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psych revision lecture Flashcards

1
Q

good structure for management

A

BIOPSYCHOSOCIAL

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2
Q

what perceptions can manifest in psych conditions?

A

illusion - misperception of real stimuli (often low stim situations)
hallucination (perception in the absence of an external stimulus (2nd person - depression) (3rd - schizophrenia - he she it)
Visual hallucination - THINK lewy body

Overvalued idea - belief sustained beyond logic / reason (not to the extent of a delusion)

Delusion

Delusional perception - resulting from a real perception - eg. red light = polic coming to get me (another schied 1st rank Sx of Schizo_)

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3
Q

Schneiderian 1st rank Sx of Schizophrenia

A

aud halluc
3rd person arguing / conversing / commenting on actions

Passivity experiences

made actions / feelings / delusions of control

thought alienation
insertion / withdrawal

delusion

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4
Q

symptoms of expression

A

loosening of association
circumstantiality
perseveration wernickes / organic or frontal lobe disorder / B1 def)
tangential - does not return to the topic
confabulation

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5
Q

symptoms of expression

A

loosening of association
circumstantiality
perseveration wernickes / organic or frontal lobe disorder / B1 def)
tangential - does not return to the topic
confabulation

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6
Q

symptoms of passivity

A

somatic passsivity (sn1strankSxofSchizo)
made acts / feelings / drives
psychomotor retardation - major depressive disorder..
stupor - loss of activity with no response to stimuli
catatonia - significantly inhibited / increased and chaotic movement

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7
Q

mood symptoms

A

flight of ideas
neologisms (MANIC PATIENTS - made up words)
pressure of speech
anhedonia
flattening of affect - reduced range of emotional expression
incongruity of affect - mania / psychosis / schizophrenia
obsession - unwanted recurrent intrusive thought
compulsion - an irresistible urge to behave in a certain way

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8
Q

misc symptoms in psych

A

depersonalisation - thoughts and feelings do not seem to belong to someone - (DISSOCIATION / ANXIETY)
derealisation - feeling as if you’re looking at yourself from the outside (DISSOCIATION / ANXIETY / TRAUMA / PD)

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9
Q

symptoms indicating psychosis?

A

loads

delusional beliefs / thought disorders / thought insertion / withdrawal / broadcast / echo / block / made acts

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10
Q

describing hallucinations

A
  1. medium (auditory etc.)

2. 2nd /3rd person

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11
Q

capgras syndrome - what is it?

A

imposter Sx

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12
Q

look at core problems in 3a handbook

A

transgender etc
Anxiety
self harm and risk - coping strategies for self harm and the sort of things you’d advise

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13
Q

describe the symptoms of psychosis:

A

positive:
delusions / halluc
meds help

negative
flat / blunted affect /
meds don’t help much

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14
Q

what are the types of schizophrenia

A

paranoid - grandiose delusions / delusions of persecution
catatonic - exitement and stupor phases
hebephrenic / disorganised - bizarre behavior
residual schizophrenia - chronic negative symptoms

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15
Q

Psychosis - other types

A

persistent delusional disorder - elderly / smells / sensory problems

acute and transient psychosis - on w/in 2wks recover in 3/12 - no Tx needed

schzoaffective

puerperal psychosis

organic psychosis

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16
Q

treatment of psychosis?

A

LEARN THIS AS GENERAL STRUCTURE…

bio - antipsychs (+clozapine for tx resistant - need to be registered with drug company to prescribe, need to check WCCs - learn SEs - toxic megacolon / neutropenia)

Psych - family therapy / cbt

Socio - family intervention / carer support / employment activie education / support with engagement and benefits

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17
Q

mood disorders - mania (bipolar 1)

presentation + symptomatology..?

A

at least 2 episodes in which patients mood and activity levels are significantly disturbed

disturbance up on some, down on some

**finish with

18
Q

hypomania - bipolar 2

A

it’s a change

lesser degree of mania - doesn’t affect functioning to same degree

19
Q

management of Bipolar

A

bio - mood stabilisers

psych - talking treatment eg. CBT / relapse prevention / psychoeducation

Socio - family or carer support / employment / activity / engagement / support / benefits

20
Q

driving in bipolar?

A

yes you can - as long as well according to doctor and inform the DVLA and med levels not

21
Q

depression:
1. symptoms
2. mild / mod / severe

A
  1. DEAD SWAMP

2. learn icd 10 again

22
Q

mx of depression

A

bio:
antidepressants (ssri / tca , both)
ect

psycho:
talking tx : CBT / CAT
group work / self help
psychoeducation

socio:
as before..

SPECIFIC:

mild:
ww
IAPT

mod:
SSRI:+ IAPT
ref to psych??

Severe
consider admission to psych ward
?ECT

23
Q

psychopharmacology of hypnotics…

A

bdzs (-pams… / chlordiazepoxide for)

24
Q

types of antidepressants:

A

SSRIs
fluoxetine
SE: abdo / suicidality / sex dysf / safe in OD

TCAs
ampitryp
SE: sedation / Anti-Chol

SNRIs

Tetracyclic - Mirtazapine

MAOi
cheese and red wine HTNive crisis

25
Q

antipsychotics - types

A 
1st gen
sulpiride / haloperidol / 
SEs:
acute dystonic crisis - Tx with IM procyclidine
EPS

2nd gen - atypical
olanzipine etc…
SEs: metabolic…

clozapine - good for tx resistant / people with bad EPS / good for psychosis in PD

26
Q

mood stabilisers

A

litium
antipsychs
anticonvs

27
Q

ADHD Tx:

A
  1. adults - methyphenidate (ritalin)
    SE - apptite suppresion / psychosis / misuse - hence weight and height for children on it….)
  2. children - parent training programmes

2nd line - atomoxetine (SSRI - liver dys / abdo pain / suicidal idealation…)

28
Q

what is mirtazapine

A

a tetracyclic

29
Q

psychological interventions…

A 
counselling
psychoeducation group
CBT 
DBT 
psychoanalytical psychotherapy
group + family therapy -> especially in childhood disorders
30
Q

psychological interventions…

A 
counselling
psychoeducation group
CBT 
DBT 
psychoanalytical psychotherapy
group + family therapy -> especially in childhood disorders
31
Q

what psychotherapeutic intervention should these be used for:

  1. exposure and response prevention
  2. EMDR
A
  1. OCD

2. PTSD

32
Q

when answering the ‘social’ bit of psych management questions - what should you think through

A

the social determinants of health

eg. housing /

33
Q

what does rapid tranquilisation mean and what is first and second line?

A

im sedation

  1. lorazepam
  2. haloperidol
34
Q

learn the appropriate MH act sections

A

section 2 - up to 28 days, mainly assessment
section 3 - treatment order - 6months
section 5(2) - doctors holding power - ANY (?registered)DOCTOR - 72hrs
section 5(4) - nurses holding power - 6hrs
section 136- public palce to safety
section 135 - home to safety

35
Q

who do you need to do an assesment under the MHA

A

AMP
section 12 approved dr
another registered doctor

36
Q

what conditions must be met regarding his health to be detained under the MHA

A

mental health disorder
nature of degree to warrant deteention in hospitall
risk to self / others / health

37
Q

what conditions must be met regarding his health to be detained under the MHA

A

mental health disorder
nature of degree to warrant detention in hospital
risk to self / others / health

38
Q

who can release someone from a section

A

RMO / cons psychiatrist / relative

39
Q

assessing suicide risk - what risk factors can you use

A

SAD PERSONS score
Sex male
Age (15-25 / >59)
depressed / hopeless

previous suicide attempt
exess etoh / drug use
rational thinking (lack of...)
single / windowed / divorced
organised plan
no social support
stated future intent
40
Q

MENTAL CAPACITY ACT:

  1. what is it
  2. what are the 5 key principles
  3. what is the 2 stage test of capcacity
A

see sheet…

and finish…

41
Q

what should you consider when you’re making a decision in someone’s best interests

A

consider a delay until the person regains capacity?
involve the person
consider their past / present wishes and feelings
consider any advanced decisions (AD - legallybinding)
beliefs and values
views of IMCA
least resustrictive option

psychiatry (4 decks)

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