Psychiatry Flashcards
Somatisation disorder
Somatisation=Symptoms
For how long the symptoms are suppose to be going on for it to be called somatisation disorder?
Multiple physical symptoms from at least 2 years.
In this patient refuses to accept reassurance or negative test results
Hypochondrial disorder is also known as
Illness anxiety disorder
Hypochondrial disorder is a
persistent belief in the presence of an underlying serious DISEASE, e.g. cancer
patient refuses to accept reassurance or negative test results
Conversion disorder is aka
Factitious disorder
Conversation disorder is
typically involves loss of motor or sensory function.
the patient doesn’t consciously feign the symptoms or seek material gain (malingering)
Dissociative disorder knew name is
Multiple personality disorder
Dissociative disorder is
is a process of ‘separating off’ certain memories from normal consciousness
in contrast to conversion disorder involves psychiatric symptoms e.g. Amnesia, fugue, stupor
Features of Schizophrenia
Auditory hallucinations
passivity phenomena
Thought disorder
Delusional perceptions(2 stage process)=traffic light is green
other features;
impaired insight
impaired incongruity
decreased speech
Neolgism; new made up words or expressions
Catatonia; repetitive or purposeless overactivity,
Negative symptoms;
Alogia;poverty of speech
Anhedonia; lack of pleasure
Avolition; lack of motivation.
PTSD Features
re-experiencing:
avoidance:
hyperarousal:
emotional numbing
PTSD treatment
Debriefing(one time sessions not recommended)
Mild; watchful waiting for 4 weeks
Severe; trauma-focused cognitive behavioural therapy (CBT) or
eye movement desensitisation and reprocessing (EMDR) therapy
Medicine treatment; venlafaxine, SSRI’s eg sertraline or Risperidone
sections
This is used for someone over the age of 16 years who will not be admitted voluntarily. Patients who are under the influence of alcohol or drugs are specifically excluded
Section 2
admission for assessment for up to 28 days, not renewable
an Approved Mental Health Professional (AMHP) or rarely the nearest relative (NR) makes the application on the recommendation of 2 doctors
one of the doctors should be ‘approved’ under Section 12(2) of the Mental Health Act (usually a consultant psychiatrist)
treatment can be given against a patient’s wishes
Section 3
admission for treatment for up to 6 months, can be renewed
AMHP along with 2 doctors, both of which must have seen the patient within the past 24 hours
treatment can be given against a patient’s wishes
Section 4
72 hour assessment order
used as an emergency, when a section 2 would involve an unacceptable delay
a GP and an AMHP or NR
often changed to a section 2 upon arrival at hospital
Section 5(2)
a patient who is a voluntary patient in hospital can be legally detained by a doctor for 72 hours
Section 5(4)
similar to section 5(2), allows a nurse to detain a patient who is voluntarily in hospital for 6 hours
Section 17a
Supervised Community Treatment (Community Treatment Order)
can be used to recall a patient to hospital for treatment if they do not comply with conditions of the order in the community, such as complying with medication
Section 135
a court order can be obtained to allow the police to break into a property to remove a person to a Place of Safety
Section 136
someone found in a public place who appears to have a mental disorder can be taken by the police to a Place of Safety
can only be used for up to 24 hours, whilst a Mental Health Act assessment is arranged
Depression vs dementia
Depression has ( BWR MSG; biologic, worried, reluctant, MMSE, short hx,global memory loss)
S=short history, rapid onset
B=biological symptoms e.g. weight loss, sleep disturbance
W=patient worried about poor memory
R=reluctant to take tests, disappointed with results
M=mini-mental test score: variable
G=global memory loss (dementia characteristically causes recent memory loss)
Cotard syndrome?
bandy ko lagta k usk andar organs mar rahay hain,
vo non existent hai ya mar gaya hai
isliye vo khana peena bhi chor deta hai
ye severe depression aur psychotic disorders mein hota hai
Othello syndrome
remember by OH HELLO MR
delusional belief that a patients partner is committing infidelity despite no evidence of this. It can often result in violence and controlling behaviour.
De Cleram bault syndrome aka Erotomania
a person of a higher social or professional standing is in love with them. Often this presents with people who believe celebrities are in love with them.
Ekbom Syndrome
pt ko lagt aha usi skin k neechay bugs hain
the user can ‘see’ bugs crawling under their skin or can be a patient who believes that they are infested with snakes.
Capgras delusion
friends or family members have been replaced by an identical looking imposter.
MOA of Benzodiazepines
enhances the effect of GABA
increases the frequency of chloride channels
Benzodiazipines are prescribed for only how much period of time?
2-4 weeks
How to withdraw benzodiazepines?
give 1/8th every fortnight
or convert to equal dose of diazepam
or reduce dose of diazepam gradually every 2-3 weeks in steps of 2 or 2.5 mg
“time needed for withdrawal can vary from 4 weeks to a year or more”
withdrawal effects from benzodiapines can occur till?
uptown 3 weeks
Benzodiazpine MOA
Barbiturate MOA
increases the frequency of chloride channel
increases the duration of chloride channels.
most common side effect of olanzapine (atypical antipsychotics) is ?
weight gain and dyslipidemia
common side effects of atypical antipsychotics?
wt gain
agranulocytosis(clozapine)
hyperprolactinemia
names of atypical antipsychotics?
olanzapine
clozapine
quetiapine
resperidone
aripiprazole(good drug specially in case of increased prolactin)
when should clozapine be started?
clozapine should be introduced if schizophrenia is not controlled despite the sequential use of two or more antipsychotic drugs (one of which should be a second-generation antipsychotic drug), each for at least 6–8 weeks.
