Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

FLASH FINALS > Psychiatry > Flashcards

Psychiatry Flashcards

1
Q

Acute stress vs PTSD - timing:

A

<4 weeks

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

Alcohol withdrawal:
6-12 hours:
Peak seizure incidence:
Peak incidence of DT:

A

Tremor, sweating, tachycardia, anxiety

36 hours

48-72 hours

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

First line Tx. alcohol w/drawal:

A

CHLORDIAZEPOXIDE or diazepam (long acting benzos)

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

Tx. Alcohol w/drawal if hepatic impairment:

A

LORAZEPAM

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

Typical antipsychotics MoA

A

D2 receptor antagonists

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

Atypical antipsychotics MoA

A

Act on a variety of receptors (D2,D3,D4,5-HT)

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

Hyperprolactinaemia - more common w/ which antipyschotics

A

Typical

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

Acute dystonia:

Treat with:

A

Sustained muscle contraction (torticolis, oculogyric crisis)

PROCYCLIDINE

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

Tardive dyskinesia:

A

Late on-set choreoathetoid movements, abnormal involuntary - chewing and pouting of the jaw

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

CV side effects of anti-psychotics:

A

Increased risk of stroke

Increased risk of VTE

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

Other side effects of antipsychotics:

A

Impaired glucose tolerance
Reduced seizure threshold (greater w/ atypicals)
Prolonged QT interval (particularly haloperidol)

antimuscarinic, weight gain, galactorrhoea, neuroleptic malignant syndrome

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

Antipsychotic monitoring: bloods

A

U&Es, FBCs, LFTs at start of therapy, annually

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

Which antipsychotic requires weekly FBCs initially

A

Clozapine

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

Other monitoring with antipsychotics (5)

A

Lipids/weight - at start of therapy, 3 months, annually

Fasting blood glucose, prolactin - at start of therapy, 6 months, annually

Blood pressure - baseline, during dose titration

Electrocardiogram - baseline

CV risk assessment - annually

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

Adverse effects of atypical antipsychotics

A

Weight gain
Clozapine assoc. w/ agranulocytosis
hyperprolactinaemia

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

Anti-psychotic w/ higher risk of dyslipidaemia and obesity

A

Olanzapine

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

Anti-psychotic w/ good side effect profile, particularly for prolactin elevation:

A

Aripiprazole

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

Clozapine side effects:

A 
Agranuloctytosis/neutropenia 
Reduced seizure threshold 
CONSTIPATION
Myocarditis: ECG to be done prior to treatment 
Hypersalivation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What social activity may require clozapine dose to be altered:

A

Smoking

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

Clozapine may be started when:

A

Schizophrenia is not controlled despite sequential use of two or more anti-psychotic drugs, each for at least 6-8 weeks.

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

BZPs act on which channels

A

Increase FREQUENCY of Chloride channels to produce sedative effect (enhance GABA)

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

Symptoms of BZP w/drawal:

A 
Insomnia
Irritability 
Anxiety 
Tremor 
Loss of appetite 
Tinnitus 
Perspiration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Barbiturate’s effect on chloride channels:

A

Increase DURATION of chloride channel opening

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

Type I bipolar:

type II bipolar:

A

Mania and depression

Hypomania and depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Hypomania vs mania
Hypomania = altered function for 4 days or more Mania = Severe functional impairment or psychotic symptoms for 7 days
26
Key differentiator between mania and hypomania:
Psychotic symptoms
27
Mood stabilizer of choice:
Lithium | Valproate also used
28
Management of mania/hypomania
consider stopping antidepressant | Antipsychotic - olanzapine or haloperidol
29
Bipolar: Depression Mx. of choice
FLUOXETINE
30
Referral Hypomania Mania
Routine referral to CMHT URGENT referral to CMHT
31
Charles-Bonnet syndrome:
Persistent complex hallucinations occurring in clear consciousness that may be assoc. with a pre-established visual impairment
32
De-Clarembault syndrome:
Erotomania: paranoid delusion that a famous person is in love with them. Usually affects females
33
Depression vs. dementia Factors favouring depression:
Short history, rapid on-set Biological symptoms - wt. loss sleep disturbance pt. worried about poor memory - global memory loss
34
Depression switching anti-depressants: | Switching SSRIs:
First SSRI is to be withdrawn gradually : before the next one started
35
Switching from fluoxetine to another SSRI
w/draw gradually then leave gap of 4-7 days before starting next SSRI
36
Switching from SSRI to TCA
Cross tapering recommended | Not w/ fluoxetine - should be withdrawn prior to TCAs
37
Switching from SSRI to SNRI
Cross-taper
38
ECT adverse effects:
Headache, nausea, short term memory impairment, cardiac arrhythmia
39
Medical tx. of choice in GAD 2nd line 3rd line
SERTRALINE another SSRI or SNRI Pregabalin
40
Chronic insomnia diagnosis requires:
difficulty sleeping for at least 3 nights/week for 3 months
41
Commonly prescribed medication that may cause insomnia:
Corticosteroids
42
When should hypnotics be considered for insomnia
Only if daytime somnolence is SEVERE
43
Hypnotics in insomnia:
Should be short acting BZPs or non-BZPs (Zopiclone, zolpidem) If no response to hypnotic DO NOT prescribe another
44
Lithium therapeutic range (mmol/L)
0.4 - 1
45
Lithium is excreted by which organs:
Kidneys
46
Adverse effects of lithium
'LITHIVM' ``` Leukocytosis Insipidus (diabetes) Tremor Hypothyroidism Increased WEIGHT Vomiting/nausea, diarrhoea Misc. - Hypercalcaemia, ```
47
Lithium monitoring:
Sample should be taken 12 hours post dose. Then weekly/after each dose until levels are stable. Once stable: every 3 months TFT and RFT should be checked 6 monthly
48
Knight's move thinking vs Flight of ideas
Flight of ideas has discernible links.
49
Mirtazapine MoA
Blocks a2 adrenergic receptors
50
OCD tx. Mild functional impairment: Moderate functional impairment: Severe:
CBT w/ ERP SSRI (Fluoxetine for body dysmorphic disorder) SSRI and CBT w/ ERP
51
If SSRI is effective in controlling OCD how long should it be continued for
12 months
52
Othello syndrome:
Convinced partner is cheating on them
53
PDs: Cluster A
Odd and eccentric: Paranoid Schizoid Schizotypal
54
PDs: Cluster B
``` Dramatic emotional and erratic: Antisocial Borderline Histrionic Narcissistic ```
55
PDs: Cluster C
Anxious and fearful: Obsessive compulsive Avoidant Dependent
56
Drug treatments for PTSD:
Venlafaxine or Sertraline - Not first-line management of PTSD
57
Strongest risk factor for developing a psychotic disorder
Family history
58
Shneider's first-rank symptoms: | mnemonic
'At The Police Department' Auditory hallucinations Thought disorder - insertion, w/drawal, broadcasting Passivity phenomena Delusional perception
59
Schizophrenia management:
CBT offered to all patients | Atypical antipsychotics are first-line
60
Schizophrenia: which system should be paid close attention, with risk factors modified to improve outcomes :
Cardiovascular disease - linked to antipsychotic medication and high smoking rates)
61
Schizophrenia: poor prognostic indicators:
``` Strong family history Gradual onset Low IQ Prodromal phase of social withdrawal Lack of obvious precipitant ```
62
Which SSRI is known to increase QT interval:
CITALOPRAM - should not be used in long QT syndrome or in combination with medications which prolong QT interval.
63
SSRI which is most useful post MI -
Sertraline - best cardiac profile
64
SSRI of choice in younger adults:
Fluoxetine
65
Common side effects in SSRIs
GI symptoms are most common | Increased risk of GI bleeding (give omeprazole if already on NSAID)
66
Maximum dose of citalopram:
40 mg - 20mg if >65 yrs
67
SSRI interactions to be aware of (4)
NSAIDs - in general do not offer but if must, give with PPI Triptans - Increased risk of serotonin syndrome MAOis - increased risk of serotonin syndrome Warfarin/herparin - do not give SSRI - consider mirtazapine
68
After initiation of SSRI, pts. should be reviewed after:
2 weeks | If <30, 1 week
69
If good response to SSRI, how long should treatment continue for
6 months
70
Discontinuing SSRI - w/drawn over
4 weeks - not necessary with fluoxetine
71
Discontinuation syndrome - SSRIs
Increased mood change restlessness, difficulty sleeping Sweating GI symptoms - pain cramping, diarrhoea
72
SSRI in pregnancy: potential side effects 1TM 3TM
1TM: Congenital heart defects 3TM: Persistent pulmonary hypertension of newborn
73
Which SSRI has increased risk of congenital malformation, thus should be avoided in pregnancy
Paroxetine
74
Sleep paralysis tx. if troublesome symptoms:
Clonazepam
75
Common side effects of TCAs:
``` Drowsiness Dry mouth Blurred vision Constipation Urinary retention Lengthening of QT interval ```
76
More sedative TCAs: | Less sedative TCAs:
More sedative: Amitriptyline, clomipramine, dosulepin, trazadone Less sedative Imipramine, lofepramine, nortryptiline
77
Somatisation disorder:
Multiple physical SYMPTOMS present for at least 2 years | pt. refuses to accept reassurance or negative results
78
Conversion disorder:
Involves loss of motor or sensory function | No psychiatric symptoms otherwise
79
Dissociative disorder:
Process of separating off certain memories from normal consciousness
80
Factitious disorder vs malingering:
Factitious = intentional production of real symptoms Malingering = Fraudulent simulation of symptoms for gain
81
Adverse effects of 'Z' drugs
Similar to BZPs | increased risk of falls in the elderly
82
Emergency detention - duration: Does it allow treatment: Who can issue one:
72 hours No treatment F2 or above
83
Short term detention: duration: Treatment? Who can issue: requires consent of:
28 days Yes Applied for an approved by 2 medical practitioners, one which must be a psychiatrist MHO
84
Compulsory treatment order: Max duration: Who can issue:
6 months Applied for by MHO with supporting letters from 2 doctors: one being the psychiatrist
85
Serotonin syndrome: px:
Myoclonus (twitching), tremor rigidity, hyperreflexia Headache, hallucinations, agitation Autonomic: Shivering, sweating hyperthermia
86
Bipolar is associated strongly with which syndrome:
DiGeorge syndrome
87
What kind of hallucinations are classical of schizophrenia:
3rd person auditory
88
Antipsychotic to give when pt. could do with losing weight:
Haloperidol | Aripiprazole
89
BZP overdose is tx. w/
Flumazenil
90
Flight of ideas is more assoc. w/ | Knight's move thinking is more assoc. w/
``` FoI = Mania KMT = Schizophrenia ```
91
Long term usage of antipsychotics may cause:
Glucose dysregulation and diabetes
92
Two classes of anti-depressants that should never be prescribed together:
SSRI and MAOIs - risk of serotonin syndrome
93
ECT causes what kind of memory loss?
Retrograde amnesia
94
Anorexia nervosa: what is raised
Gs and Cs GH Glucose Salivary Glands Cortisol Cholesterol Carotinaemia
95
TCAs - anticholinergic side-effects w/ what difference:
Weight GAIN rather than anorexia
96
Personality disorders broader treatment strategy
Dialectical behavioural therapy

FLASH FINALS (34 decks)

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