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Psychiatry and Neurology > Psych- Mood disorders and schizophrenia > Flashcards

Psych- Mood disorders and schizophrenia Flashcards

1
Q

What are the 3 cardinal symptoms of depression?

A
  1. Depressed mood
  2. Low energy/ fatigue
  3. Loss of interest/ anhedonia
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2
Q

Depression is 2 times higher in which gender?

A

Women

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3
Q

Give 4 examples of somatic (biological) symptoms of depression.

A
  1. Anhedonia
  2. Early wakening
  3. Loss of libido
  4. Poor appetite/ weight loss
  5. Depression worse in mornings
  6. Psychomotor retardation/agitation
  7. Lack of emotional reactivity to normal pleasurable surroundings
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4
Q

What are the associated symptoms of depression?

A
  1. Guilt
  2. Low self esteem
  3. Self harm/ suicide ideas
  4. Changes in appetite
  5. Pessimistic life views
  6. Disturbed sleep
  7. Reduced concentration
  8. Changes in psychomotor activity
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5
Q

________ is 2 or more years of constant depressed mood, where any normal mood rarely lasts longer than 2 weeks.

A

Dysthymia

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6
Q

Mild depression has __ cardinal symptoms and __ other symptoms.

A

2 cardinal symptoms

2 other symptoms

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7
Q

Moderate depression has __ cardinal symptoms and __ other symptoms.

A

2 cardinal symptoms

3 other symptoms

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8
Q

What are the NICE guidelines for managing depression?

A
  1. Recognise and diagnose
  2. Treat mild depression in primary care
  3. Treat moderate- severe depression in primary care
  4. Treatment by specialist mental health services
  5. Inpatient treatment for resistant/ life threatening depression
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9
Q

What are the 1st, 2nd and 3rd line treatments for depression?

A

1st line- SSRIs eg. Sertraline
2nd line- Switch SSRI, or SNRI or Mirtazapine
3rd line- SNRI or Mirtazapine or TCA

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10
Q

Bipolar disorder is defined as 2 plus episodes of ________/___________ or alternating with depression

A

Mania/ hypomania

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11
Q

In bipolar disorder, which usually lasts longer- depression or mania?

A

Depression

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12
Q

_______ is 7 plus days of sustained elevated/ irritable mood with 3 plus symptoms (spending sprees, increased libido, decreased need for sleep, increased talkativeness, etc)

A

Mania

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13
Q

Which is more commonly associated with psychosis; mania or hypomania?

A

Mania

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14
Q

What symptoms are typical of mania/ hypomania?

A 
Increased libido
Increased talkativeness, sociability and activity
Decreased need for sleep
Spending sprees
Wreckless behaviour
Distractability
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15
Q

What are the potential SEs of lithium?

A 
Weight gain
Hypothyroidism/ goitre
Renal impairment
Teratogenicity
Tremor
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16
Q

What are the features of lithium toxicity?

A 
Ataxia
Slurred speech
Tremor
UMN signs
Seizures
Diarrhoea and vomit
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17
Q

If a patient has delusions of grandeur and

auditory hallucinations are they more likely to be having mania or hypomania?

A

Mania

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18
Q

What is the NICE stepped care approach to treating anxiety?

A
  1. Recognise and diagnose
  2. Treat in primary care
  3. Review and consider other treatment
  4. Refer to secondary care
  5. Secondary care treatment
19
Q

What psychological treatments are available for anxiety?

A

CBT
Psychoeducation
Mindfullness

20
Q

What psychological treatments are available for PTSD?

A

CBT trauma focused

EMDR (eye movement desensitization and reprocessing)

21
Q

What pharmacological therapies are used for anxiety?

A
  1. SSRIs- Sertraline, Citalopram, Fluoxetine
  2. SNRIs- Venlafaxine, Duloxetine
  3. TCA/ Pregabalin
22
Q

Which class of drugs should NOT usually be used for anxiety?

A

Benzodiazepines

23
Q

Give at least 5 examples of differential diagnoses for anxiety.

A
  1. Psych- Depression, Panic disorder, PTSD, phobia, psychosis
  2. Hypoglycaemia
  3. Thyrotoxicosis
  4. Excess caffeine
  5. Acute drug/ alcohol withdrawal
  6. Parathyroid disease
  7. Phaeochromocytoma
  8. Cardiac disease
  9. Medication induced anxiety: St Johns wort, Salbutamol, Theophyline, Antidepressants, corticosteroids
24
Q

What is agoraphobia?

A

Fear and avoidance of places from which escape may be difficult/ fear of travelling alone

25
Q

What is social phobia?

A

Fear of social situations where exposed to unfamiliar people/ possible scrutiny

26
Q

An _________ is a persistent thought/ urge that is unwanted and causes distress

A

Obsession

27
Q

A _________ is repetitive behaviour that the person feels a drive to perform

A

Compulsion

28
Q

What class of drugs does Clomipramine belong to?

A

TCAs

29
Q

In anorexia nervosa patients have a BMI below what?

A

<17.5

30
Q

What are the differential diagnoses for anorexia?

A 
Bulimia
Schizophrenia
Diabetes
Addison's
Malabsorption
Malignancy
31
Q

What are the differential diagnoses for bulimia?

A

Anorexia
Klein Levin syndrome (sleep disorder)
Kluver Bucy

32
Q

What metabolic disorder can occur as a consequence of bulimia?

A

Metabolic alkalosis due to hypokalaemia

33
Q

What are the potential complications of anorexia?

A 
Oesteoporosis
Cardiac- bradycardia, hypotension, dizzyness, irregular HR, valve issues
Dry/ yellow skin
Hair loss
Amenorrhoea and fertility issues
Anaemia
34
Q

What are the potential complications of bulimia?

A 
Osteoporosis
Dry skin and brittle nails
Amenorrhoea/ oligomenorrhoea
Dental issues- bad breath, Mallory Weis tears
Hypokalaemia
35
Q

What electrolyte disturbance occurs in refeeding syndrome?

A

Hypophosphataemia

Hypomagnesia

36
Q

In refeeding syndrome, what happens to insulin secretion?

A

It increases after refeeding due to high blood sugar

37
Q

What are the differential diagnoses for dementia?

A 
Pseudodementia
Depression
Delirium
Space occupying lesion
Drug use
38
Q

Give 3 differences between delirium and dementia.

A

Delirium- acute, clouded consciousness, fluctuating mental state, reversal of sleep wake cycle, visual hallucinations common

Dementia- gradual onset, clear consciousness, no reversal of sleep-wake cycle, hallucinations uncommon

39
Q

Give at least 5 causes of delirium

A 
Infection
Dehydration
Constipation
Hypoxia
Metabolic disturbances (Low sodium or calcium)
Acute blood loss
Sepsis
Malignancy
Hypothyroidism
Hypoglycaemia
Severe asthma attack
Alcohol poisoning
Alcohol withdrawal
Medications: antihypertensives, opiates, insulin, glicazides, methotrexate, NSAIDs
40
Q

Which type of dementia typically has a younger age of onset, and involves personality changes and obsessional behaviours?

A

Fronto-temporal

41
Q

Which type of dementia involves motor changes and hallucinations, with fluctuating cognition?

A

Lewy body dementia

42
Q

Which type of dementia has knife blade changes on CT scans?

A

Fronto-temporal

43
Q

________ is an NMDA antagonist that targets excess glutamate and can be used in Alzheimer’s or Lewy body dementia.

A

Memantine

44
Q

Which class of drugs should be avoided in Lewy body dementia?

A

Typical antipsychotics

Psychiatry and Neurology (9 decks)

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