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Y5 Passmed > Psych Key Concepts > Flashcards

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
Q

First line Tx for delirium tremens/alcohol withdrawal

A

Chlordiazepoxide

Diazepam

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26
Q

Antisocial vs borderline PD differentiating feature

A 
Antisocial = men
Borderline = women
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27
Q

Most common side effect of atypical antipsychotics

A

Weight gain

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28
Q

Atypical antipsychotics

A 
Clozapine
Olanzapine
Risperidone
Quetiapine
Amisulpride
Aripiprazole
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29
Q

Short-term side effect of ECT

A

Cardiac arrhythmias

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30
Q

Alcohol withdrawal effects peak times

A

Symptoms - 6-12 hrs
Seizures - 36 hrs
Delirium tremens - 72 hrs

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31
Q

Torticollis is an example of…

A

Acute dystonic reaction

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32
Q

Definition of OCD

A

Obsessions or compulsions or both, persisting for >2 weeks

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33
Q

Management of OCD

A

Initial - low-intensity psych therapy (exposure + response prevention)
Medical - SSRIs

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34
Q

Definition of echolalia

A

Repetition of someone else’s speech including questions being asked

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35
Q

Difference between acute stress disorder and post-traumatic stress disorder

A

ASD <4wks post-event

PTSD >4wks post-event

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36
Q

How severe does trauma need to be to cause post-concussion syndrome

A

Can be trivial e.g. rugby player

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37
Q

Most common endocrine disorder in lithium toxicity

A

Hypothyroidism

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38
Q

Examples of somatic symptoms

A

Early morning waking

Changes in appetite and weight

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39
Q

How should antidepressant meds be adjusted when patient about to start ECT

A

Reduce dose, don’t stop it

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40
Q

Person believes they are dead or non-existent = …syndrome?

A

Cotard syndrome

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41
Q

Poor prognostic factor for schizophrenia

A

Low IQ

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42
Q

More tired than usual, generally unwell, weight gain. Side effects of which drug?

A

Clozapine (agranulocytosis)

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43
Q

Memory side effect of ECT?

A

Memory impairment (most important ECT side effect)

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44
Q

Which is the most important side effect of ECT and how should it be monitored?

A

Memory loss

Assess memory at start and end of each treatment

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45
Q

Most common type of amnesia post-ECT

A 
Retrograde amnesia (forgetting the past)
Anterograde amnesia possible but much less common (inability to form new memories post-insult)
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46
Q

Potential personal life feature of schizophrenia development

A

Circadian rhythm disruption (insomnia)

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47
Q

Indications for ECT

A

Treatment-resistant severe depression
Manic episodes
Episode of moderate depression known to respond to ECT
LIFE-THREATENING catatonia

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48
Q

RFs for Charles Bonnet syndrome

A 
Advanced age
Peripheral visual impairment
Social isolation
Sensory deprivation
Early cognitive impairment
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49
Q

SSRI with highest incidence of discontinuation symptoms

A

Paroxetine

50
Q

Clinical features of Korsakoff’s syndrome

A

Anterograde AND retrograde amnesia

Confabulation

51
Q

What is Korsakoff’s syndrome

A

Complication of Wernicke’s encephalopathy (suspect in alcoholic)

52
Q

Most common side-effects of SSRI discontinuation syndrome

A

GI symptoms (e.g. diarrhoea)

53
Q

Circumstantiality can be a sign of which 2 disorders?

A

Anxiety disorders

Hypomania

54
Q

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.

A

Circumstantiality

55
Q

What is lanugo hair + associated conditoin

A

Fine downy hair growth in response to loss of body fat

Anorexia nervosa

56
Q

MoA of benzos

A

Enhance GABA effect

57
Q

Temazepam

A

Benzodiazepine

58
Q

Tx for borderine personality disorder

A

Dialectical behaviour therapy (DBT)

59
Q

Incontinence type caused by TCAs

A

Overflow incontinence (due to anticholinergic effect)

60
Q

Amitriptyline

A

Tricyclic antidepressant

61
Q

Differences between Knight’s move thinking and flight of ideas

A

Knight’s move - no discernible links between topics - Schizophrenia
Flight of ideas - discernible links between topics - Mania

62
Q

Protocol for monitoring lithium levels

A

Blood test 12hrs post-dose every 3 months

63
Q

Drug causes of hyponatraemia

A

SSRIs

64
Q

Sertraline

A

SSRI

65
Q

Main risk of zopiclone in elderly

A

Increased risk of falls

66
Q

Course of action if clozapine doses missed for >48 hours

A

Doses need to be restarted again SLOWLY

67
Q

1st-line treatment for <18s with anorexia nervoas

A

Family therapy (anorexia-focused)

68
Q

1st-line treatment for acute stress disorders

A

Trauma-focused CBT

69
Q

Next step if symptoms of mania in primary care

A

Urgent referral to community mental health team

70
Q

Rasagiline

A

Monoamine oxidase inhibitor (MAOI)

71
Q

Drug combo cause of serotonin syndrome

A

SSRIs + MAOIs

72
Q

Protocol for stopping antidepressants after remission of symptoms + why

A

Should continue for AT LEAST 6 months after remission of Sx

- decreases risk of relapse

73
Q

MAIx for new onset psychosis in elderly patients

A

CT Head - rule out organic cause

74
Q

Lifestyle choice that causes rise in clozapine blood levels

A

Smoking CESSATION

75
Q

Protocol for stopping SSRI

A

Gradually reduce over 4 weeks

76
Q

Risk of SSRI use in pregnancy (particularly paroxetine)

A

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
Q

Management of PTSD

A

Trauma-focused CBT or EMDR

78
Q

2 main criteria of chronic insomnia

A

Present for 3+ nights a week

Present for ≥3 months

79
Q

SSRI electrolyte disturbance

A

Hyponatraemia

80
Q

SSRI + NSAID = ? + management

A

GI bleeding risk

- give PPI

81
Q

Migraine treatment

A

Aspirin, ibuprofen, 5HT1-receptor agonist (triptan)(don’t give in SSRIs)

82
Q

Mirtazapine characteristic side effects

A 
Sedation
Increased appetite (useful in depressed patients who aren't sleep + eating)
83
Q

Fixed, false belief (delusion) that they are infested with ‘bugs’

A

Delusional parasitosis

84
Q

Clinical features of anorexia nervosa

A

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
Q

Requirement for diagnosing personality disorders

A

Must be >18y/o

86
Q

CBT vs DBT use

A

CBT - OCD (+/- ERP)

DBT - personality disorders

87
Q

TCA side effects

A

Antimuscarinic
- blurred vision + dry mouth (particularly with imipramine)
Antihistaminic
- weight gain (clomipramine)

88
Q

Schizoid vs schizotypal personality disorders

A

Schizoid - negative symptoms of schizophrenia

Schizotypal - positive symptoms of schizophrenia

89
Q

Duloxetine MoA

A

SNRI (serotonin + noradrenaline reuptake inhibitor)

90
Q

Treatment of acute dystonia secondary to antipsychotics

A

Procyclidine

91
Q

Stepwise drugs for generalised anxiety disorder

A

1 - Sertraline
2 - Alternative SSRI or SNRI
3 - Pregabalin

92
Q

Dizziness + electric shock sensations + anxiety =

A

SSRI discontinuation syndrome

93
Q

Seizures as drug SE in psych =

A

Clozapine (reduces seizure threshold)

94
Q

Commonest clozapine SE

A

Constipation/intestinal obstruction

95
Q

Strongest RF for schizophrenia

A

FHx - having a parent with it = relative risk of 7.5

96
Q

SSRI of choice post-MI

A

Sertraline

97
Q

SSRI of choice in children/adolescents

A

Fluoxetine

98
Q

First choice SSRIs in depression

A

Citalopram + fluoxetine

99
Q

FBC side-effect of Lithium

A

Benign leucocytosis (high WCC with no other abnormalities or symptoms)

100
Q

Management of patients with poor compliance of antipsychotics

A

Once-monthly IM antipsychotic DEPOT injections

101
Q

Increased risk of what in elderly due to antipsychotics

A

Stroke + VTE

102
Q

Risk factors + protective factors for developing GAD

A

RF - aged 35-54, divorced/separated, live alone, lone parent

PF - aged 16-24, married or cohabiting

103
Q

Rare but life-threatening side effect of anti-psychotics

A

Neuroleptic malignant syndrome

104
Q

Sudden onset psychosis after starting corticosteroids =

A

Steroid-induced psychosis

105
Q

Treatment for seasonal affective disorder

A

Same as depression

- psych therapies for 2 weeks then f/u, if deterioration give SSRI

106
Q

Disease to rule out when working with a diagnosis of GAD

A

Rule out THYROID disease (hyperthyroidism)

107
Q

Administration route for depot injections

A

Intramuscular

108
Q

Best antipsychotic for side effects esp prolactin elevation

A

Aripiprazole

109
Q

Way to differentiate between OCD and psychosis

A

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
Q

Definition of Munchausen’s syndrome

A

Purposefully causing symptoms

Also known as factitious disorder

111
Q

Management of patient showing symptoms of hypomania in primary care

A

Routine referral to community mental health team to confirm diagnosis + define treatment

112
Q

Type of hallucinations that are NOT first-rank schizophrenia symptoms

A

VISUAL hallucinations

113
Q

Venlafaxine MoA

A

Serotonin and noradrenaline reuptake inhibitor

114
Q

Memory side effect of benzodiazepines

A

Anterograde amnesia (inability to form new memory + memory recall impaired)

115
Q

Management of GAD

A

SSRI first-line

If fails try another SSRI or an SNRI (e.g. duloxetine, venlafaxine)

116
Q

Paralysis that occurs after waking up or shortly before falling asleep with hallucinations (visual or auditory) that appear during paralysis

A

Sleep paralysis

117
Q

Treatment for troublesome sleep paralysis

A

Clonazepam

118
Q

Scale used for assessing SEVERITY OF ALCOHOL WITHDRAWAL

A

Clinical Institute Withdrawal Assessment for Alcohol (CIWA) scale

119
Q

Drug class to prevent seizures in alcohol withdrawal

A

Benzodiazepines

120
Q

Foods to avoid with MAOi’s

A

Tyramine-containing foods e.g. cheese, pickled herring, Bovril, Oxo, Marmite, broad beans

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