Psych Othef Flashcards
Scizophrenia va schizo-affective
the same but schizo-affective has a concurrent mood disorder
What is the difference between 1st gen and 2nd gen anti-psychotics
1st gen (typical) D2 antagonists, block dopamine in mesolimbic pathways.
extrapyramidal SE’s & hyperprolactinemia common
2nd generation (atypical) D2,3,4 & 5HT antagonist.
preferred as above SE’s less common.
side effects of anti-psychotics (both typical and atypical) in elderly
increased risk of stroke and venous thromboembolism in elderly patients
schizoid vs schizotypal
schizoid- preference for solitude, indifference towards social relationships & emotional detachment
schizotypal- unusual thought patterns, magical thinking, limited number of close relationships
features of dementia with lewy bodies
progresses over years, fluctuating symptoms, visual hallucinations, features of parkinosim
vascular dementia features
commonly after stroke, years to progress, other neurological defects, emotional unstability
depression symptoms that differentiate from being dementia
short history, rapid progression, insomnia, reduced appetite, stressors, global memory loss
BPD t1 vs t2
t1- classic, mania and depression
t2- HYPOmania and depression
circumstantiality definition
inability to answer a question without giving excessive, unnecessary detail, however it is important to note that the answer is still given
give three drug names for atypical antipsychotics
clozapine, olanzapine, risperidone
flight of ideas
going off topic, moving from one idea to another, quick, erratic often seen in mania
perseveration
pt. repeats ideas or words despite attempting to change the topic
give two drug names of typical antipsychotics
haloperidol
chlorpromazine
features of anorexia nervosa, most things low except… (4)
most things low except Gs and Cs:
Growth hormone, Glucose salvary glands, Cortisol, Cholestrol,
what is conversion disorder
aka functional neurological disorder
typically involves loss of motor or sensory function (however is in patients head)
the patient doesn’t consciously feign the symptoms (factitious disorder) or seek material gain (malingering)
wernickes encephalopathy vs korsakoffs syndrome
WE:
opthalmoplegia (lateral rectus / horizontal nystagmus),
confusion
ataxia (/any cerebellar signs)
korsakoffs syndrome:
the same as ^ +
anterograde amnesia (eg. forgets your interaction)
confabulation (mistakenly recall false info)
Knight’s move thinking aka…
This can be a feature of schizophrenia. It can be observed to involve leaps to different topics with poor associations to the previous topic, making the conversation very hard to follow.
derailment
Tangentiality
If a person starts a conversation and can be seen to wander or ‘tangent’ off to a new topic without returning, this is known as tangentiality.
Echolalia
This is the repetition of someone else’s speech.
akathisia
a sense of inner restlessness and inability to keep still
often seen in ppl who have a long history of anti-psychotic use
Acute dystonia
characterized by involuntary contractions of muscles of the extremities, face, neck, abdomen, pelvis, or larynx in either sustained or intermittent patterns that lead to abnormal movements or postures.typically spasm of facial muscles,
tardive dyskinesia
abnormal involuntary movements like licking lips.
clozapine- what kind of drug is it and its side effects (7)
atypical antipsychotic
agranulocytosis
neutropenia
REDUCES SEIZURE THRESHOLD
heart issues
defining feature which seperates depression sx from dementia sx
depression has global memory loss rather than short term memory loss- the opposite is true for for dementia
haloperidol SE
what class of drug is it
inc risk of extrapyramidal side effects eg parkinosnism and acute dystonia
typical antipsychotic
olanzapine SE
higher risk of dyslipidemia and obesity
what antipsychotic drug has the most tolerable side effect profile
apiprazole (atypical) - especially good for prolactin elevation
what are clang associations
ideas related only by rhyme or being similar sounding
which antidepressant has is useful for its sedative effects
what class of drug is it
mirtzapine - also inc weight gain
blocks akoha2-adrenergic receptors
what syndrome describes a subtype of nihilistic delusions in which the persone believes they or a part of them is dead or does not exist
what is it most commonly seen in
cotard syndrome
severe depression, also associated with schizophrenia
what is the name of the syndrome which describes deulisional parasitosis and the delusion of infestation
ekbom syndrome
what is the name of the delusion of sexual infidelity on the part of a sexual paratner
othello
the delusion of identifying a familiar person in various people they encounter.
de fregoli syndrome
This is the delusion that a person closely related to the patient has been replaced by an impostor.
capgras syndrome
list positive symptoms of schizophrenia
hallucinations.
deulsions
catatonia
disorganised speech
disorganised behaviour
negative symptoms of schizophrenia
(5)
depressed/decreased emotion
anhedonia- lack of pleasure
flat affect
alogia- poverty of speech
avolition- poor motivation
somatisation disorder vs conversion disorder
somatisation disorder- MULTIPLE PHYICAL SYMPTOMS present for at least 2 years
patient refuses to accept reassurance or negative test results
conversion- motor/sensroy loss- symptoms arent feigned
somatisation disorder vs hypochondriasis
both refuse to accept reassurance/negative results but hypochondriasis is the belief in a spoecific underlying pathology eg cancer whereas somatisation disorder is just the physical symptoms
acute alcohol withdrawal symptoms
(5)
occurs 6-12 hours post last drink
tremors, agitation, fevers, tachycardia, and hypertension,
when do seizures occur alcohol withdrawal
36 hours
peak incidence of delirium temens and symptoms
(6)
48-72 hours: coarse tremor, confusion, delusions, auditory and visual hallucinations, fever, tachycardia
what section of the mental health act allows police to bring an individual who appears to have a mental disorder from a public place to a place of safety
section 136
carbamezapine side effects
CARBA MEAN
Confusion
Ataxia
Rashes
Blurred vision
Aplastic anaemia
Marrow (bone marrow) supression
Eosinphillia
ADH release
Neutropenia
strongest risk factor for psychotic disorders
family history
when should lithium levels be checked
the sample should be taken 12 hours post-dose
knights move vs flight of ideas
Knight’s move thinking there are illogical leaps from one idea to another, flight of ideas there are discernible links between ideas
what section of the mental health act 2003 can be used to detain patients for up to 28 days for assessment
what is it called
who has to approve
section 2
short term detention order
senior psychiatrist and mental health officer
what section of the mental health act 2003 can be used to detain patients for up to 6 months
what is it called
section 3
compulsory treatment order
mho makes application. two psychiatrists or one psychiatrist and one gp approve it.
what section of the mental health act (2007) can be used to detain a patient for up to 72 hours
what is it called?
can you give treatment
5(2) just any one doctor required.
emergency detention order
does not author treatment
no right to appeal
what is thought blocking
a neuropsychological symptom expressing a sudden and involuntary silence within a speech, and eventually an abrupt switch to another topic
what is a neologosim
creation of new words/phrases
De Clerambault’s syndrome
therwise known as erotomania, is a delusional disorder in which the patient has a specific, fixed, false belief that someone else is in love with them.
physiology of anxiety: (5)
amygdala processes sensory data and passes information to the:
hypothalamus- body stress response: cortisol
periaqueductal grey- mediates fight or flight response
hippocampus- for memory and learning
cingulate cortex: mediates anxiety emotion
physiology of addiction
mesolimbic pathway- VTA releases dopamine acts on nucleus accumbens to mediate plasure/motivation
prefrontal cortex involved in goal setting/decision making, can normally override mesolimbic, drugs disrupt it
orbitofrontal cortex- motivation to act- hyperactive in cravings
hippocampus- stores memory of pleasure and learned drug associations
recommended units of alcohol a week
<14 units
what is the aversive system
promotes survival in event of stress
mediated by serotonin
appetitive system
supports seeking behaviours mediated by dopamine
what does this CT show
wide sulci narrow gyri- alzheimers
what is the pathophysiology of the defecit caused by alzheimers
impairs ach from nucleus basilis of meynart
