Psychiatry Flashcards
How long must symptoms persist for a diagnosis of schizophrenia?
At least 1 month.
Name common symptoms of schizophrenia.
Auditory hallucinations, thought insertion, withdrawal, interruption, thought broadcasting, somatic hallucinations, delusional perception, negative symptoms (including catatonia).
What is the recommended treatment for schizophrenia?
Antipsychotic medication + Cognitive Behavioral Therapy (CBT).
Provide examples of typical first-generation antipsychotics
Chlorpromazine, Haloperidol
What are common side effects of typical antipsychotics?
Extrapyramidal side effects, dystonia, parkinsonism, tardive dyskinesia, hyperprolactinemia.
Which first-generation antipsychotic is most likely to cause neuroleptic malignant syndrome?
Haloperidol.
Name some atypical second-generation antipsychotics
Clozapine, Amisulpride, Risperidone, Olanzapine, Quetiapine.
What is a serious side effect of clozapine?
Agranulocytosis, reduced seizure threshold, constipation, myocarditis, hypersalivation.
Which atypical antipsychotic is considered third-generation?
Aripiprazole
List common symptoms of depression.
A: Low mood, reduced energy, reduced activity, etc.
How long must depressive symptoms persist for a diagnosis?
2 weeks
What is the first-line treatment for mild depression lasting less than 1 year?
Watchful waiting or low-intensity psychological intervention.
For severe depression, what is the recommended treatment?
High-intensity psychological intervention + antidepressant ± Electroconvulsive Therapy (ECT).
Which antidepressant is a NaSSA (Noradrenergic and Specific Serotonergic Antidepressant)?
Mirtazapine
Differentiate between Type I and Type II bipolar disorder.
Type I involves mania and depression, while Type II involves hypomania and depression.
What is the first-line treatment for mania or hypomania?
Stop antidepressant + Atypical antipsychotic.
What is the long-term treatment for bipolar disorder?
Lithium (titrated up, needs retitration if dose missed for >48h).
Define “baby blues.”
Transient postpartum emotional symptoms including depression, tearfulness, anxiety, irritability, and fatigue.
What is the treatment approach for postnatal depression?
Edinburgh Postnatal Depression Scale; offer support and reassurance ± CBT ± antidepressant (sertraline or paroxetine).
Describe postnatal psychosis.
Rare condition with delusions, hallucinations, and thoughts of harming the baby or self, starting within 2 weeks of delivery; hospitalization + atypical antipsychotic.
List common symptoms of generalized anxiety disorder (GAD).
Nervousness, trembling, muscular tensions, sweating, lightheadedness, palpitations, etc.
How long must symptoms persist for a diagnosis of GAD?
At least 6 months.
Describe the symptoms of OCD.
Obsessional thoughts + compulsive acts.
How long must symptoms persist for a diagnosis of OCD?
2 weeks
What is the recommended treatment for OCD?
CBT with exposure response therapy ± SSRI.
List common symptoms of PTSD
Re-experiencing, avoidance, hyperarousal, emotional numbing, depression, drug or alcohol misuse, anger.
How long must symptoms persist for a diagnosis of PTSD?
4 weeks
What is the treatment for PTSD?
Trauma-focused CBT or EMDR ± Paroxetine or Mirtazapine.
Under which section can a person be admitted for assessment and treatment for 28 days?
Section 2
What is the emergency admission duration under Section 4?
72 hours
What is Section 17 of the Mental Health Act related to?
Leave of absence from the hospital.
What is the purpose of Section 136?
Transfer from a public place to a place of safety for ‘care or control’.
What is Neuroleptic Malignant Syndrome (NMS)?
A potentially life-threatening condition occurring hours to days after starting or increasing the dose of atypical antipsychotic (haloperidol).
What are the symptoms of Neuroleptic Malignant Syndrome?
Pyrexia, sweating, rigidity, tachycardia, raised CK, leukocytosis.
What is the treatment for NMS?
Stop antipsychotic + fluids ± benzodiazepine ± dantrolene ± bromocriptine.
What are the symptoms of Serotonin Syndrome?
Hyperthermia, autonomic excitation, rigidity
When does Serotonin Syndrome typically occur?
Minutes to hours after starting SSRI, MAOI, ecstasy, or amphetamine.
Who is needed to sign section 3 of MHA?
2 doctors + AMHP
1st rank symptoms of schizophrenia (4)
Delusional disorder
Passivity phenomena
Thought disorders
Hallucinations
SE of atypical antipsychotics
Weight gain / Dyslipidemia / Hyperprolactinemia / Nipple discharge / Impaired glucose tolerance
What should be coprescribed with SSRIs?
PPI to protect from GI bleed
Signs of bulimia nervosa O/E
Callous on the back of the hands (Russel Sign), parotid enlargement, poor oral hygiene
