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Phase 3a > Psych Questions > Flashcards

Psych Questions Flashcards

1
Q

What are the first rank symptoms?

A

Delusions, auditory hallucinations, thought disorder, passivity experience

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2
Q

What is somatic passivity?

A

Experience of bodily sensations (including actions, thoughts, or emotions) imposed by external agency. ‘‘They’re making me feel cold all the time’

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3
Q

What is passivity of affect?

A

Forced by an external agent to feel emotions

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4
Q

What is passivity of impulse?

A

Forced by an external agent the desire to do things

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5
Q

What is passivity of volition

A

Forced by an external agent to perform actions

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6
Q

What is the strongest risk factor for future suicide completion?

A

Male gender

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7
Q

What factors are associated with a increased risk of completed suicide at a future date, for patients who have previously failed?

A

Efforts to avoid discovery, planning, leaving a written note, final acts, violent method

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8
Q

What is thought suppression?

A

Intentionally and temporarily withholding an idea or feeling from conscious awareness

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9
Q

What is displacement of thoughts?

A

Redirection of emotions or impulses to a neutral person or object

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10
Q

What are flashbacks in PTSD?

A

A form of pseudohallucination

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11
Q

How does a prodromal phase in schizophrenia affect prognosis?

A

Associated with a poor prognosis

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12
Q

What is a prodromal phase in schizophrenia associated with?

A

Social withdrawal and isolation

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13
Q

What factors are associated with a poor prognosis in schizophrenia?

A

Strong family history, gradual onset, low IQ, prodromal phase of social withdrawal, lack of obvious precipitant

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14
Q

What is malingering?

A

Falsification or profound exaggeration of illness to gain external benefits such as avoiding work or responsibility

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15
Q

What is the MoA of tricyclic antidepressants?

A

Inhibition of monoamine reuptake on the presynaptic membrane, via binding to the ATPase monoamine pump within the presynaptic membrane

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16
Q

What is a primary delusion vs. secondary delusion?

A

Primary delusion; those which cannot be described by any previous psychopathological state, such as a mood disorder. Most commonly seen in schizophrenia

Secondary delusions: relate to patients underlying mood. Often in mania or severe depression

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17
Q

How does alcohol withdrawal affect GABA and glutamate transmission?

A

Alcohol withdrawal results from decreased inhibitory GABA and increased NMDA glutamate transmission

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18
Q

What is the triad of symptoms in Korsaokoffs?

A

anteretrograde amnesia, retrograde amnesia, confabulation

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19
Q

When checking lithium levels, how long after taking a dose should the levels be checked?

A

12 hours post dose

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20
Q

What is a short acting bendozdiazepine?

A

Lorazepam

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21
Q

What is a long acting BDZ?

A

Diazepam

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22
Q

What drug class is clomipramine?

A

TCA

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23
Q

What classic side effects are caused by TCAs?

A

Anticholinergic: dry mouth, blurred vision, urinary retention. Also weight gain (due to antagonism of histamine receptors)

Also can lengthen QT interval

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24
Q

What is the mechanism of action of venlafaxine?

A

Serotonin and noradrenaline reuptake inhibitor

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25
Q

What is the first line drug treatment for PTSD?

A

Venlafaxine or an SSRI

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26
Q

What symptoms suggest depression rather than dementia?

A

Sleep disturbance, stress triggers, normal mini-mental state

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26
Q

When should a patient be prescribed an PPI with an SSRI?

A

when they are taking NSAIDs. This is due to increased GI bleeding risk

27
Q

For a diagnosis of PTSD, how long should symptoms be present for?

A

1 month

28
Q

What should be done for SSRI dose when a patient is starting ECT

A

Reduce dose but not stop it

29
Q

Which antipsychotic has the most tolerable side effect profile?

A

Aripiprazole; particularly favourable for prolactin elevation

30
Q

What should be done if clozapine doses are missed for more than 48 hours?

A

Dose needs to be restarted again slowly

31
Q

What antipsychotic reduces seizure threshold?

A

Clozapine

32
Q

What drug class is mirtazapine?

A

Noradrenergic and specific serotonergic antidepressant

33
Q

What are symptoms of SSRI discontinuation syndrome?

A

Dizziness, electric shock sensations, anxiety. Also can be flu-like symptoms, hyperarousal, insomnia

34
Q

What GI s/e can clozapine cause?

A

Constipation/intestinal obstruction

35
Q

What are possible metabolic side effects of antipsychotics?

A

Dysglycaemia, dyslipidaemia, diabetes mellitus

36
Q

What is clang associations in thought disorders?

A

Ideas only related by rhyme or being similar sounding

37
Q

How long should antidepressants be continued after remission of symptoms to decrease risk of relapse?

A

At least 6 months

38
Q

When is ECT indicated?

A

Life threatening major depressive disorder, where catatonia is present

39
Q

What is echolalia?

A

The repitition of someone else’s speech including the questions being asked

40
Q

What is copropraxia?

A

the involuntary performing of obscene or forbidden gestures or inappropriate touching

41
Q

What is a possible side effect of SSRI use during the third trimester?

A

Risk of persistent pulmonary HTN of the newborn

42
Q

What is a risk of SSRI use during the first trimester of pregnancy?

A

Increased risk of congenital heart defects

43
Q

What SSRI particularly has risk of congenital malformations in the first trimester?

A

Paroxetine

44
Q

Why do atypical antipsychotics increase the risk of stroke and VTE in the elderly?

A

Due to hyperprolactinaemia and weight gain, which increases the risk

45
Q

What is the SSRI choice in children?

A

Fluoxetine

46
Q

What is the difference between Knight’s move and flight of ideas?

A

Knight’s move thinking there are illogical leaps from one idea to another, flight of ideas there are discernible links between ideas

47
Q

What are drugs that should be avoided in SSRIs?

A
  • NSAIDs (give PPI)
  • warfaring/heparin
  • aspirin
  • triptans
  • MAOIs
48
Q

What are the possible short term s/e of ECT?

A

Headaches, nausea, memory impairment, arrhythmias

49
Q

When should lithium levels be checked after a dose change?

A

Checked a week later, and then weekly until the levels are stable

50
Q

What test is used to differentiate organic from non organic leg paresis?

A

Hoover’s sign

51
Q

What is the general treatment for acute dystonia secondary to antipsychotics?

A

Procyclidine

52
Q

What is pseudodementia?

A

Depression-related cognitive dysfunction; depressive symptoms mimic the clinical picture of dementia.

53
Q

What factors can suggest depression over dementia?

A

Short history+ rapid onset, biological symptoms, patient worried about poor memory, global memory loss (dementia characteristically causes recent memory loss)

54
Q

What are the risk factors for the development of generalised anxiety disorder?

A

Aged 35-54, being divocerved or separated, living alone, being a lone parent

55
Q

What is an alternative tx to SSRI in OCD?

A

Clomipramine (TCA)

56
Q

What PHQ-9 scores divides ‘less’ and ‘more’ severe depression?

A

Less severe: <16
More severe: >16

57
Q

What is akathisia?

A

Sense of inner restlessness and inability to keep still

58
Q

How does frontal lobe injury typically present?

A

Motor symptoms (weakness or paralysis), difficulty with speech, disinhibition

59
Q

What is ‘stopping of voluntary movement or staying still in an unusual position’?

A

Catatonia

60
Q

What is the diagnostic criteria for insomnia?

A

Diagnosed after 3 months, if a person has trouble falling asleep or staying asleep at least 3 nights per week

61
Q

What is the risk of developing schizophrenia if one monozygotic twin is affected?

A

50%

62
Q

What type of urinary incontinence can tricyclic antidepressants cause?

A

Overflow incontinence

63
Q

What is the difference between Knight’s move and flight of ideas?

A

Knight’s move thinking there are illogical leaps from one idea to another, flight of ideas there are discernible links between ideas

64
Q

What is the regime for lithium monitoring?

A

Measured one week after starting, one week after dose change, then weekly until levels are stable. Once stable, they should be measured every 3 months. Always measured 12 hours post dose

65
Q

How do benzodiazepines work?

A

Enhance the effect of the inhibitory GABA

Phase 3a (19 decks)

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