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Year 4 Final > Psychiatry > Flashcards

Psychiatry Flashcards

1
Q

Mneumonic for 1st rank schizophrenia symptoms

A

A - Auditory Hallucinations.
B - Broadcasting of Thought.
C - Controlled Thought (delusions of control).
D - Delusional Perception

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2
Q

Effect of mesolimbic dopamine pathway?

A

DA overactivity associated with positive symptoms.

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3
Q

Effect of mesocortical dopamine pathway?

A

DA underactivity associated with negative symptoms.

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4
Q

Effect of nigrostriatal dopamine pathway?

A

D2 blockade by antipsychotic Px associated with Parkinsonian side-effects.

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5
Q

Effect of tuberoinfundibular dopamine pathway?

A

D2 blockade by antipsychotic Px leads to increased Prolactin levels and Hyperprolactinaemia.

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6
Q

Clinical features of serotonin syndrome

A

Rpid onset
Mental status change
Autonomic dysfunction- Dilated pupils, diaphoresis, tachycardia, hyperthermia, hypertension, D and V
Neuromuscular dysfunction- Tremor, hyperreflexia and myooclonus

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7
Q

Pathophysiology of neuroepleptic malignant syndrome

A

Unknown

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8
Q

Causes of neuroleptic malignant syndrome

A

Antipsychotic drugs
Dopaminergic drugs

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9
Q

Clinical features of neuroeptic malignant syndrome

A

Gradual onset
Mental state change
Autonomic dysfunction
Neuromuscular dysfunction- severe rigitidy, tremor, hyperreflexia

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10
Q

What is conversion disorder?

A

Involves loss of motor function

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11
Q

What is Charles- Bonnett syndrome?

A

characterised by persistent or recurrent complex hallucinations (usually visual or auditory), occurring in clear consciousness. This is generally against a background of visual impairment (although visual impairment is not mandatory for a diagnosis). Insight is usually preserved. This must occur in the absence of any other significant neuropsychiatric disturbance.

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12
Q

Most common opthalmic condition associated with Charles Bonett?

A

Age related macular degeneration

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13
Q

How to treat schizophrenia if severe functional impairment

A

Refer to secondary care
Offer CBT and SSRI while waiitng

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14
Q

How many months does insomnia have to last to be chronic?

A

3 months or longer

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15
Q

What medication can be used to reduce alcohol cravings?

A

Acamprostate

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16
Q

What medication can be used to reduce pleasurable effects of alcohol

A

Naltrexon

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17
Q

What medication can be used to increase sensitivity to alcohol?

A

Disulfram

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18
Q

What is the peak incidence of delerium tremens following alcohol withdrawl?

A

72 hours

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19
Q

TCA side effects

A

Drowsines
Dry mouth
Blurred vision
Constipation/retention
Worsening of QT interval

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20
Q

What is akasthia?

A

Inner restlessness and inability to keep still

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21
Q

SSRI of choice in children and adolescents

A

Fluoxetine

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22
Q

Which atypical antipsychotics has the best side effect profile, particularly for prolactin elevation?

A

Aripiprazole

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23
Q

Adverse side effects of clozapine?

A

Agranulocytosis
Reduced seizure threshold
Constipation
Myocarditis
Hypersalivation

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24
Q

Side effects of mirtazapine that can be helpful in older people?

A

Sedation and an increased appetite

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25
Q

When checking lithium levels when should the sample be taken?

A

12 hours post last dose

26
Q

Side effects of TCAs?

A

Drowiness
Dry mouth
Blurred vision
Constipation
Urinary retention
Legnthening of QT interval

27
Q

What is brief psychotic disorder?

A

Episode of psychosis lasting less than a month with a subsequent return to baseline functioning.

28
Q

What happens when triptans are used alongside SSRIs?

A

Increases risk of serotonin syndrome

29
Q

What is circumstantiality?

A

inability to answer a question without giving excessive, unnecessary detail

30
Q

What is tangentiality?

A

Wandering from a topic without returning to it

31
Q

What is an oligouric crisis?

A

Prolonged involuntary upward deviation of the eyes

32
Q

What do benzodiazepines do?

A

Inhibitory neurotransmitter gamma-aminobutyric acid (GABA) by increasing the frequency of chloride channels

33
Q

Mneumonic for atypical antipsychotics

A

CORQA
Clozapine
Olanzapine
Risperidone
Quetiapine
Aripiprazole

34
Q

What should patients have monitored when starting on an SNRI?

A

BP

35
Q

Over how many weeks should an SSRI be gradually withdrawn?

A

4 weeks

36
Q

How long after onset can PTSD be diagnosed?

A

4 weeks

37
Q

What warnings are there for antipsychotic use in the eldrly?

A

Increased risk of stroke and VTE

38
Q

What is agranulocytosis?

A

Lowering of the white blood cell count, primarily neutrophils

39
Q

How long should antidepressants be continued after remission? Why?

A

For at least 6 months to decrease risk of relapse

40
Q

What should be prescribed if patient taking SSRI and NSAID?

A

PPI

41
Q

Difference between knights move and flight of ideas?

A

Knight’s move thinking there are illogical leaps from one idea to another, flight of ideas there are discernible links between ideas

42
Q

Management of mania/hypomania in bipolar?

A

consider stopping antidepressant if the patient takes one; antipsychotic therapy e.g. olanzapine or haloperidol

43
Q

Mneumonic for SSRI side effects
SSSSRIs

A

Stomach upset
Sexual dysfunction
Sodium low
Serotonin syndrome

44
Q

Anorexia features

A

Most things low
G and C raised: Growth hormone, glucose, salivary glands, cortisol, cholstreol, carotinaemia

45
Q

Side effects of clozapine?

A

weight gain
excessive salivation
agranulocytosis
neutropenia
myocarditis
arrhythmias

46
Q

SSRI use in third trimester of pregnnacy?

A

Can cause persistent pulmonary hypertension of the newborn

47
Q

What is procyclidine?

A

anticholinergics that work by blocking acetylcholine. This helps decrease muscle stiffness, sweating, and the production of saliva, and helps improve walking ability in people with Parkinson’s disease.

48
Q

Lithium side effects

A

nausea/vomiting, diarrhoea
fine tremor
nephrotoxicity: polyuria, secondary to nephrogenic diabetes insipidus
thyroid enlargement, may lead to hypothyroidism
ECG: T wave flattening/inversion
weight gain
idiopathic intracranial hypertension
leucocytosis
hyperparathyroidism and resultant hypercalcaemia

49
Q

What is Korsakoff’s syndrome?

A

anterograde amnesia: inability to acquire new memories
retrograde amnesia
confabulation

50
Q

First line for children with ED?

A

Family based therapy

51
Q

First line for GAD?

A

Sertraline

52
Q

What antipsychotic reduced the seizure threshold?

A

Clozapine

53
Q

TCA side effects

A

drowsiness
dry mouth
blurred vision
constipation
urinary retention
lengthening of QT interval

54
Q

What is delusional parasitosis?

A

Patient with a fixed, false belief (delusion) that they are infested by ‘bugs

55
Q

Core depression symptoms

A

Anhedonia, anergia or low mood

56
Q

Lithium mneumonic

A

LITHIUM
L- leucocytosis
I - increased urine
T - Tremors
H - hypothyroid
I - increased thirst
U - underactive memory
M - myoclonus

57
Q

What are Z drugs?

A

similar effects to benzodiazepines but are different structurally. They act on the α2-subunit of the GABA receptor.

58
Q

What are the 3 groups of Z drugs?

A

Imidazopyridines: e.g. zolpidem
Cyclopyrrolones: e.g. zopiclone
Pyrazolopyrimidines: e.g. zaleplon

q

59
Q

What are the adverse effects of Z drugs?

A

similar to benzodiazepines
increase the risk of falls in the elderly

60
Q

What is de Clerambault’s syndrome?

A

form of paranoid delusion with an amorous quality. The patient, often a single woman, believes that a famous person is in love with her.

61
Q

Alternative first line to SSRI in OCD?

A

clomipramine

Year 4 Final (39 decks)

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