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Medicine Year 3 > Psychiatry > Flashcards

Psychiatry Flashcards

1
Q

What is a pseudohallucination?

A

Common after bereavement

The patient is aware that they are hallucinating

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2
Q

Define perseveration

A

Repeating the same words/answers

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3
Q

Define echolalia

A

Repeating exactly what someone has said

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4
Q

Define neologism

A

Making up new words

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5
Q

Define word salad

A

Disorganised speech, sentences that do not make sense

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6
Q

Define expressive dysphagia

A

Difficulty putting together words

Often develops following a stroke

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7
Q

First line treatment for children and young people with anorexia nervosa

A

Family based therapy

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8
Q

Define torticollis

A

Twisting of the neck (extrapyramidal side effect)

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9
Q

Which are the typical/atypical antipsychotics?

A
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10
Q

How can SSRIs cause confusion?

A

Increase the risk of hyponatremia

Measure U+E

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11
Q

What should be monitored at baseline and on dose titration

A

Blood pressure

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12
Q

What should be monitored before starting citalopram

A

ECG in people with heart disease risk

Prolongs Q-T interval

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13
Q

Define thought withdrawal

A

Belief of having the removal of a thought by an external force = thought withdrawal

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14
Q

3 features of a schizoid personality disorder

A

Prefers to be alone
Doesn’t like relationships
Low libido
(negative symptoms of schizophrenia)

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15
Q

Poor prognostic indicator for schizophrenia

A

Gradual onset
Low IQ
Prodromal phase of social withdrawal

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16
Q

Define catatonia

A

Stopping of voluntary movement or staying still in an unusual position

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17
Q

Side effect of antipsychotic medications

A

Acute dystonic reactions

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18
Q

Give 2 examples of typical antipsychotics

A

HALOPERIDOL

CHLOPROMAZINE

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19
Q

Give 3 examples of atypical antipsychotics

A

CLOZAPINE
RISPERIDONE
OLANZAPINE

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20
Q

Define akathisia

A

Sense of inner restlessness and inability to keep still

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21
Q

What happens in conversion disorder and what can it be caused by

A

Typically involves loss of motor or sensory function

Can be caused by stress

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22
Q

Treatment of delirium tremens/alcohol withdrawal

A

Chlordiazepoxide or Diazepam

Pabrinex administered to prevent the development of Wernicke’s, it does not have a role in treating acute withdrawal

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23
Q

Which gender is affected by antisocial personality disorder

A

Men

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24
Q

Common side effect in atypical antipsychotics

A

Weight gain e.g. olanzapine

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25
Q

Unexplained physical symptoms

A

Somatisation = Symptoms
hypoChondria = Cancer (underlying diagnosis)
Munchausen’s (intentional production of sx)

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26
Q

How long should antidepressants be continued for depression

A

6 months

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27
Q

A man asks for help with social anxiety. He prefers to be alone and doesn’t like to share his beliefs, which other people think are odd. He has a strong interest in the paranormal and talks in an high-pitched voice when talking about his ‘spirit-guide’

A

Schizotypal personality disorder

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28
Q

Short term side effects of ECT

A 
headache
nausea
short term memory impairment
memory loss of events prior to ECT (retrograde amnesia)
cardiac arrhythmia
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29
Q

3 timeframes in alcohol withdrawal

A

symptoms: 6-12 hours
seizures: 36 hours
delirium tremens: 72 hours

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30
Q

4 first rank schizophrenia sx

A

auditory hallucinations
thought disorders
passivity phenomena
delusional perceptions

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31
Q

Initial management of OCD

A

Exposure and response prevention or CBT

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32
Q

Schizophrenia conservative management

A

CBT

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33
Q

What class of drug is lorazepam

A

Benzo

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34
Q

Side effect of benzos

A

Anterograde amnesia

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35
Q

What is flight of ideas a feature of?

A

Mania (bipolar)

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36
Q

Define flight of ideas

A

when a patient speaks very quickly and rapidly jumps between different topics

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37
Q

Sleep in schizophrenia

A

Insomnia

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38
Q

Which type of incontinence is caused by TCA

A

Overflow

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39
Q

Clozapine dose missed for more than 48 hours

A

Titrate the dose again slowly

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40
Q

To diagnose chronic insomnia

A

Trouble falling asleep for 3 nights a week for 3 months

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41
Q

Medication to abstain from alcohol that makes you violently vomit

A

Dusulfiram (Antabuse)

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42
Q

Alternative to methadone

Tablet that goes under your tongue

A

Buprenorphine

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43
Q

Anti-craving medication for alcoholics that is safe to use with alcohol

A

Acamprosate

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44
Q

First line medication for PTSD

A

Venlafaxine or SSRI

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45
Q

When is ECT indicated

A

in life-threatening major depressive disorder, where catatonia in present

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46
Q

Strongest risk factor for psychotic disorders

A

FHx

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47
Q

First line drug for panic disorder and GAD

A

SSRI

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48
Q

What class is duloxetine

A

SNRI

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49
Q

Minimum time for depressive symptoms

A

2 weeks

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50
Q

Define torticollis

A

A type of acute dystonia with unilateral pain and deviation of the neck with pain on palpation and restricted range of motion

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51
Q

What is delusional parasitosis

A

Patient with a fixed, false belief (delusion) that they are infested by ‘bugs’

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52
Q

Conservative treatment for borderline personality disorder

A

dialectical behaviour therapy (DBT)

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53
Q

risk of developing schizophrenia if one monozygotic twin is affected

A

50%

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54
Q

When should lithium levels be measured

A

12 hours post dose

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55
Q

poor oral compliance to antipsychotics

A

Once monthly IM injections

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56
Q

Side effect of clozapine

A

Constipation/Intestinal obstruction
Agranulocytosis/neutropenia (monitor FBC)
Reduces seizure threshold

57
Q

SSRI decontinuation syndrome sx

A

GI side effects (diarrhoea), restless, mood change, insomnia, dizzy, anxiety, electric shock

58
Q

side effects of clomipramine (TCAs)

A

Dry mouth (anticholinergic) and weight gain (antihistaminic)

59
Q

What do you do with antidepressant mediation prior to starting ECT treatment

A

Reduce the dose

60
Q

Risk factor for Charles Bonnet

A

Visual impairment

61
Q

When does sleep paralysis most often occur

A

When waking from sleep

62
Q

Difference between mania and hypomania

A

Mania = psychotic symptoms

63
Q

Citalopram ECG

A

QT

64
Q

3 common features of PTSD

A

re-experiencing e.g. flashbacks, nightmares
avoidance e.g. avoiding people or situations
hyperarousal e.g.hypervigilance, sleep problems

65
Q

3 features of korsakoff

A

anterograde amnesia, retrograde amnesia, and confabulation

66
Q

Management of hypomania

A

Routine referral to CMHT

67
Q

Most tolerable antipsychotic medication with the least side effects

A

Aripiprazole

68
Q

Define tardive dyskinesia

A

Involuntary chewing/pouting of the jaw

SE antipsychotics

69
Q

SSRI of choice in paeds

A

Fluoxetine

70
Q

Sleep in mania/hypomania

A

Decreased need for sleep without feeling tired

71
Q

Define circumstantiality

A

circuitous and non-direct thinking or speech that digresses from the main point of a conversation
inability to answer a question without giving excessive and unnecessary detail
in anxiety/hypomania

72
Q

What medication interacts with SSRIs

A

Triptan

73
Q

Lithium side effect

A

Hyperparathyroidism and hypercalcaemia (back pain, constipation, headache, low mood, reduced concentration)

Hypothyroidism

74
Q

Timeframe of acute stress reaction to PTSD

A

4 weeks

75
Q

SSRI of choice post-MI

A

Sertraline

76
Q

Define othello syndrome

A

delusional jealously, usually believing their partner is unfaithful

77
Q

Side effects of mirtazapine

A

Sedation and increased appetite

78
Q

What factor increases the risk of suicide

A

Self harm

79
Q

What condition is Cotards associated with

A

Severe depression

80
Q

Side effect of zopiclone in the elderly

A

Increased risk of fall

81
Q

First line conservative treatment for acute stress disorder

A

Trauma-focused cognitive-behavioural therapy (CBT)

82
Q

Somatic symptoms in depression

A

early morning waking and changes in appetite and weight

83
Q

Management of acute dystonia secondary to antipsychotics

A

Procyclidine

84
Q

Trauma in post concussion syndrome may be trivial

A
85
Q

Metabolic side effects of antipsychotics

A

dysglycaemia, dyslipidaemia, and diabetes mellitus

86
Q

Scale used to assess alcohol withdrawal severity

A

Revised Clinical Institute Withdrawal Assessment for Alcohol (CIWA)

87
Q

Management of moderate/severe tardive dyskinesia

A

Tetrabenazine

88
Q

What endocrine abnormality can anorexia cause

A

Hypothyroidism

89
Q

What class is venlafaxine

A

SNRI

90
Q

Sudden onset psychosis following course of corticosteroids

A

Steroid induced psychosis

91
Q

How should you stop an SSRI

A

Withdraw the dose gradually over 4 weeks

92
Q

Define Erotomania (De Clerambault’s syndrome)

A

the presence of a delusion that a famous is in love with them, with the absence of other psychotic symptoms

93
Q

What abnormality can lithium cause on bloods

A

Benign leucocytosis

94
Q

ECG shows first-degree heart block, tall P-waves and flattened T-waves

A

Hypokalaemia

Bulimia

95
Q

What is pseudodementia

A

Severe depression can mimic dementia but gives a pattern of global memory loss rather than short-term memory loss

96
Q

Patient in a public place and threatening violent behaviour

A

Call the police

97
Q

Why should SSRIs and MAOIs never be combined

A

Risk of serotonin syndrome

98
Q

What class of drug is rasagiline

A

MAOIs

99
Q

Antipsychotics in the elderly

A

Increased risk of stroke and VTE

100
Q

Paroxetine in pregnancy

A

Risk of congenital malformations

101
Q

Another term for hypochondriasis

A

Illness anxiety disorder

102
Q

Type 1 vs 2 bipolar

A

Type 1: Mania

Type 2: Hypomania

103
Q

What side effect of antipsychotic medication is oculogyric crisis an example of

A

Acute dystonia

104
Q

Define clang associations

A

ideas related only by rhyme or being similar sounding

105
Q

What class is mirtazapine

A

oradrenergic and specific serotonergic antidepressant which increases release of neurotramsitters by blocking alpha2 adrenoreceptors

106
Q

Paranoid personality disorder

A

patients who are overly sensitive and can be unforgiving if insulted, question loyalty of those around them and are reluctant to confide in others

107
Q

Investigation in elderly patients with new sudden onset psychosis to rule out other causes

A

CT Head

108
Q

Which side-effect is more common with atypical than conventional anti-psychotics

A

Weight gain

109
Q

After a change in lithium dose when should levels me taken

A

Weekly until stable then 3 monthly

110
Q

Common side effect in depot antipsychotics

A

Parkinsonian symptoms

111
Q

What is Hoover’s sign

A

a quick and useful clinical tool to differentiate organic from non-organic leg paresis. In non-organic paresis, pressure is felt under the paretic leg when lifting the non-paretic leg against pressure, this is due to involuntary contralateral hip extension

112
Q

Symptoms of mania in primary care…

A

Urgent referral to CMHT

113
Q

OCD vs Psychosis

A

Obsessive-compulsive disorder can be differentiated from psychosis by the level of insight into their actions

114
Q

Borderline (emotionally unstable) personality disorder

A

associated with a history of recurrent self-harm and intense interpersonal relationships that alternate between idealization and devaluation

115
Q

Define malingering

A

Lying or exaggerating for financial gain is malingering, for example someone who fakes whiplash after a road traffic accident for an insurance payment

116
Q

How long do you continue antidepressants after remission of symptoms

A

Antidepressants should be continued for at least 6 months after remission of symptoms to decrease risk of relapse

117
Q

Avoidant personality disorder

A

fearful of criticism, being unliked, rejection and ridicule

118
Q

Blood results in anorexia

A

most things low

G’s and C’s raised: growth hormone, glucose, salivary glands, cortisol, cholesterol, carotinaemia

119
Q

Risk of SSRI use during third trimester

A

Persistent pulmonary hypertension of the newborn

120
Q

Management of severe or unresponsive OCD

A

Sertraline

121
Q

What class of drug is escitalopram

A

SSRI

122
Q

What can cause a rise in clozapine blood levels?

A

Smoking cessation

123
Q

obsessive-compulsive personality disorder

A

rigid with respect to morals, ethics and values and often are reluctant to surrender work to others

124
Q

Differentiating between Knight’s move and flight of ideas

A

Knight’s move thinking there are illogical leaps from one idea to another, flight of ideas there are discernible links between ideas

125
Q

Munchausen’s syndrome

A

Purposefully causing symptoms, for example a diabetic taking too much insulin to cause hypos

126
Q

What condition is important to rule out in anxiety

A

Thyroid disease

127
Q

MOA of benzos

A

enhance the effect of GABA, the main inhibitory neurotransmitter

128
Q

MOI - avoid which foods and why

A

Tyramine containing foods (e.g. cheese)

Risk of hypertensive crisis

129
Q

risk factor for generalised anxiety disorder

A

being divorced or separated

130
Q

Severe restlesness with antipsychotics

A

Akathisia

131
Q

What age do you need to be to diagnose a personality disorder?

A

18

Pervasive undesirable personality traits

132
Q

Management of mania/hypomania in patients taking antidepressants

A

consider stopping the antidepressant and start antipsychotic therapy

133
Q

First line for acute stress disorders

A

Trauma focused CBT

134
Q

Side effect of long-term atypical antipsychotics

A

glucose dysregulation and diabetes

135
Q

Common side effects with imipramine

A

Blurred vision and dry mouth (TCA)

136
Q

SSRI use in first trimester

A

small increased chance of congenital heart defects

137
Q

Physical finding in anorexia

A

Lanugo hair

138
Q

Which antidepressant medication would increase the GI bleeding risk and warrant a PPI

A

SSRI e.g. citalopram

Medicine Year 3 (8 decks)

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