Psychiatry Flashcards

1
Q

Which SSRI most commonly causes QT prologation?

A

Citalopram?

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2
Q

What is common side efefct of TCAs?

A

Overflow incontinence (anticholinergic effect)

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3
Q

What are the extrapyramidal side-effects of some antipsychotics?

A

1) Parkinsonism
2) Acute Dystonia
3) Akathisia
4) Tardive dyskinesia

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4
Q

Outline timeline of side effects during alcohol withdrawal.

A

1) symptoms: 6-12 hours
2) seizures: 36 hours
3) delirium tremens: 72 hours

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5
Q

What is the management of alcohol withdrawal?

A

Admit if coplex history of withdrawal

1st line long-acting benzodiazepine (e.g. chlordiazepoxide or diazepam)

If history of liver impairment: lorazepam

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6
Q

What is the management of acute dystonia secondary to antipsychotics?

A

Procyclidine

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7
Q

Which antipsychotic has the most tolerable side effect profile?

A

Aripiprazole

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8
Q

What risk do antipschotics increase in the elderly?

A

Increased stroke and VTE risk

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9
Q

What is the management of acute stress disorder?

A

1st line: trauma-focused cognitive-behavioural therapy (CBT) is usually used first-line

also: benzodiazepines

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10
Q

What are atypical antipsychotic?

A

1) clozapine
2) olanzapine: higher risk of dyslipidemia and obesity
3) risperidone
4) quetiapine
5) amisulpride
6) aripiprazole: generally good side-effect profile, particularly for prolactin elevation

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10
Q

What is best antidepressant post-MI?

A

SSRI

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11
Q

How often do you need to do FBC monitoring for Clozapine?

A

1) Weekly for 18 weeks
2) Fortnightly for uo to one year
3) Monthly thereafter

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11
Q

Why should you be careful prescribing triptans in someone taking an SSRI?

A

Increased risk of seretonoin syndrome

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12
Q

What is Cotard syndrome?

A

Cotard syndrome is characterised by a person believing they are dead or non-existent

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13
Q

What is erotomania?

A

Erotomania is a delusional disorder characterised by the mistaken perception that another person is infatuated with them.

Affected patients often exhibit ‘stalking’ behaviour, and targets are classically socially unattainable, such as celebrities.

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14
Q

What is Charles Bonnet syndrome?

A

A phenomenon in which patients with severe visual impairment report vivid hallucinations.

15
Q

What is Capgras syndrome?

A

Capgras syndrome is a neuropsychiatric phenomenon in which patients believe that a partner/family member/friend has been replaced by an imposter.

16
Q

What is Orthello syndrome?

A

Othello syndrome, also known as delusional jealousy, is a delusional disorder with male preponderance in which patients hold a firmly held belief that their partner is unfaithful, in the absence of proof.

17
Q

What are the side effects of TCAs?

A

Anticholinergic:
Blurred vision
Dry mouth
Constipation
Urinary retention

Also:
Postural hypotension
Lengthening of QT interval
Drowsiness

18
Q

What is the SSRI of choice in children and adolescents?

A

Fluoxetine

19
Q

What factor can cause a rise in clozapine levels after them being stable for a while?

A

Smoking cessation
Stopping drinking

20
Q

What are symptoms of SSRI discontinuation syndrome?

A

Dizziness, electric shock sensations and anxiety

21
Q

Which side-effect is more common with atypical than conventional anti-psychotics?

A

Weight gain

22
Q

What is the management of alcohol withdrawal?

A

first-line: long-acting benzodiazepines e.g. chlordiazepoxide or diazepam

Also: carbamazepine and phenytoin for alcohol withdrawal-related seizures

23
Q

What is the physiology of the neuroreceptors in alochol withdrawal?

A

Decreased inhibitory GABA Increased NMDA glutamate transmission

23
Q

What is the management of PTSD?

A

for mild symptoms can watch and wait

1st line: trauma-focused cognitive behavioural therapy (CBT) or eye movement desensitisation and reprocessing (EMDR) therapy

2nd line: Venlafaxine or SSRI

3rd line: In severe cases risperidone

23
Q

What is the drug management of generalised anxiety disorder?

A

NICE suggest sertraline should be considered the first-line SSRI

23
Q

What are the 4 key features in the ICD-11 classification of a personality disorders?

A

1) Persistent attern
2) Impairment
3) Duration
4) Distress or dysfunction

23
Q

What is somatisation disorder?

A
  • multiple physical SYMPTOMSpresent for at least 2 years
  • patient refuses to accept reassurance or negative test results
23
Q

What is Illness anxiety disorder (hypochondriasis)?

A
  • persistent belief in the presence of an underlyingserious DISEASE, e.g. cancer
  • patient again refuses to accept reassurance or negative test results
24
Q

What is Functional neurological disorder (conversion disorder)?

A
  • typically involves loss of motor or sensory function
  • the patient doesn’t consciously feign the symptoms (factitious disorder) or seek material gain (malingering)
  • patients may be indifferent to their apparent disorder - la belle indifference - although this has not been backed up by some studies
25
Q

What is Dissociative disorder?

A
  • multiple personality disorder
  • dissociation is a process of ‘separating off’ certain memories from normal consciousness
  • in contrast to conversion disorder involves psychiatric symptoms e.g. Amnesia, fugue, stupor
26
Q

What is Factitious disorder (Munchausen’s syndrome)?

A
  • the intentional production of physical or psychological symptoms
27
Q

What is Malingering?

A

fraudulent simulation or exaggeration of symptoms with the intention of financial or other gain

28
Q

What is the management of schizophrenia?

A

1st line: Atypical antipsychotic

All patients: CBT