Psychiatry Flashcards
defne
Othello Syndrome
Cotard’s Syndrome
Capgras Syndrome
De Clerambault’s syndrome
Charles bonnet
Othello Syndrome
Belive partner is chating on them
Cotard’s Syndrome
Belive their body is dead ro decaying - in severe depression
Capgras Syndrome
Delusion belief that reiefn or relative has been repplaced by an exact double
De Clerambault’s syndrome
Belief that another is deeply in love with them but hiding it
Charles bonnet
recutring hallucination in those with ipaired vision
define
Hallucination
Illusion
Delusion
Psychosis
Neurosis
Hallucination
Experance of sensng things that do not exist but with no external stimulus
Illusion
Misinterpriting stimulus into something that doesn’t exist.
Delusion
A fixed false belief held to 100% certainty that does not align with cultural or social norms. (for example that soup will make you better if you have a cold).
Psychosis
Perceive or interpret reality in a very different way from the people around you.
Neurosis
Heightened emotions that everyone has - overyly anxious, sad ect…
defne acute dystoniia
Acute dystonia
Sudden, sustained contraction of the neck mouth and tounge and eye muscles - medical emergancy
managamenet of ADHD
- Parental education of behaviour
- Healthy diet and exercise routine
- Methylphenidate
- Dexamphetamine
Atomoxetine
what are teh symptoms of depresson
- Low mood
- Hopelessness
- Tearful
- guilt ridden
- Suicidal thoughts
- Changes in appetite
- Changes in libido
- Changes in sleep
- Lack of energy
- Constipation
- Moving or speang slower than ussua
- Avoiding Hobbes ntrests abd socal stations
Lasting longer than 2 weeks
tests for depression
- Clincal diagnosis
- PHQ-9 patioen health questionaire 9
- Edenborough post-natal depression scale
Can consider B12 and folic acid tests
treatement of depression
Mild to moderate -
* Antidepressant - SSRIs (sertroline, fluoxatine)
* With SSRIs they have t be feeling better for 6 months before being weened off. Will take 2-4 weeks to start feeling better.
* Follow up appointment 2 weeks and then every 3 months
* Psychotherapy - CBT
* Advice on wellbeing - yoga, exercise, healthy diet.
* Antidepressants should eb contibues fro at least 6 months even if the person feels better, and then weaned off * Mirtazapine - increased appetite and drowsiness - think sam lol Triptns for migranes shouldb be avoided in SSRI takers due to increased risk of seratonin syndreom
complications of depression, protective factors ad final acts meaning
Check they rare not suicidal.
Check about self harm
SSRIs can causes hyponatremia.
* Protective factors - children, pets, family upset * Final acts - seeing friends to say goodbye, going to the bank, finialising the will, buring the medications, buying a rope ect
define and key presentations of autism
People defect n social interactions, communications and flexible behaviour.
Social interaction:
* Lack of eye contact
* Delayed smiling
* Avoid physical contaact
* Unable to read non verbal cues
* Difficulty making frends
* No desre to share attention
Communication:
* Delay or absece oin language development
* Lack of non verbal communication
* Difficulty with imaginative o imitative behaviour
* Repetative sue of phrases and words
Behaviour
* Greater interests n objects number or patterns than people
* Repetve movements - hand flappng or rocng
* Ntensve and deep intrests
* Repetative behaviour
* Anxiety and diseress being ouside the nroal rouine
* Restricted food preferences
mnumonicfor characteristics oof manaia
DIG FAST
* Distractible * Indiscresion * Grandiosity * Flight of ideas * Activity increase * Sleep defecit Takativeness
define manic and hypomanic episode
- Manic episode - persistently elevated, expansive or irritable mood lasting a week accompanied by 3 other symptoms which is severe enough to impact social or occupational functioning
Hypomanic episode - similar to manic but only last for 4 days and don’t markedly impact social functioning
treatment of bipolar
- Hospital admission - volutary or sectioning
- Refer to psychiatry
- Assess risk of suicide
ACUTE:
Mana:
* Oral antipsychotics such as haloperidol, olanzapine, quetpne, risperidone, aripiprazole
* Benzodiazapines: lorazapam and diazepam
Depression:
* Fluoxetine + olanzapine
* Quetiapine alone
* Olanzapne alone
* Lamotrigine alone
* CBT
Long term management:
* Lithium - increased risk of suicide though
Valproate
dfne and ey presentatons of anxety
Daly feelings of disproportional anxiety for months at a time which impacts a person’s everyday activity.
- Tense muscles
- Palpitations
- Sweating
- GI issues
- Chest pain
- Panic attacks
- Difficulty sleeping
- Sense of suspense
- Tired easily
- Irritable
- Difficulty concentrating
- Cant let go of worries
- Worrying affects daily life
- Avoidance od activitys
treatmen for anxety
- Mild: waiting, advive about self help (meditations ect), diet, exercise, avoiding alcohol caffien and drugs
- Moderate- sever - counselling, CBT, sertraline
- Can prescribe propanalol for the physical symptoms of anxiety, especially as a one off tablet or can take one every day.
- SERTRALINE is first kie for GAD
- SNRI can be used second lie - duloxatine
- For SSRIs, build up the dose, they should be n it and feeling for better for at least 6 months before starting to ween off.
Feeling worse, butterflies, nausea, stomach upset
treatment fo phobas
- Education and monitoring
- CBT with exposure therapy
Benzodiazapines as last line
OCD defntons
- Obsessions are uncontrolled intrusive thoughts that the person finds difficult to ignore.
- Compulsions are repetitive actions the person does to handle the obsessions.
Obsessions lead to anxiety which leads to compulations to sooth the anxiety, these then become more engrained in the persons behaviour. It has strong links with anxiety, depression, eating disorders and autism.
treatment of OCD
- Mild - education and self-help resources
- Significant - CAMHS, education, CBT, SSRIs.
- First line is CBT and exposure and respinse prevention
- Fluoxatine can be used
Clomipramine is a tricyclic one thatcan be used if others arent effectve
acute stress reacton defne and symtpms
- Anxiety low mood
- Poor concentratoin
- Wanting to be alone
- Poor sleep
- Irritability
- Recurrent dreams
- Flashbacks
- # avoidance of people, conversatios and stuations
- Emotional umbness
- Palpitations
- Nausea
- Chest pain
- Abdo pain
Breathing difficulties
symtpms ex[eranced after a dscrete event t happens n teh frst 4 wees afterths ts {TSD
treatmet of acute stress reacton
- Normally goes away by itself in a few days
- Conunselling
- Self care
- Beta bloker
Sleeo medications
ey rpesentatojs of PTSD
- Experience of truamatic event
- intrusve recolections
- Avoidance behaviours of places or events that remind people of the event
- Hyperarousal
- Nightmares
- Sleep problems
- Flashbacks
- Jumpy and anxious
Avoidance behaviour of triggers
treatment of PTSD
- CBT
- EMDR
- SSRIs - sertralne and paroxitne
TCA
causes of schizophrenia
genetics
drugs
intense emotons
stress
excessve dopamnergc actvty
key presentationsof schizophrenia
loss of ntests
socal withrawl
depression
anxiety
self neglect
positive symptoms:
- delusions
hallucinatins
thought diorders
strane mannerisim
negative changes
- social withdrawl
- speech poverty
- low self worth
- weigth changes
- sleep problems
management of schizophrenia
- Antipsychotics - typical or atypical
- Atypical are the first line - risperidone, olanzapine, queitpaine, aripiprazole
- Typical - haloperidol and chlorpromazine
- Start at low doses and titrate up
- Clozpine is second line but can causes aplastic anaemia!!!!
- It can only be prescribed by consultant psychiatirs and must be moniterd
- It also reduces the seizure threshold and makes them more likely
- Arapiprazole has the least side effects
- CBT
- Psychotherapies
- Family therapy
Social care
DSM 5 schiaophrenia criteria
DSM 5:
Two or more of the following, present for at least one month, for most days
* Hallucinations
* Delusions
* Disorganised speech
* Negative symptoms
* Grossly disorganised or catatonic behaviour
* At least one of the first three must be present, PLUS
* Social or occupational dysfunction
* No evidence of other causes for psychosis
* Not attributable to medication (illicit or otherwise)
* Increased lateral ventricel size * Reduced breain size Negative symptoms - reduced blood flow in the frotnal xortex
side effects of anti
what are poor prognostic indicators of shcizohenia
Poor prognostic indications:
* Pre morbid social withdrawal
* Low IQ
* Family History
* Gradual onset
* No obvious precipitant
Male
5 causes of psychosis
- Schizophrenia
- Depression
- Bipolar
- Drug and alcohol abuse
Neurological disorders
define schizoaffectve disorder
- Schizophrenia with a mood component (normally depression)!!!!!
- Combination of psychotic and bipolar disorder symptoms
- Schizoaffective disorder depressive type - psychotic and depressive symptoms at the same time
Schizoaffective disorder mixed type - psychotic, manic and depressive symptoms
key presentaios of schizoaffectove disprder
- Hard to concentrate
- Thoughts feel muddied
- Someone is adding or removing thoughts from your head
- People can hear your thoughts
- Belief you are being controlled
- Hallucination
Delusions