Psychiatry Flashcards
1
Q
Flight of ideas, rapid speech
A
Bipolar disorder
2
Q
PTSD diagnosis time
A
1 month
3
Q
Copropraxia
A
Involuntary obscene gestures or touching
4
Q
Echolalia
A
Meaningless repetition of another person’s spoken words
5
Q
Echopraxia
A
meaningless repetition of movements of others
6
Q
Palilalia
A
repeating own words and sentences
7
Q
Circumstantiality
A
unneccessary detail
8
Q
Tangentiality
A
detail but comes to the point
9
Q
Clang associations
A
similar sound and rhymes
10
Q
Word salad
A
incoherent speech with real words but nonsense sentences
11
Q
Knight’s move thinking
A
Severe type of loose associations; illogical leaps from one idea to another
12
Q
Flight of ideas
A
leaps from one idea to another but wit links between them
13
Q
Perseveration
A
repeating ideas or word despite attempts to change the topic
14
Q
Serotonin syndrome
A
2 antidepressants such as MAOI with Citalopram; triptans
15
Q
Neuroleptic malignant Syndrome
A
Rigidity, hyperthermia, autonomic instability and confusion.
Stopping the drug can cause
16
Q
Treatments of delirium tremens or alcohol withdrawal
A
Chlordiazepoxide or Diazepam
17
Q
Prevent Wernicke’s Using
A
IV pabrinex
18
Q
Metoclopramide SE
A
Tardive dyskinesia
Parkinsonism
Extrapyramidal SE- acute dystonia
Avoid in Bowel obstruction
19
Q
ECT can cause what type of memory impairment
A
Anterograde amnesia
20
Q
Side effect of Mirtazapine
A
Increased appetite and sedation
21
Q
SE of MAOI
A
Tyramine cheese reaction
22
Q
Tardive dyskinesia is a SE of
A
Typical antipsychotic
23
Q
Agranulocytosis is SE of
A
Clozapine
24
Q
Treating Borderline PD
A
Dialectical Behavioral therapy
25
Capgras Syndrome
Delusion that person/ place replaced by exact duplicate
26
Delusional Parasitosis
Infested by bugs
27
Fregoli syndrome
One or more familiar persons, usually persecutors following the patient repeatedly change their appearance
28
Induced delusional disorder
Two people who share the same delusion
29
Formication
Crawling, biting; Stinging sensation
30
Poor prognosis for Schizophrenia
Strong FH, Gradual onset, Low IQ, Prodromal phase of social withdrawal and lack of obvious precipitant
31
Erotomania
Presence of delusion that a famous person is in love with them, No psychotic symptoms presen
32
Hypothyroidism is associated with what bipolar disorder drug
Lithium
33
Extrapyramidal SE of antipsychotics such as oculogyric crisis can be managed by what
Anticholinergic drug called procyclidine
34
Management of serotonin syndrome - Rigidity, hyper reflexes and autonomic dysfunction
Diazepam
35
Lead pipe muscle rigidity, pyrexia and autonomic dysfunction after antipsychotic use
Neuroleptic malignant syndrome
36
Involuntary and abnormal choreoathetosis (twitching) especially chewing and lip smacking and lip pouting
Tardive dyskinesia
| Management - Tetrabenazine
37
Emotional instability, disturbed patterns of thinking or perception, impulsive behaviour and intense but unstable relationships
Borderline PD
38
Opthalmoplegia, Ataxia and Confusion in an alcoholic
Wernicke’s
| Treat using thiamine (b1)
39
Flight of ideas, pressured speech, grandiosity
Bipolar disorder
40
Auditory hallucinations is a typical feature of
Schizophrenia
41
Sensitive, unforgiving if insulted, question loyalty and reluctance to confide in others
Paranoid personality
42
Solitary activity, lack of interests and companions
Schizoid personality
43
Paranoid ideations, magical beliefs, ideas of reference, odd behaviours and speech
Schizotypal personality
44
Munchausen’s Syndrome
Causing symptoms purposefully
45
Conversion disorder
Loss of physical function but no cause
46
Dissociative disorder
Loss of function but non physical such as memory
47
Important to know: 1st Rank symptom of Schizophrenia
3rd person auditory hallucinations, Thought echo, Delusional perception, thought insertion and withdrawal and Somatic passivity
48
2nd rank symptoms of Schizophrenia
Catalonia, 2nd person auditory hallucinations
49
Confusion, visual hallucination, tachycardia, and pyrexia + alcohol abuse
Delirium tremens
50
Hyperarousal, emotional numbing, nightmares, and avoidance are core behaviours of what disorder
PTSD
51
Othello syndrome
Delusional jealousy- unfaithful
52
Very frequent mood changes; self-destructive behaviours and unstable relationships
Borderline personality disorder
53
Flashbacks, nightmares, dissociations, avoidance, sleep disturbances that has occured in first 4 weeks after traumatic event
Acute stress disorder
54
Management of acute stress disorder
Trauma focused CBT is 1st line
| Benzodiazepines for acute symptoms
55
First line for Generalized Anxiety disorder
Sertraline (SSRI)
| 2nd line SNRI or other SSRI
56
Type 1 Bipolar disorder and type 2 bipolar disorder
Type 1: mania and depression (most common)
| Type 2: hypomania and depression
57
Management of Bipolar disorder
Mood stabilizer: Lithium
Mania: Antipsychotic such as Olanzapine and Haloperidol
Depression: Fluoxetine (SSRI)
58
NICE guideline on Bipolar disorder
Hypomania - Community mental health team
| Mania or severe depression: Urgent referral to CMHT
59
When should be antidepressants stop in Bipolar disorder
If patient is taking antidepressant at onset of acute mania
60
Define cyclothymic disorder
Chronic mood fluctuations over at least 2 years with depression or hypomania
61
Most common type of dementia
Alzhiemer's dementia (55%)
62
common cause of death in dementia
Bronchopneumonia
63
characterstic of Dementia with lewy body
Visual hallucination
64
Depression with features of psychosis is always
Severe depression
65
Beck's Cognitive triad of depression
negative thoughts about self, the world and future.
66
Neurotransmitter associated with Depression
Noradrenaline
67
Management of moderate to severe depression
psychological therapy + antidepressants
68
Hypercortisolemia is a feature of what psychological disease
depression
69
Management of resistant depression
Antidepressant + lithium + Atypical antipsychotics such as Olanzapine, risperidone, Quetiapine
70
what are the types of delusions in depression
Nihilistic or meaningless life
| *associated with Cotard syndrome
71
type of hallucination in depression
Auditory
72
Citalopram, Fluoxetine, Sertraline and Paroxetine are all
SSRIs
73
Venlafaxine and Duloxetine
SNRIs
74
Mirtazapine and Mianserin
Noradrenanergic and Selective serotonin actions
75
Amitriptyline is a
TCA
76
Side effects of TCAs
Cardiotoxic, fatal in overdose, cardiac arrhythmia and Seizure
77
Side effects of SSRI
Hyponatremia, suicidal ideation
78
Only antidepressant that can be used in children
Fluoxetine
79
MAOIs SE
Hypertension and throbbing headache when tyramine is consumed
80
Confusion, delirium, shivering, sweating, changes in BP and myoclonus, hyperreflexia, ataxia, Hyperthermia, GI upset, Mydriasis, tachycardia, hyper/hypotension
```
Serotonin syndrome (Classify Sternbach's)
drugs: SSRI, MAOIs, TCAs, Lithium and Amfetamines
```
81
Core Symptoms of depression
low mood, loss of interest and low energy
82
Restrict what they eat and may compulsively overexercise to maintain a low BW
Anorexia nervosa
83
have cravings, secretly overeat and try to prevent weight gain by vomiting
Bulimia nervosa
84
Constricted affect and emotional expressiveness is associated with which eating disorder
Anorexia
85
Treatment of anorexia
Adoloscents - Anorexia focused family therapy
| 2nd line is CBT
86
Treatment of Bulimia
Self help for adults
individual eating disorder focused CBT
Family therapy for children
fluoxetine may be used
87
Highest death rate for any psychiatric disorder
Anorexia nervosa
88
unlawful behaviour, repeated lying, failure to plan, impulsive, irritability and aggressiveness, disregard safety of self and others
Antisocial PD
89
fears critisicm or rejection, unwilling to be involved unless certain of being liked, inferior to others, social inhibitions, restricted lifestyles and cravings for social contact
Anxious or avoidant PD
90
Unstable interpersonal relationships, idealization and devaluation, unstable self image, impulsivity in self-damaging area (Spending, sex, and substance abuse); recurrent suicidal behaviour
Borderline personality disorder ( linked to child hood trauma)
91
difficulty in everyday decisions without excessive reassurance from others, need others to assume responsibility, difficult in expressing disagreement with others due to fears of losing support, lack initiative
Dependent
92
Inappropriate sexual seductiveness, center of attention; shallow expression of emotions, attention seeking, impressionistic speech lacking detail and relationships considered to be more intimate than they are
Histrionic PD
93
Grandiose, preoccupation with fantasy of unlimited success, power and beauty, sense of entitlement, takes advantages of others, lack empathy, excessive need for admiration, chronic envy and arrogant attitude
Narcissistic
94
preoccupation with details, rules, lists and order, perfectionism hampers with completing tasks, meticulous, scrupulous and rigid about morality, ethics and values, stiff and stubborn
OC personality
95
Hypersensitive and unforgiving when insulted, unwarranted tendancy to question the loyalty of friends
reluctant to confide in others; preoccupation with conspiracy and hidden meaning and tend to perceive attacks on their character
Paranoid Personality
96
Indifferent to praise and critiscism, prefer solitary activities, lack interest in sexual interactions, lack desire of companionship, cold emotions, few interests and few friends or confidants other than family
Schizoid (no risk of psychosis)
97
ideas of reference (insight is retained), odd beliefs, magical thinking, paranoid ideation and suspiciousness, odd and eccenteric behaviour, lack of close friends, inappropriate affect
schizotypal PD (associated to schizophrenia)
98
Management of Personality disorder
Dialectical behaviour therapy
99
Duration of symptoms in PTSD
more than 1 month
100
Treatment of PTSD
trauma-focused CBT or eye movement desensitisation and reprocessing
Drug treatment: Venlafaxine or SSRI
Severe cases- Risperidone may be used
101
Echolalia and echopraxia (speech and behaviours) are signs of
Catatonic schizophrenia
102
First rank symptoms of Schizophrenia
3rd person auditory hallucinations, thought echo, delusional perception, thought disorder and passivity or somatic
103
2nd rank symptoms of schizophrenia
Catatonia; 2nd person auditory hallucination
104
Positive symptoms of schizophrenia
Hallucinations, and delusions
105
Negative symptoms of Schizophrenia
Poverty of speech, flat affect, poor motivation, social withdrawl
106
management of schizophrenia
oral atypical antipsychotics are 1st line
| CBT
107
Poor prognosis in Schizophrenia
strong family history, gradual onset, low IQ, prodromal phase of social withdrawl and no precipitant
108
Extra-pyramidal SE, hyperprolactinemia and tardive dyskinesia are SE of
Typical antipsychotics
109
Clozapine, risperidone, Quetiapine and Olanzapine are all
Atypical antipsychotics
110
Chlorpromazine, haloperidol, phenothiazine are all
typical antipsychotics
111
Agranulocytosis, Seizure risk, VTE, myocarditis, and cardiomyopathy is related to which antipsychotic
Clozapine
112
Metabolic SE and insulin resistance as a SE
Atypical antipsychotics
113
Extra-pyramidal SE
First generation or typical Antipsychotics
114
Contraction of muscle group to maximal limit, typically sternocleidomastoid and tongue, eye muscle involvement (oculogyric crisis) is a SE and is called
acute dystonia
Treat using antimuscranics such as procyclidine)
115
Tremor, rigidity, bradykinesia, >1 week after administration is called
Reduce dose or use antimuscranic such as procyclidine
116
Restlessness usually lower limbs and a drive to move, occurs after 1 month after initiation of antipsychotic. Is called
Akathisia
| Treat using Propranolol and benzodiazepines
117
Continous slow writing movements and sudden involuntary movements, typically oral-lingual region or chorea. Irreversible symptoms
Tardive dyskinesia
118
Fever, muscular rigidity, altered mental status, autonomic dysfunction, serious mortality, SymptomsL >38 C, muscular rigidity, confusion, agitation, altered level of consciousness, tachycardia, tachypnea, hypertension, tremor and incontinence or retention
Neuroleptic malignant Syndrome
Causes: antipsychotics, Anti-parkinsonian agents withdrawl and antidepressants, other drugs such as carbamazepine, metoclopramide
Treatment
BDZs for acute
stop antipsychotics or restart anti-parkinsonian drugs
reduce rigidity by dantrolene, lorazepam
may last 7-10 days after stopping oral antipsychotic and up to 21 daus after depot antipsychotics
119
2 years of unexplained symptoms, no physical cause, refuse to accept
Somatization disorder
120
Non-delusional disorder with the possibility of serious illness such as cancer, heart disease, HIV, AIDS despite medical reassurance
Illness anxiety disorder or hypochondriasis
121
Loss of motor function or sensory function, no pathology, stress related
Conversion disorder
122
Amnesia, memory but no pathology
Dissociative disorder
123
inducing illness - physical or psychological
Factitious disorder
124
Fraudulent stimulation or exaggeration of symptoms with the intention of financial or other gain
Malingering disorder
125
Management of opiod toxicity
Methadone or Buprenorphine
Naltrexone for relapse
Naloxone for overdose
126
Ataxia, Nystagmus, opthalmoplegia, and acute confusion
Associated with peripheral neuropathy, resting tachycardia and nutritional deficiency
CN6 palsy
Wernicke's encephalopathy
| Treat using IV pabrinex
127
Short term memory loss, confabulation (false memories)
Korsakoff's Psychosis
| Treat using oral thiamine
128
Delirium tremens treatment
Haloperidol or olanzapine
129
Acute confusional state secondary to alcohol withdrawl, medical emergency, onset 1-7 days after last drink with peak at 48 hours, features: clody consciousness, amnesia, disorientation, marked psychomotor agitation, hallucinations - Lilliputian hallucintations; delusions, cardiovascular collapse
Delirium tremens
