Psychiatry Flashcards
How long should SSRIs be tapered for?
4 weeks
Which SSRI has the greatest association with congenital malformations when used in pregnancy?
Paroxetine
What are the 4 features of PTSD?
- Avoidance
- Hyperarousal
- Re-living
- Emotional numbing
What are the first rank symptoms of Schizophrenia?
- 3rd person auditory hallucinations
- Thought disorder
- Delusional perception
- Passivitiy phenomena
How is tardive dyskinesia managed?
Tetrabenzine
What is the management of OCD?
CBT
ERP (Exposure and response prevention)
Can add SSRI
What are symptoms of alcohol withdrawal? What are features of delirium tremens?
6-12 hrs: Tremor, sweating, tachycardia, anxiety
36 hrs: Seizures
48-72 hrs: Delirium tremens
Delirium tremens: Coarse tremor Confusion Delusions Auditory/visual hallucinations Fever Tachycardia
What is the treatment of delirium tremens?
Lorazepam
What is the treatment of alcohol withdrawal?
Chlordiazepoxide or Diazepam
What are features of opioid intoxication?
X
What are features of opioid withdrawal?
X
What is Cotard syndrome?
belief they are dead
What is De clerambault syndrome?
AKA Erotomania
The patient, often a single woman, believes that a famous person is in love with her
What is Othello syndrome?
pathological jealousy, belief that partner is unfaithful
What are the risks of using SSRIs in the first trimester?
Small increased risk of congenital heart defects
What are the risks of using SSRIs in the third trimester?
Risk of pulmonary hypertension
Knights move thinking vs. Flight of ideas
Knights move thinking = Illogical leaps
Flight of ideas = Some link
Which lab results are seen in anorexia nervosa?
Hypokalaemia Low FSH and LH Hypercholesterolaemia Raised growth hormone Raised cortisol
What are the features of anorexia nervosa?
x
What features are seen in bulimia?
x
Management of chronic alcohol addiction
Two main options = Disulfram + Acamprosate
Acamprosate reduces cravings and is the preferred option
Disulfram causes a serious reaction when alcohol is drank
Neuroleptic malignant syndrome vs. serotonin syndrome - onset?
Serotonin syndrome is more sudden
Neuroleptic malignant syndrome takes 1-2 weeks
Which type of amnesia is most common following ECT?
Retrograde
First Line SSRI for anxiety?
Sertraline
Side effects of lithium?
Nausea/vomiting Diarrhoea Nephrotoxicity Fine tremor Diabetes insipidus Hypothyroidism Weight gain IIH Benign raised WCC Hyperparathyroidism —> Hypercalcaemia.
How is anorexia managed?
Treat any medical complications e.g. hypokalaemia
Controlled re-feeding to prevent refeeding syndrome
In adults - CBT-ED
In children - anorexia focused family therapy
What are clinical features of opiate withdrawal?
Agitation Anxiety Muscle aches and cramps Chills Runny eyes and nose Sweating Insomnia GI disturbance Goose skin
What patients are a risk of refeeding syndrome?
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
