Psych Misc Flashcards
Which antipsychotic can cause myocarditis?
Clozapine
Chest pain, malaise, fatigue, sweating etc
4 first rank symptoms for schizophrenia?
At The Police Department
Auditory hallucinations
Thought disorder (insertion, withdrawal, blocking, broadcasting)
Passivity phenomena
Delusional perception
Can schizophrenic patients get insomnia? Why?
Yes
Disruption of circadian rhythm
Which SSRI is associated with QT prolongation?
Citalopram
What should you be mindful of when starting an SSRI in someone with cardio Hx?
Aspirin –> Aspirin + SSRI = GI bleed risk
Start PPI as well
What is Othello syndrome?
Delusional jealousy, usually that a partner is being unfaithful when they are not
What is erotomania?
Delusion where a person believes someone else, usually a celebrity, is in love with them
Which antipsychotic can cause severe constipation
Clozapine - can lead to faecal impaction
Why can you get weight gain with TCA antidepressants?
Antihistamine effect
Which scoring system can be used to assess the severity of alcohol withdrawal?
Clinical Institute Withdrawal Assessment (CIWA-Ar)
What is Conversion disorder?
Motor and sensory loss usually brought on by stress, the patient is usually not bothered about the symptoms
What is the difference between somatisation and factitious disorder?
Somatisation - patient presents with physical SYMPTOMS for >2 years and refuses to accept reassurance
Factitious (hypochondriasm) - patient believes they have a serious DISEASE and refuses to accept reassurance
Which personality disorder is: prefers to be alone, doesn’t like forming new relationships, asexual, emotional detachment?
Schizoid
Schizotypal is when u prefer to be alone but have unusual behaviours and believe in fantasy/magic etc
Patient with bipolar disorder presents to GP with symptoms of mania, what should you do?
Refer urgently to the community mental health team
What to give for acute manic episode within bipolar?
Olanzapine
What to give for acute depressive episode within bipolar?
Quetiapine
Can valproate be prescribed by the GP for bipolar mania/hypomania?
No
What to do if someone presents with hypomania to GP (i.e. no psychosis or delusions)?
Refer routinely to community mental health team
Woman with bipolar takes olanzapine and lithium, complains of feeling tired all the time, reduced appetite and bouts of constipation - cause?
Hypothyroidism due to lithium
What electrolyte abnormality would be seen in bulimia nervosa?
hypokalaemia, hypochloraemia, metabolic alkalosis
3 signs of hypokalaemia on ECG?
1st degree heart block
tall P waves
flattened T waves
4 risk factors for the development of generalised anxiety disorder?
Age 35-55
Living alone
Being divorced/separated
Being a single parent
What investigations should be performed on a person presenting with new onset psychosis?
FBC, U&E, TFT, B12 etc
ECG
CXR (hypercalcaemia from SCC)
If elderly or suspicion, perform CT head (malignancy, stroke, trauma, infection)
Treatment for PTSD?
1st line - CBT or EMDR
2nd line - Paroxetine
3rd line - Mirtazapine, Amitriptyline
4th line - Prazosin
Management of PTSD?
1 - Education and self-help
2 - Psychological - exposure and response prevention
3 - Pharmacological
3.1 - SSRI
3.2 - Clomipramine
3.3 - Augment with Risperidone or Lamotrigine
Which antipsychotic is particularly assoc w QT prolongation?
Haloperidol
Which type of antipsychotics are particularly assoc w reduced seizure threshold?
Atypicals
Which antipsychotics are particularly assoc w hyperprolactinaemia?
Risperidone and Amisulpride
Which antipsychotics are LEAST assoc w galactorrhoea?
Olanzapine and Quetiapine
Which antipsychotics are MOST assoc w neuroleptic malignant syndrome?
Haloperidol and Chlorpromazine
Which antipsychotics are MOST assoc w metabolic syndrome?
Olanzapine and Clozapine
What is depressive personality disorder?
The patient always has a low and gloomy outlook on life but has no actual symptoms of depression
20 y/o woman admitted to A&E with a suspected OD. She has threatened to commit suicide several times since breaking up with her abusive boyfriend. She has a Hx of self-harm and depression and takes Citalopram. Which personality disorder does she likely have?
Borderline
–> Hx of recurrent self-harm and intense inter-personal relationship
What are pseudohallucinations?
Part of normal grieving process. The patient will commonly ‘see’ or ‘hear’ their loved one briefly, during the period following their death. They retain insight, and are have no other symptoms of psychosis.
Treatment of PTSD?
EMDR
If combat-related: combat-related CBT
