Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Medicine Finals > Psychiatry > Flashcards

Psychiatry Flashcards

1
Q

What are the three core symptoms of depression?

A

Low mood

Anhedonia

Reduced energy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are other cognitive symptoms of depression?

A

Reduced concentration

Feelings of guilt

Impaired memory

Nihilism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are physical symptoms of depression?

A

Reduced appetite
Reduced libido
Early morning wakening
Constipation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the ICD-10 criteria for mild depression?

A

2 core symptoms and at least 2 cognitive symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the ICD-10 criteria for moderate depression?

A

2 core symptoms and 3-4 cognitive symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the ICD-10 criteria for severe depression?

A

3 core symptoms and at least 5 cognitive symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the management of mild depression?

A

Low intensity psychosocial intervention e.g.
individual guided self help
Computerised CBT
Group based CBT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When should antidepressants be prescribed for mild depression?

A

If there is a history of moderate/severe depression

If symptoms persist after other interventions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How is moderate to severe depression managed?

A

Combination of SSRI + high intensity psychosocial intervention e.g. interpersonal therapy, behavioural activation, behavioural couples therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the preferred SSRIs to prescribe first?

A

Citalopram or fluoxetine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which SSRI is safe to use post myocardial infarction?

A

Sertraline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which SSRI is safe in children?

A

Fluoxetine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which SSRI is associated with QT prolongation?

A

Citalopram

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How long after prescribing an SSRI should you review the patient?

A

After 2 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are adverse effects of SSRIs?

A

GI symptoms

Increased risk of GI bleeding

Sexual dysfunction

Hyponatraemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which drugs interact with SSRIs?

A

NSAIDs/aspirin - co-prescribe PPI

Warfarin/heparin - consider mirtazapine instead

Triptans - increased risk of serotonin syndrome

Caution with other drugs that can cause hyponatraemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Over how long should you taper SSRIs when discontinuing?

A

Over 4 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are symptoms of SSRI discontinuation syndrome?

A

GI upset

Restlessness

Difficulty sleeping

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Which SSRI has an increased risk of congenital malformations when used in pregnancy?

A

Paroxetine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are side effects of mirtazapine?

A

Sedation

Increased appetite

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Which foods do monoamine oxidase inhibitors react with?

A

Cheese

Broad beans

Oxo

Marmite

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are side effects of tricyclic antidepressants?

A 
Drowsiness 
Dry mouth
Urinary retention 
Constipation 
Blurred vision
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How does serotonin syndrome present?

A

Increased reflexes

Myoclonus

Rigidity

Hyperthermia

Confusion/agitation

Dilated pupils

Tremor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Which drug most commonly causes serotonin syndrome?

A

MAOIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

How is serotonin syndrome managed?

A

Remove causative medication
IV fluids
Benzodiazepines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are features of generalised anxiety disorder?

A

Depersonalisation
Derealisation

Palpitations
Dizziness
Dry mouth
Headache
Nausea
Sleep disturbance
Fatigue
Irritability
Muscle tension
Poor concentration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

How is generalised anxiety disorder managed?

A
  1. Patient education
  2. Low intensity psychological interventions – self-help, group sessions
  3. Choice of high intensity CBT or drug treatment
  4. CBT + drug treatment

Marked functional impairment –> straight to step 3

Very marked function impairment/self-neglect/risk of self-harm –> straight to step 4

Drug treatment
1st line = SSRI
2nd line = alternative SSRI/SNRI

Other options
Pregabalin
Propranolol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are differential diagnoses for GAD?

A

Psychiatric:

Panic disorder
Social anxiety
Agoraphobia
Depression

Physical:

Hyperthyroidism
Cardiac disease
Substance misuse

Medication induced anxiety - salbutamol, theophylline, steroids, caffeine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is panic disorder?

A

Acute unprovoked periods of intense fear and discomfort

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

How does panic disorder present?

A 
Breathing difficulties
Hyperventilation 
Chest discomfort
Palpitations 
Dizziness/shaking
Agoraphobia

Tingling around mouth or in peripheries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is the first line management for panic disorder?

A

CBT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are other management options for panic disorder?

A

Can also prescribe an SSRI but second line after CBT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

How long do symptoms have to be present to be classed as PTSD?

A

1 month

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What are features of PTSD? (4)

A
  1. Re-experiencing - flashbacks, nightmares, intrusive thoughts
  2. Avoidance - avoiding people/situations which resemble the event
  3. Hyperarousal - exaggerated startle response, hyper vigilant to threat
  4. Emotional numbing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

How is PTSD managed?

A

Trauma focused CBT

EMDR (eye movement desensitisation and reprocessing)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is acute stress reaction?

A

Occurs in the first 4 weeks after a traumatic event

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

How is acute stress reaction managed?

A

Trauma focused CBT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is the strongest risk factor for schizophrenia?

A

Family history

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What are first rank symptoms for schizophrenia?

A

Auditory hallucinations - usually third person

Thought disorder - insertion, withdrawal, broadcasting

Passivity phenomena - belief that bodily sensations are being controlled by an external influence

Delusional perception - the traffic light is green which means I am the king

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What features of schizophrenia indicate a poor prognosis?

A

Gradual onset

Low IQ

Prodromal phase of social withdrawal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What negative symptoms are seen in schizophrenia?

A 
Catatonia 
Anhedonia
Poverty of speech
Poverty of thought 
Blunting of affect
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What is the first line treatment for schizophrenia?

A

Oral atypical antipsychotic e.g. olanzapine/risperidone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What are examples of a typical antipsychotic?

A

Haloperidol and Chlopromazine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What are extra pyramidal side effects seen in typical antipsychotics?

A

Parkinsonism

Acute dystonic reaction - sustained muscle contraction such as twisted neck or fixed position of eyeballs

Akathisia (severe restlessness)

Tardive dyskinesia - abnormal involuntary movements such as chewing or pouting of jaw

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

How is an acute dystonic reaction managed?

A

Procyclidine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What are other side effects of typical antipsychotics? (not extra-pyramidal)

A

Dry mouth, blurred vision, urinary retention, constipation

Raised prolactin (causes galactorrhea) - however this is more in atypical

Impaired glucose tolerance

Reduced seizure threshold

Prolonged QT interval

Neuroleptic malignant syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What are examples of atypical antipsychotics?

A

Olanzapine

Risperidone

Clozapine

Quietiapine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What are adverse effects of atypical antipsychotics?

A

Weight gain

Hyperprolactinaemia -> Galactorrhoea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What side effects are clozapine associated with?

A

Clozapine = 2nd gen (atypical) antipsychotic

Agranulocytosis and neutropaenia

Reduced seizure threshold

Constipation

Myocarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What is neuroleptic malignant syndrome?

A

Life threatening condition that occurs in those taking antipsychotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

How does neuroleptic malignant syndrome present?

A

Slow onset - usually within 1 to 2 weeks after starting or changing dose

Fever
Altered mental state
Muscle rigidity
Reduced reflexes
Hypertension
Tachycardia
Tachypnoea
Delirium/confusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What lab results are seen in neuroleptic malignant syndrome?

A

Raised creatinine kinase
Raised white cell count
May be AKI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

How is neuroleptic malignant syndrome managed?

A

Stop antipsychotic

IV fluids to prevent renal failure

54
Q

What is schizoaffective disorder?

A

Presence of both a mood disorder and schizophrenic symptoms at the same time

55
Q

What are the three types of schizoaffective disorder?

A

Manic

Depressive

Mixed

56
Q

How is schizoaffective disorder managed?

A

Manic type - antipsychotics, mood stabiliser

Depressive type - antidepressants

57
Q

What is Charles Bonnet Syndrome?

A

Presence of recurrent complex hallucinations in those with visual impairment

58
Q

What is type 1 bipolar disorder?

A

Mania and depression

59
Q

What is type 2 bipolar disorder?

A

Hypomania and depression

60
Q

What is the difference between mania and hypomania?

A

Duration: Mania lasts for at least 7 days, hypomania is 3-4 days

Functional impairment: seen in mania

Psychotic symptoms: may be seen in mania

61
Q

What features are seen in mania/hypomania?

A 
Elevated mood
Risk taking behaviour
Sexual promiscuity
Insomnia
Flight of ideas
Pressured speech
62
Q

What is used for the long-term management of bipolar disorder?

A

Psychological intervention e.g. CBT

First line pharmacological management = Lithium

If Lithium is not tolerated or inappropriate (e.g. unwilling to have routine bloods) -> Sodium Valproate

63
Q

Which antidepressant can be used in bipolar disorder by itself?

A

Fluoxetine

64
Q

What is the therapeutic level of lithium?

A

Between 0.5 and 1.0

65
Q

What adverse effects can lithium cause at the therapeutic level?

A

Fine tremor

Diarrhoea

Hypothyroidism

Increased thirst + Increased urination (can cause nephrogenic diabetic insipidus)

Hyperparathyroidism (hypercalcaemia)

Nephrotoxicity

Weight gain

Idiopathic intracranial hypertension

Leukocytosis

66
Q

How often should lithium levels be monitored?

A

Weekly until stable for 4 weeks then every 3 months

67
Q

What other levels are monitored whilst taking lithium? And how often ?

A

Renal function and thyroid function, every 6 months

68
Q

What medications can precipitate lithium toxicity?

A

NSAIDs

Loop diuretics

Thiazide diuretics

ACEi/ARBs

Methotrexate

69
Q

How does lithium toxicity present?

A

Coarse tremor

Increased reflexes

Confusion

Seizure

Coma

70
Q

How is lithium toxicity managed?

A

If mild/moderate - normal saline

If severe - haemodialysis

71
Q

What is an oculogyric crisis?

A

An example of an acute dystonic reaction

Fixed position of eyeballs

Can be caused by typical antipsychotics and metoclopramide

Treated with Procyclidine

72
Q

When should mirtazapine be considered?

A

In patients on warfarin/heparin

In elderly patients

73
Q

What can cause a rise in Clozapine levels?

A

Smoking cessation

74
Q

What is the first line SSRI in children and adolescents ?

A

Fluoxetine

75
Q

What level of lithium is classed as toxicity?

A
  1. 6 - 2.0 = mild toxicity
  2. 1 - 2.5 = moderate toxicity

More than 2.5 = severe toxicity

76
Q

When should clozapine be used for schizophrenia?

A

In treatment resistant schizophrenia

When others have failed

77
Q

How long should antidepressants be continued for?

A

For at least six months after the patients recover

78
Q

When can bipolar disorder be diagnosed?

A

When there has been at least one manic/hypomanic episode

79
Q

How long do symptoms have to be present for before making a diagnosis of depression?

A

Two weeks

80
Q

What are the three personality clusters?

A

A - paranoid, schizoid, schizotypal

B - antisocial, borderline, histrionic, narcissistic

C - avoidant, dependant, anankastic

81
Q

What is a paranoid personality disorder?

A

Hypersensitive

Unforgiving

Questions the loyalty of friends

Misconstrues the actions of others as attacks

82
Q

What is a schizoid personality disorder?

A

Indifference to praise or criticism

Lack of interest in sexual interactions or companionship

Preference for solitary activities

Emotional coldness

83
Q

What is a schizotypal personality disorder?

A

Odd beliefs and behaviour

Lack of close friends

Inappropriate affect

Ideas of reference

84
Q

What is an antisocial personality disorder?

A

Failure to conform to social norms

Will decent for personal profit/pleasure

Disregard for the safety of self or others

Irresponsible

Lack of remorse or guilt

85
Q

What is a borderline personality disorder?

A

Unstable interpersonal relationships

Unstable self image

Unstable behaviour

Impulsivity of reckless behaviour

Recurrent suicidal behaviour

86
Q

What is a histrionic personality disorder?

A

Need to be centre of attention

Shallow expression of emotions

Inappropriate sexual seductiveness

Over emotional

Physical appearance used for attention-seeking

87
Q

What is a narcissistic personality disorder?

A

Sense of self importance

Lack of empathy

Takes advantage of others

88
Q

What is an avoidant personality disorder?

A

Fear of rejection/criticism

Views self as inferior to others

Hypersensitive to rejection

89
Q

What is a dependent personality disorder?

A

Difficulty in making decisions without reassurance from others

Lack of imitative

Allows others to have responsibility over their life

Perceives self as helpless

90
Q

What is an anankastic personality disorder?

A

Perfectionist

Occupied with details / lists / rules

Rigid on morality / ethics / values

Stubborn

91
Q

What is an impulsive personality disorder?

A

Lack of impulse control

Outbursts of violence

Emotionally unstable

92
Q

What is obsessive-compulsive disorder?

A

Characterised by presence of

Obsessions - thoughts

Compulsions - acts

May be one or both

Symptoms cause functional impairment/stress

93
Q

How is OCD managed?

A

Mild functional impairment - CBT/ERP (exposure and response prevention)

Moderate functional impairment - SSRI / more intensive CBT

Severe functional impairment - SSRI + CBT

94
Q

What drug can be used to help with sleep paralysis?

A

Clonazepam

95
Q

What is classed as insomnia?

A

Difficult initiating or maintaining sleep for at least 3 nights a week for 3 months or longer

96
Q

What is anorexia nervosa?

A

Restriction of energy intake (also may use laxatives/over-exercising/vomiting)

Intense fear of gaining weight/becoming fat

Body dysmorphia

97
Q

What are clinical features of anorexia nervosa?

A

Low BMI

Hypotension

Bradycardia

Lanugo hair

Amenorrhoea

Hypothermia

Cardiac complications - arrhythmia, cardiac atrophy, sudden cardiac death

98
Q

What biochemistry results are typically seen in anorexia?

A

Hypokalaemia

Hypercholesterolaemia

Low sex hormones (FSH, LH, oestrogen, testosterone)

Raised growth hormone

Raised cortisol

Low T3

Impaired glucose tolerance

99
Q

How is anorexia managed?

A

Treat any medical complications e.g. hypokalaemia

Controlled re-feeding to prevent refeeding syndrome

In adults - CBT-ED

In children - anorexia focused family therapy

100
Q

What is bulimia nervosa?

A

Eating disorder characterised by episodes of binging followed by purging

May be a normal BMI

101
Q

What are clinical features of bulimia nervosa?

A

Binge eating - eating an amount of food that is more than most people would eat at once

Compensatory behaviour - vomiting laxatives, diuretics, fasting, excessive exercise

Recurrent vomiting signs - dental erosion, Russel’s sign (calluses on knuckles), parotid gland swelling

102
Q

How is bulimia managed?

A
  1. Bulimia focused self help
  2. If ineffective after 4 weeks - CBT-ED

In children - bulimia focused family therapy

103
Q

What biochemistry results can be seen in bulimia nervosa?

A

Hypokalaemia

Low chloride

Metabolic alkalosis (due to vomiting hydrochloridic acid from stomach)

104
Q

What biochemical results can be seen in refeeding syndrome?

A

Low phosphate

Low potassium

Low magnesium

105
Q

What are symptoms of alcohol withdrawal?

A

Tremor, sweating, tachycardia, anxiety

106
Q

When do seizures peak during alcohol withdrawal?

A

At 36 hours after last drink

107
Q

When does delirium tremens present and what are the features?

A

48 to 72 hours after having last drink

Coarse tremor

Confusion

Delusions

Hallucinations – visual/tactile (feeling of insects crawling on skin)

Sweating

Hypertension

Fever

108
Q

How can acute alcohol withdrawal be managed?

A

Benzodiazepines

First line is usually chlordiazepoxide

Can also use diazepam

Also prescribe Pabrinex (thiamine) to prevent Wernicke’s encephalopathy

109
Q

What is Wernicke’s encephalopathy and what is the triad of symptoms?

A

Neuro psychiatric disorder caused by thiamine deficiency

Ophthalmoplegia/nystagmus

Ataxia

Confusion

110
Q

What is Korsakoff syndrome and what are the features?

A

Memory disorder caused by thiamine deficiency

Anterograde amnesia (inability to form new memories)

Retrograde amnesia (forgetting old memories)

Confabulation

111
Q

What are clinical features of opioid intoxication?

A

Drowsiness

Confusion

Reduced respiratory rate and heart rate

Constricted pupils

Maybe evidence of needle marks

112
Q

What are clinical features of opiate withdrawal?

A

Agitation

Anxiety

Muscle aches and cramps

Chills

Runny eyes and nose

Sweating

Insomnia

GI disturbance

Goose skin

113
Q

What is an indication for electroconvulsive therapy?

A

Severe depression not managed by medication

Catatonia

114
Q

What is a contraindication to electroconvulsive therapy?

A

Raised intracranial pressure

115
Q

What are side effects of electroconvulsive therapy?

A

Headache

Nausea

Short-term memory impairment (Retrograde amnesia)

Cardiac arrhythmia

Memory loss

116
Q

What is somatisation disorder?

A

When there are multiple physical symptoms and the patient refuses to accept reassurance

117
Q

What is conversion disorder?

A

When there is a loss of motor function or sensory symptoms

Patient is not faking or trying to get material gain

No cause found

118
Q

What is malingering?

A

Fraudulent stimulation or exaggeration of symptoms for financial or material gain

119
Q

 which section of the mental health act is used for admission for assessment for up to 28 days?

A

Section 2

120
Q

Which section of the mental health act is renewable every six months?

A

Section 3

121
Q

And which section of the mental health act can be acted on by police to bring them to a place of safety?

A

Section 136

122
Q

What is section 4 of the mental health act?

A

Used in emergencies where a section 2 would cause an undesirable delay

Only needs one Dr rather than two needed by section 2

A person can be detained up to 72 hours and then is converted to do a section 2

123
Q

What patients are a risk of refeeding syndrome?

A

BMI of less than 16

weight loss of more than 15% over 3 to 6 months

Little nutritional intake for more than 10 days

Hypokalaemia hypophosphataemia or hypermagnesaemia prior to feeding

124
Q

What are the four parts of a capacity assessment?

A
  1. Can they take in information?
  2. Can they weigh up the information?
  3. Can they make a decision?
  4. Can they communicate their decision?
125
Q

What are a patient’s rights if they are detained under the Mental Health Act?

A

To be told why they are detained

To get legal advice

To know where he is

To get mental health treatment

126
Q

Can someone detained under the Mental Health Act be given medical treatment against their will?

A

No - only under the Mental Capacity Act

127
Q

How to manage an acute depressive episode in bipolar disorder?

A

Psychoogical intervention e.g. CBT

If not already taking any medication –> Fluoxetine + Olanzapine. Or just Quetiapine

If already taking Lithium –> Check plasma lithium level. If level is fine, add drugs listed above.

128
Q

How to manage an acute manic episode?

A

Consider stopping any antidepressants

If not taking any long term antipsychotics or mood stabiliser:

  1. offer antipsychotic (Haloperidol/Olanzapine/Quetiapine/Risperidone)
  2. Offer alternative from list
  3. If antipsychotic not effective – Add lithium.
  4. Add sodium valproate if lithium is not suitable (e.g. if routine blood monitoring will be an issue). Do not offer to women/girls of childbairing age unless no other choice.

If already taking lithium:
Check lithium levels to optimise treatment
Consider adding antipsychotic

129
Q

What ECG signs may be seen in anorexia nervosa?

A

Small T waves, prolonged PR, U waves (due to hypokalaemia)

130
Q

What are non psychiatric causes of catatonia?

A

Locked in syndrome

Vegetative state

Stroke

Encephalitis

Meningitis

Medicine Finals (32 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions