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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
what are the 2 core symptoms of OCD
obsessive thoughts/images compulsions
26
what are the 3 types of illusions
complete affect pareidolia
27
what is pareidolia
ability to perceive a specific, often meaningful image in a. random or ambiguous pattern
28
what are elementary visual hallucinations
flashes of light
29
what are fully organised hallucinations
visions of people/animals
30
what are functional hallucinations
where an auditory stimulus causes a hallucination
31
what is a reflex hallucination
stimulus in one sensory modality produces a sensory experience in another
32
what is an extracampine hallucination
hallucination outside limits of the sensory field, feeling of a silent neutral presence being near
33
what are hypnagogic and hypnopompic hallucinations
gogic = hallcucination when falling asleep pompic = hallucination when waking up
34
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
35
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
36
what are the 3 sub-groups of thought alienation
thought insertion thought withdrawal thought broadcasting
37
what does grandiosity mean
an exaggerated sense of ones importance, power, knowledge
38
what is dissociative amnesia
sudden amnesia that occurs during periods of extreme trauma and can last for hours or even days
39
what is confabulation
falsification of memory occurring in clear consciousness in association with organic pathology
40
what is blunting of affect
an objective absence of normal emotional responses
41
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
42
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
43
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
44
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
45
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
46
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
47
what is section 136 of the mental health act
police section person suspected of having a mental disorder in a public place
48
treatment given for bipolar disorder
lithium anticonvulsants - lamotrigine, carbamazepine, sodium valproate antipsychotic used in acute mania
49
side effects of lithium
leukocytosis insipidus fine tremor hypothyroidism increased urine teratogenic
50
side effects of lithium toxicity
blurred vision coarse tremor muscle weakness ataxia nausea and vomiting hyperreflexia circulatory failure oliguria seizures coma
51
name some first generation (typical) antipsychotics
chlorpromazine haloperidol prochlorperazine sulpride
52
side effects mostly associated with typical antipsychotics
extrapyramidal symptoms hyperprolactinaemia
53
name some second generation (atypical) antipsychotics
amisulpride aripiprazole clozapine olanzapine paliperidone quetiapine risperidone
54
what side effects are associated with atypical antipsychotics
weight gain glucose intolerance hyperprolactinaemia
55
risk factors of suicide
alcohol/substance misuse bipolar/personality disorder previous suicide attempts physical/sexual abuse possession of firearms incarcerartion chronic pain
56
what are the withdrawal symptoms of alcohol after 6 hours
tremor, nausea, vomiting, anxiety, insomnia, raised pulse, BP and temp
57
what are the withdrawal symptoms of alcohol 7-48 hours after
seizures, risk of status epilepticus
58
what are the withdrawal symptoms of alcohol 48-72 hours after
delirium tremens, tremor, hallucinations, delusions, confusion, agitation
59
what drugs are given for OCD
SSRIs clomipramine
60
what is Fregoli's illusion
belief that some person currently present in the environment is a familiar person in disguise
61
what is capgas syndrome
belief that an imposter has replaced a family member/loved one
62
what is erotomania/de clerambault syndrome
delusion in which a person believes another person usually of higher social status is in love with them
63
what drugs are given for management of PTSD
venlafaxine or SSRI (sertraline or paroxetine)
64
physical signs of anorexia nervosa
dry skin hypercarotenemia lanugo body hair acrocyanosis breast atrophy swelling of the parotid and submandibular glands thinning of hair
65
what bloods go up in anorexia
cortisol beta-carotene GH cholesterol
66
what would an ECG show in severe anorexia
prolonged QT, T wave changes, bradycardia
67
symptoms of serotonin syndrome
headaches, agitation, hallucinations, coma, sweating, shivering, tachycardia, hypertension, nausea, myoclonus, hyperreflexia, tremor
68
what is the treatment of serotonin syndrome
remove causative agent, supportive care, can give cyprohepatide
69
symptoms of neuroleptic malignant syndrome
fluctuating consciousness, stupor, hypereflexia, unstable, BP, bradycardia, sweating, salivation, incontinence, muscular rigidity, dysphasia, dyspnoea
70
complications of neuroleptic malignant syndrome
pneumonia, cardiovascular, collapse, thromboembolism, renal failure
71
management of neuroleptic malignant syndrome
diazepam, dantrolene, bromocriptine
72
how do you treat an oculogyric crisis
procyclidine
73
symptoms of a tricyclic antidepressant overdose
hypotension drowsiness seizures
74
what is cotards syndrome
delusion that denies self existence, believe they are dead
75
what is Charles bonnet syndrome
patients with significant vision loss have vivid, recurrent visual hallucinations
76
SSRI given to children/adolescents
fluoxetine
77
what are the 3 types of personality disorders in cluster A
schizoid schizotypal paranoid
78
how would someone with paranoid personality disorder present
''mad-eye moody'' distrusting, suspicious of others exploiting/infidelity? reluctant to confide in people
79
how would someone with schizoid disorder present
''batman'' emotional coldness prefers solitary activities not wanting/enjoying close relationships limited pleasure
80
how would someone with schizotypal disorder present
''willy Wonka'' eccentric socially withdrawn limited capacity for close relationships distortions in perception and thinking
81
what are the 4 disorders in cluster B
emotionally unstable/borderline dissocial histrionic narcissistic
82
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
83
how would someone with histrionic disorder present
''harley quinn'' excessive emotionality and attention seeking seductive behaviour emotions rapidly shifting and shallow
84
how would someone with narcissistic disorder present
''gilderoy lockhart'' grandiosity need for admiration lack of empathy
85
what are the 3 disorders in cluster c
dependent avoidant anankastic/OCD
86
how would someone with dependant disorder present
''Snow White'' excessive need to be taken care of - submissive clinging behaviour, fear of separation
87
how would someone with avoidant disorder present
''Charlie Brown'' social inhibition fear of inadequacy hypersensitivity to negative evaluation
88
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
89
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
90
what is clang association
using words that rhyme with each other/sound similar
91
what is echolalia
repetition of someones speech
92
what is given to treat acute mania
quetiapine benzos lithium
93
Classic quadrad symptoms of PTSD
HEAR hyperarousal emotional numbing avoidance reliving the situation
94
what is Othello syndrome
delusional jealousy - usually believing a partner is being unfaithful
95
what is given to treat tardive dyskinesia
tetrabenazine
96
what is punding
fascination with apparent mechanical tasks
97
what is mitmachen
in schizophrenia patients limb can be moved without resistance but will return back to original position once released
98
strongest risk factor for developing a psychotic disorder
family history
99
antidepressant of choice in bipolar
fluoextine
100
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
101
what is used to treat tardive dyskinesia
tetrabenazine
102
what should be monitored in venlafaxine
blood pressure
103
what test should be done when taking citalopram and why
ECG QT prolongation association
104
ECG changes seen in referring syndrome
U waves
105
what electrolyte imbalance can you get in panic disorder
hypocalcaemia
106
what do typical antipsychotics act on
D2 receptors
107
what do atypical antipsychotics act on
D2,3,4 5HT2
108
what does acamprosate do
reduces craving by enhancing GABA transmission
109
when can chlomethiazole not be used for alcohol withdrawal
if a patient continues to drink
110
how does disulfiram work
build up of acetaldehyde on consumption of alcohol causing unpleasant symptoms like flushing headache and anxiet
111
how does naltrexone work
opined antagonist to reduce pleasurable effect of alcohol
112
how does carbamazepine interact with methylphenidate
decreases levels of methylphenidate
113
how does isocarboxazid interact with methyphenidate
increases risk of a hypertensive crisis
114
what can happen in the interaction between risperidone and methylphenidate
dyskinesia

Phase 3a (7 decks)

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