psych day before cards Flashcards
Avoidance of tyramine-rich foods is necessary when taking which class of medication?
MAOI’s
Consumption of tyramine-rich foods (eg. red wine, cheese, beef/chicken liver, pickled herring) when taking monoamine oxidase inhibitors (MAOIs) can precipitate a hypertensive crisis,
Chairman Mao was responsible for a famine so you couldnt have anything nice like cheese or red wine
How do typical antipsychotics work?
Dopamine D2 receptor antagonists, blocking dopaminergic transmission in the mesolimbic pathways
More likely to cause EPSE + hyperprolactinaemia
Haloperidol. chlopromazine
Atypical?
Act on a variety of receptors (D2, D3, D4, 5-HT)
More metabolic side effects
Clozapine, risperidone, olanzapine
What are some other side effects of antipsychotics?
antimuscarinic: dry mouth, blurred vision, urinary retention, constipation
sedation, weight gain
raised prolactin
may result in galactorrhoea
due to inhibition of the dopaminergic tuberoinfundibular pathway
impaired glucose tolerance
neuroleptic malignant syndrome: pyrexia, muscle stiffness
reduced seizure threshold (greater with atypicals)
prolonged QT interval (particularly haloperidol)
Adverse effects of clozapine?
Adverse effects of clozapine
agranulocytosis (1%), neutropaenia (3%)
reduced seizure threshold - can induce seizures in up to 3% of patients
constipation
myocarditis: a baseline ECG should be taken before starting treatment
hypersalivation
Dose adjustment of clozapine might be necessary if smoking is started or stopped during treatment.
What do benzos do?
Benzodiazepines enhance the effect of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA) by increasing the frequency of chloride channels.
What are the weird syndromes you need to remember?
De Clerambault’s = erotomania (excessive horniness); makes sense, it’s French
Cotard syndrome = believing you’re dead
Othello syndrome = delusional jealousy (usually of a partner) #Shakespeare
Capgras delusion = believing a (close) acquaintance has been replaced by an imposter
Charles Bonnet syndrome (not DE Bonnet) = Recurring hallucinations in those with impaired vision
Depression vs dementia?
Factors suggesting diagnosis of depression over dementia
short history, rapid onset
biological symptoms e.g. weight loss, sleep disturbance
patient worried about poor memory
reluctant to take tests, disappointed with results
mini-mental test score: variable
global memory loss (dementia characteristically causes recent memory loss)
I dont know answers for example
What is a CI for ECT?
ONLY high ICP
How long can a grief disorder last
up to 12 months
Can start 2 weeks after event
Hoe do MAOis work?
serotonin and noradrenaline are metabolised by monoamine oxidase in the presynaptic cell
Non-selective monoamine oxidase inhibitors
e.g. tranylcypromine, phenelzine
used in the treatment of atypical depression (e.g. hyperphagia) and other psychiatric disorder
not used frequently due to side-effects
Difference between a a section 4 and 5(2)
Section 4
72 hour assessment order
used as an emergency, when a section 2 would involve an unacceptable delay
a GP and an AMHP or NR
often changed to a section 2 upon arrival at hospital
Section 5(2)
a patient who is a voluntary patient in hospital can be legally detained by a doctor for 72 hours
What is circum stantiality?
Circumstantiality is the inability to answer a question without giving excessive, unnecessary detail. However, this differs from tangentiality in that the person does eventually return to the original point.
What is tangentiality?
Tangentiality refers to wandering from a topic without returning to it.
What is a neologism
Neologisms are new word formations, which might include the combining of two words.
