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Phase 3a > Psych (things I forget) > Flashcards

Psych (things I forget) Flashcards

1
Q

What is the difference between tardive dyskinesia, acute dystonia and akathisia?

A

Tardive dyskinesia = prolonged use - choreoathetoid movements

Acute dystonia = acute reaction - sustained muscle contraction e.g. torticollis/oculogyric crisis

Akathisia = acute reaction - motor restlessness

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2
Q

What are 4 main side effects of typical antipsychotic use?

A
  • Acute dystonia
  • Akathisia
  • Parkinsonism
  • Tardive dyskinesia
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3
Q

What is used to manage tardive dyskinesia, acute dystonia and akathisia?

A

Tardive dyskinesia = tetrabenazine

Acute dystonia = procyclidine (2nd line = benzotropine)

Akathisia = propranolol

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4
Q

When should patients new on SSRIs be reviewed?

A

<25 = 1 week
>25 = 2 weeks

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5
Q

What are the clinical features of SSRI discontinuation syndrome?

A
  • Dizziness
  • Electric shock sensations
  • Anxiety
  • Sweating
  • GI symptoms
  • Restlessness
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6
Q

What should be done in patients on antidepressants displaying symptoms of mania/hypomania?

A

Stop antidepressant and start antipsychotic

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7
Q

What are risk factors for schizophrenia?

A
  • Male
  • Black
  • Family history
  • Cannabis use
  • Childhood abuse
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8
Q

What are prognostic indicators in schizophrenia?

A

Good = female/predominance of positive sx

Bad = gradual onset of sx/onset in adolescence

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9
Q

What are the NICS/CKS aspects of management for schizophrenia?

A
  • Assess risk of harm to self and others
  • Referral to psychiatric team
  • Antipsychotic under specialist supervision
  • Signpost to support for self/family
  • Offer CBT
  • Treat co-existing psychiatric/substance disorders
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10
Q

Which antidepressant commonly causes increased appetite and subsequent weight gain?

A

Mirtazapine (NaSSAs)

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11
Q

What is clang association?

A

Ideas related only by rhyme or being similar sounding

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12
Q

What should be done to patients with depression who are about to commence ECT?

A

Reduce antidepressant medication

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13
Q

What is catatonia?

A

State in which someone is awake but does not seem to respond to other people and their environment/state of near unconsciousness or insensibility

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14
Q

What is the diagnostic criteria for chronic insomnia?

A

Trouble falling/staying asleep at least 3 nights per week for >3 months in patients of any age

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15
Q

Describe the PHQ-9 score for depression

A
  • <=4 = minimal
  • 5-9 = mild
  • 10-14 = moderate (talking therapy)
  • 15-19 = moderately severe (pharmacotherapy)
  • > =20 = severe (pharmacotherapy + referral)
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16
Q

Describe alcohol withdrawal timeframes

A

6-12 hours = symptoms
36 hours = seizures
72 hours = delirium tremens

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17
Q

What does acamprosate do?

A

NMDA receptor antagonist - reduces alcohol cravings

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18
Q

What does disulfiram do?

A

Acetaldehyde dehydrogenase inhibitor - causes unpleasant symptoms when someone has alcohol

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19
Q

What does naltrexone do?

A

Reduces the pleasurable effects of alcohol

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20
Q

What medications are used in drug overdoses?

A

Naloxone

Paracetamol - acetylcysteine

21
Q

What are investigative features of anorexia?

A
  • Most things low
  • Gs and Cs raised = Growth hormone, Glucose, salivary Glands, Cortisol, Cholesterol, Carotinaemia
22
Q

What is neuroleptic malignant syndrome and what are the causes?

A

Life-threatening disorder characterised by confusion, rigidity and fever

  • Adverse reaction to antipsychotics (dopamine receptor agonists)
  • Abrupt withdrawal of dopaminergic medication
23
Q

What are the investigations for neuroleptic malignant syndrome?

A
  • Raised CK
  • Raised WCC
  • Deranged LFTs
  • Abnormal U&Es
  • Metabolic acidosis
24
Q

What is the difference between conversion disorder and somatisation disorder?

A

Conversion disorder = loss of motor/sensory function

Somatisation disorder = multiple unexplained symptoms >2 years

25
Q

What electrolyte imbalance are SSRIs associated with?

A

Hyponatraemia

26
Q

What are the risks of SSRIs in pregnancy?

A

1st trimester = increased risk of congenital heart defects

2nd trimester = increased risk of persistent pulmonary HTN

27
Q

What is De Clerambault’s syndrome?

A

A delusion in which someone believes that a famous person is in love with them

28
Q

What is Capgras syndrome?

A

A delusion in which someone believes that a person closely related to them has been replaced by an imposter

29
Q

What is Cotard syndrome?

A

A delusion in which someone believes that they are dead or non-existent

30
Q

What should be monitored at initiation and dose titration of SNRIs?

A

Blood pressure

31
Q

What should be monitored at initiation and dose titration of SSRIs?

A

U&Es

32
Q

What should be monitored at initiation and dose titration of TCAs?

A

ECG

33
Q

What are the clinical features of lithium toxicity?

A
  • Coarse tremor
  • Ataxia
  • Hyperreflexia
  • GI upset
  • Polyuria
34
Q

What are the investigations for generalised anxiety disorder?

A
  • 24 hour urine metanephrines
  • ECG
  • FBC
  • Iron studies
  • TFTs
35
Q

What score is used to investigation alcohol abuse?

A

AUDIT

36
Q

Give 2 examples of typical antipsychotics and their common side effect

A
  • Haloperidol
  • Chlorpromazine
  • Parkinsonism’s
37
Q

What is the difference between hypoactive sexual desire disorder, female sexual arousal disorder and sexual aversion disorder?

A
  • Hypoactive sexual desire disorder = lack of interest in sex but not physiological response to arousal (lack of interest but may still enjoy)
  • Female sexual arousal disorder = lack of desire to have sex and experience vaginal dryness
  • Sexual aversion disorder = disgust at thought of sex
38
Q

What is the management for mood stabilisation in bipolar affective disorder?

A
  • Lithium
  • Sodium valproate may be used second line
39
Q

Give 2 examples of monoamine oxidase inhibitors and the main complication

A
  • Phenelzine
  • Isocarboxazid
  • Tyramine cheese reaction
40
Q

How often does clozapine need to be monitored?

A
  • 1 blood test (FBC) per week for the first 18 weeks
  • Fortnightly until 1 year
  • Monthly
41
Q

What are the side effects of clozapine and when may the dose need to be adjusted?

A
  • AGRANULOCYTOSIS
  • Reduced seizure threshold
  • Constipation
  • Myocarditis
  • Hypersalivation
  • Dose adjustment needed if patient stops/starts smoking
42
Q

What test can be done to test cognition?

A

6CIT - six item cognitive impairment test

43
Q

What do egosyntonic and egodystonic mean?

A

Egosyntonic - in keeping with ones’ beliefs and values

Egodystonic - very different to ones’ normal beliefs and values

44
Q

What is the difference between flight of ideas and knight’s move thinking and what are they commonly seen in?

A

Knight’s move = thoughts move from one topic to another without any logical connections between them (schizophrenia)

Flight of ideas = increased rate of thought and some logical links between frequent changes of topics (mania/hypomania)

45
Q

What is the management for OCD?

A
  • CBT/exposure and response prevention
  • SSRI (not fluoxetine)
  • Clomipramine
46
Q

What is the management for PTSD?

A
  • Trauma-focused CBT/eye movement desensitisation and reprocessing therapy
  • Venlafaxine
  • SSRI
47
Q

What are the first rank symptoms of schizophrenia?

A
  • Third person auditory hallucinations
  • Thought disorders
  • Delusional perceptions
  • Passivity phenomenon
48
Q

What are positive symptoms of schizophrenia?

A
  • Hallucinations
  • Thought disorders
  • Delusional perception
  • Passivity phenomenon
  • Persecutory delusions
49
Q

What are negative symptoms of schizophrenia?

A
  • Affective blunting
  • Poverty of speech (alogia)
  • Anhedonia

Phase 3a (21 decks)

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