Psychiatry Flashcards
How long must sx persist for a diagnosis of depression?
2 weeks
What is 1st line pharmacological mx for generalised anxiety disorder in Adults?
Sertraline
How is persistent subclinical or mild-moderate depression mx?
1st line is CBT
How is moderate to severe depression mx?
1st line is CBT + antidepressant (SSRI)
How is severe depression +/- adverse effects such as psychosis managed?
ECT is 1st line
How much longer after remission of depression should SSRIs be continued for?
6 Months
Why may antipsychotics such as mirtazapine be useful in anorexia nervosa?
Help to settle anxiety/depression and a SE is weight gain which also helps.
What is Russell’s sign seen in Bulimia pts? What are other signs?
Russell’s: Scarring of the knuckles associated with self-induced vomiting.
Others: dental erosion, parotid swelling, amenorrhoea, and Boerhaave syndrome/mallor-weiss tear are complications that they may present with.
Schizotypal personality disorder is a class A personality disorder, what are the symptoms do you see?
Unusual social behaviour, bizarre/magical thinking, distorted perceptions.
How is schizotypal personality disorder different from schizophrenia?
SPD pts can maintain their grasp on reality and do not hold their beliefs with such unwavering certainty.
What do you see in pts with schizoid personality disorder?
Impaired relationships and attachement.
What do you see in patient with paranoid personality disorder?
Enduring pattern of irrational suspicion and mistrust of others.
What age must you be to be diagnosed with a class A personality disorder?
18 and over.
What has a better prognosis for Schizophrenia, predominantly -ve sx or predominantly +ve sx?
Having predominantly +ve sx (hallucinations and delusions) are a sign of a good prognosis.
What is the difference between type 1 and 2 Bipolar disorder?
Type 1: one or more manic episodes and one or more depressive episodes
Type 2: recurrent depressive episodes, tend to be able to continue with ADLs
What is used to manage chronic bipolar disorder?
Lithium or valproate as mood stabilisers and high intensity psychological therapies.
How long must sx persist for to diagnose PTSD?
1 month of sx symptoms affecting day-to-day life
What is delusional parasitosis?
Unshaken belief of infection with parasite within their skin.
What is a Capgras delusion?
Misidentification syndrome where the pt thinks their loved ones have been replaced by a clone.
What is Fregoli Disorder?
someone who believes everyone is the same person dressed in different designs, associated with injury to the right frontal area, left tempoparietal area, and fusiform gyrus.
What is a cotard delusion?
pt believes they are dead, non-existing, or rotten
What is thought blocking?
Pt halts their thought process, may be seen as withdrawal from conversation/interaction and abrupt silence.
Seen in schizophrenic pts.
What type of electrolyte disturbance is associated with purge-type bulimia?
Metabolic acidosis (vomiting = loss of acid) with hypokalaemia (vomiting induces RAAS).
What blood test abnormality is commonly found in someone with Anorexia Nervosa?
Low WCC secondary to malnutrition.
How long does an acute stress reaction last? How long is the onset from a significant event?
<4 weeks.
Onset within a couple of days of significant event.
How long does adjustment disorder last? How long since a significant event does it onset?
- Lasts <6 months
- Onset < 3 months since event
What is 1st line medication for mania?
Risperidone (2nd gen antipsychotic)
