Psychiatry Flashcards
1
Q
Quetiapine (atypical antipsychotic) effect on weight
A
Promotes weight gain
2
Q
First line treatment for obesity
A
Lifestyle intervention (CBT, diet, physical activity)
3
Q
Unipolar mood disorders
A
Only low moods (depression)
4
Q
The most strongly heritable mental illness is
A
Bipolar disease, 10x increase in 1st degree relatives
5
Q
Mania in Bipolar I
A
Often extreme, increased mood and activity for more than 7 days
6
Q
Mania in bipolar II
A
Hypomania, more than 4 days to count
7
Q
Mania is defined as 3 or more of
A
Grandiosity, sleep decrease, speech change, racing thoughts, distractibility, agitation, impulsivity
8
Q
Flight of ideas
A
Jumping from one idea to the next
9
Q
DDX suspected mania
A
Hypomania, psychosis, substance use, delirium, catatonia, anxiety, endocrine, neurological, cerebrovascular
10
Q
Chance of recurrence after first manic episode
A
90%
11
Q
Treating mania
A
Requires medication and almost always hospitalization
12
Q
Gold standard treatment for bipolar 1
A
Lithium
13
Q
Lithium treats
A
BPD1, and can be helpful in BPD2
14
Q
Can a breastfeeding woman take lithium?
A
No, lithium is contraindicated during breastfeeding
15
Q
Which organ function can be reduced by lithium
A
Both thyroid and renal function (if used long term)
16
Q
Divalproex sodium is also known as
A
Valproic acid
17
Q
Med class Valproic acid
A
Anti-epileptic, can also be helpful in BPD
18
Q
Can a pregnant woman take Valproic acid?
A
No, it is contraindicated
19
Q
Main indication for Lamotrigine is
A
bipolar depression
20
Q
Lamotrigine has a risk of which side effect
A
SJS - drug emergent rash
21
Q
4 commonly used atypical antipsychotics include
A
Quetiapine, olanzapine, risperidone, aripiprazole
22
Q
First line treatment for acute mania
A
Lithium, divalproex
23
Q
First line treatment for bipolar depression
A
Lithium, Lamotrigine, Quetiapine
24
Q
Overdose of TCAs can cause death by
A
Cardiac arrhythmia
25
How long til some benefit of antidepressants are seen?
2-3 weeks
26
How long until maximal benefit of antidepressants?
6-8 weeks
27
SADPERSONS for
Suicide and self harm behaviour
28
SADPERSONS stands for
```
Sex (male)
Age (<19, >45)
Depression
Previous attempt
Ethanol
Rational thinking loss
Social
Organized plan
No spouse
Sickness
```
29
SIGECAPS screens for
Depression
30
SIGECAPS stands for
```
Sleep
Interest
Guilt
Energy
Concentration
Appetite
Psychomotor
Suicidal ideation
```
31
How does ECT work for depression?
ECT induces generalized seizures
32
Most common side effect of ECT
Anterograde memory loss
33
Risperidone is commonly used to treat
Schizophrenia, bipolar disorder, irratability associated with autistic disorder
34
Risperidone class
Second generation atypical antipsychotic
35
Trying to conceive on risperidone
May cause hyperprolactinemia, which may cause a reversible decrease in reproductive function
36
Mechanism of action Risperidone
High 5HT2 and D2 receptor antagonists
| Serotonin and dopamine receptor antagonist
37
Form 1 basic definition
Application for psych assessment
38
Form 1 is completed by
An MD
39
Form 1 is valid up to
72 hours
40
Form 42 basic definition
Notice to patient that theyre on a form 1 and why
41
Form 42 is completed by
MD, given to patient
42
Form 2 basic definition
Order for examination
43
Form 2 filled out by
Justice of the peace, based on information from public, family, friend, loved ones
44
Form 2 is valid for
7 days
45
When a patient arrives due to form 2
They must be assessed then placed on form 1, admitted voluntarily, or allowed to leave
46
Form 3 basic definition
Certificate of involuntary admission
47
Form 3 can last
Up to 14 days
48
Form 3 must be signed by
A different doctor than the form 1, a psych consult
49
Form 30 basic definition
Notifies the patient theyre on a form 3, and why, and what their rights are
50
PTSD first line treatments
Trauma focused CBT and antidepressants (SSRI/SNRI)
51
PTSD related nightmares can be treated with
Prazosin - alpha blocker
52
In what case of cognitive impairment would you choose to order CSF in investigations?
If it is early onset
53
Routine imaging for cognitive impairment
Brain CT or MRI
54
Routine lab testing with cognitive impairment
CBC, B12, TSH, CMP
55
Initial workup for suspected dementia should include
Neuropsychological testing, lab work, and imaging
56
Adjustment disorder is
Mood and behaviour symptom onset within 3m of an identifiable stressor
57
Management for adjustment disorder is
Psychotherapy with adjunctive pharmacotherapy (short term sleep aids, or anxiolytics)
58
Personalization
Seeing yourself as the cause of some negative external event for which you were not primarily responsible
59
What % of personality traits are inherited?
40-60%
60
Cluster A personality disorders “odd and eccentric” (3)
Paranoid, schizoid, schizotypal
61
Cluster B personality disorders “dramatic, emotional, erratic” (4)
Histrionic, narcissistic, antisocial, borderline
62
Cluster C personality disorders “anxious, fearful” (3)
Avoidant, dependent, obsessive compulsive
63
Most common personality disorder is
Obsessive compulsive personality disorder
64
Define obsessive compulsive personality disorder
Pervasive pattern of perfectionism, inflexibility, and need for control, stable course over time
65
Major depressive disorder Sx must be present for
2+ weeks
66
How many Sx does a person need for diagnosing MDD?
5/9 with 1 being mood/adhedonia
67
Escitalopram, citalopram, sertraline, fluoxetine, paroxetine, fluvoxamine are from the class
SSRI antidepressants
68
Venlafaxine, desvenlafaxine, duloxetine are from the class
SNRI antidepressants
69
Bupropion drug class
NDRI
70
Mirtazapine drug class
NaSSA
71
Trazodone drug class
SARI
72
Amitriptyline, nortryptiline, desipramine, imipramine, clomipramine drug class
Tricyclics antidepressants
73
Phenelzine drug class
MAOI
74
What is behavioural inhibition
Distress and withdrawal from unfamiliar situations which can develop into anxiety
75
Primary coping strategy in anxiety is
Avoidance
76
Main cause of disability in anxiety is
Avoidance
77
Panic disorder is
Recurrent unexpected panic attacks in the absence of triggers
78
Agoraphobia is
Marked unreasonable fear about a situation with active avoidance of that situation
79
Generalized anxiety disorder is
Excessive anxiety about multiple events or activities accompanied by somatic symptoms, symptoms tend to overlap with depression
80
Positive psychiatric symptoms are
Excess or distortion of normal function or experience
81
Examples of positive psych symptoms
Delusions, hallucinations, disorganized thinking, abnormal motor behaviour
82
Negative psych symptoms
Diminished or absent normal function
83
Negative psych symptom examples
Affect diminished, avolition (loss of initiative), alogia (reduced speech), anhedonia (loss of enjoyment)
84
Define delusions
Fixed false beliefs that arent changeable despite evidence
85
Bizzare delusions differ from non bizzare because
They are clearly implausible
86
How long must schizophrenia sx last to be diagnosed?
6m+
87
MRI findings in schizophrenia
Frontal lobe smaller, bigger lateral and third ventricles than average
88
1st generation antipsychotics work as
Potent DA D2 blockers
89
2nd gen antipsychotics work by
Combination of D2 and 5HT blocking
90
Side effects common to type 1 antipsychotics
Extra pyramidal/motor side effects like dystonia, Parkinsonism, tardive dyskinesia
91
Side effects of second gen antipsychotics
Increased BMI, lipid abnormalities, diabetes
92
Clozapine has a higher risk of which side effect amongst antipsychotics
Agranulocytosis
93
Schizoeffective disorder is like schizophrenia but
The delusions and hallucinations last 2+ weeks, there must be a mood issue, and psychosis
94
Delusional disorder definition
One or more delusions persistent for more than a month, not markedly impaired
95
Schizophreniform disorder is just like schizophrenia but
Between 1 month and 6 months duration
96
Brief psychotic disorder duration is
At least a day, less than a month
97
Drugs that can cause psychosis
Cannabis, stimulants, hallucinogens
98
Medical issues that can cause psychosis
Delirium, structural (tumour/stroke), degeneration (huntingtons/parkinsons), epilepsy, endocrine, infections
99
DBT for BPD focuses on
Decreasing self harm and impulsivity, increasing ability to cope
100
Acute stress disorder is like PTSD but...
Less than 6m (more than 1m)
101
Adjustment disorder
Maladaptive reaction to a stressor, condition remits within 6m of the stressor resolving
102
Alcohol or benzo withdrawal is treated commonly with
Diazepam
103
Which benzos bypass liver metabolism?
Lorazepam, oxazepam, temazepam
104
Medications used to reduce alcoholism (3)
Naltrexone, acamprosate, disulfiram
105
Three treatment options for tobacco use disorder
Nicotine replacement therapy, bupropion, varenicline
106
After a suicide attempt, someone who wishes they died is
3x more likely to attempt suicide in a short time interval
107
Fitness to stand trial has 3 components
Understanding the nature and object of the hearing, possible consequences of the hearing, and can communicate with counsel
108
Duty to warn and protect (3 factors)
Identifiable target, seriousness, imminence
109
What are two main types of ADHD
Inattention and hyperactivity, Sx for 6m
110
Labeling
An extreme form of over generalization “I’m a total idiot”
111
Over generalization
Seeing one negative event as proof of a never ending pattern
111
Fortune telling
Anticipating that things will turn out badly, and this is a fact
111
Catastrophizing
Exaggerating the importance of negative things and the likelihood of a disastrous outcome
112
Which antidepressant is associated with dose dependent hypertension
Venlafaxine
113
MAOI hypertensive crisis refers to
Severe hypertension after patients on MAOIs ingest foods containing tyramine (sympathomimetic)
114
Patients treated with lithium need to be monitored for
Hypothyroidism
115
Treating lithium induced hypothyroidism
T4 supplementation
116
Circadian rhythm sleep wake disorder characterized by sleep onset insomnia and excessive morning sleepiness
Delayed sleep wake phase disorder
117
Circadian rhythm disorder characterized by inability to stay awake in the evening and early morning insomnia
Advanced sleep wake phase disorder
