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Psych Key Concepts Flashcards

1
Q

What is erotomania/De Clerambault’s syndrome?

A

A delusional disorder characterised by a delusion that someone famous is in love with them, with the absence of other psychotic symptoms

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2
Q

What are 3 important metabolic side effects of antipsychotics?

A

Dysglycaemia
Dyslipidaemia
Diabetes mellitus

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3
Q

What is the definition of mania?

A

Persistently elevated mood state with psychotic symptoms

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4
Q

Which type of bipolar disorder is associated with mania and hypomania?

A 
Mania = type 1
Hypomania = type 2
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5
Q

What important systemic disease can long-term atypical antipsychotic use lead to?

A

Diabetes and glucose dysregulation

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6
Q

What is the first-line treatment for generalised anxiety disorder?

A

SSRIs

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7
Q

If CBT or EMDR therapy are ineffective in PTSD, what are the first-line drug treatments?

A

Venlafaxine (specifically)

or SSRI

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8
Q

Examples of acute dystonia

A

Torticollis

Oculogyric crisis

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9
Q

Agranulocytosis/neutropenia is a life-threatening side effect of which drug and how should you monitor patient

A

Clozapine

Monitor FBC

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10
Q

Thought withdrawal definition

A

Belief of having removal of a thought by an external force

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11
Q

Management of mania/hypomania in patients on antidepressants

A

Stop antidepressant

Start antipsychotic

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12
Q

Other name for erotomania

A

Other name for De Clerambault’s syndrome

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13
Q

Hoover’s sign description + use

A

Pressure felt UNDER paretic leg when lifting non-paretic leg against pressure due to involuntary contralateral hip extension
Differentiates ORGANIC from NON-ORGANIC leg paresis

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14
Q

Drugs to be avoided with SSRIs

A

Triptans

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15
Q

Sign that increases risk of completed suicide

A

Efforts to avoid discovery

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16
Q

Long-term lithium use side-effects

A

Hyperparathyroidism and CONSEQUENTIAL hypercalcaemia

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17
Q

Difference between somatisation and hypochrondriacal disorder

A

Both represent medically unexplained symptom disorders
Somatisation - worried about the symptoms
Hypochondriacal - worried about serious underlying disease

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18
Q

Triad for Schizoid personality disorder

A

Prefer to be alone
Don’t like relationships
Low libido

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19
Q

Poor prognostic factor for schizophrenia

A

Gradual onset

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20
Q

Name for stopping of voluntary movement or staying still in an unusual position

A

Catatonia

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21
Q

Acute dystonic reactions are adverse effect of which medications

A

Antipsychotics

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22
Q

Features of acute dystonic reaction

A

Eye movement/deviation + blinking for a period of time (3 minutes+)

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23
Q

Inner restlessness + inability to keep still

A

Akathisia

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24
Q

Positive drop-arm test + Dx

A

Patient unconsciously exhibits controlled drop of their arm such that it avoids hitting their face
- CONVERSION disorder (like the Hoover’s sign)

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25
First line Tx for delirium tremens/alcohol withdrawal
Chlordiazepoxide | Diazepam
26
Antisocial vs borderline PD differentiating feature
``` Antisocial = men Borderline = women ```
27
Most common side effect of atypical antipsychotics
Weight gain
28
Atypical antipsychotics
``` Clozapine Olanzapine Risperidone Quetiapine Amisulpride Aripiprazole ```
29
Short-term side effect of ECT
Cardiac arrhythmias
30
Alcohol withdrawal effects peak times
Symptoms - 6-12 hrs Seizures - 36 hrs Delirium tremens - 72 hrs
31
Torticollis is an example of...
Acute dystonic reaction
32
Definition of OCD
Obsessions or compulsions or both, persisting for >2 weeks
33
Management of OCD
Initial - low-intensity psych therapy (exposure + response prevention) Medical - SSRIs
34
Definition of echolalia
Repetition of someone else's speech including questions being asked
35
Difference between acute stress disorder and post-traumatic stress disorder
ASD <4wks post-event | PTSD >4wks post-event
36
How severe does trauma need to be to cause post-concussion syndrome
Can be trivial e.g. rugby player
37
Most common endocrine disorder in lithium toxicity
Hypothyroidism
38
Examples of somatic symptoms
Early morning waking | Changes in appetite and weight
39
How should antidepressant meds be adjusted when patient about to start ECT
Reduce dose, don't stop it
40
Person believes they are dead or non-existent = ...syndrome?
Cotard syndrome
41
Poor prognostic factor for schizophrenia
Low IQ
42
More tired than usual, generally unwell, weight gain. Side effects of which drug?
Clozapine (agranulocytosis)
43
Memory side effect of ECT?
Memory impairment (most important ECT side effect)
44
Which is the most important side effect of ECT and how should it be monitored?
Memory loss | Assess memory at start and end of each treatment
45
Most common type of amnesia post-ECT
``` Retrograde amnesia (forgetting the past) Anterograde amnesia possible but much less common (inability to form new memories post-insult) ```
46
Potential personal life feature of schizophrenia development
Circadian rhythm disruption (insomnia)
47
Indications for ECT
Treatment-resistant severe depression Manic episodes Episode of moderate depression known to respond to ECT LIFE-THREATENING catatonia
48
RFs for Charles Bonnet syndrome
``` Advanced age Peripheral visual impairment Social isolation Sensory deprivation Early cognitive impairment ```
49
SSRI with highest incidence of discontinuation symptoms
Paroxetine
50
Clinical features of Korsakoff's syndrome
Anterograde AND retrograde amnesia | Confabulation
51
What is Korsakoff's syndrome
Complication of Wernicke's encephalopathy (suspect in alcoholic)
52
Most common side-effects of SSRI discontinuation syndrome
GI symptoms (e.g. diarrhoea)
53
Circumstantiality can be a sign of which 2 disorders?
Anxiety disorders | Hypomania
54
Circuitous and non-direct thinking or speech that digresses from the main point of a conversation. Eventually ends with reaching final goal of the conversation.
Circumstantiality
55
What is lanugo hair + associated conditoin
Fine downy hair growth in response to loss of body fat | Anorexia nervosa
56
MoA of benzos
Enhance GABA effect
57
Temazepam
Benzodiazepine
58
Tx for borderine personality disorder
Dialectical behaviour therapy (DBT)
59
Incontinence type caused by TCAs
Overflow incontinence (due to anticholinergic effect)
60
Amitriptyline
Tricyclic antidepressant
61
Differences between Knight's move thinking and flight of ideas
Knight's move - no discernible links between topics - Schizophrenia Flight of ideas - discernible links between topics - Mania
62
Protocol for monitoring lithium levels
Blood test 12hrs post-dose every 3 months
63
Drug causes of hyponatraemia
SSRIs
64
Sertraline
SSRI
65
Main risk of zopiclone in elderly
Increased risk of falls
66
Course of action if clozapine doses missed for >48 hours
Doses need to be restarted again SLOWLY
67
1st-line treatment for <18s with anorexia nervoas
Family therapy (anorexia-focused)
68
1st-line treatment for acute stress disorders
Trauma-focused CBT
69
Next step if symptoms of mania in primary care
Urgent referral to community mental health team
70
Rasagiline
Monoamine oxidase inhibitor (MAOI)
71
Drug combo cause of serotonin syndrome
SSRIs + MAOIs
72
Protocol for stopping antidepressants after remission of symptoms + why
Should continue for AT LEAST 6 months after remission of Sx | - decreases risk of relapse
73
MAIx for new onset psychosis in elderly patients
CT Head - rule out organic cause
74
Lifestyle choice that causes rise in clozapine blood levels
Smoking CESSATION
75
Protocol for stopping SSRI
Gradually reduce over 4 weeks
76
Risk of SSRI use in pregnancy (particularly paroxetine)
1st trimester - Small increased chance of congenital heart defects 3rd trimester - persistent pulmonary hypertension of newborn Paroxetine has a general increased risk of congenital malformations (esp in 1st trim)
77
Management of PTSD
Trauma-focused CBT or EMDR
78
2 main criteria of chronic insomnia
Present for 3+ nights a week | Present for ≥3 months
79
SSRI electrolyte disturbance
Hyponatraemia
80
SSRI + NSAID = ? + management
GI bleeding risk | - give PPI
81
Migraine treatment
Aspirin, ibuprofen, 5HT1-receptor agonist (triptan)(don't give in SSRIs)
82
Mirtazapine characteristic side effects
``` Sedation Increased appetite (useful in depressed patients who aren't sleep + eating) ```
83
Fixed, false belief (delusion) that they are infested with 'bugs'
Delusional parasitosis
84
Clinical features of anorexia nervosa
Most things low G's and C's high - growth hormone, glucose, salivary glands - cortisol, cholesterol, carotinaemia (it might help to think of the body as being under stress due to not eating so GH, glucose, cortisol all likely to be high)
85
Requirement for diagnosing personality disorders
Must be >18y/o
86
CBT vs DBT use
CBT - OCD (+/- ERP) | DBT - personality disorders
87
TCA side effects
Antimuscarinic - blurred vision + dry mouth (particularly with imipramine) Antihistaminic - weight gain (clomipramine)
88
Schizoid vs schizotypal personality disorders
Schizoid - negative symptoms of schizophrenia | Schizotypal - positive symptoms of schizophrenia
89
Duloxetine MoA
SNRI (serotonin + noradrenaline reuptake inhibitor)
90
Treatment of acute dystonia secondary to antipsychotics
Procyclidine
91
Stepwise drugs for generalised anxiety disorder
1 - Sertraline 2 - Alternative SSRI or SNRI 3 - Pregabalin
92
Dizziness + electric shock sensations + anxiety =
SSRI discontinuation syndrome
93
Seizures as drug SE in psych =
Clozapine (reduces seizure threshold)
94
Commonest clozapine SE
Constipation/intestinal obstruction
95
Strongest RF for schizophrenia
FHx - having a parent with it = relative risk of 7.5
96
SSRI of choice post-MI
Sertraline
97
SSRI of choice in children/adolescents
Fluoxetine
98
First choice SSRIs in depression
Citalopram + fluoxetine
99
FBC side-effect of Lithium
Benign leucocytosis (high WCC with no other abnormalities or symptoms)
100
Management of patients with poor compliance of antipsychotics
Once-monthly IM antipsychotic DEPOT injections
101
Increased risk of what in elderly due to antipsychotics
Stroke + VTE
102
Risk factors + protective factors for developing GAD
RF - aged 35-54, divorced/separated, live alone, lone parent | PF - aged 16-24, married or cohabiting
103
Rare but life-threatening side effect of anti-psychotics
Neuroleptic malignant syndrome
104
Sudden onset psychosis after starting corticosteroids =
Steroid-induced psychosis
105
Treatment for seasonal affective disorder
Same as depression | - psych therapies for 2 weeks then f/u, if deterioration give SSRI
106
Disease to rule out when working with a diagnosis of GAD
Rule out THYROID disease (hyperthyroidism)
107
Administration route for depot injections
Intramuscular
108
Best antipsychotic for side effects esp prolactin elevation
Aripiprazole
109
Way to differentiate between OCD and psychosis
Level of insight into actions e.g. they truly believe that if they don't follow through on their compulsions then something bad will actually happen then = psychosis
110
Definition of Munchausen's syndrome
Purposefully causing symptoms | Also known as factitious disorder
111
Management of patient showing symptoms of hypomania in primary care
Routine referral to community mental health team to confirm diagnosis + define treatment
112
Type of hallucinations that are NOT first-rank schizophrenia symptoms
VISUAL hallucinations
113
Venlafaxine MoA
Serotonin and noradrenaline reuptake inhibitor
114
Memory side effect of benzodiazepines
Anterograde amnesia (inability to form new memory + memory recall impaired)
115
Management of GAD
SSRI first-line | If fails try another SSRI or an SNRI (e.g. duloxetine, venlafaxine)
116
Paralysis that occurs after waking up or shortly before falling asleep with hallucinations (visual or auditory) that appear during paralysis
Sleep paralysis
117
Treatment for troublesome sleep paralysis
Clonazepam
118
Scale used for assessing SEVERITY OF ALCOHOL WITHDRAWAL
Clinical Institute Withdrawal Assessment for Alcohol (CIWA) scale
119
Drug class to prevent seizures in alcohol withdrawal
Benzodiazepines
120
Foods to avoid with MAOi's
Tyramine-containing foods e.g. cheese, pickled herring, Bovril, Oxo, Marmite, broad beans

Y5 Passmed (3 decks)

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