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Medicine > Psychiatry > Flashcards

Psychiatry Flashcards

1
Q

Name 3 SSRIs

A

Sertraline
Fluoxetine
Citalopram

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2
Q

Name 4 SNRIs

A

Duloxetine
Venlafaxine
Desvenlafaxine
Levomilnacipran

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3
Q

Name 2 NASSAs

A

Mirtazapine
Aptazapine

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4
Q

What is the MOA of NASSAs?

A

alpha-2 adrenergec receptor antagonist

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5
Q

What is the MOA of benzodiazepines?

A

Bind GABA reducing neural excitability

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6
Q

Name 3 short acting benzodiazepines

A

Lorazepam
Alprazolam
Clonazepam

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7
Q

Name 3 long acting benzodiazepines

A

Diazepam
Temazepam
Chlodiazepoxide

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8
Q

What is the MOA of pregabalin and what is it used for in psychiatry?

A

Enhances GABA

Resolves anxiety

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9
Q

What is Buspirone used for?

A

anxiety

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10
Q

What is the main congenital defect associated with Lithium use?

A

Ebstein’s anomaly

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11
Q

What is methylphenidate used for?

A

Noradrenaline and dopamine re-uptake inhibitor

Acts as a CNS stimulant or ADHD

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12
Q

Name 2 FGA-Ps

What is their MOA?

A

Haloperidol
Chlorpromazine

D2R antagonists

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13
Q

What are the risks associated with FGA-Ps?

A

Extrapyramidal SEs
Hyperprolactinaemia
Neuroleptic malignant syndrome

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14
Q

Name 3 SGA-Ps

A

Clozapine
Olanzapine
Risperidone

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15
Q

What risks are associated with Clozapine?

A

agranulocytosis
seizures

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16
Q

Which patients should you be wary of on Olanzapine?

A

DM patients

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17
Q

What are the general types of SEs with SGE-Ps?

A

Metabolic SEs

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18
Q

What is the MOA of Procyclidine?

What is it used for?

A

Blocks central cholinergic receptors

Treats extrapyramidal SEs (parkinsonism, acute dystonia, akathisia…)

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19
Q

What is tetrabenazine used for?

A

Used for tardive dyskinesia and Huntington’s

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20
Q

What is Bromocriptine used for?

A

Sometimes used for neuroleptic malignant syndrome

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21
Q

What would you use to treat morphine dependent patients?

A

Buprenorphine

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22
Q

What would you use to treat alcohol relapse?

A

Acamprosate
Disulfiram (Antabuse)

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23
Q

How would you treat acute alcohol withdrawal?

A

Chlordiazepoxide

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24
Q

What drug should you switch people to if they’re having a SE of antpsychotics?

A

Aripiprazole

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25
Q

What is the difference between Acute Dystonia and Tardive Dyskinesia?

A

Acute Dystonia - head, face, neck (abnormal posturing)

Tardive Dyskinesia - face, tongue

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26
Q

What are the 2 main features of Neuroleptic Malignant Syndrome and how is it managed?

A

Fever, rigidity

Dantrolene, IV fluids

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27
Q

What chemical side effect is associated with sertraline use?

A

Hyponatraemia

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28
Q

What needs to be considered with clozapine in smokers?

A

Smoking cessation risks an increase in clozapine levels

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29
Q

What are the different clusters of personality disorders?

A

A (odd / eccentric) - paranoid, schizoid, schizotypical
B (dramatic / emotional / erratic) - antisocial, borderline, histrionic, narcissistic
C (anxious / fearful) - OCD, avoidant, dependant

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30
Q

How would you manage BPD?

A

Dialectical behaviour therapy
Atypical antipsychotics

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31
Q

Name all 7 of Schneider’s First Rank Symptoms

A

Delusions
Thought broadcasting
Thought withdrawal
Somatic passivity
Narration
Audible thoughts
Voices arguing

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32
Q

What drug is used to treat PTSD? What is its’ MOA?

A

Venlafaxine (SNRI)

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33
Q

What is the main side effect of SNRIs?

A

HTN

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34
Q

How would you differentiate avoidant and schizoid personality disorders?

A

Avoidant - Michael scott, loner but wishes the office were his friends
Schizoid - Dwight, loner but doesn’t care

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35
Q

How would you manage a manic/hypomanic patient on antidepressants?

A

Stop antidepressants
Start antipsychotics

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36
Q

What drug interaction may cause serotonin syndrome?

A

SSRI + triptan = serotonin syndrome

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37
Q

How do you treat panic disorder?

A

SSRI

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38
Q

What urological side effect is associated with TCA’s?

A

Overflow incontinence

(because of anticholinergic effect)

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39
Q

Describe Othello syndrome

A

Unfounded jealousy

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40
Q

Describe Fregoli syndrome

A

Believing that multiple people are the same person changing their appearance to deceive you

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41
Q

Describe Folie A deux

A

shared hallucinations / delusions between individuals

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42
Q

Describe Erotomania

A

XS sexual drive

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43
Q

Describe factitious disorder

A

consciously pretending you have a mental illness

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44
Q

What are the physiological features of anorexia nervosa?

A

^GH, glucose, cortisol, carotin, and salivary gland secretions

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45
Q

Describe Charles Bonnet syndrome

A

Visual hallucinations + visual loss

Pt normally has good insight

46
Q

What psychiatric disorder might corticosteroids trigger?

A

Sudden onset psychosis

47
Q

What are the stages of alcohol withdrawal?

A

Symptoms 6-12 hours
Seizures 36 horus
Delirium tremens 72 hours

48
Q

Name 3 CNS stimulants used to treat ADHD

A

Methylphenidate
Dexamfetamine
Atomoxetine

49
Q

What is the danger of offering sertraline with NSAIDs?

How can this be avoided?

A

GI bleeding risk

Offer a PPI too

50
Q

What is the most common side effect of olanzapine

A

SGAp

So plyuria and polydipsia (glucose dysregulation and DM)

51
Q

What medication should never be coadministered with SSRIs?

Why?

A

MAOi’s

Risk of serotonin syndrome

52
Q

Name 4 signs of lithium toxicity

A

coarse tremor
CNS disturbance
arrhythmias
visual disturbance

53
Q

What is the classic triad of Wernicke’s enecphalopathy?

A

Ophthalmoplegia
Ataxia
Confusion

54
Q

Which type of tremor is a side effect of lithium, and which is a sign of toxicity?

A

SE - fine tremor

Toxicity - coarse tremor

55
Q

What is the largest risk associated with ECT?

A

Memory loss

56
Q

Which ECG change is associated with haloperidol?

A

QT prolongation

57
Q

Name 2 questionaires used for alcoholism patients

What are they used for?

A

CAGE - assesses alcohol intake

AUDIT - do they need specialist evaluation?

58
Q

How long does someone need to show signs of depression to make a formal diagnosis?

A

14 days

59
Q

How would you manage the cognitive and somatic manifestations of anxiety?

A

Cognitive - SSRIs

Somatic - BBs

60
Q

What is the relevance of ramipril to psychiatry?

A

it’s an ACEi increasing serum lithium levels

61
Q

When would you commence dialysis for pts with lithium toxicity?

A

if >4

OR

> 2.5 w/ renal dysfunction

62
Q

Name one similarity and a difference between schizoid and schizotypal personality disorders

A

Both difficulty interacting

Schizotypal - bizarre or magical thinking

63
Q

Roughly, how is bipolar affective disorder managed?

A

Acute mania - quetiapine

Long-term treatment - Lithium

64
Q

How would you differentiate opioid intoxication and opioid withdrawal?

A

Intoxication - drowsy, bradycardia, constricted pupils

Withdrawal - agitation, sweating, dilated pupils

(tihnk parasympathetic vs sympathetic)

65
Q

Name 4 positive symptoms of schizophrenia

A

ABCD

Auditory hallucinations
Broadcasting of thoughts
Control issues
Delusional perception

66
Q

Name 4 negative symptoms of schizophrenia

A

4 As

Alogia
Anhedonia
Affective incongruity or blunting
Avolition

67
Q

How would bulimia cause hypokalaemia?

A

Activates RAAS, retaining sodium, bicarbonate, and water, and expelling K+

68
Q

How would you manage an acute heroin withdrawal?

A

Don’t prescibe opiates, but offer symptomatic management

69
Q

What is the MOA of loperamide?

What is it used for?

A

opioid agonist

diarrhoea

70
Q

What blood test result supports NMS?

A

^CK

71
Q

Which ECG change is associated wth refeeding syndrome?

A

Prominent U waves (feature of hypokalaemia)

72
Q

How can you mitigate refeeding syndrome?

A

Pabrinex (high dose vitamins) before feeding

Phosphate supplement prophylaxis

Monitor boods and replenish electrolytes

slowly build calorie intake

73
Q

What is the first line management for delirium tremens?

A

lorazepam PO

74
Q

What might sodium valproate be used for in psychiatry?

What are its’ side effects?

A

BPD

VALPROATE
Vomiting
Alopecia
Liver toxicity
Pancreatitis / Pancytopaenia
Retention of fats (weight gain)
Oedema
Anorexia
Tremor
Enzyme inhibition

75
Q

How would you differentiate OCD and OC personality disorder?

A

OCPD - compulsions seen as a benefit to their life

OCD - distressing, anxiety

76
Q

What properties of Chlorphenamine do you need to be aware of?

A

Anti-histamine, crosses BBB so can lead to anti-depressant / anxiety effects

Risk of acute delirium or anti-cholinergic actions (dry mouth, urinary retention) in elderly patients

77
Q

Under what section of hte MHA can police move someone who appears to have a mental disorder from a public place to a place of safety?

A

Section 136

78
Q

What does section 5(2) of the MHA describe?

A

Voluntary patient in hospital can be legally detained by a doctor for 72 hours

79
Q

What does section 2 of the MHA describe?

A

Admission for assessment for up to 28 days and is non-rnewable

Health professional must discharge the patient at the end of the 28 days if they have no reason to detain them further

80
Q

What does section 3 of the MHA describe?

A

Admission for treatment only.

You can’t give treatment without a diagnosis, so pt would have to be admitted under Section 2 first

Allows for treatment for up to 6 months and is renewable

81
Q

What does section 4 of the MHA describe?

A

can be used for emergencies where a section 2 would cause an ‘undesirable delay’

82
Q

What effect would anorexia nervosa have on FBC?

A

Low WCC

83
Q

What is Capgras delusion?

A

Misidentification syndrome in which the patient believes that someone close to them has been replaced by a clone

84
Q

How would you differentiate NMS and serotonin syndrome?

A

NMS - gradual onset (days/weeks), normal pupils, hyporeflexia

SS - onset in hours, clonus

85
Q

What is ritalin?

What are its’ SEs?

A

Methylphenidate

Stimulant used to treat ADHD but is often used illictly

SE - insomnia, restlessnes, pyrexia, HTN, tachycardia…

86
Q

What is conversion disorder?

A

Neurologicla symptoms without any underlying neurological cause

87
Q

What is Somatoform disorder?

A

presence of non-neurological symptoms without an obvious cause

88
Q

What is hypochondriasis?

A

Patients believe they have a serious illness and will frequently want tests and investigations to get anwers

89
Q

What is Manchaeusen syndrome?

A

Patients fake illnesses to receive attention playing the patient role

90
Q

What is malingering?

A

Falsification or exaggeration of illness to gain external benefits

91
Q

What are you at risk of when you co-administer Sertraline and clopidogrel?

A

SSRI + antocoagulant = bleeding

92
Q

What is agnosia?

A

The inability to recognise people, objects, or places that were once known to a person

93
Q

What score on the AUDIT questionaire supports the use of chlordiazepoxide, bypassing CBT?

A

20

94
Q

How do you treat an acute paracetamol overdose?

A

N-acetyl cysteine

95
Q

What drug is used as a synthetic opioid agonist in opioid substitution therapy for patients with opiod dependence?

A

Methadone

96
Q

What is the difference between Bipolar 1 and 2?

A

1 - mania
2 - hypomania

97
Q

Which dementia subtype is haloperidol contraindicated in?

A

Lewy body dementia

98
Q

What psychiatric medication group might cause anticholinergic effects?

A

TCA - amitryptiline

99
Q

How would you use SSRIs to treat OCD?

A

Highe dose than for depression and requires 12 weeks for an initial response

100
Q

Which antidepressant risks increased appetitie and weight gain?

A

Mirtazapine

101
Q

Following a change in dose, how should lithium levels be monitored?

A

12 hours after first dose, then…

Weekly until levels are stable

102
Q

Describe Ekbom syndrome

A

Pt believes they are infested with parasites

103
Q

What is Russell’s sign?

A

Scarring of hte knuckles associated with bulimia

104
Q

Describe Pica

A

Eating non-food items or food items in abnormal quantities

105
Q

What is the most common SE of amitriptyline?

A

Urinary retention

106
Q

What is the 1st line option for schizophrenia?

A

RisperidoneW

107
Q

What are the signs of TCA overdose?

A

Confusion
seizure
^HR
Hypotension
Dilated pupils

108
Q

What ECG changes are seen in TCA overdose?

A

Prolonged QRS
^QTc interval

109
Q

What is the first line treatment for mdoerate / severe OCD?

A

Clomipramine

110
Q

Which SSRI is most likely to lead to QT prolongation and Torsades de pointes?

A

Citalopram

111
Q

What is the most effective antipsychotic for negative symptoms of schizophrenia?

A

Clozapine

Medicine (22 decks)

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