Psychiatry Flashcards
Patient presents with first time short history of psychosis investigation?
Urinary Toxicology
- drug intoxication important to rule out
First line medication in schizophrenia?
risperidone- 2nd gen antipsychotic
-less likely to cause extra pyramidal side effect s
How do 2nd generation antipsychotics work?
transiently inhibit D2 and 5HT-3 receptors
-less likely to cause extrapyramidal side effects
Why do 1st gen antipsychotics cause extrapyramidal side effects?
through inhibition of D2 receptors- causes decrease dopamine activity via nigrostriatal pathway (responsible for movement and sensory stimulus)
Clozapine side effect
agranulocytosis!
Indication for clozapine use?
treatment resistant schizophrenia
-patient who has been treated with 2 antipsychotics already
Most likely finding on blood tests when suspected re-feeding syndrome
hypokalaemia, hypophosphatemia and hypomagnesaemia
Pharmacological management of anorexia nervosa with mild-moderate depression
Mirtazapine- causes weight gain
is a tetracyclic antidepressant
what is conduct disorder?
similar to antisocial disorder but in <18 y/o
often presents with aggression towards peers and animals
definition of acute stress disorder
acute stress reaction in 4 weeks after traumatic event
features:
intrusive thoughts
dissociation
avoidance
negative mood
after how many weeks can PTSD be diagnosed
4 weeks
side effects of atypical antipsychotics e.g. olanzapine
metabolic effects
impaired glucose tolerance
weight gain
raised prolactin
agranulocytosis
what is somatisation disorder?
multiple physical SYMPTOMS present for at least 2 years
patient refuses to accept reassurance or negative test results
what is hypochondriasis?
persistent belief in underlying serious DISEASE e.g. cancer
what is malingering
fraudulent stimulation or exaggeration with the intention of financial or other gain
how often should lithium monitoring be performed
weekly after initiation and after each dose change until levels stable
once stable- check every 3 months
symptoms of SSRI discontinuation syndrome
dizziness, electric shock and anxiety
what is the medical management of delirium tremens/alcohol withdrawal?
oral chlordiazepoxide or diazepam
SSRI side effects
GI => most common
hyponatraemia
GI bleeding -> PPI should be prescribed if patient also using NASIDs
how long after remission of symptoms of depression should antidepressants be continued for?
at least 6 months - to reduce the risk of relapse
what is the SSRI of choice in children and adolescents?
fluoxetine
(fluoxeTEEN)
diagnosis of schizoaffective disorder is based off of what?
presence of an affective disorder - mania or depression and
evidence of schizophrenia (psychotic features)q
what is emergency detention certificate?
detention of patient for 72 hours
DOES NOT authorise treatment
- any medical professional
what is short term detention certificate?
detention and initiation of treatment for 28 days
- initiated by psychiatrist and MHO
