Psych peer teaching

Question 1

What is section 2 of the MHA

Answer 1

Admission for assessment.
28 days
2 doctors and an AMHP

Question 2

What is section 3 of MHA

Answer 2

Admission for treatment
6 months
Can be renewed
2 doctors and an AMHP

Question 3

What is section 4 of MHA

Answer 3

Emergency treatment.
Prior to 2 or 3
72 hours
1 doctor 1 AMHP

Question 4

What is section 5(2)

Answer 4

Detention fo a patient already in hospital.
72 hours
Doctor looking after patient

Question 5

What is section 5(4)

Answer 5

Nurses holding powers

6 hours

Question 6

Section 135

Answer 6

Force entry into house for MHA assessment. Requires magistrates court warrant and AMHP or doctor present

Question 7

Section 136

Answer 7

Arrest someone in public place who is suffering from a mental health disorder

Question 8

Generalised anxiety disorder

Answer 8

Generalised anxiety persistent but not restricted to any particular environmental settings

Question 9

Phobic disorders

Answer 9

Group of disorders where anxiety is evoked only in well defined situations that are not currently dangerous

Question 10

Panic disorder

Answer 10

Recurrent attacks of severe anxiety, which are unpredictable and not restricted to any particular situation

Question 11

Autonomic arousal symptoms

Answer 11

Palpitations
Tachycardia
Sweating
Dry mouth

Question 12

Physical symptoms of neuroses (anxiety)

Answer 12

Breathing difficulties, choking sensation, chest pain, nausea, hot flushes, numbness, tingling

Question 13

Mental state symptoms of neuroses

Answer 13

Depersonalisation, fear of losing control, concentration difficulties

Question 14

Symptoms of tension present in neuroses

Answer 14

Muscle aches/pains, restlessness/inability to relax

Question 15

Anxiety treatment

Answer 15

Education then IAPT then CBT or SSRI then inpatient

Question 16

Which SSRI for anxiety

Answer 16

Sertralline

Question 17

Define PTSD

Answer 17

Delayed or protracted response to a stressful event of a threatening or catastrophic nature

Question 18

PTSD presentation

Answer 18

Reliving of the stressor
Emotional blunting
Hypervigilence
Avoidance of things associated
Inability to recall aspects of the event

Question 19

PTSD management

Answer 19

Watchful waiting at first
Trauma focussed CBT
Eye movement desensitisation and reprocessing
Antidepressants (paroxetine)

Question 20

Acronym for depression symptoms

Answer 20

DEAD SWAMP

Question 21

What are the symptoms of depression

Answer 21

Depressed mood
Energy levels reduced
Anhedonia
Disturbed sleep

Suicidal ideation
Worthlessness
Appetite reduced
Mentation decreased
Pscyhomotor retardation

Question 22

Depression treatment

Answer 22

Eductation, IAPT and medications, CBT, then inpatient MDT

Question 23

Examples of SNRI

Answer 23

Duloxetine

Venlafaxine

Question 24

Examples of SSRIs

Answer 24

Sertralline
Fluoxetine
Citalopram

Question 25

Examples of TCAs

Answer 25

Amitriptylline, clomipramine

Question 26

Examples of NaSSA

Answer 26

Mirtazapine

Question 27

Examples of MAO inhibitors

Answer 27

Phenelzine, moclobemide

Question 28

What is the pharmacological treatment of depression

Answer 28

SSRI then SNRI then TCA

Question 29

how do ssris work

Answer 29

Increase free serotonin by blocking reuptake pumps, stopping serotonin from being recycled in the synapse

Question 30

SSRI prescribing info

Answer 30

Start low dose and titrate up, continue for 6 months after recovery

Question 31

Sertralline fun fact

Answer 31

Most cardio or neuroprotective

Question 32

Fluoxetine fun fact

Answer 32

Has a long half life

Question 33

How do SNRIs work

Answer 33

Inhibit reuptake of serotonin and noradrenaline.

Question 34

Fun fact about venlafaxine

Answer 34

Needs monitoring (ECG and BP) for cardiovascular side effects as can exacerbate arrythmias

Question 35

How do tricyclic antidepressants work

Answer 35

Inhibit reuptake of serotonin and noradrenaline but act as anticholinergics

Question 36

Anitcholinergic side effects

Answer 36

Dry mouth, blurred vision, urinary retention

Question 37

TCA side effects

Answer 37

anticholinergic, overdose and arrythmias

Question 38

Mirtazepine mode of action

Answer 38

Noradrenergic and specific serotonergic antidepressant

Question 39

MAO inhibitors (phenelzine) special precautions

Answer 39

Dietary as hypertensive criss with tyramine

Question 40

Bipolar 1 definition

Answer 40

One or more manic episodes with or without a history of depressive episodes

Question 41

Bipolar 2 definition

Answer 41

One or more depressive episodes with at least one hypomanic episode

Question 42

Acronym for mania symptoms

Answer 42

I DIG FAST

Question 43

Mania symptoms

Answer 43

Irratibility/elevated mood Distractibility Inhibition loss Grandiosity Flight of ideas Activity increased Sleep not needed Talkative

Question 44

Name three mood stabilisers

Answer 44

Lithium Valproate Lamotrigine

Question 45

Other treatments for bipolar

Answer 45

Antipsychotics (haloperidol, olanzapine) and antidepressants (fluoxetine)

Question 46

Lithium fun fact

Answer 46

Ebsteins phenomenon- cardiac anomaly in babies if mother has taken lithium

Question 47

Lamotrigine fun fact

Answer 47

Can cause steven johnsons syndrome- hypersensitivity

Question 48

Valproate fun fact

Answer 48

Terratogenic

Question 49

How does lithium work

Answer 49

inhibits cAMP which inhibits Monoamines

Question 50

What is a safe level of lithium

Answer 50

0.6-1

Question 51

What bloods for someone on lithium

Answer 51

Li, U and E, TFT, calcium

Question 52

Toxicity level of lithium

Answer 52

>1.5mmol/L

Question 53

Symptoms of lithium toxicity

Answer 53

Tremor, anorexia, diarrhoea and vomitting, ataxia, dysarthria, delirium, fasiculations, hypotension, arrythmias, seizures, coma

Question 54

First rank symptoms of schizophrenia

Answer 54

``` 3rd person auditory halllucinations Thought withdrawal, insertion and broadcast Delusional perceptions Delusions of control Somatic passivity ```

Question 55

Positive symptoms of schizophrenia

Answer 55

An excess or distortion of normal functioning e.g. delusions, hallucinations, thought disorder. Caused by overactivity of recepetors in the mesolimbic pathway

Question 56

Negative symptoms

Answer 56

Decrease or loss of functioning e.g. blunting of affect, poverty of speech. Caused by underactivity of receptors in the mesocortical pathway

Question 57

Paranoid schizophrenia

Answer 57

Paranoid delusions, auditory hallucinations and perceptual disturbances

Question 58

Catatonic schizophrenia

Answer 58

Hyperkinesis or negativism

Question 59

Hebephrenic schizophrenia

Answer 59

Fluctuating affect

Question 60

Residual schizophrenia

Answer 60

Long term negative symptoms

Question 61

Simple schizophrenia

Answer 61

Negative symptoms without psychotic symptoms

Question 62

First generation antipsychotics

Answer 62

Chlorpromazine, haloperidol

Question 63

How do first generation antipscyhotics work

Answer 63

Dopamine (D2) antagonists

Question 64

How do second generation antipsychotics work

Answer 64

Dopamine (D2) antagonists and serotonin (5HT2A) antagonists.

Question 65

Antipsychotics side effects

Answer 65

Extrapyrimidal- dyskinesia, parkinsonism, neuroleptic malignant syndrome

Question 66

Second generation antipsychotics

Answer 66

Risperidone, olanzapine, clozapine

Question 67

Clozapine

Answer 67

2nd gen for treatment resistnat. Blocks D1 and D4 and 5HT2A. Risk of agranulocytosis

Question 68

Metabolic antipscyhotic side effects

Answer 68

Weight gain | Diabetes

Question 69

Anticholinergic side effects

Answer 69

Dry mouth, blurred vision, difficulty passing urine, urinary retention, constipation

Question 70

Antiadrenergic side effects

Answer 70

postural hypotension, tachycardia, sexual dysfunction

Question 71

Antihistminergic side effects

Answer 71

Sedation

Question 72

Cardiovascular antipscyhotic side effects

Answer 72

Prolonged QT interval

Question 73

Hormonal antipscyhotic side effects

Answer 73

Increased plasma prolactin

Question 74

Describe anorexia

Answer 74

``` Restricted diet Excessive exercise Induced vomiting and purging Use of appetite suppressants Diuretics ```

Question 75

Describe bulimia

Answer 75

Repeated bouts of overeating | Pattern of overeating followed by vomiting or use of purgatives

Question 76

Signs of eating disorders

Answer 76

Loss of muscle mass Dry skin, brittle hair and nails Russel sign Lanugo hair

Question 77

What is russel sign

Answer 77

Callused skin over interphalangeal joints

Question 78

What is lanugo

Answer 78

Fine, downy body hair