms, what management may they have been started on to cause these symptoms
2) Likely other symptoms/signs
3) Management

A

1) Serotonin syndrome. Caused withering minutes of first taking SSRI
2) Tachycardia. Myoclonus. Increased reflexes. Tremor.
3) Stop SSRI and supportive measures

44
Q

Names 2 first and 2 second gen antipsychotics

A

1st
Haloperidol and Chlorpromazine
2nd
Olanzepine and Clozapine

45
Q

2 side effects of clozapine

A

Agranulocytosis

Hyper-salivation

46
Q

Other side effects of antipsychotics

A

Anti-histaminic - weight gain, sedation
Anti-muscarinic - can’t wee, can’t see, can’t spit can’t shit
Increased prolactin - titties.
Anti-adrenergic - Postural hypotension, Tachycardia, Ejaculatory failure

47
Q

First line mx for bipolar disorder

Second line

A

Lithium

Valproate

48
Q

How would you follow up a patient started on lithium

A

1) Bloods 12hr after lithium dose at least every 3m - FBC (leukocytosis) and lithium level.
2) U/Es - renal output
3) TFTs

49
Q

1) Cause of lithium toxicity

2) Symptoms of Lithium Toxicity

A

1) 4 Ds (Dehydration, Drugs (NSAIDs and ACEI), Diuretics, Depletion of Sodium)
2) TOXIC
T - tremor
O - oliguria/renal failure
X - AtaXia
I - Increased reflexes
C - Convulsions, confusion and coma

50
Q

Contraindication of valproate

A

Pregnant - neural tube defects = spina bifida

51
Q

Indication of poorer prognosis in schizophrenia

A

Low IQ

52
Q

When should a patient be reviewed following a dose change of their lithium

A

1 week

53
Q

3 drugs to be cautious prescribing alongside SSRI

A

NSAIDS - GI bleed give PPI
Heparin
Warfarin

3B + Finals (15 decks)

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