Psych Summary Cards Flashcards
GAD - medical causes / 3 main categories of CF / T
c - hyperthyroid / hypoglycaemia / CF - apprehension / motor / autonomicT - benzo’s and CBT
eating disorder - anorexiadiagnostic CF / what is important to ask in Soc Hx / complications
CFwhat is their occupationcomplic - osteop, pancreatitis, suicide, anaemia
bulimia - diag CF / common exam finding
o/e - callus, teeth decay, parotomegaly
medical causes of depression
dementia
important first step of any investigation
CLINICAL hx and MSE
what are the Cf of Mania?
elated mood, pressured speech, increased energy, grandiose thoughts, sexual disinhibition, lack of sleep, overly familiar
complications of alcohol dependance
PHYSICAL - Liver disease, peripheral neuropMENTAL - depression, dementiaSOCIAL - unemployment
complications of opiate dependnacy
PHYSICAL - infections, BBVMENTAL - psychosis, anxietySOCIAL and LEGAL
CF of opiate dependance
flu-like symptoms, yawning, sweating, dilated pupils, piloerection
Bipolar - RF / main split of CF / key investigation points / T
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.
depression - medical causes / RF / grading severity / core features
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
personality disorder categories + T
- 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)
post natal blues - timescale and T
post natal dep - specific CF - timescale, RF and T
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.
schizo - c/rf + CF
fam hx / cannabisCF - first rank + others
adhd - assoc disorders/ RF , CF (2 main categories), T , normal timeline
Learning diff, depression, anti-social behaviour, MALECF - innattention and hyperactivity symptomsT - education, CBT and Ritalin (…???…)should resolve around puberty time
NAI - RF / signs for suspicion / what must always be done if suspected
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
depression in youth - RF / CF (which are diff to adult)
RF - fam hxCF - apathy, school refusal, failure to thrive
dementia - CF , forms, T
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
autism - CF, T
TRIAD:poor lamnguage skills, poor social interaction, rituals and routines, also low iq?T - SALT, CBT, education of family
downs - CF, complications
ROSOLEACV defects, squint, hypothyroid, loss of hearing
serotonergic syndrome CF
myoclonus, death…
benzo’s indication
anxiety, withdrawls,
ECT ind and contra-ind
depression, catatonic schiz, maniacontra ind = raised ICP
lithium - ind, pre-treatment tests, OD management, OD CF, contra ind
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
lithium - mustn’t be given/ given with caution with what other calss of drug?
diuretic
what is ssri commonly given with?
PPI
what can lithium cause?
weight gain, resulting in hypothyroid/ hyperparathyroid/ ATN/ Diabetes Insip
when side effects from anti-psychotics arise, what method must be used to stop these from continuing.
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.
what should be considered when choosing a new nti-depressant?
- patient preference
- insomnia (amatryp is sedating)
- job (heavy machinery?)
- suicidal?
what can be given alongside benzo in anxiety?
b blocker
reversible causes of dementia? (4)
alcohol, hypothyroid, depression, defeciency
