Psych Summary Cards

Question 1

GAD - medical causes / 3 main categories of CF / T

Answer 1

c - hyperthyroid / hypoglycaemia / CF - apprehension / motor / autonomicT - benzo’s and CBT

Question 2

eating disorder - anorexiadiagnostic CF / what is important to ask in Soc Hx / complications

Answer 2

CFwhat is their occupationcomplic - osteop, pancreatitis, suicide, anaemia

Question 3

bulimia - diag CF / common exam finding

Answer 3

o/e - callus, teeth decay, parotomegaly

Question 4

medical causes of depression

Answer 4

dementia

Question 5

important first step of any investigation

Answer 5

CLINICAL hx and MSE

Question 6

what are the Cf of Mania?

Answer 6

elated mood, pressured speech, increased energy, grandiose thoughts, sexual disinhibition, lack of sleep, overly familiar

Question 7

complications of alcohol dependance

Answer 7

PHYSICAL - Liver disease, peripheral neuropMENTAL - depression, dementiaSOCIAL - unemployment

Question 8

complications of opiate dependnacy

Answer 8

PHYSICAL - infections, BBVMENTAL - psychosis, anxietySOCIAL and LEGAL

Question 9

CF of opiate dependance

Answer 9

flu-like symptoms, yawning, sweating, dilated pupils, piloerection

Question 10

Bipolar - RF / main split of CF / key investigation points / T

Answer 10

RF - genetic FHx is bigCF - HYPOmania / Mania w/o psychosis / Mania WITH psychosisI - always mention MSE as this can be a big giveaway (if patient is dressed innapropriately)T - if needed, admit under MHA and stabilise mood. Anti-psychotic (olanzapine) in short term and lithium long term.ECT can be used if patient has not slept to a dangerous degree.

Question 11

depression - medical causes / RF / grading severity / core features

Answer 11

c - dementia / alcohol / hypothyroid / parkinsons / b-blocker / rf - physical illness/ low social / fhx / poor support networlseverity - MILD - 2 core + 2 other cfMOD - 2 core + 3 other cfSEVERE - 3 core + 4 additional +/- psychosis

Question 12

personality disorder categories + T

Answer 12

1. odd/eccentric (paranoid/ schizoid)2. Dramatic / emotional (histrionic/ dissociative/ unstable)3. Fearful/ Anxious (OCD)T - treat the cause of personality type (eg if anxious give benzo’s)

Question 13

post natal blues - timescale and T

Question 14

post natal dep - specific CF - timescale, RF and T

Answer 14

specific CF are those ABnormal for a mother post-delivery: - feelings of guilt for being bad mother - doesnt feel attached to childnormally within 1 month, and should resolve within 6 months.RF - single parent, poor support, low social classAvoid meds if possible to manage with reassurance.

Question 15

schizo - c/rf + CF

Answer 15

fam hx / cannabisCF - first rank + others

Question 16

adhd - assoc disorders/ RF , CF (2 main categories), T , normal timeline

Answer 16

Learning diff, depression, anti-social behaviour, MALECF - innattention and hyperactivity symptomsT - education, CBT and Ritalin (…???…)should resolve around puberty time

Question 17

NAI - RF / signs for suspicion / what must always be done if suspected

Answer 17

RF - single parent, unwanted preg, physical r mental handicapsuspicion signs - hx doesnt make sense/ changeshx doesnt match injjrieschild has stipubic hair in nappybruising NOT over bony areadelayed presentationchild development delayedpoor hygiene*Always:1. document EVERYTHING2. involve a senior doctor3. social services

Question 18

depression in youth - RF / CF (which are diff to adult)

Answer 18

RF - fam hxCF - apathy, school refusal, failure to thrive

Question 19

dementia - CF , forms, T

Answer 19

memory loss, confusion, changed behaviour, personality change, mood changeVasc, Alzh, Lewy B, fronto tempT - educate family, care package, encourage to speak to DVLA, risk assessment in houseanti deps if needed, acetylcholine esterase inhibitors can slow progression in alzheimers

Question 20

autism - CF, T

Answer 20

TRIAD:poor lamnguage skills, poor social interaction, rituals and routines, also low iq?T - SALT, CBT, education of family

Question 21

downs - CF, complications

Answer 21

ROSOLEACV defects, squint, hypothyroid, loss of hearing

Question 22

serotonergic syndrome CF

Answer 22

myoclonus, death…

Question 23

benzo’s indication

Answer 23

anxiety, withdrawls,

Question 24

ECT ind and contra-ind

Answer 24

depression, catatonic schiz, maniacontra ind = raised ICP

Question 25

lithium - ind, pre-treatment tests, OD management, OD CF, contra ind

Answer 25

acute treatment of mania / maintainance of bipolar affective disorderpre t = ECG, TFT’s, U+E’sOD:CF - severe nausea, D+V, disorientation, seizures, drowsinessM - assess serum lithium + ECG and U+E’s

Question 26

lithium - mustn’t be given/ given with caution with what other calss of drug?

Answer 26

diuretic

Question 27

what is ssri commonly given with?

Answer 27

PPI

Question 28

what can lithium cause?

Answer 28

weight gain, resulting in hypothyroid/ hyperparathyroid/ ATN/ Diabetes Insip

Question 29

when side effects from anti-psychotics arise, what method must be used to stop these from continuing.

Answer 29

Taper and stop SSRI. Leave one week gap and then start Venlafaxine at half dose initially.

At baseline measure U&Es, ECG and blood pressure.

Question 30

what should be considered when choosing a new nti-depressant?

Answer 30

1. patient preference
2. insomnia (amatryp is sedating)
3. job (heavy machinery?)
4. suicidal?

Question 31

what can be given alongside benzo in anxiety?

Answer 31

b blocker

Question 32

reversible causes of dementia? (4)

Answer 32

alcohol, hypothyroid, depression, defeciency