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MRCP Part 1 > Psychiatry > Flashcards

Psychiatry Flashcards

1
Q

Charles Bonnet Syndrome Features

A

Hallucinations of Faces or Objects Larger or Smaller than Normal

Associated with Age Related Macular Degeneration

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2
Q

Risk Factors of Schizophenia

A

Family History
Afro Carribean

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3
Q

Somatization vs Malingering vs Hypochondriasis vs Conversion vs Dissociative

A
  1. Factitious Disorder AKA Munchausen’s
  2. Malingering - Financial Gain
  3. Functional (CONVERISONAL) Neurological Disorder - Sensory or Motor Symptoms unexplained - NEAD IBS + La Bella Indifference (Doesn’t Worry Much)

4.5
Somatization - Physical Symptoms , unexplained but anxious and stressy

  1. Dissociative - Psychological Dissociation
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4
Q

TCA

  1. MOA
  2. Side Effects
  3. Which TCA has the lowest risk of OD ?
  4. Which TCA has the HIGHEST risk of OD ?
A

Histamine Antagonism
Drowsiness

Muscarinic Antagonism
Cant Pee Cant Shit Cant Spit Cant See

Adrenergic Antagonism
Postural Hypotension

Anti Na Channels - QT prolongation

  1. Lowest - Lofepramine
    Highest - Amitriptyline and Dosulepin
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5
Q

Where is the lesion in Korsakoff’s ?

A

Mammillary bodies of the hypothalamus and the medial thalamus

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6
Q
A

objective finding of poor short-term memory is more common in DEMENTIA,

subjective complaint of poor memory is more common in DEPRESSION.

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7
Q

Types of Personality Disorders

A
  1. Paranoid
  2. Schizoid (Emotionally Cold)

a. Indifference to praise and criticism
b. Preference for solitary activities
c. Lack of interest in sexual interactions
d. Lack of desire for companionship

  1. Schizotypal (Magical Thinking)

Lack of Close Friends other than family

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8
Q

SSRI FACTS !!!

A
  1. If <25 or Suicidal Risk review in 1 week or else 2 weeks
  2. Graduated Withdrawal over 4 weeks (Not with Fluoxetine)
  3. 6 months post symptom resolution before stopping
  4. Paroxetine has highest risk of discontinuation symptoms
  5. SSRI in 3rd Trimester PPH in the newborn
  6. Co -prescription with Triptan / MAOI cause Serotonin Syndrome
    6 Avoid NSIAD’s and Aspirin and Warfarin (Switch to Mirtazapine)
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9
Q

Antidepressant for Bulimia ?

A

HIGH DOSE FLUXOTEINE

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10
Q

When to give Paroxetine ?

A

P=Pregnancy/Post-natal/higher incidence of discontinuation symptoms.

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11
Q

Which drug makes you sleepy vs makes it difficult to sleep ?

A

Memantine (Sleepy) vs Donepezil (Insomnia)

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12
Q

Grief Reactions

  1. Atypical
  2. Prolonged
  3. Delayed
A
  1. Females > Males
    If Sudden Unexpected Deaths , Relationship Problems before Death
    Lasts >6-12 months
  2. > 12 months
  3. > 2 weeks before grief starts
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13
Q

Baby Blues vs Post Natal Depression vs Puerperal psychosis

A

Baby Blues

5-7 days after birth
Reassurance

Post Natal Depression

Starts within a month –> Peak at 3 months
Paroxetine

Puerperal psychosis

2-3 weeks after birth
Admit

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14
Q

Mania vs Hypomania

A

Mania
> 7 days
Impairs ADL
Psychotic Symptom’s

Hypomania
<7 days
NO impact on ADL
No Psychotic Symptom’s

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15
Q

How to differentiate Antisocial vs Avoidant Personality Type

A

Antisocial -
Against Law
Remorseless

Avoidant - Dhanu

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16
Q

Syndromes to Remember

A

CotarD - Dead

CapgRas - Replaced by exact double

Couvade - Pregnancy… (Yeah, I got nothing for this one.)

De ClerambauLt’s - Celebrity is deeply in love with them

Othello - Believes their partner is playing them like a cello.

17
Q

In Anorexia what is elevated ?

A

G’s and C’s raised:

growth hormone, glucose, salivary glands,

cortisol, cholesterol, carotinaemia

18
Q

What is the difference between Somatization and Hyperchondriasis

A

Somatization: Symptom of illness
Hypocondriasis: belief of illness

19
Q

Risk Factors for Suicide SADPERSON SCORE

A

S: Male sex
A: Age (<19 or >45 years)
D: Depression
P: Previous attempt
E: Excess alcohol or substance use
R: Rational thinking loss
S: Social supports lacking
O: Organized plan
N: No spouse
S: Sickness (ie chronic disease/disability/pain)

20
Q

PTSD Treatment

A

Watchful Waiting if Mild symptoms <4 weeks

If Military - trauma-focused CBT / EMDR

If Severe - Venlafaxine or Sertraline

NICE recommends Risperidone

21
Q

Typical Antipsychotics (Haloperidol and Chlopromazine) which receptor does it block ?

22
Q

OCD Treatment

A

Mild
CBT/ERT

Moderate
Intensive CBT or SSRI
Fluoxetine (12 weeks longer than depression) or Clomipramine if SSRI CI

Severe
Secondary Care

continue SSRI for 12 months if response is good

23
Q

Sleep Paralysis + Hallucinations = What Drug ???

A

Clonazepam

24
Q

How to BZD Withdrawal ?

A

Switch to DIAZEPAM and wean over 2 months

25
Q

SSRI + NSAID = GI bleeding risk - give a PPI

MRCP Part 1 (17 decks)

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