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Psychiatry > Psych Disorders Due To AMC > Flashcards

Psych Disorders Due To AMC Flashcards

1
Q

Name 4 infections diseases that commonly manifest with neuropsychiatric manifestations

A
  1. Hiv/aids
  2. Syphilis
  3. Lyme disease
  4. Prion disease eg creutzfeldt - Jakob disease
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2
Q

Name. 4 rheumatological/ autoimmune conditions with neuropsychiatric manifestations

A
  1. SLE
  2. Sarcoidosis
  3. Vasculitides
  4. Multiple sclerosis
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3
Q

Name 4 endocrinological conditions with neuropsych manifestations

A

1 cushings

  1. hypo/ hyper thyroidism
  2. Hypo /hyper parathyroidism
  3. Adrenal insufficiency
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4
Q

Name 6 NB vitamin deficiencies conditions with neuropsych manifestations

A 
Thiamine (B1)
B12
B3
B6
Folate
Vit D
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5
Q

Name an NB micronutrient abnormality with neuropsych manifestations

A

Hypo/hyper calcaemia

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6
Q

Name 5 diagnostic considerations if a patient has psychiatric symptoms and a medical condition?

A

1 delirium

  1. MC causing psych symptoms
  2. AMC and psych symptoms co-exist/co-morbid
  3. Psychological response to AMC
  4. Medication causing psychiatric symptoms
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7
Q

Name 3 red flags and 3 orange flags pointing to AMC as a cause of psych symptoms

A 
Red flags: 
1. late onset of initial presentation
2. Known MC or abnormal physical exam
3. Medication use (esp new )
Orange flags: atypical presentation, no family history, treatment resistance or unusual treatment response.
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8
Q

Name 5 situations in which brain imaging (preferably MRI) is mandatory

A
  1. Localising signs on neurological exam ( ID focal path and/or space - occupying lesion)
  2. New onset seizures
  3. Cognitive impairment excessive or atypical for psych condition
  4. Possible encephalitis (pyrexia, headache, seizures, cognitive impair)
  5. Possible fall, cognitive impair, vulnerability factors eg anticoag or alcoholism (exclude subdural haematoma )
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9
Q

Name 5 metabolic conditions with neuropsych manifestations

A
  1. Acute hepatic porphyrias
  2. Wilson’s disease! (Excess copper)
  3. Amyloidosis
  4. Hepatic encephalopathy
  5. uraemia
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10
Q

In What type of seizure is psychopathology commonly found?

A

Complex partial seizures (ie focal seizures in which patient has lost conciousness)

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11
Q

What is the most specific lab test for epilepsy?

A

Elevated prolactin 15-20 minutes after seizure

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12
Q

Which psychiatric drugs are contraindicated in epilepsy? (5)

A
  1. Tricyclic antidepressants
  2. bupropion (atypical antidepressant)
  3. Low potency typical antipsychotics (phenothiazines) eg chlorpromazine, thioridazine
  4. Clozapine: dibenzodiazepines atypical neuroleptic
  5. Lithium
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13
Q

What is the best class of antidepressant for an epilepsy patient?

A

SSRI

Do not give TCA or bupropion

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14
Q

What is the best antipsychotic to prescribe to epilepsy patient?

A

Haloperidol (low pro-convulsive effect)

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15
Q

Neuropsych symptoms are more common in tumours at which 2 locations in the brain?

A

Frontal and temporal

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16
Q

Name 3 common psych symptoms in multiple sclerosis

A

Depression, cognitive decline, fatigue

17
Q

What psych disorders can thiamine (b1) deficiency cause in the acute and chronic state?

A

Acute: wernicke encephalopathy
Chronic: korsakoff syndrome

18
Q

Who is particularly at risk for wernicke encephalopathy?

A

Heavy drinkers -impaired absorb

19
Q

Name the triad for pellagra

A

3 Ds
Dementia, dermatitis, diarrhea
(B3 niacin deficiency )

20
Q

What causes pellagra

A

Niacin ( vit B3) deficiency

21
Q

Name the psychiatric symptoms associated with hyperthyroidism (7)

A
  1. Depression
  2. Cognitive impair
  3. Psychosis
  4. Mania RARE
  5. anxiety
  6. Insomnia
  7. Mood lability
22
Q

Name the psychiatric symptoms associated with hypothyroidism ( 5 )

A
  1. Depression
  2. Cognitive impair
  3. Psychosis
  4. Apathy
  5. myxoedema madness
23
Q

What is the most common psychiatric symptom of Cushing’s?.

A

MDD

24
Q

What are the 2 most common psychiatric symptoms caused by exogenous hypercortisolism?

A

Mania and psychosis

25
Q

What are the 3 most common psychiatric manifestations of Lupus?

A
  1. cognitive impair
  2. Depression
  3. Mania ( due to steroid rx)
26
Q

Which Mc is most likely to present with delirium?

A

Electrolyte imbalance: calcium derangement and hyponatraemia

27
Q

Which mc is the great imitator of almost any psych disorder?

A

Tertiary syphilis

28
Q

Name the 3 core features of HAD (HIV associated dementia)

A
  1. cognitive changes: psychomotor slowing, memory, attention, executive dysfunction
  2. Motor changes: hand writing, tremor, clumsiness, gait abnormal
  3. Behavioural problems: severe MDD, apathy, aggression
29
Q

Name 5 diagnostic differentials in patients with HIV and psychotic symptoms

A
  1. Delirum
  2. Other medical causes (increased risk in HIV)
  3. Other causes: substances, meds, mental condition
  4. had
  5. Psychosis, mood disorder due to HIV
30
Q

Describe the 3 classifications /categories of HAND (HIV ass neurocog disorders) according to severity

A
  1. Asymptomatic neurocognitive impairment:doesn’t interfere with daily functioning
  2. Mild neurocognitive disorder: mild interference
  3. HIV associated dementia: marked
31
Q

Name the 3 core features of HAND (HIV associated neurocognitive disorder) and give 3 examples for each.

A

1 cognitive changes: memory, concentration and attention, executive functioning, decreased ability to learn new info, slow processing
2 behaviour and mood: apathy, social withdraw, lack energy, disinhibition, personality, emotional lability, aggression
3 motor: general motor slowing, decline handwriting, clumsiness, leg weak, unsteady gait, tremor

32
Q

Name 4 medical conditions causing Catatonia

A
  • Neurological disorders: nonconvulsive status epilepticus, head trauma
  • infections: encephalitis
  • metabolic disturbances: hepatic encephalopathy, hyponatraemia, hypercalcaemia
  • neuroleptic malignant syndrome
33
Q

Name 3 medications causing Catatonia

A
  • Corticosteroids
  • immune suppressants
  • antipsychotics - May also be seen in neuroleptic induced Parkinsonism/ neuroleptic malignant syndrome

Psychiatry (31 decks)

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