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Phase 3a > psychiatry > Flashcards

psychiatry Flashcards

1
Q

What is passivity phenomena

A

The fear of losing control/someone taking control

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2
Q

What are olfactory hallucinations

A

smelling something that isn’t there

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3
Q

What is the difference between illusions and hallucinations

A

illusions have the presence of a stimulus, hallucinations are not attached to any stimulus

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4
Q

What is the difference between a sensory distortion and a sensory deception

A

distortion is changes in intensity, quality, spatial form
deception is an illusion or hallucination

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5
Q

What does anergia mean

A

loss of energy

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6
Q

what does anhedonia mean

A

loss of pleasure

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7
Q

3 core symptoms of depression

A

low mood
anhedonia
anergia

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8
Q

what is the criteria for mild depression

A

core symptoms + 2-3 others

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9
Q

what is the criteria for moderate depression

A

core symptoms, >4 other symptoms, functioning affected

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10
Q

what is the criteria for severe depression without psychotic symptoms

A

several depressive symptoms, suicidal and a marked loss of functioning

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11
Q

what is the presentation of depression with psychotic symptoms

A

typically mood congruent (nihilistic, guilty delusions and derogatory voices)

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12
Q

what is bipolar affective disorder

A

depression + mania/hypomania

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13
Q

what is bipolar I

A

depression and mania (mainly/sometimes only mania)

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14
Q

what is bipolar II

A

depression and mild hypomania (more episodes of depression)

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15
Q

what is rapid cycling bipolar

A

episodes only last few hours or days

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16
Q

what is hypomania and how long does it usually last for

A

<4 days
- elevated mood
- increased energy
- poor concentration
- mild reckless behaviour
- increased libido
- decreased need for sleep
- overfamiliarity

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17
Q

what are the symptoms of mania and how long does it usually last for

A

> a week
- uncontrollable extreme elevation
- over activity
- pressure of speech
- impaired judgement
- social disinhibition
- extreme risk taking
- self-esteem grandiosity
- psychotic symptoms

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18
Q

what are the first rank symptoms of schizophrenia

A

thought alienation
passivity phenomena
3rd person auditory hallucinations
delusional perception

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19
Q

secondary symptoms of schizophrenia

A

delusions
2nd person auditory hallucinations
hallucinations in any other modality
thought disorders
catatonic behaviour
negative symptoms

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20
Q

what are positive psychotic symptoms

A

hallucinations
delusions
passivity phenomena
thought alienation
lack of insight
disturbance in mood

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21
Q

what are negative psychotic symptoms

A

blunting of affect
amotivation
poverty of speech
poverty of thought
poor non-verbal communication
clear deteriorating in functioning
self neglect
lack of insight

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22
Q

what are the symptoms of generalised anxiety

A

excessive anxiety across different situations
> 6 months
tiredness
poor concentration
irritability
muscle tension
disturbed sleep - usually initial insomnia

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23
Q

what are the physical symptoms of panic disorder

A

palpitations
chest pain
choking
tachypnoea
dry mouth
urgency of micturition
dizziness
blurred visions
parasthesia

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24
Q

what are the psychological symptoms of panic disorder

A

feeling of impending doom
fear of dying
fear of losing control
depersonalisation
derealisation

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25
Q

what are the 2 core symptoms of OCD

A

obsessive thoughts/images
compulsions

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26
Q

what are the 3 types of illusions

A

complete
affect
pareidolia

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27
Q

what is pareidolia

A

ability to perceive a specific, often meaningful image in a. random or ambiguous pattern

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28
Q

what are elementary visual hallucinations

A

flashes of light

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29
Q

what are fully organised hallucinations

A

visions of people/animals

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30
Q

what are functional hallucinations

A

where an auditory stimulus causes a hallucination

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31
Q

what is a reflex hallucination

A

stimulus in one sensory modality produces a sensory experience in another

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32
Q

what is an extracampine hallucination

A

hallucination outside limits of the sensory field, feeling of a silent neutral presence being near

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33
Q

what are hypnagogic and hypnopompic hallucinations

A

gogic = hallcucination when falling asleep
pompic = hallucination when waking up

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34
Q

what are the 4 different types of thought disorders

A

disorder of stream of thoughts
disorder of possession of thoughts
disorder of content of thoughts
disorder of form of thoughts

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35
Q

what occurs in disorders of stream of thought

A

disorders of tempo - flight of ideas, inhibition or slowness of thinking, circumstantiality
disorders of continuity of thought - perseveration, thought blocking

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36
Q

what are the 3 sub-groups of thought alienation

A

thought insertion
thought withdrawal
thought broadcasting

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37
Q

what does grandiosity mean

A

an exaggerated sense of ones importance, power, knowledge

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38
Q

what is dissociative amnesia

A

sudden amnesia that occurs during periods of extreme trauma and can last for hours or even days

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39
Q

what is confabulation

A

falsification of memory occurring in clear consciousness in association with organic pathology

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40
Q

what is blunting of affect

A

an objective absence of normal emotional responses

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41
Q

what is section 2 of the mental health act

A

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

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42
Q

what is section 3 of the mental health act

A

6 months treatment
need 2 doctors, 1 AMHP
suffering from mental disorder, treatment in health and safety interests, appropriate treatment must be available

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43
Q

what is section 4 of the mental health act

A

72 hour emergency order
when waiting for second doctor would lead to undesirable delay
1 doctor, 1 AMHP

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44
Q

what is section 5(4) of the mental health act

A

patient already admitted and wanting to leave
nurses holding power for 6 hours until doctor can attend
cannot be treated

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45
Q

what is section 5(2) of the mental health act

A

patient already admitted and wanting to leave
72 hour doctor holding power allowing time for section 2or 3 assessment
cannot be treated

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46
Q

what is section 135 of the mental health act

A

police section
needs court order to access patients home and remove to place of safety or for further assessments

47
Q

what is section 136 of the mental health act

A

police section
person suspected of having a mental disorder in a public place

48
Q

treatment given for bipolar disorder

A

lithium
anticonvulsants - lamotrigine, carbamazepine, sodium valproate
antipsychotic used in acute mania

49
Q

side effects of lithium

A

leukocytosis
insipidus
fine tremor
hypothyroidism
increased urine
teratogenic

50
Q

side effects of lithium toxicity

A

blurred vision
coarse tremor
muscle weakness
ataxia
nausea and vomiting
hyperreflexia
circulatory failure
oliguria
seizures
coma

51
Q

name some first generation (typical) antipsychotics

A

chlorpromazine
haloperidol
prochlorperazine
sulpride

52
Q

side effects mostly associated with typical antipsychotics

A

extrapyramidal symptoms
hyperprolactinaemia

53
Q

name some second generation (atypical) antipsychotics

A

amisulpride
aripiprazole
clozapine
olanzapine
paliperidone
quetiapine
risperidone

54
Q

what side effects are associated with atypical antipsychotics

A

weight gain
glucose intolerance
hyperprolactinaemia

55
Q

risk factors of suicide

A

alcohol/substance misuse
bipolar/personality disorder
previous suicide attempts
physical/sexual abuse
possession of firearms
incarcerartion
chronic pain

56
Q

what are the withdrawal symptoms of alcohol after 6 hours

A

tremor, nausea, vomiting, anxiety, insomnia, raised pulse, BP and temp

57
Q

what are the withdrawal symptoms of alcohol 7-48 hours after

A

seizures, risk of status epilepticus

58
Q

what are the withdrawal symptoms of alcohol 48-72 hours after

A

delirium tremens, tremor, hallucinations, delusions, confusion, agitation

59
Q

what drugs are given for OCD

A

SSRIs
clomipramine

60
Q

what is Fregoli’s illusion

A

belief that some person currently present in the environment is a familiar person in disguise

61
Q

what is capgas syndrome

A

belief that an imposter has replaced a family member/loved one

62
Q

what is erotomania/de clerambault syndrome

A

delusion in which a person believes another person usually of higher social status is in love with them

63
Q

what drugs are given for management of PTSD

A

venlafaxine or SSRI (sertraline or paroxetine)

64
Q

physical signs of anorexia nervosa

A

dry skin
hypercarotenemia
lanugo body hair
acrocyanosis
breast atrophy
swelling of the parotid and submandibular glands
thinning of hair

65
Q

what bloods go up in anorexia

A

cortisol
beta-carotene
GH
cholesterol

66
Q

what would an ECG show in severe anorexia

A

prolonged QT, T wave changes, bradycardia

67
Q

symptoms of serotonin syndrome

A

headaches, agitation, hallucinations, coma, sweating, shivering, tachycardia, hypertension, nausea, myoclonus, hyperreflexia, tremor

68
Q

what is the treatment of serotonin syndrome

A

remove causative agent, supportive care, can give cyprohepatide

69
Q

symptoms of neuroleptic malignant syndrome

A

fluctuating consciousness, stupor, hypereflexia, unstable, BP, bradycardia, sweating, salivation, incontinence, muscular rigidity, dysphasia, dyspnoea

70
Q

complications of neuroleptic malignant syndrome

A

pneumonia, cardiovascular, collapse, thromboembolism, renal failure

71
Q

management of neuroleptic malignant syndrome

A

diazepam, dantrolene, bromocriptine

72
Q

how do you treat an oculogyric crisis

A

procyclidine

73
Q

symptoms of a tricyclic antidepressant overdose

A

hypotension
drowsiness
seizures

74
Q

what is cotards syndrome

A

delusion that denies self existence, believe they are dead

75
Q

what is Charles bonnet syndrome

A

patients with significant vision loss have vivid, recurrent visual hallucinations

76
Q

SSRI given to children/adolescents

A

fluoxetine

77
Q

what are the 3 types of personality disorders in cluster A

A

schizoid
schizotypal
paranoid

78
Q

how would someone with paranoid personality disorder present

A

'’mad-eye moody’’
distrusting, suspicious of others
exploiting/infidelity?
reluctant to confide in people

79
Q

how would someone with schizoid disorder present

A

'’batman’’
emotional coldness
prefers solitary activities
not wanting/enjoying close relationships
limited pleasure

80
Q

how would someone with schizotypal disorder present

A

'’willy Wonka’’
eccentric
socially withdrawn
limited capacity for close relationships
distortions in perception and thinking

81
Q

what are the 4 disorders in cluster B

A

emotionally unstable/borderline
dissocial
histrionic
narcissistic

82
Q

how would someone with dis social disorder present

A

'’joker’’
disregard and violation of the rights of others
unlawful behaviour
deceitful, lies repeatedly
irritable and aggressive
lacks remorse

83
Q

how would someone with histrionic disorder present

A

'’harley quinn’’
excessive emotionality and attention seeking
seductive behaviour
emotions rapidly shifting and shallow

84
Q

how would someone with narcissistic disorder present

A

'’gilderoy lockhart’’
grandiosity
need for admiration
lack of empathy

85
Q

what are the 3 disorders in cluster c

A

dependent
avoidant
anankastic/OCD

86
Q

how would someone with dependant disorder present

A

'’Snow White’’
excessive need to be taken care of - submissive
clinging behaviour, fear of separation

87
Q

how would someone with avoidant disorder present

A

'’Charlie Brown’’
social inhibition
fear of inadequacy
hypersensitivity to negative evaluation

88
Q

how would someone with anakastic/OCPD present

A

'’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

89
Q

how would someone with anakastic/OCD present

A

'’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

90
Q

what is clang association

A

using words that rhyme with each other/sound similar

91
Q

what is echolalia

A

repetition of someones speech

92
Q

what is given to treat acute mania

A

quetiapine
benzos
lithium

93
Q

Classic quadrad symptoms of PTSD

A

HEAR
hyperarousal
emotional numbing
avoidance
reliving the situation

94
Q

what is Othello syndrome

A

delusional jealousy - usually believing a partner is being unfaithful

95
Q

what is given to treat tardive dyskinesia

A

tetrabenazine

96
Q

what is punding

A

fascination with apparent mechanical tasks

97
Q

what is mitmachen

A

in schizophrenia patients limb can be moved without resistance but will return back to original position once released

98
Q

strongest risk factor for developing a psychotic disorder

A

family history

99
Q

antidepressant of choice in bipolar

A

fluoextine

100
Q

blood tests for cognitive decline + any further tests

A

FBC
ESR/CRP
U+Es
calcium
HbA1c
liver function
thyroid function
B12 and folate

urine culture, chest xray, ECG, HIV/syphilis screen

101
Q

what is used to treat tardive dyskinesia

A

tetrabenazine

102
Q

what should be monitored in venlafaxine

A

blood pressure

103
Q

what test should be done when taking citalopram and why

A

ECG
QT prolongation association

104
Q

ECG changes seen in referring syndrome

A

U waves

105
Q

what electrolyte imbalance can you get in panic disorder

A

hypocalcaemia

106
Q

what do typical antipsychotics act on

A

D2 receptors

107
Q

what do atypical antipsychotics act on

A

D2,3,4
5HT2

108
Q

what does acamprosate do

A

reduces craving by enhancing GABA transmission

109
Q

when can chlomethiazole not be used for alcohol withdrawal

A

if a patient continues to drink

110
Q

how does disulfiram work

A

build up of acetaldehyde on consumption of alcohol causing unpleasant symptoms like flushing headache and anxiet

111
Q

how does naltrexone work

A

opined antagonist to reduce pleasurable effect of alcohol

112
Q

how does carbamazepine interact with methylphenidate

A

decreases levels of methylphenidate

113
Q

how does isocarboxazid interact with methyphenidate

A

increases risk of a hypertensive crisis

114
Q

what can happen in the interaction between risperidone and methylphenidate

A

dyskinesia

Phase 3a (7 decks)

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