Psychiatry Flashcards

Question

what is akathisia

Answer 1

it is the feeling of inner restlessness and tension, an urge to constantly move parts of the body, especially the legs, and difficulty maintaining a posture for a few minutes

Answer 2

antipsychotics - first generation such as haloperidol are more likely to cause it than second generation

Answer 3

this is the presence to neurological symptoms without any underlying neurological causes - often linked with emotional distress

Answer 4

at least 1 month and must interfere with day to day activities

Answer 5

Constipation due to impairment of intestinal peristalsis

Answer 6

this is characterised by attention seeking behaviour, they are willing to be viewed as dependent on others and weak to gain attention. They use speech/dress to seek attention - dont display self harm or suicidal behaviour

Answer 7

this is characterised by fear of abandonment. They will have excessive reliance on caregivers and they may feel unable to make decisions when the caregiver is not around

Answer 8

this is scarring of the knuckles indicative of bulimia

Answer 9

this is repetitive movements often affecting the face and jaw. This is often due to antipsychotic medication

Answer 10

Depression can be diagnosed if symptoms are present nearly every day for 2 weeks or longer

Answer 11

Disturbance of multiple higher cortical functions - memory - thinking - orientation - comprehension - calculation - learning capacity - language - judgement - consciousness is not clouded

Answer 12

disturbances of - consciousness - attention - perception - thinking - memory - psychomotor behavior - emotion - sleep wake schedule severity ranges from mild to severe

Answer 13

Positive symptoms - thought echo, insertion, withdrawal, broadcasting - delusions of perception - delusions of control - over valued ideas - auditory hallucinations with 3rd person voice - catatonic behaviour Negative symptoms - blunted affect - apathy, loss of drive - social isolation - poverty of speech - poor self care

Answer 14

symptoms for 2 weeks with sustained dysfunction triad of: lowering of mood, anhedonia, reduction of energy plus - decreased concentration - reduced self confidence and self esteem - ideas of guilt and worthlessness - poor sleep and early waking - loss of appetite - loss of weight - loss of libido - psychomotor retardation

Answer 15

symptoms or features for 7 days with sustained dysfunction - elevated mood - distractable - delusions of grandeur - flight of ideas - pressure of speech - disinhibited ideas - decreased need for sleep - increased energy

Answer 16

recurrent panic attacks of severe anxiety somatic symptoms - heart racing, sweating, cant breath etc feeling of unreality - depersonalisation or derealisation recurrent over one month

Answer 17

recurrent obsessional thoughts or compulsive acts obsessional thoughts are: ideas, images, impulses compulsive acts or rituals are stereotypes behaviours that are repeated to prevent some objectively unlikely event anxiety worsens if compulsions are ignored

Answer 18

anxiety that is general and consistent (not about one specific thin) complaints of persistent nervousness, trembling, muscular tensions, sweating, light headedness, palpitations, dizziness

Answer 19

this is anxiety at particular events/situations/things situations are avoided to prevent anxiety secondary = fear of dying, losing control or going mad phobic anxiety and depression often coexist

Answer 20

deliberate and sustained weight loss induced and sustained by the patient dread of fatness under nutrition of varying severity with changed in body function restrictive dietary choice including excessive exercise, induced vomiting and use of appetite suppressants and diuretics

Answer 21

repeated bouts of overeating and preoccupation with the control of body weight pattern of overeating followed by purging/vomiting repeated vomiting is likely to give rise to disturbances of the body electrolytes and physical complications can have bulimia without purging - controlled by excessive exercise or restrictive eating after

Answer 22

this is behavioural, cognitive and physiological phenomena that develops after repeated and sustained substance use - strong desire to take the drug - difficulties in controlling its use - persistent use despite harmful consequences - higher priority given to the drug than other activities and obligations

Answer 23

donepezil rivastigmine galantamine

Answer 24

agitation dizziness fatigue insomnia headaches

Answer 25

cardiac problems asthma COPD urinary retention

Answer 26

Alzheimer's disease

Answer 27

constipation dizziness drowsiness

Answer 28

in hepatic impairment and if the patient is on antipsychotics

Answer 29

citalopram fluoxetine paroxetine sertraline

Answer 30

GI problems diarrhoea abdominal pain insomnia nausea sexual dysfunction

Answer 31

citalopram

Answer 32

fluoxetine

Answer 33

duloxetine venlafaxine

Answer 34

GI problems diarrhoea nausea abdominal pan sexual dysfunction drowsiness palpitations fatigue anxiety dry mouth rhabdomyeitis SIADH

Answer 35

cardiac disease mania - can make worse seizures

Answer 36

mianserin mirtazapine

Answer 37

cardiac problems diabetes mellitus seizures

Answer 38

amitriptyline clomipramine imipramine

Answer 39

fatigue oedema postural hypotension abdominal problems dry eyes

Answer 40

patients with risk of overdosing

Answer 41

aripiprazole clozapine olanzapine quetiapine

Answer 42

weight gain hyperlipidaemia hypercholesterolaemia hypersalivation sexual problems

Answer 43

risk of agranulocytosis and neutropenia

Answer 44

lithium valproic acid carbamazepine lamotrigine atypicals

Answer 45

GI problems nausea

Answer 46

sodium valproate

Answer 47

depression anxiety disorders mood disorders eating disorders psychotic disorders

Answer 48

emotionally unstable personality disorder

Answer 49

it refers to the way in which someone thinks, and helps people unlearn unhelpful ways of thinking uses a mix of CBT and mindfulness and psychotherapy

Answer 50

complex clinical conditions - where the therapist spends time with the patient helping them to explore their thought, feelings, emotions etc

Answer 51

assessed using 4 domains 1. can the patient understand what is being said to them - understand the nature of the treatment 2. retain that information 3. use that information to make an informed decision 4. relay their decision back to the medical practitioner

Answer 52

1. capacity is assumed 2. practical steps are taken to help 3. allow unwise decisions 4. best interest 5. least restrictive

Answer 53

assessment for up to 28 days

Answer 54

treatment for up to 6 months

Answer 55

emergency admission for 72 hours

Answer 56

doctors holding power for 72 hours

Answer 57

nurses holding power for 6 hours - have to be a mental health nurse or learning disability nurse

Answer 58

it is the warrant the police can use to enter you home - there is a type 1 and type 2

Answer 59

it is what the police can use to have someone assessed who is in a public place

Answer 60

this is a community treatment order - normally after a section 3 when someone leaves hospital that allows them to be recalled without another MHA assessment

Answer 61

impulsive angry hedonistic unstable low self esteem chronic emptiness self harm unstable relationships

Answer 62

sensitive bears grudges suspicious combative fears of infidelity self referential preoccupied with conspiracies

Answer 63

perfectionist stubborn rigid unable to delegate pays undue attention to detail

Answer 64

worried isolated avoids social situations inadequate poor self image

Answer 65

uncaring callous lacking remorse manipulative violent blames others amoral

Answer 66

cold aloof detached indifferent to praise/criticism solitary emotionally blunted

Answer 67

dramatic vain self obsessed centre of attention sexual shallow obsessed with appearance

Answer 68

grandiose views themselves as special jealous self centred manipulative prone to fantisies

Answer 69

strange odd behaviour strange beliefs out of keeping with societal norms not fully psychotic

Answer 70

needy low self esteem unable to make decisions fears being alone

Answer 71

1. constitutional deposition - emotional instability, anxiousness, impulsiveness 2. conditions during childhood - trauma, neglect, abuse, deprivation 3. social context - opinions about themselves and the world

Answer 72

eccentric/odd - group A emotional/erratic - group B anxious/fearful - group C

Answer 73

they show emotional coldness they omit close friends and lack close friends they are isolated and take pleasure in few activities they have a restricted interest in sex it is more common in men

Answer 74

4 of the following - anhedonia -emotional coldness - lack of feelings towards others - indifference to praise or criticism - sexual indifference - solitary habits - no desire for close friends - disregard for social norms

Answer 75

magical thinking and eccentric behaviours they have paranoid ideation they experience unusual perceptions and have unusual thinking they lack friends they are socially anxious

Answer 76

need a minimum of 4 of these continuously or repeatedly over at least 2 years - inappropriate affect - odd, eccentric or peculiar behaviour - poor rapport with others off beliefs or magical thinking - suspicious, paranoid - unusual perceptual experiences - vague circumstantial thinking with odd speech - occasional quasipsychotic episodes

Answer 77

spouse suspected cheating unforgiving and suspicious perceives attacks from others and sees an enemy in everyone confiding in others is feared threats are seen in benign things

Answer 78

must have at least 4 of excessive sensitivity tendency to bear grudges suspicious and distorting of the facts combative personality recurrent suspicions of infidelity self referential attitude preoccupations with conspiracies

Answer 79

cannot follow the law obligations are ignored remorselessness recklessness underhandedness unable to plan temper

Answer 80

at least 3 of unconcern for others irresponsibility - disregard for social norms lack of maintaining social relationships violence: low tolerance to frustration lack of guilt or remorse prone to blaming others

Answer 81

paranoid ideas relationship instability angry outbursts and affective instability impulsive behaviours suicidal behaviour emptiness

Answer 82

any three from (but * is a must!!) impulsive actions quarrelsome behaviour and conflict * outbursts of anger unstable mood hedonism plus two of the following uncertain self image unstable emotional relationships recurrent threats of self harm chronic feelings of emptiness

Answer 83

provocative seductive behaviour relationships considered overly intimate needs to be the centre of attention influenced easily emotionally liable and shallow concern with physical appearance exaggerated motion

Answer 84

exaggerated expression of emotions suggestibility shallow and liable affect continual excitement and being the centre of attention inappropriate seductiveness over concern with physical attractiveness

Answer 85

is easily jealous lacks empathy overreacts to criticism views themselves as special and exaggerates own importance manipulative of others expectations are unrealistic

Answer 86

at least 5 from: grandiose sense of self importance preoccupation of fantasies of success belief they are special and unique need for excessive admiration a sense of entitlement exploitation of relationships lack of empathy envy or belief others are envious of them arrogant behaviour

Answer 87

avoids occupational activities views self as socially inept occupied with being rejected or criticised inhibited in new situations declines to get involved embarrassed socially refrains from intimacy

Answer 88

persistent feelings of tension belief one is socially inept preoccupation with being rejected or criticised avoidance of people restrictions in lifestyle due to need for security avoidance of social events

Answer 89

difficulty making decisions go to excessive lengths to obtain help preoccupied with fear of isolation exaggerated fear of inability to cope needs others to make decisions for them difficulty disagreeing with others ending relationships is difficult for them noticeable difficulty in initiating things

Answer 90

allowing others to make their important choices undue compliance with others wishes unwillingness to make any demands feeling uncomfortable alone preoccupation with fears of being left alone inability to make decisions

Answer 91

loses point (due to preoccupation) ability is compromised by perfectionism unable to discard worthless objects - hording friends are excluded they are often inflexible and rigid in their way reluctance to delegate stubborn

Answer 92

excessive doubt reoccupation with rules, details, order perfectionism interferes with tasks/job etc preoccupation with productivity excessive pedantry - the quality of being too interested in formal rules and small details that are not important rigidity

Answer 93

Lack of emotion or small emotional range - Apathy loss of energy - Anergia lack of interest or low motivation - anhedonia affective flattening - black blunted facial expression difficulty, poverty or inability to speak reduction difficulty or inability to initiate and persist in goal directed behaviour autistic like features absent minded, reduced concentration activities of daily living are avoided

Answer 94

marked decrease in reaction to the immediate surrounding environment sometimes taking the form of motionless and apparent unawareness, rigid or bizarre postures or aimless excess motor activity

Answer 95

aripiprazole clozapine olanzapine paliperidone quetiapine risperidone

Answer 96

chlorpromazine fluphenazine haloperidol

Answer 97

suicide and self harm anxiety and obsessive compulsive disorders depression abuse of alcohol and recreational drugs inability to work or attend school legal and financial issues hopelessness self isolation health and medical problems stigmatisation aggressive behaviour

Answer 98

shaking trembling muscle spasms muscle twitches

Answer 99

drowsiness weight gain blurred vision constipation lack of sex drive dry mouth

Answer 100

tardive dyskinesia - persistent involuntary movement of the lips, jaw or face and extremities pseudo parkinsonism dystonia - irregular muscle contractions akathisia - inability to sit still

Answer 101

it is a serious neurological disorder affecting the nervous system that usually develops rapidly over 24-72 hours and may occur during administration or withdrawal/change of antipsychotic medication

Answer 102

sweating or fever with high temperature tremour, rigidity or loss of movement difficulty in speaking or swallowing rapid heart beat, very rapid breathing and changes in blood pressure changes in consciousness, from lethargy and confusion to stupor or coma

Answer 103

Prominent U waves due to the hypokalaemia

Answer 104

the inability to recognise people, places or things that were once known to that person

Answer 105

an abnormal buildup of cerebrospinal fluid (CSF) in the brain's ventricles (cavities). It occurs if the normal flow of CSF throughout the brain and spinal cord is blocked in some way. This causes the ventricles to enlarge, putting pressure on the brain.

Answer 106

Wet, wobbly, wacky - urinary incontinence - gait dysfunction - dementia

Answer 107

lithium is known to increase the chances of developing Ebsteins abnormality (congenital abnormality), where the leaflets of the tricuspid valves are displaced

Answer 108

when someone believes that someone similar to them has been replaced by an exact clone (may or may not want to harm them)

Answer 109

In ekbom syndrome a patient experiences delusional beliefs that they are infested with insects/parasites and will complain of them crawling on their skin

Answer 110

Procyclidine

Answer 111

vomiting alopecia liver toxicity pancreatitis/pancytopenia retention of fats (weight gain) oedema anorexia tremor enzyme inhibition

Answer 112

Have you every wanted to cut down on your drinking Are people every annoyed at your drinking do you ever feel guilty by your drinking do you need a drink first think in the morning (eye opener)

Answer 113

How often do you drink (0-4) How many units do you drink per week (0-4) How often have you had over 6 units if female and over 8 units in male in the last year (>3 times = bad)

Answer 114

origin pattern quantification behaviours abstinence ask about dependence and the impact on life

Answer 115

it is a pattern of drinking that causes health problems, includes psychological

Answer 116

chronic disease in which a person craves alcoholic drinks and is unable to control this - require greater amounts of alcohol and have withdrawal

Answer 117

increased risk of mouth, throat and breast cancer stroke heart disease liver disease: cirrhosis, alcoholic liver disease brain damage/damage to nervous system depression dementia self harm

Answer 118

mood change, insomnia, tremor, nausea and vomiting, confusion, hallucinations, seizures in severe cases Wernickes

Answer 119

benzodiazepines IV thiamine

Answer 120

change in mental state, ocular abnormalities, ataxia, hypotension, tachycardia, seizures, hallucinations, hypo/perthermia, spasticity

Answer 121

significant development of tolerance and dependence insomnia infections o the heart lining and valves abscesses chronic chest infections chronic and severe constipation depression antisocial personality sexual dysfunction and increased risk of STI irregular menstrual cycle increased risk of HIV and Hepatitis

Answer 122

it is used in treatment resistant schizophrenia - someone who has not responded to or has not tolerated two previous antipsychotic medications (in which one has to be an atypical medication)

Answer 123

after 48 hours their healthcare provider must be contacted and the patient has to be started back down at the lowest dose as they will have a loss of tolerance

Answer 124

smoking causes clozapine to be metabolised quicker, and therefore someone may need a higher dose to get the same effect

Answer 125

0.4-1mmol/L measured 12 hours post dose given

Answer 126

nephrogenic diabetes tremors dry mouth diarrhoea GI upset increased weight underactive thyroid in pregnant women - Ebsteins phenomina

Answer 127

BMI cardiac function heart function thyroid function renal function

Answer 128

IV fluids stop and review medications may need haemodialysis

Answer 129

overdose on the medication interactions - diuretics dehydration - vomiting and diarrhoea low sodium diet reduced renal function change in lithium brand

Answer 130

gastro pain drowsiness tremor ataxia hair loss sedation increased appetite weight gain blood dysstasias (decreased WCC, liver damage)

Answer 131

skin rashes steven johnson syndrome

Answer 132

every six months monitor thyroid, calcium, renal function

Answer 133

liver function testing every 6 months

Answer 134

it is when there is too much serotonin in the body causing neuromuscular hyperactivity, autonomic dysfunction and altered mental state

Answer 135

agitation, anxiety, restlessness, disorientation, diaphoresis hyperthermia tachycardia nausea, vomiting tremor muscle rigidity hyperreflexia myoclonus dilated pupils ocular clonus dry mucous membranes flushed skin increased bowel sounds a bilateral Babinski sign.

Answer 136

dizziness nausea restlessness headache tachycardia sweating insomnia panic attacks feeling tense dread low mood depersonalization and disconnect

Answer 137

struggling to breathe dissociation loss of control fainting symptoms chest pain

Answer 138

self help - relaxation techniques talking therapies CBT medication - SSRI, pregabalin, beta blockers

Answer 139

constipation hypoxia infection metabolic disturbance pain sleeplessness prescriptions hypo or hyperthermia organ dysfunction nutrition environmental changes drugs (CHIMPS PHONED)

Answer 140

it is an acute, transient and reversible state of confusion, usually as a result of a biological process - cognition is highly fluctuant

Answer 141

it is an irreversible, progressive decline and impairment of more than one aspect of higher brain function (concentration, memory, language, personality, emotion)

Answer 142

people with memory problems or higher critical thinking issues which is not severe enough to interfere with their everyday life - 10-15% will go onto develop dementia

Answer 143

1. does the person understand the information relevant to the decision 2. can the person retain the information for long enough to make a decision 3. can the person weigh up the information and use it to make a decision 4. can the person communicate their decision in any way back to the practitioner

Answer 144

malnourished slow pulse delayed capillary refill postural tachycardia low blood pressure muscle weakness back and bone pain less than 75% weight for height

Answer 145

changes in eating what do they think about food what was eaten yesterday do they vomit after eating how much exercise do they do ask about body checking do they use diet pills/laxatives how much water do they drink do they smoke

Answer 146

arrhythmias prolonged QT signs of electrolyte disturbance sinus bradycardia

Answer 147

low calcium, magnesium and phosphate

Answer 148

hyponatraemia hypokalaemia dehydration electrolyte disturbance

Answer 149

combination of talking therapy and supervised weight gain - up to 40 weeks CBT - MANTRA (understanding ED) - specialist supportive clinical management - focal psychodynamic therapy - nutritional support

Answer 150

guided help - CBT 20 sessions over 20 weeks - self care

Answer 151

guided self help - CBT 20 sessions over 20 weeks

Answer 152

it can happen when someone has been malnourished begins feeding again it is due to metabolising nutrients again as the body tries to do normal carbohydrate metabolism but due to low macronutrients it is unable to

Answer 153

confusions and disorientation seizures cardiomyopathy nausea and vomiting hypotension double vision swallowing issues trouble breathing kidney dysfunction muscle weakness

Answer 154

it is a condition which has an effect on a persons IQ and affects all aspects of learning and areas of life not just education - Downs syndrome, Williams syndrome, Aspergers syndrome

Answer 155

it doesnt affect a persons IQ/general intelligence, and will affect areas of learning but not other areas of life - dyslexia, dyspraxia, dyscalcula, dysgraphia

Answer 156

education services support and training for family careers choice of housing housing planning annual health check liaison workers reasonable adjustments specialist health and social care early years services help with personal budget

Answer 157

traumatic stress increases amygdala function and reduces hippocampal volumes. It increases cortisol and noradrenaline responses to stress. It also reduces the connections between the prefrontal cortex and the limbic system

Answer 158

that young children need to develop a relationship with at least one primary care giver for normal social and emotional development

Answer 159

secure anxious preoccupied dismissive avoidant fearful avoidant

Answer 160

difficulty in identifying, expressing and managing emotions internalise or externalise stress reactions depression, anxiety or anger aggressive behavious behaviour regression

Answer 161

before the harm - what happened before - was the self harm planned or impulsive - have they harmed before During - were they alone - what did they use to harm themselves - was the intent to end their lives - did they want to be found After - did they seek help - what is the patients current mood

Answer 162

what was taken how much was taken where did you get it from how long have they been thinking about the overdose was it taken with alcohol

Answer 163

where are the cuts how many cuts do they have how does it make them feel when they do it is it done with the intent to kill themselves how deep are the cuts

Answer 164

the level of intent/hopelessness the level of lethality (how much do they want to die) do they live alone their level of lack of sleep or agitation their age, sex have they had mental health issues previously do they have absent rational thinking do they have any protecting factors

Answer 165

it is a false perception of objects or events involving your senses: sight, sounds, smell, touch

Answer 166

it is a false belief or judgement about external reality, occurring especially in mental conditions

Answer 167

auditory smell hearing tactile somatic gustatory

Answer 168

symptoms must be present for one month and supported by indications of social dysfunction at work/school/interpersonal relationships for at least 6 months

Answer 169

stress bereavement loss of job or home divorce end of relationship abuse - drug, physical, emotional, sexual

Answer 170

impaired control over the substance increasing priority over other aspects of life psychological features such as neuroadaption

Answer 171

14 units per weeks spread over 3 or more days

Answer 172

tremors autonomic arousal - tachycardia, fever, pupillary dilation, increased sweating

Answer 173

alcohol hallucination seizures at 36 hours

Answer 174

delirium tremens altered mental status hallucinations

Answer 175

benzodiazepines Naltrexone: opiate blocker, makes alcohol less enjoyable acamprosate: increases GABA to reduce cravings Disulfiram: inhibits acetaldehyde dehydrogenase

Answer 176

rhinorrhoea lacrimation diarrhoea pupillary dilation piloerection tachycardia hot flushes nausea and vomiting

Answer 177

altered mental status slurred speech ataxia respiratory distress hypothermia euphoria disinhibition aggression anterograde amnesia labile mood

Answer 178

tremor nausea and vomiting tachycardia postural hypotension agitation malaise hallucinations seizures

Answer 179

adderall methamphetamines cocaine

Answer 180

tachycardia, hypertension, mydriasis, tactile hallucinations, chest pain

Answer 181

dysphoria lethargy psychomotor agitation ]craving increased appetite insomnia

Answer 182

LSD, marijuana, ecstasy, PCP

Answer 183

salience - when something becomes important mood modification tolerance withdrawal relapse

Answer 184

short attention span quickly loosing interest constant fidgeting impulsive behaviour disruptive poor organisation acting without thinking

Answer 185

prematurity low birth weight low paternal education prenatal smoking maternal depression

Answer 186

made my specialist in adults use the - Diagnostic interview for ADHD in adults questionnaire use the DSM-5 criteria looking at inattention and symptoms of hyperactivity and impulsivity - children up to 16 have to have 6 or more symptoms across both categories - over 17 only need 5 ore more symptoms

Answer 187

present for at least 6 months and be present in multiple settings

Answer 188

initially watch and wait period for up to 10 weeks including encouraged self care and behavioural management medication: methylphenidate

Answer 189

blood pressure heart rate - measured every 6 months

Answer 190

lower educational and employment attainment poor self esteem relationship issues sleep disturbance substance abuse self harm

Answer 191

Trait anxiety is when worry and fear permeate your experiences on a regular basis—not just in response to a stressful situation and is influenced by - stable characteristics from genetics and environment - adaptive responses to treat during childhood experienced calibrate the CNS response to a threat in adulthood

Answer 192

it is the state of feeling anxious - in the disorder these symptoms become more severe and persistant

Answer 193

suspense recurrent thoughts of negative outcomes reduced concentration hyper vigilance

Answer 194

there is a reduced functional connectivity between the prefrontal cortex and the limbic system variations in 5-HT transporter resulting in reduced 5-HT signalling dysregulation of the hypothalamic-pituitary-adrenal axis

Answer 195

Avoidance Attention and cognitive bias anxious rumination low self worth poor sleep

Answer 196

it is a neurodevelopmental disorder which is characterised by abnormal social interaction, communication and restricted and repetitive behaviours

Answer 197

a condition forming part of the autistic spectrum, characterized chiefly by repetitive patterns of behaviour, preoccupation with restricted interests, and difficulties with social interaction, without intellectual impairment or significant problems with verbal communication.

Answer 198

infantile spasms congenital rubella tuberous sclerosis fragile X syndrome

Answer 199

male sex family history genetic variants such as PTEN, MeCP chromosomal abnormalities

Answer 200

social interaction: lack of emotional response, unable to interpret cues, inability to form social attachment communication: delayed or minimally expressive speech, impairment of make believe, lack of social gestures, one way conversation restricted, repetitive behaviour: resist change, preoccupied with specific interests, inability to adapt to new environments

Answer 201

a clinical assessment which shows deficits across all three domains (discussed in clinical features card) - features must be observable in all environments and present from early childhood

Answer 202

diagnostic interview for social and communication disorders autism diagnostic observation schedule

Answer 203

non pharmacological: specialist education, occupational therapy, speech therapy, clinical psychology, sleep hygiene, care agencies

Answer 204

SSRI if the patient has anxiety or depression children with sleep issues may benefit from the use of melatonin

Answer 205

it is a mood disorder characterised by episodes of mania or hypomania and depression

Answer 206

1st degree relatives of a person with bipolar disorder are at an increased risk of developing bipolar, unipolar and schizophrenia - 60% chance with identical twins - polygenic inheritance

Answer 207

negative life events can precipitate depressive or manic episodes

Answer 208

increased dopamine activity in the brain may be important in the development of mania disturbances in the hypothalamic - pituitary- adrenal axis can result in increased cortisol secretion

Answer 209

genetic factors prenatal exposure to toxoplasma gondii premature birth childhood maltreatment postpartum period issues cannabis use

Answer 210

the person has experienced at least one episode of mania

Answer 211

the person has experienced at least 1 episode of hypomania but never an episode of mania, they must have also experienced at least one episode of major depression

Answer 212

this is cycling between hypomania and depression for at least 2 years

Answer 213

elevated mood increased activity level grandiose delusions energy increase pressure of speech decreased need for sleep inability to maintain attention inflated self esteem loss of normal social inhibitions risky sexual activity

Answer 214

needs to last for at least 7 days and have a significant negative functional effect

Answer 215

persistent elation in mood (less than in mania) increased energy and activity increased sociability talkativeness over familiarity increased sexual energy decreased need for sleep irritability

Answer 216

baseline bloods - FBC, U+E, LFT, TFT, CRP, B12, folate, vitamin D, ferritin HIV testing toxicology physical exam CT head

Answer 217

at least 7 days of mania or at least 4 days of hypomania depression

Answer 218

acute: oral antipsychotics for mania (olanzapine, risperidone, etc.) if patient on antipsychotic this should be tapered off and discontinued benzodiazepines can be used in short term to manage symptoms or increased activity and allow better sleep if patient depressed need to be careful with what is given due to mania risk - fluoxetine+olanzapine, quetiapine alone, olanzapine alone, lamotrigine alone

Answer 219

mood stabilisers: lithium (if not effective valproate psychotherapies: CBT, interpersonal or family focused therapies

Answer 220

increased risk of death by suicide increased risk of death by general medical conditions side effects of antipsychotics socioeconomic effects

Answer 221

12 hour bloods weekly initially until stable once stable do 3 monthly bloods then do bloods every 6 months

Answer 222

amyloid plaques and neurofibrillary fibers (tau) have a medial temporal lobe atrophy

Answer 223

hypertension smoking diabetes mellitus hyperlipidaemia obesity

Answer 224

cognitive impairment mood disturbance psychosis delusions paranoia

Answer 225

spherical lewy body proteins (alpha synuclein) are deposited within the brain

Answer 226

visual hallucinations parkinson like symptoms cognitive ddecline problems multitasking and performing complex tasks sleep disorders - often will present first fluctuation in cognitive ability

Answer 227

neuronal damage and cell death in the frontal and temporal lobes - atrophy occurs due the deposition of abnormal proteins (often tau)

Answer 228

altered mood apathy disinhibition increased impulsivity progressive decline in interpersonal skills decline in understanding words or speech difficulty in name retrieval not knowing the meaning of common words breakdown of language speech no longer fluent speech apraxia

Answer 229

family history abuse, neglect trauma toxins genetic conditions fetal alcohol syndrome maternal chicken pox prematurity meningitis autism epilepsy

Answer 230

hyperactive hypoactive

Answer 231

identify and treat underlying cause calm/consistent aids they may need independence orientate the patient involve family/carers in management haloperidol if antipsychotic required - 0.5mg

Answer 232

decreased level of consciousness respiratory depression pin point pupils

Answer 233

nausea vomiting confusion drowsiness

Answer 234

ABCDE Naloxone - initially 400 micrograms, of no response then give 800 for up to two doses at one minute intervals (subcut/IM) oxygen- non-rebreathe mask 15L assess consciousness - AVPU scale

Answer 235

mostly via glucuronidation and sulphation. 5% is metabolised by cytochrome p450 into N-acetyl-p-benzoquinone imine (NAPQI) this binds to glutathione to become non toxic and is secreted in the urine

Answer 236

acute: excess amounts ingested quickly staggered: excess amounts ingested over longer than 1 hour therapeutic: excess ingested with the intent to treat pain/fever without self harm intent

Answer 237

history of self harm history of frequent or repeated pain medication use low body weight cytochrome p450 inducers (phenytoin, rifampicin) glutathione deficiency - ED, alcoholism

Answer 238

nausea and vomiting mild to moderate abdominal pain/tenderness

Answer 239

moderate to severe abdominal pain metabolic acidosis jaundice AKI hepatic encephalopathy coma bruising/systemic haemorrhage

Answer 240

paracetamol concentration LFTs INR U+E plasma bicarbonate plasma glucose FBC lactate

Answer 241

if less than 8 hours after overdose: take bloods and start on acetylcysteine if paracetamol high if over 8 hours after overdose: bloods and if paracetamol is over 150mg/kg or the person is symptomatic start acetylcysteine immediately - if someone has taken a staggered overdose start acetylcysteine immediately regardless of level

Answer 242

1) standard 21 hour - 150mg/kg over 1 hour then 50mg/kg over 4 hours then 100mg/kg over 16 hours 2) modified 12 hour (SNAP) : 100mg/kg over 2 hours then 200 mg/kg over 10 hours

Answer 243

flumazenil - not always recommended as long term use can cause withdrawal seizures

Answer 244

agitation euphoria blurred vision slurred speech ataxia

Answer 245

over 500mg/kg

Answer 246

mild: tinnitus, lethargy, dizziness, N+V severe: dehydration, sweating, bounding pulse, deafness, breathlessness, confusion

Answer 247

salicylate concentration measured U+E glucose potassium urine pH ABG

Answer 248

activated charcoal within one hour of ingestion aggressive rehydration sodium bicarb if aspirin levels v.high haemodialysis in severe cases

Answer 249

benzodiazepines

Answer 250

severe resistant depression severe depressive disorder causing harm to patient catatonia severe or ongoing mania

Answer 251

6-12 sessions occurring twice weekly patient reassessed after each session and may stop before the end of the course/continue depending on the clinical presentation

Answer 252

a muscle relaxant - suxamethonium

Answer 253

short term memory loss retrograde amnesia post ECT headache post ECT muscle aches brief confusion or drowsiness

Answer 254

risks of anaesthesia - airway issues, dental damage risk of prolonged seizure

Answer 255

recent MI/stroke increased intercranial pressure active bleeding retinal detachment

Answer 256

it can sedate when given during the day

Answer 257

it helps to induce sleep at night

Answer 258

used in disorders relating to sleep and anxiety

Answer 259

benzodiazepines

Answer 260

Mirtazapine

Answer 261

amitriptyline imipramine

Answer 262

tranylcypromine phenelzine isocarboxazid

Answer 263

dry mouth blurred vision constipation drowsiness dizziness weight gain sweating arrhythmia impotence

Answer 264

risk of hyponatraemia - nausea - headache - muscle pain - loss of appetite - confusion - tired - disorientated

Answer 265

this is a long acting antipsychotic which is given every two to four weeks

Answer 266

flupentixol deconate zuclopenthixol deconate aripiprazole

Answer 267

weekly bloods for the first 18 weeks they bloods every other week up to 1 year after that blood tests are monthly

Answer 268

short acting - lasts up to 4 hours, get crash after long acting - take one a day and lasts from 6-8 hours. fewer ups and downs during the day

Answer 269

IQ between 50-69 some difficulties in acquisition and comprehension of complex language and academic skills most can manage basic self care, domestic and practical skills can live and work independently

Answer 270

IQ 35-49 basic language and academic skills some will manage basic self care, domestic and practical skills consistent support to live alone

Answer 271

IQ 20-34 very limited language and academic skills may have motor impairments require daily support

Answer 272

IQ <20 very limited communication skills may have some basic concrete skills may have motor and sensory impairment will need daily support

Answer 273

chromosomal/genetic abnormalities congenital malformations prenatal exposures - alcohol, sodium valproate, rubella, zika virus birth complications and premature birth childhood illness - meningitis, encephalitis, measles, epilepsy childhood brain injury childhood neglect

Answer 274

care environment with little opportunity for social interaction excessive sensory stimulation care environments which are crowded, unresponsive or unpredictable abuse and neglect developmentally inappropriate care environments illness care environment where disrespectful social relationships and poor communication is typical

Answer 275

this is when someone already in hospital goes AWOL and you need the police to bring them back in

Answer 276

this is a service which appoints a second opinion doctor which safeguards the rights of the patient subject to the mental health act

Answer 277

being assessed or treated for a mental health condition if you are at risk of getting worse without treatment if your safety or someone elses safety is at risk if you dont get treatment

Answer 278

different to next of kin, it is something the patient doesnt have a say in - hierarchy of blood relatives - preference is given to age - preference is given to those who live with the patient

Answer 279

family history age female personality traits childhood trauma lack of social support marital status

Answer 280

substance abuse physical health traumatic life events low self esteem lack of social support poor socioeconomic status

Answer 281

substance abuse physical health failure to cope with loss ongoing loss lack of support

Answer 282

current employment good social support being in a relationship

Answer 283

genetics personality physical illness serotonin imbalance neuroendocrine issues substance misuse

Answer 284

traumatic life events low self esteem lack of education

Answer 285

anhedonia loss of emotions diurnal changes early morning waking agitation appetite and weight change delusions hallucinationa

Answer 286

Mild: two typical core and two other symptoms Moderate: two typical core and at least 3 other symptoms Severe: all three typical core symptoms and at least 4 other symptoms

Answer 287

mild: self help, guided CBT, mindfulness, interpersonal psychotherapy, SSRIs, counselling moderate: CBT and SSRIs, individual CBT and behavioral therapy, psychotherapy Severe: consider antipsychotics and ECT. same management as above. Need regular risk assessments.

Answer 288

suicide self harm substance misuse recurrence of depression reduced quality of life antidepressant side effects

Answer 289

unwanted and uncontrolled thoughts and intrusive images which are hard to ignore

Answer 290

these are repetitive actions the person feels they must do, anxiety generating, often a way to control obsessive throughs

Answer 291

OCD - obsessive type, compulsive type, mixed body dysmorphic disorder body focused repetitive behaviour disorder hypochondriasis hoarding disorder

Answer 292

combination of SSRIs and psychological therapy - exposure and response prevention therapy - clomipramine (TCA) - adjunctive antipsychotics if required

Answer 293

this is one or more firmly held false beliefs that are persistent for at least 1 month. - no other psychotic symptoms

Answer 294

persecutory referential grandiose erotomanic nihilistic somatic jealous

Answer 295

these are situations that could occur in real life

Answer 296

these are implausible. they reflect beliefs that would be physically impossible

Answer 297

- presence of one of more delusion for >1 month - diagnostic criteria for schizophrenia not met - patients function not markedly impaired, behaviour not obviously bizarre or odd - disturbance is not better explained by another mental disorder

Answer 298

extreme anxiety triggered by particular situations or objects

Answer 299

when the fear is out of proportion to the danger when it lasts for more than 6 months when it has significant impact on day to day life

Answer 300

animals natural environment - heights, water, dark, germs body based phobias sexual phobias food phobias

Answer 301

it is the sense of intense fear when in social situations - may struggle with talking in groups, starting conversations, public speaking, speaking on the phone, meeting new people, working, talking to authority figures

Answer 302

extreme or irrational fear of entering open or crowded places, of leaving one's own home, or of being in places from which escape is difficult. - may struggle out the house, being in big open space, being in crowds, traveling by car/bus/plane

Answer 303

dizziness lightheadedness chest pain shortness of breath numbness dissociation

Answer 304

trauma learned responses from childhood experiencing long term stress genetic factors

Answer 305

CBT exposure therapy hypnotherapy antidepressants (SSRI) benzodiazepines for severe anxiety beta blockers for symptoms control

Answer 306

these are mood changes typically in the first week or so after birth characterised by mood swings, low mood, anxiety, irritability and tearfulness. - thought to be due to significant hormone fluctuation, recovery from birth and responsibility of caring for a neonate

Answer 307

this is a triad of low mood, anhedonia and low energy typically presenting around 3 months after birth lasting at least 2 weeks

Answer 308

mild: additional support, self help, follow up moderate: antidepressants (SSRI) and CBT severe: specialist psychiatric help and rarely impatient help on the mother and baby unit

Answer 309

this is used to assess how the mother has felt over the past week as a screening tool - 10 questions with total score of 30, a score of 10 or more suggest postnatal depression

Answer 310

it is a rare but severe condition characterised by delusions, hallucinations, depression and mania presenting typically between two to three weeks post delivery

Answer 311

neonatal abstinence syndrome - first few days after birth baby may be irritable and have poor feeding

Answer 312

it is life threatening alcohol withdrawal caused when someone with moderate to severe alcohol intake suddenly stops drinking. needs immediate medical care

Answer 313

tremors shakes confusion agitation and anxiety psychosis sensory disruption disorientation bouts of heavy sweating hyperthermia headaches nausea and vomiting hallucinations

Answer 314

(not fully curable) supportive therapy benzodiazepines IV fluids thiamine, folate, vitamins, electrolytes

Answer 315

it is caused by thiamine deficiency in alcoholism

Answer 316

the patient can develop korsakoff syndrome - memory impairment - behavioural changes - hallucinations

Answer 317

IV thiamine (pabrinex)

Answer 318

polyuria/polydipsia weight gain cognitive problems tremor sedation GI distress T wave change and wide QRS issues with renal function and hypothyroidism long term

Answer 319

it is involuntary muscle contractions, eye spasms/blinking, twisting head or protruding tongue - can cause painful muscle contractions

Answer 320

involves twisting of the torso and the neck - severe

Answer 321

dehydration rapid antipsychotic dose increase or initiation withdrawal of antiparkinsonian medication predisposing drugs

Answer 322

Benzodiazepines stop any causative agents supportive measures: oxygen, IV fluids, decrease temp with cooling blankets allow two+ weeks before restarting medication if rhabdomyolysis occurs then you need vigorous hydration and IV sodium bicarbonate

Answer 323

mild: stop medication, maybe add in a serotonin blocker moderate: observed in hospital for at least 24 hours severe: ICU give benzodiazepines for symptoms iv fluids and oxygen cyproheptadine - serotonin blocking agent

Answer 324

it is a state in which someone is awake but doesnt seem to respond to other people or the environment around them - can affect movement, speech and behaviour

Answer 325

sitting and staring into space holding unusual postures holding arms and legs in whatever position someone moves them into repetitive movements repeating the same phrase over and over repeating words and phrases they hear holding strange faces not eating or drinking sudden agitation

Answer 326

schizophrenia depression mood disorders OCD PTSD psychosis infections brain injury drug and alcohol use metabolic disorders autoimmune disorders

Answer 327

treat the underlying cause if physical lorazepam single dose challenge - symptoms tend to improve ECT monitor nutrition and hydration

Answer 328

AKI dehydration malnutrition pressure ulcers infections blood clots death

Answer 329

1. disturbance in awareness and attention 2. acute onset 3. disturbance in cognition 4. not explained by pre existing conditions 5. evidence of organic cause

Answer 330

in the first 18 weeks of treatment

Answer 331

fever mouth ulcer sore throat

Answer 332

treatment is often supportive until neutrophil count is back up stop clozapine can use granulocyte colony stimulating factor to reduce agranulocytosis time

Answer 333

increased risk of myocarditis (inflammation of the heart), possibly due to IgE hypersensitivity can cause cardiomyopathy

Answer 334

1-2 months after starting the medication

Answer 335

tachycardia fever flu like symptoms chest pain breathlessness

Answer 336

about 9 months after starting the treatment

Answer 337

gut hypomobility

Answer 338

thought that clozapine causes anticholinergic inhibition of the GI smooth muscle contraction and peristalsis pus it compounds the issue from serotonin receptor antagonism as serotonin plays a role in gut motility

Answer 339

bloating low stool frequency distension discomfort constipation ileus (paralytic) ischaemia necrosis

Answer 340

stool charts fiber in diet drinking plenty of fluid have a low threshold for reporting and gut issues !!! prescribe laxatives/stool softeners to help prevent long term constipation

Answer 341

change in bowel habit straining stomach aches feeling sick smelly wind hard stool

Answer 342

abdominal pain or discomfort for over an hour swollen or distended stomach overflow diarrhoea sickness or vomiting absent bowel sounds sepsis symptoms

Answer 343

it is when the mind has lost contact with reality, resulting in disrupted thoughts and perceptions and have difficulty determining what is real and what is not

Answer 344

delusions and hallucinations incoherent speech and behaviour suspicions and paranoia trouble thinking clearly withdrawing socially overly intense or unusual ideas lack of feelings decline in self care disruption of sleep difficulty telling reality from fantasy emotional disruption harming themself or others

Answer 345

complex combination of factors - genetics - exposure to stress/trauma - mental illness - physical illness - disease of older age - drugs and alcohol - sleep deprivation

Answer 346

antipsychotics specialty care recovery orientated team approach therapy if trauma involved

Answer 347

it occurs after a traumatic event characterised by feeling numb, having trouble sleeping, and reliving the traumatic event, with the symptoms lasting over one month

Answer 348

delayed onset - symptoms emerge over 6 months after the event complex - trauma at an early age/lasted a long time birth trauma - traumatic childbirth

Answer 349

It is when you experience some PTSD symptoms while supporting someone close to you who has experienced trauma

Answer 350

reliving the experience nightmares intense distress alertness/feeling on edge panicking upset or angry easily hypervigilance lack of sleep irritability avoidance of feelings or memories avoiding certain places emotionally numb difficult feelings/beliefs - unable to trust

Answer 351

difficulty controlling emotions distrustful feelings of emptiness or loneliness avoiding friendships or relationships dissociation suicidal ideation

Answer 352

if the symptoms are for less than 1 month the GP may suggest watchful waiting to see sx progression talking therapy: trauma focused CBT, eye movement desensitisation and reprocessing medication may be offered to patients who are experiencing depression, sleep issues or didnt respond to talk therapy

Answer 353

it is psychosis as well as mood disorder symptoms

Answer 354

psychosis: hallucinations, delusions, disorientation, confusion, feeling disconnected, difficulty with concentration, lack of motivation mood: excited, irritated, lack of sleep, sad, low, little connection with others

Answer 355

bipolar type - manic episodes along with psychosis depressive type - depressive episodes with psychosis

Answer 356

symptoms need to last for 1 month or longer you have psychosis and mood symptoms at the same time you have had mood symptoms for most of the time you have been unwell you have had a period of time (over 2 weeks) with psychosis without mood symptoms

Answer 357

traumatic life events childhood trauma genetic predisposition

Answer 358

talking therapies - CBT, mindfulness, psychodynamic therapies art therapy medication: antipsychotics, mood stabilisers, antidepressants (need to be careful with these as they increase the likelihood of a manic episode)

Answer 359

it is a mental disorder which affects thinking, perception and affect

Answer 360

family history and genetics malnutrition viral infection during pregnancy drug abuse social and environmental - trauma, socioeconomic class

Answer 361

rule out biological cause first - bloods, urine, drug screen, syphilis/HIV screen, CT head - then use the ICD 11 criteria: at least two symptoms for most of the time for at least 1 month, with one of the symptoms being a core symptom of schizophrenia

Answer 362

dialect behavioural therapy - designed for people that feel emotions very deeply, helps people understand their feelings, manage them and make changes

Answer 363

it is when mental factors cause physical symptoms affected people tend to be emotional about their symptoms and can affect day to day life unknown cause can persist a long time

Answer 364

chest pains dizziness tiredness back pain GI upset

Answer 365

it is when something is wrong but there is no known/diagnosable cause

Answer 366

somatisation disorder hypochondriasis conversion disorder body dysmorphic disorder pain disorder

Answer 367

it is when people fear minor symptoms may be due to a serious disease - fear, lots of time thinking about symptoms - people may accept that their symptoms are minor - reassurance often doesnt help

Answer 368

person has symptoms which suggests a disease of the brain or nerves, but due to mental factors - loss of vision, deafness, weakness, paralysis

Answer 369

it is when a person experiences persistent pain that cant be attributed to a physical condition or biological cause

Answer 370

it is when someone fakes illnesses (physical or mental) which they may or may not benefit from - can also create illness or injury in another person

Answer 371

Modafinil (CNS stimulant) sleep hygiene

Answer 372

HLA BDQ B1 0602

Answer 373

at least two of the following for at least 6 months - incongruent mental and physical appearance - strong desire for opposite gender genitalia - strong desire to be opposite gender - strong desire to be treated like the other gender - mentally feels like the opposite gender - doesnt like to look at/wants to remove own genitals or secondary sexual characteristics

Answer 374

Dizziness electric shock sensations anxiety restlessness

Answer 375

paroxetine

Answer 376

aripiprazole

Answer 377

after 1 week

Answer 378

after 2 weeks

Answer 379

increased appetite sedation

Answer 380

MAOI = such as phenelzine this can occur when a patient eats cheese, causing a hypertensive crisis

Answer 381

hyperparathyroidism - resultant hypercalcaemia leading to symptoms of 'stones, bones, abdominal moans and psychologic moans'

Answer 382

predisposing precipitation presenting perpetuating protective

Answer 383

bio - genetics, birth complications, past medical history, drug history psych - trauma, abuse, self esteem, mood and personality social - relationships, finances, stress, culture

Answer 384

thinking ' if A happens then B will happen' - pathognomonic for schizophrenia

Answer 385

depersonalisation - thinks they are not real derealisation - thinks the world around them isnt real

Answer 386

where they believe everyone in the world is actually just one single person all wearing masks

Answer 387

where they believe their partner to be unfaithful

Answer 388

they believe that a high status person is in love with them (erotomania)

Answer 389

citalopram

Answer 390

have a baseline monitor then weekly for 4 weeks then after 2 weekly

Answer 391

triptans decrease efficacy of SSRIs if someone is taking SSRI and NSAID you need to co-prescribe a PPI

Answer 392

in first trimester - CHD and cleft palate third trimester - Persistent pulmonary hypertension of the newborn

Answer 393

confusion hot dry skin increase Ach symptoms - cramps, increased salivation, lacrimation, muscular weakness, paralysis, muscular fasciculation, diarrhea, and blurry vision

Answer 394

a wide QRS >100ms and QT prolongation >480ms

Answer 395

weight gain and sedation

Answer 396

slowly reduce and then stop over 3 months to prevent a relapse

Answer 397

FBC, U+E, HbA1C, LFT, prolactin also need to do a BMI measurement

Answer 398

acute dystonic reaction akathisia parkinsonism tardive dyskinesia

Answer 399

IM/IV procyclidine

Answer 400

po propranolol

Answer 401

PO tetrabenazine

Answer 402

rhabdomyolysis AKI

Answer 403

NSAIDs - AKI diuretics - increase dehydration ACEi - can precipitate lithium toxicity

Answer 404

to promote communication strength to reduce emotional avoidance to modify dysfunctional behaviour

Answer 405

increased appetite increased seep mood may seem okay on good occasions catatonia very sensitive

Answer 406

it is subclinical depression for 2 or more years

Answer 407

female EUPD depression bereavement trauma or abuse LGBTQ

Answer 408

if they made a conscious effort to not be found if they left a note if they planned the death if they have no regret after the attempt

Answer 409

mania requires an urgent referral hypomania requires a routine referral

Answer 410

the temporal lobe

Answer 411

delusional perceptions thought alienation - insertion, withdrawal, broadcast, word salad third person auditory hallucinations passivity

Answer 412

non auditory hallucinations catatonia delusions reduced insight

Answer 413

bio- genetics, stimulants, palpitations, increased T4, withdrawal psych - mental health history, trauma, abuse social - stress, life events

Answer 414

over 1 month of at least 4 weekly spells of 10-30minutes of panic attacks

Answer 415

withdrawal symptoms - use of substance to avoid tolerance narrow repertoire craving loss of control rapid reinforcement - quick return to old level after stopping primacy - takes precedence over physiological need continued use despite harm

Answer 416

it is 12 months of over three of the dependence symptoms/terms

Answer 417

in pregnancy and when the person is still drinking alcohol

Answer 418

use of methadone/Buprenorphine and naltrexone

Answer 419

psychosis, impaired judgement, panic attack, dilated pupils, hyperreflexia

Answer 420

seizures coronary artery vasospasm ischaemic colitis hyperthermia QRS widening

Answer 421

SCOFF - make self sick after food - loss of control of food - one stone in last 3 months lost - food dominates life - fat perception

Answer 422

everything will be reduced except growth hormone and cortisol which will be raised

Answer 423

refeeding syndrome infertility amenorrhoea osteoporosis

Answer 424

eccentric/odd - paranoid - schizotypal - schizoid

Answer 425

erratic/wild - narcissistic - histrionic - EUPD - antisocial

Answer 426

anxious - anankastic - OCPD - avoidant - dependent

Answer 427

neuroleptic malignant syndrome serotonin syndrome lithium toxicity alcohol overuse

Answer 428

their growth charts as it can cause slow growth - 6 monthly also need to do baseline ECG as there is a risk of right bundle branch block

Answer 429

ASD ADHD PANDAs

Answer 430

non-goal oriented movement

Answer 431

echolalia coprolalia - verbal swearing copropraxia - middle finger

Answer 432

Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections - can cause OCD or tics after a strep infection

Answer 433

should be reduced but not stopped