Psychiatry Flashcards
A breastfeeding woman requires an SSRI what is the preferred medication?
Setraline
Paroxetine
What scale is used in postnatal depression?
Edinburgh Postnatal Depression Screen
What monitoring is required in SSRIs?
BP at initiation and every time dose is titrated
What monitoring is required for citalopram ?
ECG
What should be measured before and during Antipsychotic use?
Hb1Ac
What should be monitored in SSRS use?
U + E
Particularly Na+ as hyponatraemia is a cause of confusion in elderly.
ADHD - managent
Watch and wait for 6 weeks
Refer to secondary care
Mild to moderate - Parent training and education
Severe - Medication
Medication ADHD rules
Only if over 5 years old
Baseline ECG required
6 monthly weight and height measurements
Medication in ADHD
Methylphenidate 1st line
Lisdexamfetamine - second line
Which atypical antipsychotic has the best side affect profile?
Aripiprazole
Management of GAD
Education and monitor -> Low intensity psychotherapy -.> CBT or medication
Medication - SSRI sertraline is first line
- Venlafaxin or another SSRI
- Pregablin
What is first line for acute stress disorder?
CBT
Management of OCD
Mild - CBT + exposure response and prevention ERP
Moderate - SSRI or more intensive CBT + ERP
Severe - SSRI + CBT + ERP
SSRI - fluoxetine
Use for at least 12 months to prevent relapse
If failure to respond to an SSRI trial another SSRI
Confusion Hyperthermia Hyperreflexia Pupil dilation Use of SSRIs
Seretonin Syndrome
Linked to ecstasy or amphetamine overdose
Tramadol can trigger it swell
Is someone presents with mania in a primary care setting what is the management?
Referral to Community Mental Health Team
What is the first line medication used in Post MI depression?
Setraline
PTSD - management
Mild - watch and wait for 4 weeks
Severe - CBT EMDR or medication
Venlafaxine or SSRI
Multiple physical symptoms and refusal to believe negative results or reassurance
Somatisation Disorder
Persistent belief in serious underlying disorder
Illness anxiety disorder
Hypochondriasis ( C for Cancer)
Loss of motor or sensory function
Involuntary
Current stressful change
Conversion disorder
Internal production of physical/psychological symptoms
Munchausen / factitious disorder
Creation of symptoms for financial or personal gain
Malingering
Hypomania in the community
Routine referral to CMHT
Urgent if threat to own life or others
How long can a normal grief reaction last?
<6 months
Management of frontotemporal dementia
No pharmacological management
Refer to psychiatry and organise social support
Oppositional defiant disorder.
Persistent defiant and hostile behaviour towards authoritative figures
Conduct disorder
<18 years old
Behaviour and attitude that continually disrespects the rights of others
What lobe is affected in early Alzheimers?
Temporal
Antisocial vs conduct disorder
Conduct disorder occurs before 18 years old
