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CFPC exam KM > Psychiatry > Flashcards

Psychiatry Flashcards

1
Q

What is SICK FM

A

Symptoms of anxiety:
Sleep disturbance
Irritable
Concentration poor or mind goes blank
Keyed up or restless/on edge
Fatigued easily
Muscle tension

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2
Q

Contraindications for psychostimulants

A

Glaucoma, untreated hypertsh, mod htn, cardio dz, mania/psychosis

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3
Q

Early warning signs of autism at any age

A

Parental concerns
Developmental regression
Loss of social behahaviour and communication

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4
Q

Early warning signs of autism at age 6-12 months

A

Decreased smiles
Limited eye contact
Limited sharing of sounds
Limited facial expressions
Decreased babbling, gestures, response to name

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5
Q

Early warning signs of autism at age 9-12 months

A

Repetitve behaviours
Unusual play

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6
Q

Early warning signs of autism atvage 15-24 months

A

Diminished, atypical or no spontaneous or meaningful 2 word phrases

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7
Q

Diagnostic criteria for autism

A

Persistent deficit in social communication and social interaction across multiple contacts as manifested by the following:
- deficits in social-emotional reciprocity
- deficits and non-verbal communication
- deficit in relationships

Restricted repetitive patterns has manifested by at least two of the following:
- stereotyped repetitive motor movements
- insistence on sameeness, inflexible adherence to routine or retualised patterns
- highly restricted fixated interest
- hyper or hypo reactivity to sensory input

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8
Q

Bipolar 1 vs Bipolar 2

A

Bipolar 1: One or more manic or mixed episode. Depressive episode not required. Manic episode lasts at least one week, most of the day, most days of the week. Cause functional impairment, not related to substance use or medical condition.

Bipolar 2: One or more major depressive episode and one or more hypomanic episode lasts 4 or more days but <7 days.

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9
Q

Cyclothymic disorder

A

Several hypo, manic and depressive episodes that do not meet criteria for two or more years, not without symptoms for more than two

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10
Q

What is the monitoring for lithium?

A

12 hour trough levels, five days after dose change
Cr, TSH, calcium every 3-6 months

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11
Q

What is the monitoring for divalproex?

A

12 hour trough levels
CBC, LFTs every 3-6 months

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12
Q

What is the monitoring for atypical antipsychotics?

A

Monitor BP, FBG lipids every 12 months

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13
Q

Acute management of mania?

A

Monotherapy: lithium, quetiapine

Combination: Quetiapine + Li/DVP

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14
Q

Four categories relating to conduct disorder

A

Aggression to people and animals
Destruction of property
Deceitfulness and theft
Serious violations of rules

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15
Q

Treatment for conduct disorder

A

** Psychotherapy

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16
Q

SIGECAPS for depression

A

Depressed mood most of the day
Sleep - insomnia or hypersomnia
Interest - diminished in almost all activities most the day
Guilt
Energy low
Concentration low
Appetite - increased or decreased
Psychomotor agitation or retardation
Suicidal ideation

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17
Q

What antidepressants require a two week washout period

A

MAOIs

18
Q

Best antidepressants for elderly

A

Duloxetine, sertraline, Mirtazapine

19
Q

Antidepressants for perimenopausal

A

Desvenlafaxine

20
Q

Symptoms of discontinuation syndrome

A

Flu like symptoms
Insomnia
Nausea
Imbalance
Sensory disturbance
Hyperarousal

21
Q

What antidepressants are most commonly associated with discontinuation syndrome?

A

Paroxetine
Venlafaxine

22
Q

What antidepressants are the least commonly associated with discontinuation syndrome?

A

Fluoxetine
Vortioxetine

23
Q

Symptoms and signs of serotonin syndrome

A

Mild:
Nervousness, insomnia, tremor, nausea, and diarrhoea, big pupils

Moderate:
Hyperreflexia, sweating, agitation, and restlessness, inducible clonus, side to side eye movements

Severe:
Fever higher than 38.5, confusion and delirium, sustained clonus, and rigidity, rhabdomyolysis, death

24
Q

Highest risk meds for serotonin syndrome

A

MAOI
ex. Selegiline

25
Q

Treatment for serotonin syndrome

A

Discontinue maths, restart lowest dose or alternative, ER and cyprohepatadine

26
Q

Definition of obsessions and compulsions

A

Obsessions: recurrent unwanted and intrusive thoughts, images or urges that cause marked anxiety.

Compulsions: repetitive behaviours for mental acts that are performed to reduce the anxiety generated by the obsessions

27
Q

Schizoid personality disorder

A

DISTANT

Detached/Flat affect
Indifferent to criticism/ praise
Sexual experiences of little interest
Tasks done soilitarily
Absence of close friends
Neither desire nor enjoys relationships
Takes pleasure in few activities

28
Q

Schizotypal personalitiy disorder

A

ME PECULIAR

Magic thinking or odd beliefs
Experiences unusual perceptions
Paranoid ideation
Eccentric behaviour or appearance
Constricted or inappropriate affect
Usual thinking and speech
Lacks close friends
Ideas of reference
Anxiety in social situations
R/O pyschosis

29
Q

Antisocial personality disorder?

A

CORRUPT

Conforming to law lacking
Obligations ignored
Recklessness disregard for safety
Remorseless
Underhanded
Planning insufficient - impulsive
Temper issues

**Prior diagnosis of conduct disorder

30
Q

Bordline personality disorder?

A

AM SUICIDE

Abandonment
Mood instability

Suicidal
Unstable/intense relationships
Impulsivity/irritability - spending
Control of anger
Identity disturbance
Dissociative
Emptiness

Tx: Dialectical behavioural therapy

31
Q

Histrionic personality disorder?

A

ACTRESSS

Appearance focused
Center of attention
Theatrical
Relationships considered more intimate then they are
Easily influenced
Seductive behaviours
Shallow emotions
Speech - vague

32
Q

Narcissistic personality disorder?

A

SPEEECIAL

Special - believe they are unique
Preoccupied with fantasies
Envious
Entitlement
Excess admiration required
Conceited
Interpersonal exploitation
Arrogance
Lacks empathy

33
Q

Avoidant personality disorder?

A

AVOIDER

Avoids social type of work
Views self is inept or an appealing
Occupied with fear of rejection or criticism
Inhibited in new interpersonal relationships
Don’t get involved when uncertain of being liked
Embarassement prevents new activities
Restraint within intimate relationships

34
Q

Dependant personality disorder?

A

RELIANCE

Reassurance required
Expressing disagreement difficult
Life responsibilities, assumed by others
Initiating projects difficult
Alone
Nuturance
Companionship
Exaggerated fears of being left to care for self

35
Q

Obsessive compulsive personality disorder?

A

OBSESSOR

Obsessed over details
Both miserly with self and others
Shows perfectionism that interferes with task completion
Excessively devoted to work
Super consciousness
Supervision required for delegated tasks
Object hoarder
Rigidity

36
Q

Schizophrenia diagnosis

A

2 or more of the following symptoms present for most of a month, at least one symptom must be in the first three:
- delusions
- hallucinations
- disordered, thinking speech

  • grossly, disorganised or catatonic behaviour
  • negative symptoms, for example, diminished, emotional expression
  • mark, social occupational or self care dysfunction
  • continuous signs of disturbance for six or more months with over one month of symptoms
37
Q

What is Wernicke encephalopathy caused by

A

Low thiamine

38
Q

What does delirium tremens happened?

A

3 to 5 days after last drink

39
Q

When do alcohol withdrawal seizures happen

A

24 to 72 hours after last drink

40
Q

Treatment for alcohol withdrawal inpatient

A

Benzodiazepines
Diazepam 10 mg QID then decrease by 10 mg a day \

Lorazepam 2 mg Q4H for two days and 1 mg Q4H for two days

41
Q

Treatment for alcohol withdrawal as an outpatient

A

Diazepam 5 mg QID + 5 mg Q4H PRN (max 2) the decrease by 5 mg per day

42
Q

Medical options for alcohol dependence

A

Naltrexone. Contraindicated in liver, failure and ongoing opioid use, Monitor LFTs.

Can also trial gabapentin

CFPC exam KM (16 decks)

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