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9. Liaison psychiatry > Psychiatric effects of medical conditions > Flashcards

Psychiatric effects of medical conditions Flashcards

1
Q

Percentage of patients with coronary heart disease who have comorbid depression

A

20%

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2
Q

Relationship between coronary heart disease and depression

A

Higher rates of depression in patients with coronary heart disease
Depression increases risk of coronary heart disease, even if treated

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3
Q

Percentage of patients with congestive heart failure who have depression

A

21.5%

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4
Q

Psychiatric symptoms of hyperthyroidism

A

Generalised anxiety
Depression
Irritability
Hypomania
Cognitive dysfunction

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5
Q

Most common psychiatric symptom of hyperthyroidism

A

Generalised anxiety

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6
Q

Psychiatric symptoms of hypothyroidism

A

Depression
Cognitive dysfunction
Rarely psychosis

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7
Q

Psychiatric symptoms of mild to moderate hypercalcaemia

A

Depression
Apathy
Irritability
Loss of initiative

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8
Q

Psychiatric symptoms of severe hypercalcaemia

A

Delirium
Psychosis
Catatonia
Lethargy
Coma

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9
Q

Psychiatric symptoms of Cushing’s syndrome

A

Depression
Anxiety
Mania/hypomania
Psychosis
Cognitive dysfunction

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10
Q

Most common psychiatric symptom of Cushing’s syndrome

A

Depression

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11
Q

Psychiatric symptoms of mild to moderate hypocalcaemia

A

Anxiety
Parasthaesia
Irritability
Emotional lability

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12
Q

Psychiatric symptoms of severe hypocalcaemia

A

Psychosis
Mania
Tetany
Seizures

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13
Q

Psychiatric symptoms of Addison’s disease

A

Apathy
Anhedonia
Fatigue
Depression

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14
Q

Psychiatric symptoms of acromegaly

A

Mood lability
Personality change
Depression

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15
Q

Psychiatric symptom caused by acromegaly treatment

A

Psychosis caused by D2 agonists given as treatment e.g. bromocriptine

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16
Q

Symptoms of phaeochromocytoma

A

Tachycardia
Labile hypertension
Sweating
Palpitations
Episodic panic/anger

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17
Q

Screening test for phaeochromocytoma

A

Urinary catecholamines

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18
Q

Urinary catecholamines seen in high levels in phaeochromocytoma

A

Vanillyl mandelic acid
Metanephrines

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19
Q

Best diagnostic test for phaeochromocytoma

A

Plasma metanephrine level

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20
Q

Increase in rate of depression among patients with diabetes than the general population

A

2-3x higher in patients with diabetes

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21
Q

Prevalence of major depression among people with advanced cancer

A

5-15%

22
Q

Prevalence of delirium in palliative patients shortly before death

A

62%

23
Q

Dose adjustment needed for benzodiazepines in end stage renal failure

A

50% reduction

24
Q

Antidepressants which can be given at normal dose in end stage renal failure

A

Imipramine
Amitriptyline

25
Q

Antipsychotic which does not need dose reduction in end stage renal failure

A

Haloperidol

26
Q

Features of uraemic encephalopathy

A

Cognitive dysfunction
Motor dysfunction
Vomiting
Restlessness
Myoclonus
Coma

27
Q

Bacterium which causes Lyme disease

A

Borrelia burgdorferi

28
Q

Percentage of patients with a tick related target lesion who develop CNS symptoms

A

15%

29
Q

Features of early stage neurologic lyme disease

A

Facial palsy
Shooting pains
Fever
Headache
Photophobia
Back pain worse at night

30
Q

Features of late stage neurologic lyme disease

A

Cognitive deficits, especially memory issues
Processing impairment
Psychosis
Seizures
Violence
Irritability
Anxiety
Depression

31
Q

Features of insulinomas

A

Recurrent headache
Lethargy
Diplopia
Blurred vision
Depression
Psychosis

32
Q

Percentage of patients with sarcoidosis who have depression

A

20%

33
Q

Ophthalmic complication of topiramate

A

Angle closure glaucoma

34
Q

Drug used to treat migraines which is contraindicated in angle closure glaucoma

A

Topiramate

35
Q

Antidepressant with the best evidence base following MI

A

Sertraline

36
Q

Antidepressants most often used for depression after MI where sedation is required

A

Mirtazapine
Trazodone

37
Q

Increased risk of depression in a patient with heart failure compared to the general population

A

3x higher

38
Q

Likely diagnosis in a patient with mania, a facial rash and mouth ulcers

A

SLE

39
Q

Antidepressants considered safest for use by patients with epilepsy

A

SSRIs
Moclobemide

40
Q

Thyroid condition associated with depression and rapid cycling bipolar disorder

A

Subclinical hypothyroidism

41
Q

Male:female ratio of hypothyroidism

A

1:6

42
Q

Test of effort used to help diagnose conversion disorder

A

Hoover’s test

43
Q

Features of neurosyphillis

A

Meningitis
Facial nerve palsy
Eye problems - pupillary changes, retinitis, uveitis etc.
Depression, mania, psychosis, dementia
Paraesthesia
High stepping gait

44
Q

Drug class of choice for depression in patients who have had a stroke

A

SSRI

45
Q

Drug class of choice for depression in patients with MS

A

SSRI

46
Q

Drug class of choice for depression in patients with Parkinson’s disease

A

SSRI

47
Q

Drug class of choice for depression in patients with HIV

A

SSRI

48
Q

Drug class of choice for depression in patients with epilepsy

A

SSRI

49
Q

SSRIs with most evidence for post-stroke depression

A

Fluoxetine
Citalopram

50
Q

SSRI with most evidence for depression in MS

A

Sertraline

51
Q

Suicide rate in patients with epilepsy compared to the general population

A

3x higher in patients with epilepsy

52
Q

Most common time for patients with epilepsy to complete suicide

A

Within the first 6 months of diagnosis

9. Liaison psychiatry (4 decks)

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