Psychiatric effects of medical conditions Flashcards
Percentage of patients with coronary heart disease who have comorbid depression
20%
Relationship between coronary heart disease and depression
Higher rates of depression in patients with coronary heart disease
Depression increases risk of coronary heart disease, even if treated
Percentage of patients with congestive heart failure who have depression
21.5%
Psychiatric symptoms of hyperthyroidism
Generalised anxiety
Depression
Irritability
Hypomania
Cognitive dysfunction
Most common psychiatric symptom of hyperthyroidism
Generalised anxiety
Psychiatric symptoms of hypothyroidism
Depression
Cognitive dysfunction
Rarely psychosis
Psychiatric symptoms of mild to moderate hypercalcaemia
Depression
Apathy
Irritability
Loss of initiative
Psychiatric symptoms of severe hypercalcaemia
Delirium
Psychosis
Catatonia
Lethargy
Coma
Psychiatric symptoms of Cushing’s syndrome
Depression
Anxiety
Mania/hypomania
Psychosis
Cognitive dysfunction
Most common psychiatric symptom of Cushing’s syndrome
Depression
Psychiatric symptoms of mild to moderate hypocalcaemia
Anxiety
Parasthaesia
Irritability
Emotional lability
Psychiatric symptoms of severe hypocalcaemia
Psychosis
Mania
Tetany
Seizures
Psychiatric symptoms of Addison’s disease
Apathy
Anhedonia
Fatigue
Depression
Psychiatric symptoms of acromegaly
Mood lability
Personality change
Depression
Psychiatric symptom caused by acromegaly treatment
Psychosis caused by D2 agonists given as treatment e.g. bromocriptine
Symptoms of phaeochromocytoma
Tachycardia
Labile hypertension
Sweating
Palpitations
Episodic panic/anger
Screening test for phaeochromocytoma
Urinary catecholamines
Urinary catecholamines seen in high levels in phaeochromocytoma
Vanillyl mandelic acid
Metanephrines
Best diagnostic test for phaeochromocytoma
Plasma metanephrine level
Increase in rate of depression among patients with diabetes than the general population
2-3x higher in patients with diabetes
Prevalence of major depression among people with advanced cancer
5-15%
Prevalence of delirium in palliative patients shortly before death
62%
Dose adjustment needed for benzodiazepines in end stage renal failure
50% reduction
Antidepressants which can be given at normal dose in end stage renal failure
Imipramine
Amitriptyline
Antipsychotic which does not need dose reduction in end stage renal failure
Haloperidol
Features of uraemic encephalopathy
Cognitive dysfunction
Motor dysfunction
Vomiting
Restlessness
Myoclonus
Coma
Bacterium which causes Lyme disease
Borrelia burgdorferi
Percentage of patients with a tick related target lesion who develop CNS symptoms
15%
Features of early stage neurologic lyme disease
Facial palsy
Shooting pains
Fever
Headache
Photophobia
Back pain worse at night
Features of late stage neurologic lyme disease
Cognitive deficits, especially memory issues
Processing impairment
Psychosis
Seizures
Violence
Irritability
Anxiety
Depression
Features of insulinomas
Recurrent headache
Lethargy
Diplopia
Blurred vision
Depression
Psychosis
Percentage of patients with sarcoidosis who have depression
20%
Ophthalmic complication of topiramate
Angle closure glaucoma
Drug used to treat migraines which is contraindicated in angle closure glaucoma
Topiramate
Antidepressant with the best evidence base following MI
Sertraline
Antidepressants most often used for depression after MI where sedation is required
Mirtazapine
Trazodone
Increased risk of depression in a patient with heart failure compared to the general population
3x higher
Likely diagnosis in a patient with mania, a facial rash and mouth ulcers
SLE
Antidepressants considered safest for use by patients with epilepsy
SSRIs
Moclobemide
Thyroid condition associated with depression and rapid cycling bipolar disorder
Subclinical hypothyroidism
Male:female ratio of hypothyroidism
1:6
Test of effort used to help diagnose conversion disorder
Hoover’s test
Features of neurosyphillis
Meningitis
Facial nerve palsy
Eye problems - pupillary changes, retinitis, uveitis etc.
Depression, mania, psychosis, dementia
Paraesthesia
High stepping gait
Drug class of choice for depression in patients who have had a stroke
SSRI
Drug class of choice for depression in patients with MS
SSRI
Drug class of choice for depression in patients with Parkinson’s disease
SSRI
Drug class of choice for depression in patients with HIV
SSRI
Drug class of choice for depression in patients with epilepsy
SSRI
SSRIs with most evidence for post-stroke depression
Fluoxetine
Citalopram
SSRI with most evidence for depression in MS
Sertraline
Suicide rate in patients with epilepsy compared to the general population
3x higher in patients with epilepsy
Most common time for patients with epilepsy to complete suicide
Within the first 6 months of diagnosis
