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Phase 3a > Psychiatry > Flashcards

Psychiatry Flashcards

1
Q

What components are in a formulation?

A
  • predisposing
  • precipitating
  • presenting
  • perpetuating
  • protective
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2
Q

What is included in an MSE?

A

A - appearance and behaviour
S - speech
E - emotion
P - perception
T - thought
I - insight
C - cognition

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3
Q

What is the definition of mental health disorder?

A

Disorder of mind excluding alcohol and drugs

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4
Q

What is the definition of psychosis?

A

Loss of touch with reality + impaired function

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5
Q

What is the definition of a hallucination?

A

An unreal interpretation of an unreal stimulus (e.g. hearing voices)

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6
Q

What is the definition of an illusion?

A

An unreal interpretation of a real stimulus (e.g. leaves rustling mistaken for footsteps)

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7
Q

What is a delusion?

A

A fixed false unshakeable belief out of keeping with social norms

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8
Q

What is the definition of delusional perception?

A

‘If A happens, B will happen’ (pathognomonic for schizophrenia)

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9
Q

What is the definition of flight of ideas?

A

Rapid stream of consciousness - jump between topics

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10
Q

What is the definition of formal thought disorder?

A

Disordered pattern of speech as a result of disordered thought

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11
Q

What is the definition of knight move?

A

Illogical jumps from a point and not returning

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12
Q

What is the definition of tangeniality?

A

Deviating from a point and not returning

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13
Q

What is the definition of circumstantiality?

A

Deviating from a point but returns

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14
Q

What is the definition of depersonalisation?

A

When someone thinks there not real

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15
Q

What is the definition of derealisation?

A

When someone thinks the world around them isn’t real

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16
Q

What is the definition of obsession?

A

Mental preoccupation, pervasive and recurrent

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17
Q

What is the definition of compulsion?

A

Urge + action or obsession to obtain relief

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18
Q

What are some of the thought problems patients experience?

A
  • Insertion
  • withdrawal
  • broadcast
  • passivity
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19
Q

What is somatoform disorder?

A

Medically unexplained symptoms

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20
Q

What is hypochondriasis?

A

Mental preoccupation that a patient has a life threatening illness despite a lack of symptoms and negative tests

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21
Q

What is conversion disorder?

A

Neuro symptoms (e.g. weakness) in absence of pathology therefore put down to psych

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22
Q

What are some of the types of delusion?

A
  • persecutory - mc
  • grandiose
  • guilt + worthlessness
  • nihilistic
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23
Q

What is Capgras delusion?

A

The belief that a close relative has been replaced with an imposter

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24
Q

What is Fregoli delusion?

A

The belief that everyone is one person with masks

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25
Q

What is Othello delusion?

A

The belief that their partner is unfaithful (extreme jealousy)

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26
Q

What is de clerambault delusion?

A

The belief that a exalted yet inaccessible person is in love with the patient

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27
Q

What is Ekbom delusion?

A

Restless leg syndrome, painful calf cramping, “creepy crawly”

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28
Q

What is Cotard delusion?

A

The belief that the patient is dead and rotting

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29
Q

How long do antidepressants take to start working?

A

4-6 weeks

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30
Q

What is there an increased risk of in under 30s starting antidepressants?

A

Increased suicide risk

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31
Q

How long do antidepressants need to be taken after symptoms improve?

A

Keep taking for 6 months after symptoms improve and then wean over 4 weeks - prevents serotonin discontinuation syndrome

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32
Q

What are the symptoms of serotonin discontinuation syndrome?

A
  • nausea + vomiting
  • agitation
  • insomnia
  • paraesthesia
  • flu like symptoms
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33
Q

According to the MHA 1983 what do you need to be able to detain a patient?

A
  • Evidence of a mental health illness
  • They’re going to be a risk to society
  • They will benefit from admission
  • There is treatment available for them
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34
Q

What are the principles of the MHA 1983?

A
  • need to pick the least restrictive option available
  • patient needs to be safe
  • improve patient wellbeing ‘
  • give effective treatment
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35
Q

True or false: the MHA can override the MCA?

A

True

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36
Q

What is the most commonly used SSRI?

A

Sertraline

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37
Q

What are some available SSRIs?

A
  • Sertraline
  • Paroxetine
  • Fluoxetine
  • Citalopram
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38
Q

Which SSRIs can be used when breastfeeding?

A

Paroxetine and fluoxetine

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39
Q

Which SSRI is most likely to cause QTc prolongation on an ECG?

A

Citalopram

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40
Q

What are some of the side effects of SSRIs?

A
  • GI - n+v, pain, increased GI bleed risk
  • Impotence and decrease libido
  • Serotonin syndrome
  • QTC prolongation
  • Hyponatremia
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41
Q

What medications can SSRIs interact with?

A
  • Triptans - decrease the efficiency
  • NSAIDs - GI bleeds, co-prescribe a PPI
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42
Q

What congenital defects can paroxetine cause in the first trimester?

A
  • Congenital heart defects
  • Cleft palate
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43
Q

What congenital defects can paroxetine cause in the third trimester?

A

Persistent pulmonary hypertension of the newborn

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44
Q

What are some examples of SNRIs (antidepressants)?

A
  • Venlafaxine
  • Duloxetine
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45
Q

What are some side effects of of SNRIs?

A
  • Nausea and vomiting
  • dry mouth
  • rhabdomyolysis
  • SIADH
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46
Q

What are some examples of tricyclic antidepressants?

A
  • amitriptyline (sedating)
  • imipramine (non sedating)
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47
Q

What are the side effects of tricyclic antidepressants?

A
  • Dry eyes, mouth, dehydrated, constipation
  • impotence
  • sedation
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48
Q

What are the side effects for overdosing on tricyclic antidepressants?

A
  • Dry hot skin
  • confusion
  • Increased acetylcholine symptoms
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49
Q

How is a tricyclic antidepressant overdose diagnosed?

A

ECG - Wide QRS + QTC prolongation

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50
Q

How is a tricyclic antidepressant overdose treated?

A

IV Bicarb

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51
Q

What are the side effects of mirtazapine?

A
  • weight gain
  • sedation
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52
Q

What is first line for depression if a patient is on warfarin or LMWH?

A

mirtazapine

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53
Q

What are the symptoms of major serotonin syndrome?

A
  • Hyperreflexia
  • ankle clonus
  • dilated pupils
  • autonomic symptoms
  • maybe increased creatinine kinase
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54
Q

What is the treatment for serotonin syndrome?

A

Stop SSRI and give chlorpromazine

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55
Q

How should antipsychotic medications be stopped?

A

Gradual reduction when stopping (over 3 months) to prevent relapse

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56
Q

What is checked at the 12 monthly review for a pt on antipsychotics?

A

FBC, U+E, HbA1C, LFT, prolactin, BMI

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57
Q

What are typical antipsychotics?

A

Haloperidol and chlorpromazine

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58
Q

What are the side effects of typical antipsychotics?

A
  • Acute dystonic reaction
  • Akathisia - Lower leg motor restlessness
  • Parkinsonism
  • Tardive dyskinesia - years after
  • lactation
  • decreased libido
  • infertility
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59
Q

What are atypical antipsychotics?

A

Risperidone, olanzapine, quetiapine, aripiprazole, clozapine

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60
Q

What are atypical antipsychotics associated with?

A
  • Weight gain
  • Metabolic syndromes - T2DM, Cushings
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61
Q

When will clozapine be used on a patient?

A

When 2 different antipsychotics have been tried

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62
Q

When are patients on clozapine monitored?

A
  • First 18 wk - weekly
  • Then fortnightly for 16 wk
  • Then monthly
  • Monitor - FBC, BP, BMI, SE
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63
Q

Which antipsychotic is proven to work on the mesocortical pathway and the mesolimbic pathway?

A

Clozapine

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64
Q

What are the main side effects of clozapine?

A
  • Agranulocytosis
  • Hypersalivation
  • Weight gain
  • Constipation
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65
Q

What needs to happen if a patient on clozapine misses a dose for more than 48hr?

A

Need to retitrate their dose - start on lower and work way back up

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66
Q

What needs to happen if a patient on clozapine’s smoking status changes?

A

Need to retitrate their dose - smoking decreases bioavailability of clozapine

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67
Q

What causes major neuroleptic malignant syndrome?

A

Overuse of antipsychotic or hypersensitivity reaction to antipsychotic

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68
Q

What are the symptoms of major neuroleptic malignant syndrome?

A
  • Hyporeflexia
  • Rigidity
  • Normal pupils
  • Raised creatine kinase +/- raised WCC
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69
Q

What is the treatment for major neuroleptic malignant syndrome?

A

Stop the antipsychotic, give dantrolene IM and bromocriptine

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70
Q

What are the complications of major neuroleptic malignant syndrome?

A
  • Rhabdomyolysis
  • AKI due to acute tubular necrosis
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71
Q

What is lithium used for?

A

Mood stabiliser - acts on cAMP

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72
Q

What medication does lithium interact with?

A
  • NSAIDs
  • diuretics
  • ACE inhibitors
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73
Q

What side effects can lithium cause?

A
  • Dehydration
  • renal failure
  • lithium toxicity
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74
Q

What level of serum lithium in the blood is classed as lithium toxicity?

A

> 1.5mmol/l

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75
Q

What are the symptoms of lithium toxicity?

A
  • Leucocytosis
  • diabetes insipidus
  • tremor - coarse
  • dehydration
  • hypothyroidism
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76
Q

True or false: lithium is teratogenic?

A

True

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77
Q

When are you going to measure lithium levels in a pt?

A
  • 12hr post first dose
  • weekly till stable
  • 3 monthly
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78
Q

What are you going to monitor on patients on lithium?

A

FBC, U+E, TFT, eGRF, BMI, ECG

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79
Q

What are the symptoms of syndrome of irreversible lithium effectuated neurotoxicity?

A
  • cerebellar symptoms
  • dementia
  • parkinsonism
  • dystonia
  • akathisia
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80
Q

If lithium cannot be used as a mood stabiliser what else can be?

A
  • carbamazepine
  • valporate
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81
Q

What are benzodiazepines used for?

A

sedation, alcohol withdrawal, anxiety

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82
Q

What are some examples of benzodiazepines?

A

chlordiazepoxide, diazepam, lorazepam

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83
Q

When would ECT (electroconvulsive therapy) be used?

A

In severe refractory depression and severe mania and sometimes catatonic schizophrenia

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84
Q

What are the complications of ECT?

A
  • Amnesia (short term)
  • Confusion (long term)
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85
Q

What is ECT contraindicated in?

A
  • <12yr old
  • HTN
  • MI <3m ago
86
Q

What is the most widely used talking therapy that can be used for most conditions?

A

CBT

87
Q

What are the principles of couples therapy?

A
  • Promote communication
  • Reduce emotional avoidance
  • Modify dysfunctional behaviour
88
Q

What is depression classified as?

A

> 2 weeks of anhedonia, low mood and low energy most days

89
Q

What are the risk factors for depression?

A

Bio - chronic pain, post partum, chronic steroid use, low T4 (hypothyroidism)
Psych - trauma, low self esteem, abuse
Social - bereavement, stressed, significant life event

90
Q

What are the main biological theories that have been implicated in depression?

A
  • Stress-vulnerability (different people different thresholds)
  • Monoamine hypothesis (reduced monoamine neurotransmitters (dopamine, serotonin, norepinephrine) causes depression)
91
Q

What are the symptoms of depression?

A

S - suicidality/ self harm
I - low interest
G - guilt or worthlessness
E - low energy
C - low concentration
A - low appetite
P - psychomotor retardation
s - decreased sleep

92
Q

What are the symptoms of atypical depression?

A
  • increased appetite
  • increased sleep
  • mood fluctuation
93
Q

How is depression diagnosed?

A

Bloods - FBC, U+E, TFT, prolactin, syphilis serology, B12, folate
Questionnaires - PHQ-9 (community), HADS (hospital), Edinburgh (postnatal)

94
Q

What is the treatment for depression?

A

Mild - 1.CBT, 2.SSRI
Moderate-Severe - SSRI + intense CBT
Last line - ECT

95
Q

What is the treatment for seasonal affective disorder?

A

Light therapy, SSRI

96
Q

What is the treatment for dysthymia?

A

Low intensity CBT

97
Q

What are some differentials for depression?

A
  • Seasonal affective disorder
  • dysthymia
  • other mental health conditions
  • Alzheimer’s
  • substance misuse
98
Q

What are the risk factors for self harm?

A
  • LGBTQ
  • Female
  • Emotionally unstable personality disorder
  • depression
  • bereavement
  • trauma/abuse
99
Q

What are risk factors for suicide?

A
  • Male
  • Old age and teens
  • depressed
  • PHx parasuicide
  • alcohol
  • psychotic
  • low social support
  • organised plan
  • not married
  • chronic illness
100
Q

Which patients have an increased risk of recurrent suicide?

A
  • Made a conscious effort not to be found
  • If they leave a note
  • If they plan their death
  • No regret afterwards
101
Q

What is bipolar type 1?

A

When a pt has alternating bouts of mania (psychotic symptoms) and depression

102
Q

What is bipolar type 2?

A

When a pt has bouts of hypomania (no psychotic symptoms) and depression

103
Q

What is cyclothymia?

A

When a pt has bouts of hypomania and subclinical depression

104
Q

What can precipitate a manic episode?

A
  • Benzodiazepine use
  • SSRI use
  • Alcohol
  • LSD
105
Q

What are the risk factors for bipolar?

A
  • Family history
  • stress
  • abuse/trauma
  • substance abuse
    Mean age - 24/25
106
Q

What are the symptoms of mania?

A

> 7 days of symptoms
- irritability
- distractable
- insomnia
- grandiose delusions
- flight of ideas
- activities increased
- speech increased
- thoughtless - increased risk taking behaviours

107
Q

What are the symptoms of hypomania?

A

4-7 days
- increased mood
- mildly distractable
- decreased sleep and food need
- no grandiose delusions
- talkative
- mildly reckless
- no hallucinations

108
Q

What GP referrals are made for mania and hypomania?

A

Mania - urgent CMHT referral
Hypomania - routine CMHT referral

109
Q

How is bipolar diagnosed?

A
  • clinical diagnosis
  • depression bloods
110
Q

What are the treatments for bipolar?

A

Acute - Antipsychotics (and stop taking SSRI for depression)
Long term - Lithium

111
Q

What is schizophrenia?

A

Disassociation from reality >28 days and not as a result of substance abuse

112
Q

Who is most affected by schizophrenia?

A

Median age - 25
M=F

113
Q

What lobe is most commonly affected in schizophrenia?

A

Temporal

114
Q

What are the main theories for schizophrenia?

A
  • Neurodevelopmental hypothesis - hypoxic ischaemic injury or any other birth complication can impair brain development, therefore increase risk
  • Neurotransmitter hypothesis - increased neurotransmitter in mesolimbic pathway = positive symptoms. Reduced neurotransmitter in mesocortical pathway = neg symptoms
115
Q

What are the risk factors for schizophrenia?

A
  • Family history !!!!!!!
  • Smoking cannabis in youth
  • Traumatic birth
  • Trauma + abuse
116
Q

What is the most common type of schizophrenia?

A

Paranoid schizophrenia

117
Q

What are the types of schizophrenia?

A
  • Paranoid
  • hebephrenic (young people)
  • catatonic
118
Q

What are the 1st rank symptoms of schizophrenia (Schniders symptoms)?

A
  • delusional perceptions
  • thought alienation - insertion, withdrawal, broadcast
  • third person auditory hallucinations
  • passivity
119
Q

What are the 2nd ranked symptoms of schizophrenia?

A
  • non-auditory hallucinations
  • catatonia
  • delusions
  • decreased insight
120
Q

Can you drive after a diagnosis of schizophrenia?

A

Can’t drive until 3 months on treatment and well or you have a good psychiatry report

121
Q

What are the differentials for psychosis?

A
  • drug induced schizophrenia
  • depression
  • post partum psychosis
  • schizoaffective
  • syphilis
  • Huntington’s
122
Q

How is schizophrenia diagnosed?

A

Bloods - Toxicology, FBC, U+E, TFT, B12+folate, syphilis
Diagnosis needs either 1 1st rank symptom or 2 2nd rank symptoms for >28 days

123
Q

How is schizophrenia treated?

A
  • Antipsychotic for at least 6-8 weeks, then another if unsuccessful, last line = clozapine
  • Consider MHA 2 or 3 section
  • CBT, CMHT
  • Consider social worker
124
Q

What is delusional disorder?

A

Pt has an isolated delusion >3m, no psychosis or loss of function

125
Q

What is schizoaffective disorder?

A

Schizophrenia + at least 1 mood disorder

126
Q

How is schizoaffective disorder treated?

A
  • Antipsychotics
  • Mood treatments
127
Q

What are the types of anxiety disorder?

A
  • GAD
  • Panic disorder
  • Simple/specific phobias
  • OCD
  • PTSD
128
Q

Which model explains the rational behind developing an anxiety disorder?

A

Triple vulnerability model : Genetic predisposition + life factor (loss of control) + life stress

129
Q

What are the risk factors for an anxiety disorder?

A

Bio- genetics, stimulant drugs, palpitations, increased T4, withdrawal
Psych- MHx, trauma, abuse
Social- stress, life event

130
Q

What is generalised anxiety disorder?

A

Pervasive, persistent non specific anxiety >6m

131
Q

Who is most commonly affected by GAD?

A

Females, 40-65yrs

132
Q

What are the symptoms of GAD?

A

I’m MISERAble
M - muscle tension
I - irritable and insomnia
S - sweaty
E - low energy
R - restlessness
A - autonomic - palpitations, SOB, tremor

133
Q

How is GAD diagnosed?

A

Bloods - FBC, U+E, TFT, Glucose, urine toxicity
Q = GAD-7 (5-9 mild, 10-14 mod, 15+ severe /21)

134
Q

What is the treatment for GAD?

A
  1. Patient education
  2. low intensity CBT
  3. high intensity CBT + SSRI + CMHT referral
  4. Propranolol for muscle tension
135
Q

What is panic disorder?

A

A pervasive disorder, lasting > 1 month with at least 4x week spells of 10-30min panic attacks

136
Q

Who is most affected by panic disorders?

A

F
20-30yrs

137
Q

What are the symptoms of panic disorder?

A

3cs - chest pain, choking, chills
MISERABLE - muscle tension, irritable+insomnia, sweaty, low energy, restlessness, autonomic,

138
Q

How is panic disorder diagnosed?

A
  • Panic disorder severity scale (PDSS)
  • PHQ-PD
139
Q

How is panic disorder treated?

A

Self help CBT + education -> higher intensity CBT + SSRI (CMHT referral)

140
Q

What are simple/specific phobias?

A

An irrational extreme fear leading to avoidance and catastrophising

141
Q

How are simple/specific phobias treated?

A

Exposure re-exposure and prevention therapy (ERP) and then consider SSRI

142
Q

What is OCD?

A

> 2 weeks of >4 days a week of recurrent pervasive obsessions, resulting in compulsions for relief.
Pt recognises actions are unnecessary but is obsessed.

143
Q

What are the symptoms of OCD?

A

4d/week for >2 weeks where obsessions need compulsions for anxiety relief
No action = no relief
MISERABLE symptoms

144
Q

How is OCD diagnosed?

A

Yale Brown OCD scale

145
Q

How is OCD treated?

A

-ERP + CBT -> SSRI (2nd line clomipramine)

146
Q

How long does a patient with OCD need to keep taking their SSRI?

A

Takes up to 12 weeks to start working, then needs to take for up to a year before being weaned off

147
Q

What is PTSD?

A

> 28d prolonged stress reaction to a previous traumatic event

148
Q

What are the symptoms of PTSD?

A

H - hyperarousal
E - emotional blunting
A - avoidance
R - reliving experiences

149
Q

How is PTSD diagnosed?

A

Trauma screening Q

150
Q

How is PTSD treated?

A
  • Eye movement desensitisation and reprocessing therapy (EMDR)
  • For combat related use trauma related CBT
  • Consider SSRI in severe cases
151
Q

What is an acute stress reaction?

A

<28 days, self resolving

152
Q

What pathway do addictive behaviours work on?

A

Mesolimbic reward pathway

153
Q

What are symptoms of dependence?

A
  • withdrawal - taking substance to avoid withdrawal
  • tolerance
  • narrowed repertoire
  • craving
  • loss of control
  • rapid reinforcement - quick return to old level after stopping
  • primacy - takes precedence over physiological needs
  • continued use despite harm
154
Q

How does alcohol affect the body?

A
  • GABAergic CNS retardant
  • increases adipose mass
  • increased cortisol
  • decreased co-ordination
155
Q

What are the symptoms of alcohol intoxication?

A
  • increased sexual arousal
  • increased risk taking behaviours and confidence
  • ataxic gait
  • slurred speech
  • vomiting
  • altered GCS scale
156
Q

What are the symptoms of alcohol withdrawal?

A

6-12hr - anxiety + fine tremor
36hr - seizures (typically tonic-clonic)
72hr - delirium tremens

157
Q

What may been seen on bloods of a pt who is alcohol dependent?

A
  • macrocytic anaemia
  • raised GGT
  • raised CDT
  • raised ALP
158
Q

How can alcohol dependence be diagnosed?

A
  • Bloods
  • Cage + audit questionnaires
  • Once stable use the CLWA-Ar (clinical withdrawal assessment - alcohol related)
159
Q

What level of alcohol concentration needs to be in your blood for it to be illegal to drive?

A

> 0.08%

160
Q

What is the treatment for acute alcohol withdrawal?

A

IV Chlordiazepoxide

161
Q

What is the treatment for long term alcohol withdrawal?

A

Naltrexone - opioid inhibitor - decreases pleasure
Acamprosate - NDMA inhibitor - reduces craving
Disulfiram - AAD inhibitor - induces hangover symptoms when alcohol is consumed - contraindicated in pregnancy

162
Q

What are the symptoms of taking opioids?

A
  • Pain relief
  • constipation
  • pin-point pupils
  • euphoric
163
Q

What is the main side effect of taking opioids?

A

Respiratory depression

164
Q

What is the treatment for opioid dependency?

A

Acute= IV 400mg naloxone
Long = methadone/buprenorphine + naltrexone

165
Q

What are the withdrawal symptoms of opioids?

A
  • yawning
  • dilated pupils
  • lacrimation
  • rhinorhea
166
Q

What symptoms can NDMA dependency cause?

A
  • agitation
  • HTN
  • tachycardia
  • hyperthermia
  • hyponatremia
  • decrease appetite
167
Q

What are the symptoms of amphetamine dependency?

A
  • agitation
  • hyperthermia
  • hallucinations
  • dilated pupils
168
Q

What are the symptoms of cocaine dependency?

A
  • coronary artery vasospasm
  • angina
  • seizures
  • ischaemic colitis
  • hyperthermia
169
Q

What are the symptoms of LSD dependency?

A
  • hallucinations
  • psychosis
  • impaired judgement
  • dilated pupils
  • hyperreflexia
170
Q

How is anorexia defined?

A

BMI <17.5, with body dysmorphia, purging, compensation and physical symptoms

171
Q

What are the risk factors for anorexia?

A
  • family history
  • personal history of being overweight
  • EUPD
  • depression
  • trauma + abuse
  • Female 20-40
  • bodybuilding/social media
172
Q

What are the symptoms of anorexia?

A
  • Low BMI, Purging (laxatives, vomiting), compensation (e.g. increased exercise when overeating), deliberate weight loss and body dysmorphia for >3months
  • Dry thin skin + lanugo hair + dental caries + gum retraction
  • CV - arrhythmias, bradycardias + hypotension
  • Endo - impaired glucose tolerance, amenorrhoea
  • Osteopenia + muscle wasting
173
Q

How is anorexia diagnosed?

A
  • SCOFF questionnaire
  • SUSS test
  • Bloods - FBC, U+E, TFT, Oest, HbA1C (All low)
  • Raised Growth hormone and cortisol
  • Low BP
  • ECG
174
Q

What is the treatment for anorexia?

A
  • Structured eating plan (AdCalD3, vitamins, K+, Na+) + treat in community with CBT
  • In severe cases consider inpatient admission + fluoxetine e.g. 15 BMI
175
Q

Why are people with anorexia’s electrolytes checked when refeeding?

A

Risk of refeeding syndrome

176
Q

What are the possible complications of anorexia?

A
  • Refeeding syndrome
  • Infertility
  • Amenorrhoea
  • Osteoporosis
177
Q

What is bulimia nervosa?

A

Preoccupation with body image causing >2 weekly episodes for >3 months of binge+purge cycles

178
Q

What are the symptoms of bulimia nervosa?

A
  • > 2 ep >3 months of binge-purge with normal BMI
  • Russel sign - knuckle callouses due to vomiting
  • GORD/Reflux
  • Parotitis
  • Halitosis
  • Dental cavities
179
Q

How is bulimia nervosa diagnosed?

A
  • Bloods
  • Venous blood gas
  • SCOFF Q
180
Q

What would show on a VBG for someone with bulimia nervosa?

A

Hypokalaemic hypochloremic metabolic alkalosis

181
Q

What is the treatment for bulimia nervosa?

A

CBT alone

182
Q

What questions are in the SCOFF questionnaire?

A
  • Make yourself sick after food?
  • Lost control of food?
  • One stone + loss in last 3 months
  • Food dominates life?
  • Fat perception?
183
Q

What is binge eating disorder?

A

Planned binge eating eps >3 months with overweight BMI

184
Q

What is the treatment for Binge eating disorder?

A

CBT

185
Q

How old do you have to be to be diagnosed with a personality disorder?

A

18

186
Q

What features do people with paranoid personality disorder present with?

A
  • Sensitive
  • Unforgiving
  • Takes attacks on character seriously
187
Q

What features do people with schizotypal personality disorder present with?

A
  • Inappropriate affect
  • Magical thinking
  • Ideas of reference
  • Odd behaviour
  • MADHATTER
188
Q

What features do people with schizoid personality disorder present with?

A
  • Cold
  • Solitude
  • Decreased libido
  • Thinks worlds uncanny
  • BATMAN
189
Q

What features do people with narcissistic personality disorder present with?

A
  • Believes life’s a competition
  • Grandiose
  • Entitled
190
Q

What features do people with histrionic personality disorder present with?

A
  • Craves centre of attention
  • Flirtatious
  • Considers relationships closer than they are
191
Q

What features would someone with Emotionally unstable personality disorder present with?

A
  • Crave sympathy
  • Impulsive acts (self harm)
  • Poor relationship history
192
Q

What features would someone with antisocial personality disorder present with?

A

Repeated unlawful violent acts

193
Q

What features would someone with obsessive compulsive personality disorder present with?

A
  • Strict time regulation
  • Refuses to delegate
  • Perfectionist
194
Q

What features would someone with avoidant personality disorder present with?

A

Craves companionship + intimacy but fear of rejection

195
Q

What features would someone with dependent personality disorder present with?

A
  • Want others to make big decisions for them
  • Submissive
196
Q

How are personality disorders diagnosed?

A

Minnesota multiple personality inventory

197
Q

What is the treatment for a personality disorder?

A
  • CBT
  • Dialectal behavioural therapy for EUPD
198
Q

What can cause a learning difficulty?

A

> 100 normal
- ASD
- ADHD
- Genetic (Down’s)
- TORCH

199
Q

What is autistic spectrum disorder?

A

Spectrum of severity with impaired communication + social interaction <3 years

200
Q

What are the symptoms of autistic spectrum disorder?

A
  • Reduced speech
  • Reduced empathy
  • Isolation (reduced interest in shared play)
  • Concrete thinking
  • Specific knowledge
  • Tics
  • Ritualistic behaviour
  • Reduced emotional cues
201
Q

How is autism diagnosed?

A

M-CHAT screening

202
Q

How is autism treated?

A

Supportive

203
Q

What is ADHD?

A

Hyperactivity, impulsivity and attention deficit (mc 6-12yrs)

204
Q

How is ADHD diagnosed?

A

DIVA-5

205
Q

How is ADHD treated?

A
  • Trial of watch and wait
  • Methylphenidate
206
Q

What are tics associated with?

A
  • ASD
  • ADHD
  • PANDAS
207
Q

What is PANDAS?

A

Paediatric autoimmune neuropsychiatric disorders associated with strep infection

208
Q

What is sleep disorder?

A

Insomnia >3d/week

209
Q

How is sleep disorder treated?

A

Zopiclone

210
Q

What are the symptoms of narcolepsy?

A
  • Cataplexy
  • Visual hallucinations
  • Excessive daytime sleepy
  • Sleep paralysis
  • Sleep difficulty
211
Q

How is narcolepsy treated?

A

Modafinil + sleep hygiene

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