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FFP Medicine > psychiatry > Flashcards

psychiatry Flashcards

1
Q

what is the ICD-10 criteria of psychosis?

A

1 or more of:
· Thought echo, insertion, withdrawal or broadcast
· Delusions of control or passivity
· Hallucinatory voices giving a running commentary discussing the patient amongst themselves
Other persisting delusions

2 or more of:
· Persistent hallucinations
· Thought disorganisation (loosening of association, incoherence or neologism)
· Catatonic symptoms – immobile, unresponsive stupor
· Negative symptoms
· Change in personal behaviour (loss of interest, aimlessness or social withdrawal)

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2
Q

What are the risks of SSRIs during first and third trimester pregnancy?

A

first: risk of congenital malformations
third: risk of persistent pul hypertension

  • Paroxetine has an increased risk of congenital malformations, particularly in the first trimester
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3
Q

what are symptoms of SSRI discontinuation?

A

GI symptoms: diarrhoea, nausea
increased mood change
restlessness
difficulty sleeping
unsteadiness
sweating
gastrointestinal symptoms: pain, cramping, diarrhoea, vomiting
paraesthesia

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4
Q

what is De Clerambault’s syndrome

A

Delusional disorder-Eroctomania: presence of a delusion that a famous perso is in love with them, with the absence of other psychotic symptoms

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5
Q

what are the risks of zopiclone in the elderly?

A

increases risk of falls in the elderly

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6
Q

what is the MOA of zopiclone?

A

Z drug: binds to alpha 2 GABA receptor
Cyclopyrrolones

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7
Q

What is Munchausen’s syndrome?

A

aka Factitious disorder. Purposefully causing symptoms, for example a diabetic taking too much insulin to cause hypos

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8
Q

What is malingering?

A

faking symptoms for financial or or personal gain

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9
Q

what is conversion disorder?

A

also known as Functional Neurological Symptom Disorder (FNSD), typically presents with neurological symptoms such as paralysis, blindness, or seizures that cannot be explained by medical evaluation.

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10
Q

what is dissociative disorder?

A

disruptions or gaps in memory, awareness, identity or perception that are too extreme to be considered mere forgetfulness. These disorders often develop as a way to cope with trauma.

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11
Q

What is the difference between tangentiality vs circumstantiality

A

tangentiality= wandering from a topic without returning to it (doesnt answer q)
circumstantiality= wandering from topic and eventually answers it (inability to answer a question without adding un-necessary details)

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12
Q

how can you differentiate depression with Alzheimer’s dementia in elderly?

A

depression: loss of appetite, waking up early, poor concentration, recent grief, short history- rapid onset, pt worried about poor memory
global memory loss

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13
Q

What is Korsakoff’s syndrome?

A

complication of Wernicke’s encephalopathy including anterograde amnesia, retrograde amnesia, and confabulation

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14
Q

What are the symptoms of Wernicke’s encephalopathy?

A

clinical triad of ataxia, ophthalmoplegia and confusion

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15
Q

what is somatisation disorder?

A

characterised by the recurrent presentation of physical symptoms such as nausea, headaches, and palpitations in the absence of a detectable organic cause. These symptoms are not intentionally produced or feigned,

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16
Q

what are the key symptoms of borderline personality disorder?

A

fluctuating mood, turbulent relationships and self-harm. Paranoid thoughts and visual or auditory hallucinations can also occur.

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17
Q

what is knight’s move thinking?

A

severe type of loosening of associations, where there are unexpected and illogical leaps from one idea to another. It is a feature of schizophrenia.
can have slow speech

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18
Q

what are the symptoms of post concussion syndrome?

A

headache
fatigue
anxiety/depression
dizziness

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19
Q

how can schizoid and avoidant PD be differentiated?

A

avoidant: social isolation and avoidance of activities due to a fear of embarrassment, criticism and fear of others

schizoid: preference of being alone due to lack of interest

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20
Q

What is Charles Bonnet syndrome and what ophthalmological dx is it associated with?

A

CBS is 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.

ass with age related macular degeneration

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21
Q

which medication can help treat SE of tardive dyskinesia?

A

tetrabenazine

22
Q

which medications can help treat SE of acute dystonia?

A

Procyclidine and benztropine

23
Q

Which psychology therapy can help with personality disorders?

A

dialectical behaviour therapy

24
Q

which SE is more common in ECT- retrograde or anterograde amnesia?

A

retrograde amnesia (ability to remember past events)

25
Q

after a change in dose in lithium, how often should dose be checked?

A

one week later, then weekly until levels are stable

26
Q

what is torticollis?

A

type of acute dystonia- wry neck, unilateral pain and deviation of the neck with pain on palpation and restricted range of motion.

27
Q

when should clozapine be initiated for schizophrenia?

A

treatment resistant scz- when at least 2 antipsychotics been tried for 6-8 weeks sequentially, with at least one atypical antipsychotic

28
Q

when should pts <25 be reviewed when starting SSRI?

A

after one week

29
Q

what is the prevalence of schizophrenia in the general population?

A

1%

30
Q

how does tardive dyskinesia manifest?

A

orofacial dyskinesias

31
Q

how does akathisia manifest?

A

unpleasant sense of restlessness

32
Q

what is most likely SE of risperidone?

A

extra pyramidal symptoms (compared to other atypical anti psychotics)

33
Q

define neologism in psychiatry?

A

made up word or phrase by the patient

34
Q

define akathisia and if ass with anti psychotics, what is the risk?

A

inability to remain still
associated with suicide

35
Q

what can occur after newly starting a patient on clozapine that is benign?

A

benign fever- but a persistent increase can suggest agranulocytosis and infection- request full blood count

36
Q

define anhedonia

A

inability to feel pleasure

37
Q

define Circumstantiality

A

non direct thinking/ speech that digresses from main point of conversation (include unnecessary points and insignificant details)

38
Q

what are two important RF for suicide?

A

self harm and hopelessness

39
Q

what is initial insomnia?

A

where onset of sleep is delayed (can’t fall asleep)

40
Q

define formal thought disorder

A

A pattern of disordered language that reflects disordered thought form

e.g. loosening of association (derailment), flight of ideas, circumstantial thoughts, tangential thoughts, thought block

41
Q

define psychomotor agitation

A

a state of restlessness and anxiety that results in repetitive and unintentional movements (common in bipolar)

42
Q

what are the short term side effects of ECT?

A

headache
nausea
short term memory impairment
memory loss of events prior to ECT
cardiac arrhythmia

43
Q

why must tyramine containing foods be avoided with MOAi?

A

to avoid hypertensive crisis

44
Q

which medication can cause hyperparathyroidism and hypercalcemia?

A

long term use of lithium

45
Q

how often should lithium doses be taken until stable?

A

weekly

46
Q

what is first line treatment for acute stress disorder?

A

trauma based CBT

47
Q

what are the side effects of atypical antipsychotics in the elderly?

A

stroke and VTE

48
Q

In a patient aged 20-50 with spontaenous encephalitis and changes in temporal lobe- what would this suggest?

A

HSV encephalitis

49
Q

what eye defect palsy can raised ICP cause?

A

CN III palsy

50
Q

what blood test needs to be done before starting lithium?

A

thyroid function

51
Q

what is the first and second line medical management of panic disorder?

A

SSRI’s (citalopram, esclitaopram, sertraline, paroxetine) or SNRI (venlafaxine) - second line are TCAs (clomipramine)

52
Q
A

FFP Medicine (14 decks)

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