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Yr 5 PACES > Psych VIVAs > Flashcards

Psych VIVAs Flashcards

1
Q

mechanism of alcohol’s effects

A

anxiolytic: increased GABA
euphoric: increased dopamine
amnesic: decreased NMDA mediated glutamate

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2
Q

recommended alcohol limit in UK

A

14 units/week w. several alcohol free days

M: 3-4 units/day
F: 2-3 units/day

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3
Q

signs of alcohol dependency

A

compulsion
aware of harm but continues
neglect of other activities
tolerance
sx of withdrawal
time w. substance incrases
out of control use
past sobriety attempts failed

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4
Q

signs of acute alcohol intoxication

A

labile mood
aggression
impaired judgement
slurred speech
unsteady gait
ataxia

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5
Q

signs of acute alcohol poisoning

A

cold clammy skin
unconscious
puking
slow breathing

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6
Q

risks assoc. w. excessive drinking

A

liver disease
cardiovascular disease
malnutrition

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7
Q

signs of alcohol withdrawal

A

autonomic: tachycardia, hypertensive, sweating, tremor

GI: n&v

mood: anxious + irritable

sleep disturbance: insomnia + nightmares

psych: hallucinations

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8
Q

what is delirium tremens

A

acute confusional state secondary to alcohol withdrawal 48hr after abstinence

delirium
extreme fear
autonomic disturbance
tremor
hallucinations

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9
Q

why is pabrinex given to alcoholics

A

prevent Wernicke’s

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10
Q

what is Wernicke’s encephalopathy

A

acute onset
confusion + opthalmoplegia + ataxia
secondary to neuronal damage due to thiamine deficiency

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11
Q

what is Korsakoff’s psychosis

A

consequence of Wernicke’s

irreversible anterograde amnesia + confabulation

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12
Q

tools for assessing alcohol dependence

A

AUDIT - identify disorder
SAD-Q - assess severity

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13
Q

Physical complications of AN

A

bradycardia + hypotension
GI upset
amenorrhoea + infertility
osteoporosis
peripheral neuropathy

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14
Q

mortality of AN

A

10%

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15
Q

when to admit for inpatient treatment of AN

A

BMI <13 or rapid weight loss
serious physical complications
high suicide risk

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16
Q

RFs for self harm

A

age
stressors
abuse
personality disorders

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17
Q

outline MHA of 1983

A

2: up to 28 days for assessment, requires AMHP + Dr
3: up to 6 months for treatment, requires Dr + Sec12 approved Dr
5(2): detention for 72hrs for further detention assessment under MHA
136: police power, public place
137: police power, forced entry into private property

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18
Q

key points of consent in children

A

Gillick competence in <16s
can consent if deemed capacitous
cannot refuse treatment

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19
Q

aetiology of Alzheimers

A

late onset - apolipoprotein E4 allele

early onset - AD mutation of beta-amyloid

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20
Q

RFs for Alzheimer’s

A

age
female
vascular RFs
head injury
low IQ

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21
Q

Clusters of personality disorders

A

A - odd
B - dramatic
C - anxious

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22
Q

personality disorder vs personality trait

A

disorder is:
pervasive
persistent
pathological

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23
Q

big five personality traits

A

openness
conscientiousness
extroversion
agreeableness
neuroticism

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24
Q

dxic criteria for BPAD

A

≥2 episodes, one of which is mania/hypomania w. complete recovery between

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25
Q

types of BPAD

A

1: manic + depressive
2: hypomanic + depressive
rapid cycling: >4 eps/year
mixed: both in single episode, present every day for ≥1/52

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26
Q

therapeutic range of lithium

A

0.6-1.0 mmol/L
toxicity > 1.2

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27
Q

SEs of lithium

A

lethargy
insipidus diabetes
tremor
hypothyroidism
intestinal
urine increased
metallic taste

28
Q

precipitating factors of lithium OD/toxicity

A

dehydration
ACEi
ARBs
dialysis

29
Q

long term consequences of lithium use

A

renal impairment
hypothyroidism

30
Q

teratogenic effects of mood stabilisers

A

lithium - Ebstein’s anomaly
valproate/carbamazepine - spina bifida

30
Q

SEs of clozapine

A

agranulocytosis
neutropenia
lower seizure trheshold

30
Q

how does smoking affect clozapine therpay

A

requires higher dose

30
Q

define delirium

A

acute confusional state from physical cause

31
Q

drugs that may cause psychosis

A

steroids
ethambutol
cannabis
cocaine

32
Q
A
33
Q

define delusional disorder

A

fixed firm false belief outside relevant cultural norms and other than those which are schizophrenic

34
Q

criteria for delusional disorder

A

present for 3 months
no persistent hallucinations
delusions persist without mood disturbances

35
Q

core symptoms of depression

A

low mood
anergia
anhedonia

36
Q

physical causes of depression

A

anaemia
hypothyroidism
Cushing’s
dementia

37
Q

cognitive symptoms of depression

A

selective memory for negative events
pathological guilt
pessimism

38
Q

Beck’s cognitive triad

A

negative views about:
self
world
future

39
Q

features of abnormal grief

A

disabling
>6 months duration
delayed

40
Q

psychosis in depression vs schizophrenia

A

depression: mood congruent

41
Q

route of administration of drugs for opiate withdrawal

A

methadone - oral liquid
buprenorphine - sublingual tablet

42
Q

MoA of methadone and buprenorphine

A

methadone - full mu agonist
buprenorphine - partial mu agonist

43
Q

GAD vs panic disorder

A

GAD: no specific triggering stimulus
continuous and generalised

panic: sudden attacks of extreme anxiety

44
Q

define agoraphobia

A

fear of being unable to easily escape to a safe place

45
Q

define social phobia

A

fear of being scrutinised/criticised by others

46
Q

prognosis of anxiety disorder

A

1/3 - full recovery
1/3 - partial improvement
1/3 - considerable disability

47
Q

define mild LD

A

IQ 50-69
struggle at school
delayed development
live/work independently w. appropriate support

48
Q

define moderate LD

A

IQ 35-49
language/cognition: less developed
motor: limited, reduced self-care
simple practical work if supported
long term supported accom

49
Q

define severe LD

A

IQ 20-34
language: little/none
motor: markers impairment
simple tasks w. support
24 hr support

50
Q

define profound LD

A

IQ <20
severely limited language and mobility
significant assoc. medical conditions
high support level

51
Q

associated conditions of LDs

A

epilepsy
mental health problems
ASD
mood/anxiety disorders

52
Q

obsession vs delusional belief

A

obsession: repetitive intrusive thoughts
evidence of resistance and avoidance

53
Q

incidence of puerperal psychosis

A

1 in 1000

54
Q

main SEs of atypical antipsychotics

A

metabolic
extrapyramidal

55
Q

MoA of atypical antipsychotics

A

blocks dopamine and serotonin receptors

56
Q

defin schizoid personality disorder

A

avoid interpersonal relationships
difficulty expressing emotions

57
Q

define somatisation

A

multiple recurrent frequently changing physical symptoms caused by psychological distress

58
Q

define hypochondrial disorder

A

persistent preoccupation on specific condition

59
Q

examples of medically-unexplained symptoms

A

conversion disorder
fibromyalgia
chronic fatigue syndrome

60
Q

medications to avoid on SSRIs

A

NSAIDs + aspirin
triptans
warfarin/heparin

61
Q

SEs of SSRIs

A

n & v
appetite/weight changes
anxiety/agitation
headache
sweating
hyponatraemia

62
Q

cardinal features of PTSD

A

reliving
hyperarousal
avoidance

63
Q

define adjustment disorder

A

greater than expected reaction to life changes but not severe enough to diagnose anxiety disorder/depression

64
Q

physical manifestations of anxiety

A

tremor
palpitations
sweating
hyperventilation

Yr 5 PACES (5 decks)

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