psychiatry Flashcards
What is passivity phenomena
The fear of losing control/someone taking control
What are olfactory hallucinations
smelling something that isn’t there
What is the difference between illusions and hallucinations
illusions have the presence of a stimulus, hallucinations are not attached to any stimulus
What is the difference between a sensory distortion and a sensory deception
distortion is changes in intensity, quality, spatial form
deception is an illusion or hallucination
What does anergia mean
loss of energy
what does anhedonia mean
loss of pleasure
3 core symptoms of depression
low mood
anhedonia
anergia
what is the criteria for mild depression
core symptoms + 2-3 others
what is the criteria for moderate depression
core symptoms, >4 other symptoms, functioning affected
what is the criteria for severe depression without psychotic symptoms
several depressive symptoms, suicidal and a marked loss of functioning
what is the presentation of depression with psychotic symptoms
typically mood congruent (nihilistic, guilty delusions and derogatory voices)
what is bipolar affective disorder
depression + mania/hypomania
what is bipolar I
depression and mania (mainly/sometimes only mania)
what is bipolar II
depression and mild hypomania (more episodes of depression)
what is rapid cycling bipolar
episodes only last few hours or days
what is hypomania and how long does it usually last for
<4 days
- elevated mood
- increased energy
- poor concentration
- mild reckless behaviour
- increased libido
- decreased need for sleep
- overfamiliarity
what are the symptoms of mania and how long does it usually last for
> a week
- uncontrollable extreme elevation
- over activity
- pressure of speech
- impaired judgement
- social disinhibition
- extreme risk taking
- self-esteem grandiosity
- psychotic symptoms
what are the first rank symptoms of schizophrenia
thought alienation
passivity phenomena
3rd person auditory hallucinations
delusional perception
secondary symptoms of schizophrenia
delusions
2nd person auditory hallucinations
hallucinations in any other modality
thought disorders
catatonic behaviour
negative symptoms
what are positive psychotic symptoms
hallucinations
delusions
passivity phenomena
thought alienation
lack of insight
disturbance in mood
what are negative psychotic symptoms
blunting of affect
amotivation
poverty of speech
poverty of thought
poor non-verbal communication
clear deteriorating in functioning
self neglect
lack of insight
what are the symptoms of generalised anxiety
excessive anxiety across different situations
> 6 months
tiredness
poor concentration
irritability
muscle tension
disturbed sleep - usually initial insomnia
what are the physical symptoms of panic disorder
palpitations
chest pain
choking
tachypnoea
dry mouth
urgency of micturition
dizziness
blurred visions
parasthesia
what are the psychological symptoms of panic disorder
feeling of impending doom
fear of dying
fear of losing control
depersonalisation
derealisation
what are the 2 core symptoms of OCD
obsessive thoughts/images
compulsions
what are the 3 types of illusions
complete
affect
pareidolia
what is pareidolia
ability to perceive a specific, often meaningful image in a. random or ambiguous pattern
what are elementary visual hallucinations
flashes of light
what are fully organised hallucinations
visions of people/animals
what are functional hallucinations
where an auditory stimulus causes a hallucination
what is a reflex hallucination
stimulus in one sensory modality produces a sensory experience in another
what is an extracampine hallucination
hallucination outside limits of the sensory field, feeling of a silent neutral presence being near
what are hypnagogic and hypnopompic hallucinations
gogic = hallcucination when falling asleep
pompic = hallucination when waking up
what are the 4 different types of thought disorders
disorder of stream of thoughts
disorder of possession of thoughts
disorder of content of thoughts
disorder of form of thoughts
what occurs in disorders of stream of thought
disorders of tempo - flight of ideas, inhibition or slowness of thinking, circumstantiality
disorders of continuity of thought - perseveration, thought blocking
what are the 3 sub-groups of thought alienation
thought insertion
thought withdrawal
thought broadcasting
what does grandiosity mean
an exaggerated sense of ones importance, power, knowledge
what is dissociative amnesia
sudden amnesia that occurs during periods of extreme trauma and can last for hours or even days
what is confabulation
falsification of memory occurring in clear consciousness in association with organic pathology
what is blunting of affect
an objective absence of normal emotional responses
what is section 2 of the mental health act
28 days assessment
treatment can be given without consent
need 2 doctors (S12 approved and 1 AMHP)
patient must be suffering from mental disorder needing medical treatment, treatment available, in health and safety best interests
what is section 3 of the mental health act
6 months treatment
need 2 doctors, 1 AMHP
suffering from mental disorder, treatment in health and safety interests, appropriate treatment must be available
what is section 4 of the mental health act
72 hour emergency order
when waiting for second doctor would lead to undesirable delay
1 doctor, 1 AMHP
what is section 5(4) of the mental health act
patient already admitted and wanting to leave
nurses holding power for 6 hours until doctor can attend
cannot be treated
what is section 5(2) of the mental health act
patient already admitted and wanting to leave
72 hour doctor holding power allowing time for section 2or 3 assessment
cannot be treated
what is section 135 of the mental health act
police section
needs court order to access patients home and remove to place of safety or for further assessments
what is section 136 of the mental health act
police section
person suspected of having a mental disorder in a public place
treatment given for bipolar disorder
lithium
anticonvulsants - lamotrigine, carbamazepine, sodium valproate
antipsychotic used in acute mania
side effects of lithium
leukocytosis
insipidus
fine tremor
hypothyroidism
increased urine
teratogenic
side effects of lithium toxicity
blurred vision
coarse tremor
muscle weakness
ataxia
nausea and vomiting
hyperreflexia
circulatory failure
oliguria
seizures
coma
name some first generation (typical) antipsychotics
chlorpromazine
haloperidol
prochlorperazine
sulpride
side effects mostly associated with typical antipsychotics
extrapyramidal symptoms
hyperprolactinaemia
name some second generation (atypical) antipsychotics
amisulpride
aripiprazole
clozapine
olanzapine
paliperidone
quetiapine
risperidone
what side effects are associated with atypical antipsychotics
weight gain
glucose intolerance
hyperprolactinaemia
risk factors of suicide
alcohol/substance misuse
bipolar/personality disorder
previous suicide attempts
physical/sexual abuse
possession of firearms
incarcerartion
chronic pain
what are the withdrawal symptoms of alcohol after 6 hours
tremor, nausea, vomiting, anxiety, insomnia, raised pulse, BP and temp
what are the withdrawal symptoms of alcohol 7-48 hours after
seizures, risk of status epilepticus
what are the withdrawal symptoms of alcohol 48-72 hours after
delirium tremens, tremor, hallucinations, delusions, confusion, agitation
what drugs are given for OCD
SSRIs
clomipramine
what is Fregoli’s illusion
belief that some person currently present in the environment is a familiar person in disguise
what is capgas syndrome
belief that an imposter has replaced a family member/loved one
what is erotomania/de clerambault syndrome
delusion in which a person believes another person usually of higher social status is in love with them
what drugs are given for management of PTSD
venlafaxine or SSRI (sertraline or paroxetine)
physical signs of anorexia nervosa
dry skin
hypercarotenemia
lanugo body hair
acrocyanosis
breast atrophy
swelling of the parotid and submandibular glands
thinning of hair
what bloods go up in anorexia
cortisol
beta-carotene
GH
cholesterol
what would an ECG show in severe anorexia
prolonged QT, T wave changes, bradycardia
symptoms of serotonin syndrome
headaches, agitation, hallucinations, coma, sweating, shivering, tachycardia, hypertension, nausea, myoclonus, hyperreflexia, tremor
what is the treatment of serotonin syndrome
remove causative agent, supportive care, can give cyprohepatide
symptoms of neuroleptic malignant syndrome
fluctuating consciousness, stupor, hypereflexia, unstable, BP, bradycardia, sweating, salivation, incontinence, muscular rigidity, dysphasia, dyspnoea
complications of neuroleptic malignant syndrome
pneumonia, cardiovascular, collapse, thromboembolism, renal failure
management of neuroleptic malignant syndrome
diazepam, dantrolene, bromocriptine
how do you treat an oculogyric crisis
procyclidine
symptoms of a tricyclic antidepressant overdose
hypotension
drowsiness
seizures
what is cotards syndrome
delusion that denies self existence, believe they are dead
what is Charles bonnet syndrome
patients with significant vision loss have vivid, recurrent visual hallucinations
SSRI given to children/adolescents
fluoxetine
what are the 3 types of personality disorders in cluster A
schizoid
schizotypal
paranoid
how would someone with paranoid personality disorder present
'’mad-eye moody’’
distrusting, suspicious of others
exploiting/infidelity?
reluctant to confide in people
how would someone with schizoid disorder present
'’batman’’
emotional coldness
prefers solitary activities
not wanting/enjoying close relationships
limited pleasure
how would someone with schizotypal disorder present
'’willy Wonka’’
eccentric
socially withdrawn
limited capacity for close relationships
distortions in perception and thinking
what are the 4 disorders in cluster B
emotionally unstable/borderline
dissocial
histrionic
narcissistic
how would someone with dis social disorder present
'’joker’’
disregard and violation of the rights of others
unlawful behaviour
deceitful, lies repeatedly
irritable and aggressive
lacks remorse
how would someone with histrionic disorder present
'’harley quinn’’
excessive emotionality and attention seeking
seductive behaviour
emotions rapidly shifting and shallow
how would someone with narcissistic disorder present
'’gilderoy lockhart’’
grandiosity
need for admiration
lack of empathy
what are the 3 disorders in cluster c
dependent
avoidant
anankastic/OCD
how would someone with dependant disorder present
'’Snow White’’
excessive need to be taken care of - submissive
clinging behaviour, fear of separation
how would someone with avoidant disorder present
'’Charlie Brown’’
social inhibition
fear of inadequacy
hypersensitivity to negative evaluation
how would someone with anakastic/OCPD present
'’Monica geller’’
orderliness with details, rules and lists
perfectionism to the extent where they are unable to complete the project
rigid/stubborn
believe everyone should follow the same rules
how would someone with anakastic/OCD present
'’Monica geller’’
orderliness with details, rules and lists
perfectionism to the extent where they are unable to complete the project
rigid/stubborn
believe everyone should follow the same rules
what is clang association
using words that rhyme with each other/sound similar
what is echolalia
repetition of someones speech
what is given to treat acute mania
quetiapine
benzos
lithium
Classic quadrad symptoms of PTSD
HEAR
hyperarousal
emotional numbing
avoidance
reliving the situation
what is Othello syndrome
delusional jealousy - usually believing a partner is being unfaithful
what is given to treat tardive dyskinesia
tetrabenazine
what is punding
fascination with apparent mechanical tasks
what is mitmachen
in schizophrenia patients limb can be moved without resistance but will return back to original position once released
strongest risk factor for developing a psychotic disorder
family history
antidepressant of choice in bipolar
fluoextine
blood tests for cognitive decline + any further tests
FBC
ESR/CRP
U+Es
calcium
HbA1c
liver function
thyroid function
B12 and folate
urine culture, chest xray, ECG, HIV/syphilis screen
what is used to treat tardive dyskinesia
tetrabenazine
what should be monitored in venlafaxine
blood pressure
what test should be done when taking citalopram and why
ECG
QT prolongation association
ECG changes seen in referring syndrome
U waves
what electrolyte imbalance can you get in panic disorder
hypocalcaemia
what do typical antipsychotics act on
D2 receptors
what do atypical antipsychotics act on
D2,3,4
5HT2
what does acamprosate do
reduces craving by enhancing GABA transmission
when can chlomethiazole not be used for alcohol withdrawal
if a patient continues to drink
how does disulfiram work
build up of acetaldehyde on consumption of alcohol causing unpleasant symptoms like flushing headache and anxiet
how does naltrexone work
opined antagonist to reduce pleasurable effect of alcohol
how does carbamazepine interact with methylphenidate
decreases levels of methylphenidate
how does isocarboxazid interact with methyphenidate
increases risk of a hypertensive crisis
what can happen in the interaction between risperidone and methylphenidate
dyskinesia
