Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Phase 3a > Psychiatric > Flashcards

Psychiatric Flashcards

1
Q

what is the common pharmacological action of antidepressants?

A

elevate levels of one or more monoamine neurotransmitters n the synaptic cleft

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How do tricyclic antidepressants work?

E.g Amitriptyline

A

blockage of both noradrenaline and serotonin re-uptake pumps presynaptically

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How do SSRI work?

E.g citalopram, Fluoxetine, Sertaline

A

selective presynaptic blockage of serotonin re-uptake pumps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How do SNRI work?

e.g Venlafaxine

A

presynaptic blockage of both serotonin and noradrenaline re-uptake pumps (with no affect on muscarinic, histaminergic or alpha-adrenergic receptors)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How do Monoamine oxidase inhibitors (MAOI) work?

E.g Phenelzine, Tranylcypromine, Isocarboxazid

A

non-selective and irreversible inhibits of monoamine oxidase A and B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How to Reversible inhibitor of Monoamine oxidase A work?

e.g moclobeminde

A

selective and reversible inhibition of monoamine oxidase A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Indications for SSRI’s?

A

Depression
Anxiety disorders
OCD
Bulimia Nervosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What SSRI is used in Bulimia nervosa?

A

Fluoexetine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

indications for TCA?

A 
Depression
Anxiety disordrs
OCD
Chronic pain 
nocturnal enuresis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

indications for MAOI?

A

Depression
anxiety
Eating disorders
Parkinsons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

S.E and contraindications of SSRI?

A
  • Fewer anticholinergic affects than TCA and are not sedating
  • Are alerting, so prescribe in morning
  • Common SE= N&V, diarrhoea, pain, anxiety, agitation, weight loss and loss of appetite, insomnia, sweating sexual dysfunction
  • CI= Mania
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Tricyclic Antidepressants- SE and CI?

A
  • SE- dry mouth, constipation, urinary retention and dizziness (anticholinergic effects)
  • Postural hypotension (due to alpha-adrenergic)
  • Weight gain and sedation (histaminergic)
  • Cardiotoxic–> Prolonged QT, ST elevation, heart block, arrythmias
  • CI= recent MI, arrhythmia, severe liver disease, mania
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

MAOI- SE and CI?

A
  • Now is 2nd line due to many interactions with certain foods
    High risk of Serotonin syndrome
    S.E- Anticholinergic effects and postural hypertension
    CI- Phaeochromoctyoma, CVD, hepatic impairment , Mania
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is serotonin syndrome?

A

neuromuscular abnormalities, altered conscious level, autonomic instability
Is fatal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Name the 2 types of Mood stabilisers?

A

1) Lithium

2) Anti-convulsants= sodium valproate, carbamazepine and lamotrigine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Indications for lithium?

A
  • Acute mania
  • Prophylaxis of bipolar affective disorder
  • Treatment for resistant depression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Indications for sodium valporate?

A
  • Epilepsy
  • Acute mania
  • Prophylaxis of Bipolar
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

indications for carbamazepine?

A
  • epilepsy
  • Prophylaxis of Bipolar
  • Trigeminal neuralgia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Lithium range ?

A
  • 0.5-1

Over 1.5 is toxic, and over 2 is dangerous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What drugs can increase lithium levels?

A
  • Diuretics, NSAIDs and ACE-i (stopping renal clearance)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

S.E of lithium?

A
  • Thirst, polydipsia polyuria, weight gain, oedema
  • Fine tremor
  • Precipitation of skin problems
  • Concentration/memory problems
  • ECG changes= T wave flattening or inversion
  • Hypothyroidism
  • Leucocytosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Signs of lithium toxicity?

A
  • N&V, apathy, coarse tenor, ataxia, muscle weakness
  • Dangerous levels= nystagmus, dysarthria, impaired consciousness, hyperactive tension reflexes, renal function and electrolyte imbalances
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Things to do before prescribing lithium? (testing for CI)

A
  • FBC
  • Renal function and electrolytes
  • Thyroid function
  • Pregnancy test
  • ECG
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

S.E of sodium valproate?

A
  • Increased appetite and weight gain
  • Sedation and dizziness
  • Ankle swelling
  • N&V
  • Tremor
  • Can cause haematological abnormalities and raised liver enzymes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

S.E of carbamazepine?

A
  • N&V
  • skin rashes
  • Blurred or double vision
  • Ataxia, drowsiness and fatigue
  • Hyponatraemia, haem abnormalities and raised liver enzymes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Name x2 1st generation antipsychotics?

A
  • Chloropromazine

- Haloperidol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Name x4 2nd generation (atypical) antipsychotics?

A
  • Clozapine
  • Olanzapine
  • Quetiapine
  • Risperidone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Mode of action of anti-psychotics?

A
  • Antagonism of dopamine D2 receptors in the mesolimbic dopamine pathway–> area associated with delusions, hallucinations, thought disorders etc. Also area where most illicit drugs work, thus euphoria etc…
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is different about Clozapines mode of action?

A

its a weak D2 antagonist, but a strong affinity for serotonin type 2 and D4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

S.E of Clozapine?

A
  • Rare serious side effects such as agranulocytosis, myocarditis and cardiomyopathy
  • thus reserved for treatment resistant cases
    (needs weekly FBC’s then montly)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what are the extrapyramidal S.E of anti-psychotics?

A
  • parkinsonism motorsyptoms
  • acute dystonia
  • Akathisia
  • Tardive dyskinesia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

indications for antipsychotics?

A
  • Schizophrenia, schizoaffective disorder, delusional disorder
  • depression or mania with psychosis
  • psychosis due to substance abuse
  • delirium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Triad in Neuroepileptic malignant syndrome and Serotonin syndrome?

A
  • neuromuscular abnormalities
  • altered consciousness
  • autonomic dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

NMS vs Serotonin syndrome?

A
  • NMS= caused by too much dopamine antagonist. Get reduced activity (rigidity, dysphagia etc)
  • SS= too much serotonin (increased activity)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Blood results of NMS and SS?

A

elevated CK, WCC and hepatic transaminases

Also see a metabolic acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Drugs used for Anxiety and lack of sleep?

A
  • Benzodiazepines
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Mode of action of benzo’s?

A

potentiate the action go GABA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

indications for benzo’s?

A
  • insomnia
  • Anxiety disorders
  • alcohol withdrawl
  • akathisia
  • acute mania or psychosis (sedation)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

indication for Electroconvulsive therapy?

A
  • severe depression (when life is threatened, poor fluids and feeding, suicidal intent etc)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

S.E of ECT?

CI of ECT?

A 
S.e= loss of memory. confusion, Nausea, headache and muscle pain
CI= Heart disease, Raised ICP, risk of cerebral bleeding etc
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What is a mental disorder?

A

any disorder or disability of the mind

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What is the mental health act?

A

provides a legal framework for the care and treatment of individuals with mental disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is a section 2?

A

Admission for assessment.
compulsory detention for assessment. used for when diagnosis and response to treatment are unknown. lasts for 28 days and requires 2 doctors (one doctor must be section 12 approved)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is a section 3?

A

Admission for treatment.
Compulsory admission fo treatment. used when diagnosis and treatment is established. Can last up to 6 months and needs 2 doctors to approve (one doctor must be section 12 approved)

45
Q

What is a section 4?

A

Emergency admission for assessment.
done when there is no time to wait for section 2 procedures in the community. lasts 72 hours (1 doctor above F2 can do it)

46
Q

What is a section 5 (2)?

A

doctors holding power.
detention of a hospital inpatient receiving any form of treatment in order to give time for section 2 or 3 (doesn’t have to be psych)
Any doctor can do

47
Q

What is a section 5(4)?

A

Nurses holding power of up to 6 hours. must be registered mental health nurse

48
Q

What is a section 135?

A

Police to enter a private premises to remove someone with a suspected mental health disorder to a place of safety . can last up to 72 hours

49
Q

What is a section 136?

A

Police to remove someone suspected with mental health disorder from public place to a place of safety for up to 72 hours

50
Q

3 core symptoms of Depression?

A
  • low mood
  • adhedonia
  • anergia
51
Q

The other symptoms of depression can be divided in to?

A
  • Biological

- Cognitive

52
Q

Biological symptoms of depression?

A
  • Early morning wakening
  • Depression is worst in morning
  • marked loss of appetite with weight loss
  • psychomotor retardation or agitation
  • loss of libido
53
Q

Cognitive symptoms of depression?

A
  • reduced concentration or memory
  • poor self esteem
  • guilt
  • hopelessness
  • suicide or self harm
54
Q

In severe depression with psychosis, what hallucinations are often experienced?

A
  • 2nd person auditory

- olfactory (smell of rotting flesh)

55
Q

To diagnose depression, mild, moderate or severe, what must the patient have?

A
  • A 2 week history of 2/3 core symptoms plus…
  • Mild= 2 other symptoms
  • moderate= 3 other
  • severe= 4 other but all core symptoms!
56
Q

What is Dysthymia?

A
  • A chronically depressed mood that usually has its onset in early adulthood and may remain throughout the patients life, with variable periods of wellness in between.
57
Q

What is cyclothymia?

A
  • A milder version of bipolar affective disorder resulting in instability of mood involving mild elation and mild depression. It has no interference with every day life.
58
Q

What is Schizoaffective disorder?

A

Diagnosis made when patients presents with both mood symptoms (depression or mania) and schizophrenic symptoms within the same episode of illness

59
Q

What is Bipolar affective disorder?

A
  • Mood is considered to deviate from normal to either a depressed or elated (manic) pole
60
Q

What is mixed affective disorder?

A
  • when manic and depressive symptoms rapidly alternate (in same day)
61
Q

What are the Biological symptoms of Mania?

A
  • Decreased need for sleep

- Increased energy

62
Q

What are the cognitive symptoms of Mania?

A
  • Elevated sense of esteem or grandiosity
  • poor concentration
  • accelerated thinking (pressure of speech) (flight of ideas)
  • impaired judgement and insight
63
Q

What is hypomania?

A
  • mood elevation with periods of depression. not as bad as bipolar affective disorder. considerable interference with life.
64
Q

What is Psychosis?

A
  • a mental state in which reality is grossly distorted, resulting in symptoms such as delusions, hallucinations and though disorder
65
Q

What is a hallucination?

A
  • perception scouring in the absence of an external physical stimulus, which have the following important characteristics…
  • to the patient, the hallucination is as real as a normal sensory experience
  • they are experienced via 1 of the 5 sensory modalities
  • they occur without an external stimulus
66
Q

What are the 4 types of Auditory hallucinations?

A

1) Elementary
2) first person (own thoughts spoken out loud)
3) Second person (patients hears a voice talking directly to them)
4) third person (patient hears multiple voices talking to them, e.g. devil and angel)

67
Q

What is an illusion?

A

misperception of a real external stimuli

68
Q

What is a pseudohallucination?

A

a hallucination experienced by the patient but they regard it not true but continue to experience the hallucination.

69
Q

What is a delusion?

A
  • unshakable false belief that is not accepted by others
  • no difference between delusion and true belief to patient
  • delusion is false due to faulty reasoning
  • out of keeping with patients social and cultural beliefs
70
Q

What is a primary delusion?

A

do not occur in response to any previous psychopathological state

71
Q

What is a secondary delusion?

A
  • the consequence of pre-existing psychopathological state
72
Q

What are mood congruent delusions?

A
  • content of delusions are appropriate to patients mood (seen in depression or mania etc.)
73
Q

What is Capras syndrome?

A
  • belief that a familiar person has been replaced with an exact double/imposter= delusion of misidentification
74
Q

What is Fregoli syndrome?

A
  • belief that a complete stranger is actually a familiar stranger already known to one
75
Q

What are somatic delusions?

A
  • false belief concerning ones body- e.g. bowels are rotting, skin is dirty with bacteria
76
Q

What is circumstantial thinking?

A

-Speech is delayed in reaching its final goal as of the over inclusion of detail, however the speaker will then get to the point

77
Q

What is tangential thinking?

A
  • Speaker derives from the original train of thought but never returns to the original point
78
Q

What is flight of ideas?

A
  • thinking is markedly accelerated, resulting in a stream of connected concepts
79
Q

What is loosening of association?

A
  • patients train of thought shifts suddenly from one very loosely or unrelated idea to the next
80
Q

What is thought blocking?

A
  • patients experience a sudden cessation to their flow of thought, often mid-sentence
81
Q

What is preservation?

A
  • an initial correct response inappropriately repeated (often organic brain disease)
82
Q

What are negative symptoms?

A
  • Negative symptoms are thoughts, feelings, or behaviors normally present that are absent or diminished in a person with a mental disorder.
83
Q

6 clinical deficits that come under negative symptoms?

A

1) Marked apathy
2) poverty of thought and speech
3) blunting of affect
4) social isoloation
5) poor self care
6) cognitive deficits

84
Q

diagnostic guidlines for Schizophrenia?

A

One or more of the following: (for a month)

a) thought echo, insertion, withdrawn or broadcast
b) Delusions of control or passivity delusional perception
c) Hallucinatory voices giving a running commentary
d) bizarre delusions

OR 2 or more of the following:

i) hallucinations that occur every day for weeks that are associated with fleeting delusions or sustained over valued ideas
ii) thought disorganisation
iii) catatonic symptoms
iv) negative symptoms
v) change in personal behaviour

85
Q

What are schneiders first rank symptoms of schizophrenia?

A

1) delusional perception
2) delusions of thought control (insertion, withdraws broadcast)
3) delusions of control
4) hallucinations (audible)

86
Q

What is paranoid schizophrenia?

A

Dominated by presence of hallucinations and delusions (positive symptoms) negative symptoms and catatonic symptoms are not prominent.

87
Q

What is Hebephrenic/disorganised schizophrenia?

A

characterised by thought disorganisation, disturbed behaviour and inappropriate or flat affect

88
Q

What is catatonic schizophrenia?

A

rare form characterised by one or more catatonic symptoms

89
Q

What is residual schizophrenia?

A

1 year of predominantly negative symptoms which must have been preceded by at least one clear cut psychotic episode in the past

90
Q

What is delusional disorder?

A

the development of a single or set of delusions for a period of at least 3 months is the most or only prominent symptom. comes on in middle age and can persist throughout life.

91
Q

What are the 2 components of Anxiety?

A
  • Thoughts of being apprehensive, nervous or frightened

- Awareness of physical reaction to anxiety= autonomic or peripheral

92
Q

What is generalised (free floating) Anxiety?

A
  • does not occur in discrete episodes and tends to lasts hours, days etc. associated with excessive worrying, or apprehension of normal events
93
Q

What is paroxysmal anxiety?

A
  • abrupt onset, discrete episodes and short and severe. ETC panic attacks
  • Can be divided into Episodes without an external threat or those with
94
Q

What is Generalised anxiety disorder? what are the 3 key elements?

A

patients describe excessive worry about minor matters and are apprehensive on most days

  1. apprehension
  2. motor tension (inability to relax)
  3. autonomic overactivity (sweating and shit)
95
Q

What is panic disorder?

A

Characterised by presence of panic attacks that occur unpredictability and not restricted to any particular situation.

96
Q

What are obsessions?

A

involuntary thoughts, images or impulses which have these following characteristics..

  • recurrent and intrusive (unpleasant or distressing)
  • enter the mind against conscious resistance
  • patients recognise them as product of their own mind
97
Q

What are compulsions?

A

repetitive mental operations or physical acts with the following characteristics

  • patients fell compelled to perform them in response to their own obsessions or irrational rules
  • they are performed to reduce anxiety through thoughts that they will prevent a dreaded event
98
Q

What is the diagnosis criteria of OCD?

A

purely obsessions and compulsions without any other psychiatric illness.

  • present for at least 2 weeks
  • distressing patients life
  • acknowledge from patients own mind
  • obsessions are unpleasantly repetitive
  • one thought or act is restricted unsuccessfully
  • a compulsive act isn’t pleasurable
99
Q

4 conditions that patients can develop after a traumatic stressor?

A

1) an acute adjustment disorder
2) acute stress reaction or PTSD
3) Dissociative disorder
4) another psychiatric condition- depression, anxiety etc

100
Q

What is adjustment disorder?

A
  • emotional or behavioural symptoms within 3 months of the first stressor but resolves in 6 months
  • characterised by mood or anxiety symptoms
  • many experience suicidal ideation
101
Q

What is acute stress reaction?

A
  • happens few minutes after initial stressor and results n patients becoming dazed and disorientated. can last up to 48 hours
102
Q

What is PTSD?

A

-develop between 1-6 months of initial traumatic stressor
repetitive re-expereince of traumatic event in form of flashback, internal or external cues resembling stressor and hallucinations or illusion.
-will try to avoid the stressor
- increased arousal (insomnia, angry outbursts etc)
- Can have amnesia during re-experience

103
Q

What is delirium?

A
  • acute or fluctuating cognitive impairment and consciousness, drowsy or agitated, psychosis may be present, and will all continuously fluctuate
104
Q

Name some causes of delirium? (illness)

A
  • infection/sepsis
  • hypoglycaemia
  • electrolyte disturbances
  • thyroid
105
Q

Name some drugs that can cause delirium?

A
  • Anticholinergics
  • Benzo’s
  • Opiates
  • CO
  • Cannabis
106
Q

What is Dementia?

A
  • A syndrome of acquired progressive generalised cognitive impairment associated with functional decline. Conscious level is normal. Symptoms should be present for 6 months before diagnosis.
107
Q

Alzheimers disease progression?

A
  • Gradual onset with progressive cognitive decline- early memory loss
108
Q

Vascular dementia progression?

A
  • Stepwise deterioration in cognition
  • Evidence of cerebrovascular disease or stroke
  • Focal neurological signs and symptoms
109
Q

What is mixed dementia?

A
  • Alzheimers and vascular

Phase 3a (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions