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Health Care Concepts > Psychiatry > Flashcards

Psychiatry Flashcards

1
Q

What are Signs?

A

Objective findings elicited by clinician.

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2
Q

What are symptoms?

A

Subjective experiences reported by the patient.

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3
Q

What is described as a combination of signs and symptoms?

A

Syndrome

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4
Q

What is the major psychotic disorder?

A

Schizophrenia

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5
Q

What are examples of mood disorders?

A

Depression and Bipolar Disorder

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6
Q

What is Affect?

A

It is an observed expression of emotion

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7
Q

Fill in the blanks. “ In a warm affect , expressed emotion is _____ while in a ______ expressed emotion is reduced.

A

Warm affect - expressed emotion is appropriate
Blunted affect - expressed emotion is reduced.

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8
Q

A normal mood can be described as?

A

Euthymic

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9
Q

An elated mood can be described as ?

A

Mania

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10
Q

What is perception?

A

This is a process by which sensory stimuli brought to awareness.

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11
Q

What are examples of disorders of perception?

A

Hallucination
Illusion

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12
Q

What is the most common form of Hallucination in Schizophrenia?

A

Auditory ( hearing voices)

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13
Q

True or False? A hypnogogic hallucination occurs when one is awakening while a hypnopompic hallucination occurs while sleeping.

A

FALSE!!! Hypnogogic - sleeping
‘ I go to sleep’
Hypnopompic - awake
‘I wake up PrOMPtly ‘

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14
Q

What is an illusion?

A

Misperception of stimulus

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15
Q

What are subdivisions of disorders of thought?

A

Thought form
Thought content- Delusions

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16
Q

What are examples of disorders of thought form?

A

*Neologism- new words
*Word salad: Incoherent mixture of words
*Loosening of association: Ideas shift from one subject to another

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17
Q

What is Delusion?

A

Fixed, False Belief, inappropriate to socio-cultural background.
ex: Rojay lol

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18
Q

A belief that you one has more power, wealth, smarts, or other grand traits than is true is an example of what delusion.

A

Delusion of Grandeur

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19
Q

A belief that a partner is being unfaithful to another is a example of what delusion?

A

Delusion of Jealousy

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20
Q

Fill in the blanks.” ______ is the belief that un-related occurrences in the external world have a special significance for the person who is being diagnosed.”

A

A delusion of reference

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21
Q

True or False? A Somatic delusion, occurs when the individual believes something is wrong with part or all of their body.

A

TRUE!!

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22
Q

What are examples of psychotic disorders?

A

Halllucinations
Delusions
Disorder in Thought form

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23
Q

Fill in the Blanks . In depression , your mood is _____ while in _____ your mood is elevated.”

A

Depression - mood is depressed
Bipolar disorder - mood is elated

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24
Q

In order for one to be diagnosed with major depression , what is the criteria?

A

Patient must present with 5 symptoms in 2 weeks

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25
Q

What are the symptoms of Major Depression?

A

S- Sleep—insomnia or hypersomnia
I- Interest—loss of interest in pleasurable activities (anhedonia)
G- Guilt—feelings of guilt or worthlessness
E- Energy—fatigue or loss of energy
C- Concentration—diminished ability to concentrate or focus
A- Appetite—increase or decrease in appetite or weight
P - Psychomotor retardation or agitation
S- Suicidality or thoughts of self-harm (active or passive)

“sig e caps”

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26
Q

What is Patient depressive disorder( Dysthmia)?

A

Dysthymia can be thought of as a milder form of depression that is more chronic (lasting at least 2 years, or 1 year in children and adolescents).

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27
Q

What are examples of Anxiety Disorders?

A

P- Phobias
P- Panic disorder
P- PTSD
O- OCD
G- Generalised Anxiety Disorder

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28
Q

In OCD ( Obsessive - Compulsive disorders) , What are Obsessions and what are compulsions?

A

Obsessions -recurrent thoughts that cause distress to the patient.

Compulsions- Compulsions are compensatory actions that the patient does to relieve the anxiety caused by the obsessions

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29
Q

What are symptoms experienced by PTSD patients?

A

*Trauma Exposure: (disaster, MVA, rape etc) Witness it, Experience it, Told about it
* Re-experience trauma- (recollections, flashbacks, nightmares, bad dreams)
* Avoidance (thoughts, people, places, things)
* Memory activated
* Arousal increased: (Hypervigilance,emotional outburst, sleep disturbances, exaggerated startle response)

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30
Q

What is the time period to be diagnosed with PTSD?

A

Patients must have symptoms for at least one month .
*If shorter they are diagnosed with Acute Stress Disorder (ASD)

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31
Q

Delirium, Demtentia and Amnestic Disorders are examples of what kind of disorders?

A

Neuroognitive disorders

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32
Q

What is Delirium?

A

This is a disorder which causes changes in consciousness ,changes in cognition ( memory, orientation, language) perceptual disturbance,acute onset, fluctuating course

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33
Q

True or False? Dementia is Irreversible while Delirium is reversible.

A

TRUE!!

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34
Q

What are characteristics of Dementia?

A

M - Memory impairment
A- Aphasia (language disturbance)
A-Apraxia (inability to carry out motor activity despite intact motor function)
A- Agnosia (failure to recognize objects despite intact sensory function)
E- Executive function impaired (SOAP)

” Dementia patients MAAAE have these symptoms’

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35
Q

True or False? They psychiatric history is best performed with multiple informants and must be approached with a high level of sensitivity.

A

TRUE!!

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36
Q

What does demographics of the psychiatric patient include?

A

Patient’s name
Age
Address
Marital status
Religion
Occupation
Circumstances of referral

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37
Q

When listening to the presenting complaint, who is information taken from?

A

The patient and informant

38
Q

What does the History of the Presenting complaint include?

A

*Duration, Frequency, Intensity
*Precipitating and relieving factors
*Review of symptoms of likely diagnoses (as suggested by PC): psychosis, depression, anxiety, etc

39
Q

True or False? When taking the family history of the psychiatric patient, the occupations/achievements of siblings as compared to those of patient.

A

TRUE!!

40
Q

What are different aspects of the Personal History of the psychiatric patient?

A

Antenatal and perinatal history
Developmental history
Childhood illness, separation
School history: academics, social, behavioural
Occupational history: achievement, stability
Trauma history
Forensic history

41
Q

What are different aspects of the Past medical/surgical History of the psychiatric patient?

A

Relationship to current illness
Head trauma /head injury
Seizures
Recent infections/sexual
Endocrine illnesses
Chronic illnesses/ meds for chronic illnesses
Vitamin deficiencies

42
Q

What is the Mental Status Examination?

A

The MSE examines mental and emotional functioning, it is a combination of Observation (Inspection) and Interview.

43
Q

What are factors that can affect the patient’s MSE?

A

*Cultural background
*Educational level
*Religious beliefs
*Type and severity of mental illness, e.g. he/ she may be too psychotic, depressed, angry, drowsy, … to fully participate

44
Q

What are the different components of the MSE?

A

I - Insight ( level at which patient realises smn wrong)
M- Mood ( depressed,elated, angry)
P- Perception(hallucination, illusions)
A- Appearance( grooming,appropriateness)
A- Attitude ( retardation, mannerism, eye contact)
A- Affect (blunted ,labile, sus)
C- Cognition ( orientation, memory, general knowledge)
T- Thought form( tangentiality, loose association)
T- Thought content( delusional, suicidal,obsessions)
S- Speech ( rate, rhythm ,pitch)
Judicious- Judgment

” Impaaactts of the MSE should be judicious”

45
Q

What would be the appearance of a Manic patient versus a psychotic patient?

A

Manic- bright colours, heavy makeup
Psychotic- poor grooming

46
Q

What is Tangentality?

A

One idea leads to another to which there is some connection, but the patient never concludes his/ her original point.

47
Q

What is Circumstantiality?

A

The patient considers many related (but unnecessary) ideas before returning to the main point.

48
Q

What is Loose of association?

A

No connection between words/ sentences/ phrases.

49
Q

What are some Organic causes of Psychiatric symptoms?

A

Thyroid disease- Depression
Auto immune (SLE)- psychosis, mood disorder
VitaminB12 deficiency- Dementia & delirium
STDs- anxiety , anger

50
Q

How long does a patient have to experience specific symptoms in order for them to be diagnosed with Schizophrenia?

A

More than 6 months

51
Q

How long does a patient have to experience specific symptoms in order for them to be diagnosed with Generalised anxiety disorder ( GAD)?

A

At least 6 months

52
Q

How is the approach to managing the psychiatric patient described as?

A

Holistic Approach

53
Q

What is the main approach model used in management of the psychiatric patient?

A

Biopsychosocial approach

54
Q

What does the psychological treatment of the psychiatric patient entail?

A

Supportive therapies
Psychotherapies
Psychoanalysis

55
Q

What does the social treatment of the psychiatric patient entail?

A

Community Care
Rehabilitation

56
Q

What is the purpose of Antipsychotics ?

A

These drugs are noted to reduce delusions , hallucinations and to have a sedating/calming effect.

57
Q

What are the two types of antipsychotics?

A

Typical and Atypical

58
Q

What are examples of Typical Antipsychotics?

A

Please -Phenothiazines (Chlorpromazine)
Buy - Butyrophenones (Haloperidol)
Some -Substituted benzamides (Amilsulpride)
Typical- Thioxanthines (Clopixol)
Drugs- Diphenylbutylpiperidines (Pimozide)

59
Q

What are examples of Atypical Antipsychotics?

A

Can - Clozapine(Clozaril)
Queen- Quetiapine (Seroquel)
Zendaya- Zisprasidone (Geodon)
Order- Olanzapine (Zyprexa)
Atypical -Aripripazole (Abilify)
Rx- Risperidone (Risperdol)

60
Q

What is the action of mechanisms for Typical antipsychotics?

A

They may block serotonin, dopamine, adrenergic, histaminergic and cholinergic receptors ( increase cAMP).

61
Q

True or False? Atypical antipsychotics block serotonin receptors while some block dopamine receptors ONLY in the limbic system.

A

TRUE!!!

62
Q

What are examples of Antidepressant drugs?

A

*Selective Serotonin Reuptake inhibitor( SSRI)
*Selective Serotonin and Noradrenaline reuptake inhibitor (SNRI)
*Atypical Antidepressants
*St.John’s Worts( Hypericum)
*Tricyclics
*Monoamine Oxidase Inhibitors
*New reversible MAOI eg: moclobemide
*Noradrenaline selective reuptake inhibitor (NaSSA ) ex reboxetine

63
Q

What are examples of Selective Serotonin Reuptake Inhibitors?

A

Fluoxetine, fluvoxamine, paroxetine, sertraline, escitalopram, citalopram.

64
Q

What is the mechanism of action for SSRI’s?

A

They block the reuptake of Serotonin

65
Q

What are examples of Selectively Serotonin - Norepinephrine Reuptake Inhibitors?

A

Venlafaxine, desvenlafaxine, duloxetine, levomilnacipran, milnacipran.

66
Q

What is the mechanism of action for SNRI?

A

They inhibit reuptake of Serotonin and NE

67
Q

What are examples of Tricyclics ( TCA)?

A

Amitriptyline, nortriptyline, imipramine, desipramine, domipramine, doxepin, amoxapine.

68
Q

What is the mechanism of action for TCA’s?

A

They block reuptake of norepinephrine and serotonin into the presynaptic neuron

69
Q

What are examples of MAO’s?

A

Tranylcypromine, Phenelzine, Isocarboxazid, Selegiline (selective MAO-B inhibitor).

(MAO Takes Pride In Shanghai).

70
Q

What is the mechanism of action of MAO’s

A

They inhibit monoamine oxidase thus causing an increase in the levels of serotonin, dopamine and NE

71
Q

What are examples of Atypical antidepressants?

A

Trazadone, Nefazadone & Bupropion

72
Q

What is the mode of administration for antidepressants?

A

Orally

73
Q

What type of drugs are used in the treatment of of bipolar disorder and aggression?

A

Mood stabilisers

74
Q

What is the most common mood stabilizer?

A

Lithium

75
Q

What is the mechanism of action for mood stabilisers?

A

They involve the sodium and potassium and GABA inhibitory systems.

76
Q

What is the most important class of Tranquillisers?

A

Benzodiazepines, eg:alprazolam

77
Q

What makes up the team within community care for a psychiatric patient?

A

Psychiatric nurse, Psychiatric aides, Psyhciatrist

78
Q

What are examples of Anxiety disorders?

A

Panic Disorder
Phobias
Generalised Anxiety disorder
OCD
PTSD

79
Q

What is Agoraphobia?

A

Fear of being in an open or overcrowded space/ leaving one’s home

80
Q

What are the characteristics of delirium?

A

A-Acute – onset
F- Fluctuation – course
A- Attention – decreased concentration
C- Consciousness – decreased level
T- Thoughts - disorganized

“It is A FACT that you’re delirious”

81
Q

What are neurocognitive disorders?

A

Delirium
Dementia

82
Q

True or False? Dementia is classified to it’s aetiology.

A

TRUE!!

83
Q

What type of Dementia can be associated with diabetes mellitus , hypertension and cerebrovascular accidents (CVA)?

A

Vascular Type

84
Q

What are the etiologic factors of Alzheimer’s Disease?

A

Amyloid plagues & tau proteins in the brain

85
Q

What type of Dementia has spontaneous features of Parkinson’s disease?

A

Lewy- Body dementia

86
Q

True or False? HIV infection is associated with Dementia.

A

TRUE!!

87
Q

Bovine Spongiform Encephalopathy (BSE) aka mad cow disease is a form of what disease that causes dementia?

A

Prion disease

88
Q

What is the name of the brain disorder due to thiamine deficiency which causes neurocognitive disorders contributing to dementia?

A

Wernicke-Korsakoff Encephalopathy

89
Q

What are symptoms of Dementia?

A

Memory Impairment (short -term first)
Aphasic speech - ( Language disturbances)
Apraxia - inability to carry out motor activity despite intact motor function.
Agnosia- Failure to recognise objects despite intact sensory function.
Impairment in executive Functioning ( Sequencing, organising, abstracting and planning)

90
Q

What is a major neurocognitive disorder?

A

Amnestic disorder

91
Q

True or False? Valporic Acid is a mood stabiliser

A

TRUE

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