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Phase 3A content > Psychiatry > Flashcards

Psychiatry Flashcards

1
Q

What are the symptoms of depression?

A

Sustained low mood
Anhedonia
Poor concentration and memory
Poor sleep
Worthlessness, hopelessness, guilt
Suicidal ideation
Can have psychotic symptoms

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2
Q

Treatment for mild depression?

A

No medication
Counselling, CBT and self help

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3
Q

Treatment for moderate depression?

A

CBT
Medication (SSRI’s and SNIRI’s)

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4
Q

Treatment for severe depression with psychotic symptoms?

A

Antidepressant plus antipsychotic
ECT

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5
Q

Is 1 episode of mania enough to categorise as bipolar disorder?

A

No, for a diagnosis of bipolar it is 2 or more episodes of mania/hypomania

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6
Q

What is bipolar disorder type 1?

A

Patients experience mania and depression

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7
Q

What is bipolar type 2?

A

Patients experience hypomania and depression

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8
Q

What is hypomania?

A

An episode lasting longer than 4 days, less severe symptoms than mania. No psychotic symptoms

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9
Q

What is mania?

A

An episode lasting longer than 1 week. Can include psychotic symptoms

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10
Q

Which medications are used in the long term management of bipolar?

A

Lithium, valproate and carbamazepine.
Olanzapine, quetiapine, aripiprazole

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11
Q

What may you see that has changed in the thoughts of someone with bipolar disorder?

A

Inflated view of own importance
Grandiose
Chance relationships
Verbal associations
Clang association

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12
Q

What is different in the speech of those with bipolar?

A

Pressure of speech
Increase rate
Difficult to interrupt

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13
Q

What tests must be carried out on patients taking lithium?

A

Renal function as excreted by the kidney
TFT’s as can cause hypothyroidism

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14
Q

Name 3 side effects of lithium.

A

Leucocytosis (elevated WBC)
Diabetes insipidus
Tremors

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15
Q

How long does a section 2 of the MHA last?

A

28days

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16
Q

What is the purpose of a section 2?

A

For assessment of a mental disorder

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17
Q

How long is a section 3 of the MHA?

A

6 months (can be renewed)

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18
Q

What is the purpose of a section 3?

A

For treatment in the presence of a mental disorder

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19
Q

How many doctors and how many advanced medical practioners are required for a section 2 and 3 to be instigated?

A

2 doctors and 1 advanced mental health practioner

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20
Q

How long is section 4?

A

72 hours

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21
Q

What is the purpose of section 4 of the MHA?

A

For emergency when a patient needs to be detained but a second doctor is not able to be present

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22
Q

What is a section 5.2?

A

A doctors holding power, to wait for evaluation for a S2 and S3

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23
Q

What is a section 5.4?

A

A nurses holding power, to wait for medical assessment

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24
Q

How long is a section 5.2?

A

72 hours

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25
Q

How long is a section 5.4?

A

6 hours

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26
Q

What is a section 135 used for?

A

Police section
Go into a patients home and remove them to a place of safety

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27
Q

What is a section 136 used for?

A

Police section
Person suspected to have a mental disorder in a public place

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28
Q

Which questionnaire is used to assist the diagnosis of depression?

A

PHQ-9

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29
Q

What is the definition of dysthymic disorder?

A

Subthreshold depressive symptoms lasting between 2-5 years

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30
Q

What are the 4 classic symptoms of PTSD?

A

HEAR
Hyperarousal
Emotional numbing
Avoidance
Reliving the situation

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31
Q

What are the diagnostic criteria for PTSD?

A

Traumatic event
Symptoms 1-6 months after the event
Lasts more than 4 weeks

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32
Q

What is the first line treatment for PTSD?

A

EMDR or trauma focused CBT

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33
Q

Which disorder presents within a month of a traumatic event?

A

Acute stress disorder

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34
Q

Which medications are most effective in treating PTSD?

A

Venlafaxine and sertraline
+/- zopiclone for sleep

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35
Q

What is OCD?

A

Chronic anxiety with obsessions and/or compulsions

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36
Q

What is an obsession?

A

Pts own idea/ impulse repetative and intrusive

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37
Q

What is a compulsion?

A

Patient recognises that the behaviour is a problem but is unable to stop doing it

38
Q

What is the treatment for OCD?

A

Psychological therapy with ERP (exposure and response therapy)
SSRI first line pharmacological treatment.

39
Q

What are positive symptoms of schizophrenia?

A

Things that might start happening

40
Q

Name 5 positive symptoms of schizophrenia.

A

Delusions
Hallucinations
Formal thought disorder
Thought interference
Passivity

41
Q

What are negative symptoms of schizophrenia?

A

Things that might stop happening

42
Q

Name 5 negative symptoms of schizophrenia.

A

Anhedonia
Affect blunting
Asocial
Alogia (poverty of speech)
Attention deficit

43
Q

Name 4 1st rank symptoms of schizophrenia.

A

Auditory hallucinations
Thought disorder (thought broadcasting)
Passivity phenomena (bodily sensations being controlled by external influence
Delusional perceptions

44
Q

What is believed to be the cause of Alzheimer’s disease?

A

Senile plaques, neurofibrillary tangles and neuronal loss

45
Q

What is believed to be the cause of vascular dementia?

A

Micro infarcts in cerebral blood vessels, due to HTN

46
Q

What is lewy body dementia?

A

Abnormal deposits of alpha synuclein

47
Q

Name 5 risk factors for developing dementia?

A

Age
FHx
Down’s syndrome
Cerebral vascular disease
Hyperlipidaemia
Lifestyle
Poor education

48
Q

What type of memory is lost first in dementia?

A

Recent memory is lost first

49
Q

What is nominal dysphasia?

A

Inability to recall the names of people or objects

50
Q

How does the progression of Alzheimer’s and vascular dementia differ?

A

Alzheimer’s is gradual, whereas vascular shows a stepwise progression.

51
Q

What is the mneumonic to remember the causes of delirium?

A

PINCH ME

52
Q

What does the mneumonic PINCH ME stand for?

A

Pain
Infection
Nutrition
Constipation
Hydration
Medication
Environment

53
Q

What is the class of drugs used to slow the progression of dementia called?

A

Acetylcholinesterase inhibitors

54
Q

Name 3 acetylcholinesterase inhibitors?

A

Donepezil
Galantamine
Rivastigmine

55
Q

What is the definition of delirium?

A

An acute, fluctuating change in mental state

56
Q

What tests are used in the confusion screen?

A

Bloods
Urinalysis
Imaging (CT head and CXR)

57
Q

What cognitive screening tools are used in dementia?

A

MMSE
ACEII
MoCA

58
Q

What are the characteristic signs of Lewy body dementia?

A

Hallucinations
Parkinsonian symptoms (stiffness, tremors and slow movements)
Along with other dementia symptoms such as memory problems etc.

59
Q

What age does frontotemporal dementia typically present?

A

45-65

60
Q

What are the characteristic symptoms seen in frontotemporal dementia?

A

Personality and behaviour changes
Language problems (slow speech, struggle with pronounciation)
Memory changes come later on

61
Q

What is mild cognitive impairment?

A

Cognitive changes that are serious enough to be noticed by family members but do not affect the individuals ability to carry out everyday activities.

62
Q

What are the types of side effects associated with typical antipsychotics?

A

Extrapyramidal SE’s

63
Q

What are extrapyramidal symptoms, give 5 examples?

A

Dystonia (continuous spasms/muscle contractions)
Akathisia (restlessness)
Parkinsonism’s (rigidity)
Bradykinesia (slowing of movement)
Tardive dyskinesia (irregular jerky movements)

64
Q

What is the mechanism of action of antipsychotics?

A

Type 2 dopamine receptor antagonists

65
Q

Name 2 typical antipsychotics.

A

Haloperidol and fluphenazine

66
Q

Which symptoms are antipsychotics used to treat?

A

Positive symptoms such as hallucinations and dellusions.

67
Q

What is neuroleptic malignant syndrome?

A

A severe consequence of taking antipsychotic medications. Causing fever, altered mental state, rigidity and autonomic dysfunction.

68
Q

Name 4 atypical antipsychotics.

A

Quetiapine
Olanzapine
Risperidone
Aripiprazole
Clozapine

69
Q

What are the clinical indications for atypical antipsychotics?

A

Schizophrenia (both positive and negative symptoms)
Adjunctive therapy in depression
OCD

70
Q

What must be closely monitored for in patients taking clozapine?

A

Agranulocytosis
Lowers seizure threshold
Constipation

71
Q

What is the definition of a personality disorder?

A

An enduring pattern of inner experience and behaviour that deviated markedly from the expectations of the individuals culture.

72
Q

What do patients present like with a cluster A personality disorder?

A

Odd or eccentric

73
Q

What is a cluster B personality disorder?

A

Patients tend to appear dramatic, emotional or erratic

74
Q

What is a cluster C personality disorder?

A

Patients tend to appear anxious or fearful

75
Q

What are the characteristic features of EUPD?

A

Impulsive, poor response to criticism
Self image and chronic feelings of emptiness
Intense and unstable relationships
Self harm
Suicide attempts profound

76
Q

What is histrionic PD?

A

Self dramatization,
Shallow affect
egocentricity
Craving attention
Maniuplative behaviour

77
Q

What is avoidant PD?

A

Tension
Self-consciousness
Fear of negative evaluation by others
Timid
Social inhibition
Insecure

78
Q

What is dependant PD?

A

Reassurance required
Expressing disagreement is difficult
Lack of self confidence
Abandonment fears

79
Q

What is the management of personality disorders?

A

DBT
Crisis team

80
Q

What is the recommended alcohol limit per week?

A

14 units

81
Q

What are the symptoms of alcohol withdrawal?

A

Malaise, tremor, nausea, insomnia, transient hallucinations, autonomic hypersensitivity.

82
Q

How long does it take for alcohol withdrawal symptoms to show?

A

6-12 hours after last drink

83
Q

What are some of the more severe side effects of alcohol withdrawal?

A

Seizures
Delirium tremens

84
Q

What is Wernicke’s encephalopathy?

A

Thiamine deficiency
Caused by alcohol misuse

85
Q

What is the presentation of patients with wernickes?

A

Ataxia
Delirium
Hypothermia
Nystagmus

86
Q

What is the treatment for wernicke’s?

A

IV Pabrinex (thiamine

87
Q

What is Korsakoff’s syndrome?

A

Inability to lay down new memories
Amnesia
Disorientation to time

88
Q

What is the SADQ questionnaire?

A

Severity of alcohol dependence questionnaire

89
Q

What is Chlordiazepoxide used for?

A

A medication used to treat the symptoms of anxiety and agitation caused by alcohol withdrawal.

90
Q

Which medications can be given to help maintain alcohol remission and reduce relapse?

A

Acamprosate, naltrexone or disulfiram

91
Q

What can affect blood clozapine levels?

A

Smoking lower blood clozapine levels. Therefore smoking cesation will cause them to rise

92
Q

What is the name of the delusional disorder where people feel they are dead, and which psychiatric condition is this most commonly associated with?

A

Cotard syndrome and major depressive disorder

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