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AMK > Psychiatry > Flashcards

Psychiatry Flashcards

1
Q

Which drug would cause:
Malaise, chest pain, sweating, neutropenia

A

Clozapine

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2
Q

Schizophrenia management

A

Oral atypical antipsychotics are first like

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3
Q

Side effects atypical antipsychotics

A

Metabolic side effects

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4
Q

Examples of atypical antipsychotics

A

Olanzapine, clozapine, risperidone

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5
Q

Side effects of risperidone

A

Galactorrhoea

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6
Q

Examples of tricyclic antidepressants

A

Amitriptyline

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7
Q

Side effects of tricyclic antidepressants

A

Dry mouth

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8
Q

MOA typical antipsychotics

A

D2 antagonists

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9
Q

Side effects typical antipsychotics

A

Extrapyramidial (Parkinson’s etc) and hyperptolactinaemia

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10
Q

Examples of typical antipsychotics

A

Haloperidol and chlorpromazine

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11
Q

Sx lithium toxicity

A

Tremor
Hyperreflexia
Seixure
Confusion

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12
Q

Management lithium toxicity

A

Resuscitation with saline
Haemodialysis in severe cases

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13
Q

Precipitating factors of lithium toxicity

A

Dehydration
Renal failure
Drugs (diuretics, ACEi, NSAIDs)

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14
Q

How do you differentiate between depression and dementia?

A

Depression has a short, rapid onset and is associated with biological sx like weight loss
Pt is also aware of and worries about memory
Dementia causes recent memory loss, depression is global

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15
Q

PTSD management

A

Watchful waiting if sx mild and less than 4 weeks
SSRI is first line after social therapies

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16
Q

Which medication can counteract alcohol cravings?

A

Acamprostate

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17
Q

Pt presents with these sx:
agitation/anxiety, insomnia, hallucinations spasms, dry mouth

A

Benzo withdrawal

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18
Q

Tricyclic antidepressants MOA

A

Monoamine uptake inhibitors

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19
Q

E.g tricyclic antidepressants

A

Amitriptyline

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20
Q

S/e TCAs

A

Sedation, dry mouth hyponatraemia

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21
Q

Withdrawal sx TCAs

A

Agitation, sweating, headache

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22
Q

Positive sx schizophrenia

A

Delusions, hallucinations, thought disorder

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23
Q

Schneider’s first rank sx of schizophrenia

A

Positive sx of schizophrenia
Primary decisions (appear with no precipitating event)
Persistent delusions (arise with period of perplexity)
Secondary delusions

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24
Q

Negative sx of schizophrenia

A

Reduced function
Alogia - poverty of speech
Lack of emotion
Lack of interest in life, self care etc

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25
Q

Management schizophrenia

A

Atypical antipsychotics are first line

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26
Q

Sx PTSD

A

Flashbacks, hypervigilant
Avoidance behaviour

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27
Q

Treatment for PTSD

A

CBT
and SSRIs

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28
Q

Treatment for depression

A

SSRIs

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29
Q

E.g. anti-convulsant

A

Sodium valproate

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30
Q

Sx serotonin syndrome

A

Confusion, agitation, seizures

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31
Q

Herbal cause of serotonin syndrom

A

St John’s Wort

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32
Q

E.g. SSRIs

A

Fluoxetine (children)
Seetraline

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33
Q

Sx SSRI discontinuation

A

Dizziness and vertigo
Electric-shock feelings
Flu sx

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34
Q

SNRI e.g.

A

Venlafaxine

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35
Q

Delerium tremens

A

Caused by increased alcohol

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36
Q

Sx delirium tremens

A

Tachycardia, sweating, hallucinations

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37
Q

Tx delerim tremens

A

Benzodiazepines and thiamine

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38
Q

Lewy Body Dementia sx

A

Steady decline and visual hallucinations

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39
Q

Tx Lewy Body Dementia

A

ACHEi - rivastigmine

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40
Q

Fronto-temporal dementia sx

A

Preserved memory but personality changes and metabolic disorders

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41
Q

Vascular dementia sx

A

Shuffling gait, neural infarcts

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42
Q

Risk factor vascular dementia

A

Stroke or TIA

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43
Q

Sx Alzheimer’s

A

Tau tangles
Slowly progressive memory loss

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44
Q

Tx Alzheimer’s

A

AChEi
RIvastigmine, donepezil

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45
Q

ADHD tx

A

Atomoxetine 0 noradrenaline reuptake inhibitor

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46
Q

Citalopram MOA

A

SSRI

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47
Q

Haloperidol MOA

A

Dopamine antagonist

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48
Q

First line therapy for ADHD

A

Methylphenidate - dopamine/norepinephrine reuptake inhibitor

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49
Q

Which antidepressants can you not eat with wine and cheese

A

MAOI

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50
Q

What happens when you eat wine/cheese when on MAOI

A

Tachycardia and headache

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51
Q

Schizoid personality disorder

A

Loss of interest and interaction with others - not related to delusions

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52
Q

First line anti-psychotic for schizophrenia

A

Risperidone

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53
Q

Is group or individual CBT offered first?

A

Group - lower intensity

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54
Q

Opiate overdose

A

Decreased consciousness, decreased HR, RR etc

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55
Q

Withdrawal sx opiate

A

agitation, goose skin, increased hr and bp

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56
Q

What is acute stress disorder?

A

Reaction to a traumatic event <4 weeks ago

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57
Q

Difference between PTSD and ACD

A

PTSD is longer than 4 weeks, ACD is less

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58
Q

Sx acute stress disorder

A

Intrusive thoughts
Dissociation
-ve mood
Sleep disturbance

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59
Q

Treatment ACD

A
  • CBT
    Benzodiazepines
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60
Q

What is agoraphobia?

A

Fear of open spaces

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61
Q

Diagnosing anorexia

A

DSM 5 criteria: restriction of energy intake, intense fear of gaining weight, disturbed vision of body

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62
Q

Adult treatment for anorexia

A
  • *CBT-ED
  • Maudsley Anorexia Nervosa Treatment
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63
Q

Child treatment for anorexia

A
  • *Anorexia focussed family therapy
  • CBT
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64
Q

which antipsychotic has increased risk of long QT?

A

haloperidol

65
Q

Why is it dangerous to give typical antipsychotics in the elderly?

A

Increased risk of VTE and stroke

66
Q

What is aphonia?

A

Inability to speak

67
Q

How do benzodiazepines work?

A

Binds to GABAa receptor to increase frequency of Cl- channels

68
Q

Uses benzodiazepines

A

sedation, anti-convulsant, muscle relaxation

69
Q

How to withdraw from benzodiazepine

A

Reduce dose and switch to diazepam

70
Q

Difference between hypomania and mania

A

Mania is 7+ days, hypomania is 4+ days
Psychotic sx indicate mania

71
Q

Type 1 bipolar disorder

A

mania (delusions/hallucinations) and depression, lasting for 7+ days

72
Q

Type 2 bipolar disorder

A

hypomania and depression, lasting for 4+ days

73
Q

Treatment for bipolar disorder

A

Treat symptoms

74
Q

BPD mood stabiliser

75
Q

BPD mania/hypomania tx

A

haloperidol/olanzapine

76
Q

BPD depression tx

A

Talking therapies/fluoxetine

77
Q

What is Charles bonnet syndrome?

A

Visual impairment + visual/auditory hallucinations

78
Q

What is Cotard’s syndrome?

A

Pt believes body parts are dead

79
Q

De Clerambault’s syndrome

A

Single female pt believes a famous person is in love with her

80
Q

What is delusional parasitosis

A

Pt believes they are infected with parasites

81
Q

Absolute contraindication to electroconvulsive therapy

A

Increased ICP

82
Q

what is GAD?

A

Excessive worry and heightened tension

83
Q

Causes of GAD

A

Hyperthyroidism/cardiac disease/medication

84
Q

Medications causing GAD

A

Salbutamol, theophylline, caffeine

85
Q

Treatment GAD

A
  • 1 = education and monitoring
  • 2 = low-intensity psychological interventions
  • 3 = high-intensity psychological interventions (CBT) + drug treatment
86
Q

Drug ladder for GAD

A
  • Sertraline SSRI
  • Alternative SSRI or SNRI (duloxetine or venlafaxine)
  • Pregabalin
87
Q

Treatment for panic disorder

A

CBT or drugs (SSRI first line but if contra-indicated/no response after 12 weeks then give imipramine)

88
Q

What are the stages of grief?

A

Denial - anger - bargaining - depression - acceptance

89
Q

What is Othello’s syndrome?

A

Pathological jealousy where a person is convinced that their partner is cheating on them with no real proof

90
Q

What is OCD?

A

A combination of obsessions (unwanted intrusive thoughts) and compulsions (repetitive behaviours)

91
Q

Treatment for mild OCD

A

CBT (including exposure and response prevention) or SSRI

92
Q

Treatment for moderate OCD

A

intensive CBT (inc. ERP) or SSRI (fluoxetine for body dysmorphia)

93
Q

SSRI for body dysmorphia

A

fluoxetine

94
Q

Treatment for severe OCD

A

intensive CBT + SSRI

95
Q

Treatment for PTSD if CBT ineffective?

A

SSRI or venlafaxine

96
Q

Characteristics of PTSD

A

Sx present for more than a month

97
Q

Sx PTSD

A

intrusive images, flashbacks, avoidance, irritability

98
Q

Management for PTSD

A

CBT or SSRI/venlafaxine if severe

99
Q

SSRI giving high risk of long QT

A

citalopram

100
Q

SSRI for post-MI

A

sertraline

101
Q

SSRI for kids or body dysmorphia

A

fluoxetine

102
Q

How do you prescribe SSRI if pt taking NSAIDs

103
Q

Over which time period should you withdraw a SSRI

104
Q

Why does fluoxetine have a reduced frequency of side effects

A

Longer half life

105
Q

How do you transfer from fluoxetine to another SSRI

A

Wait a week after finishing fluoxetine

106
Q

Medication causing urinary retention

A

TCA - amitriptyline

107
Q

What is akathisia?

A

Severe restlessness

108
Q

Disulfarim function

A

makes pt sick if they drink alcohol

109
Q

Disulfarim MOA

A

inhibitor of acetaldehyde dehydrogenase

110
Q

Paranoid personality disorder

A

Hypersensitivity and lack of forgiveness
Questions loyalties of friends

111
Q

Schizoid personality disorder

A

Indifference to praise or criticism
Prefers solitary activities
Lack of desire/interest/emotion

112
Q

Schizotypal personality disorder

A

Odd beliefs and magical thinking
Paranoid and suspicious

113
Q

Peak incidence of delirium tremens after alcohol withdrawal

114
Q

How to switch from SSRI to TCA

A

cross-tapering is recommended

115
Q

What is the difference between echolalia and palilalia?

A

Palilalia is repeating your own words, echolalia is repeating someone else’s

116
Q

Paranoid personality disorder

A

hypersensitive, questions loyalty of friends, reluctant to confide in others, preoccupation with conspirational beliefs, imagined attacks on their character

117
Q

Schizoid personality disorder

A

indifference to praise/criticism, prefers solitary activities, lack of interest in relationships/life, emotionally cold, few confidants

118
Q

Schizotypal personality disorder

A

odd beliefs and magical thinking, eccentric behaviour, lack of close friends beyond family, odd speech

119
Q

Antisocial personality disorder

A

fails to conform to norms, deceiving, impulsiveness, aggressive, disregard of safety, lack of remorse

120
Q

Borderline personality disorder

A

efforts to avoid abandonment, unstable relationships, unstable self-image, recurrent suicidal behaviour, feelings of emptiness

121
Q

Histrionic personality disorder

A

sexually inappropriate, attention seeking, dramatic

122
Q

Narcissistic personality disorder

A

sense of self-importance and entitlement, excessive need for admiration

123
Q

Obsessive-compulsive personality disorder

A

meticulous and scrupulous, unwilling to pass tasks to other people, stiffness and stubbornness

124
Q

Avoidant personality disorder

A

avoids activities due to fear of rejection, fear of embarrassment, fear of not being liked, social isolation

125
Q

Dependent personality disorder

A

fear of looking after themselves, excessive effort to obtain support from others, need reassurance from others

126
Q

Features of psychosis

A

hallucinations, delusions, thought disorganisation, agitation, depression

127
Q

What is SAD?

A

Mild depression in winter months

128
Q

Treatment for SAD

A

Treat the same way as mild depression - start with CBT and follow up in 2 weeks. If deterioration, prescribe SSRI

129
Q

Somatisation disorder

A

physical symptoms present for 2+ years with no explanation

130
Q

Hypochondriasis

A

patient believes presence of disease

131
Q

Conversion disorder

A

loss of motor/sensory function

132
Q

Dissociative disorder

A

‘separating’ certain memories from real consciousness (involves psychiatric sx)

133
Q

Factitious disorder

A

also known as Munchausen’s, intentional production of physical/psychological sx (normally for emotional need)

134
Q

Malingering

A

exaggeration of sx for financial or other gain

135
Q

Strongest risk factor for schizophrenia

A

Family history

136
Q

First rank sx for schizophrenia

A
  • Auditory hallucinations
  • Thought disorder
  • Passivity phenomena (sensations controlled by external influence)
  • Delusions
137
Q

Negative sx schizophrenia

A
  • Blunting of affect
  • Anhedonia
  • Alogia
  • Avolition
138
Q

TReatment schizophrenia

A

CBT and atypical antipsychotics

139
Q

Section 2 of MHA

A

<28 days, AMHP and relative detain pt for tx

140
Q

Section 3 of MHA

A

<6 months, AMHP and 2 doctors, for tx

141
Q

Section 4 of MHA

A

72h assessment - emergency
Normally followed by 2

142
Q

Section 5(2) of MHA

A

Detain pt who is in hospital for 72h

143
Q

Section 5(4) of MHA

A

Doctor detains hospital pt for 6h

144
Q

Section 17a of MHA

A

Recalls pt for tx if they don’t comply with previously agreed meds plan

145
Q

Section 135 of MHA

A

Police break into house to remove pt

146
Q

Section 136 of MHA

A

police detain pt in public

147
Q

How long after starting treatment with SSRI should you be reviewed if you are 43 with no other relevant conditions?

148
Q

How long after starting treatment with SSRI should you be reviewed if you are <30 or at high risk ?

149
Q

How long should you take SSRIs for after resolution of sx

150
Q

Over how long should you withdraw SSRIs?

151
Q

Side effect zopiclone elderly

A

Increased fall risk

152
Q

Medications you should avoid if taking SSRI

A

Triptans
MAOis
Warfarin/heparin

153
Q

sx SSRI discontinuation syndrome

A

dizziness, anxiety, electric shock sensations

154
Q

which drugs cause hyponatraemia?

155
Q

Which drugs cause hypertension?

156
Q

Stages of alcohol withdrawal and timing

A

sx between 6-12h
seizures 36h
delirium tremens 72h

157
Q

How often do you check renal and thyroid function when taking lithium?

158
Q

when taking a blood sample of a pt on lithium, how long should you wait before taking sample after pt has had lithium dose?

159
Q

when changing lithium dose, how often should you monitor?

A

check weekly until stable then 3 monthly

AMK (33 decks)

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