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Nick's MD3 > Psychiatry > Flashcards

Psychiatry Flashcards

1
Q

What are the 3 criteria for compulsory treatment under the Mental Health Act (2014)?

A
  1. The person appears to have a mental illness
  2. They need treatment to prevent serious harm to the person, deterioration in their health or serious harm to another person
  3. There is no less restrictive way to proceed
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2
Q

Give a 1 line definition of Bipolar I disorder

A

Lifetime occurrence of at least one manic episode

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3
Q

How long must a hypomanic episode last by definition?

A

At least 4 consecutive days

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4
Q

Mnemonic for major depressive episode

A 
5 DIG SPACES
Depressed mood
Interest (loss of)
Guilt or worthless
Sleep disturbance
Psychomotor retardation or agitation
Appetite change
Concentration loss
Energy loss
Suicidal tendencies
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5
Q

What are the characteristics of the disorganised subtype of schizophrenia?

A

Prominent disorganised speech and behaviour, flat or inappropriate affect

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6
Q

How is anorexia nervosa stratified for severity?

A

BMI 17 and over = mild
BMI in the 16s = moderate
BMI in the 15s = severe
BMI under 15 = extreme

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7
Q

How long should your treat an episode of MDE if there have been 2 episodes in the past 5 years?

A

For at least 3 years after remission at the dose required to reach remission

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8
Q

What are the essential diagnostic features of bulimia nervosa?

A
  1. Binge eating (lots of food and no control)
  2. Prevent weight gain (eg vomit, diuretics, laxatives, fasting, exercising)
  3. At least once a week for 3 months
  4. Self-evaluation unduly influenced by body shape and weight
  5. Not exclusively during anorexia nervosa
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9
Q

Name 4 relatively indicative Sx of MDD?

ie relatively specific cf depression in other conditions

A

Anhedonia
Psychomotor retardation
Worthlessness
Guilt

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10
Q

Prystiq
What is the generic name?
What class of drug is it?

A

Desvenlafaxine

SNRI

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11
Q

How long can an Assessment Order last under the Mental Health Act?

A

24 hours (but can be extended to 72 hours under exceptional circumstances)

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12
Q

Mnemonic for serotonin syndrome

A 
HARMED 
Hyperthermia 
Autonomic instability 
Rigidity 
Myoclonus 
Encephalopathy 
Diaphoresis
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13
Q

What are the characteristics of the residual subtype of schizophrenia?

A

Ongoing negative symptoms or

Two or more of the other subtypes in attenuated form

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14
Q

What does blunted affect mean?

A

Patient displays no signs of emotion eg no facial expression, body gestures, loss of empathy, loss of awareness of emotional significance of events. Suggests schizophrenia

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15
Q

Overall what proportion of illness time are patients with Bipolar depressed?

A

75%

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16
Q

Define hallucination

A

Perception-like experience in the absence of an external stimulus

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17
Q

What are the 3 essential diagnostic features of anorexia nervosa?

A
  1. Low weight
  2. Fear of gaining weight or interfering with weight gain
  3. Disturbed body image or lack of recognition of seriousness of low body weight
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18
Q

Give a 1 line definition of the diagnostic criteria for schizophreniform disorder

A

Less than 6 months of schizophrenia

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19
Q

One line definition of Malingering

A

Intentional production of physical or psychological Sx for external incentive eg Ferris Beuller

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20
Q

What are the ‘simplified’ DSM5 criteria for PTSD?

A

TRACH

Trauma Re-experience Avoidance Cognitive/mood changes Hyperarousal

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21
Q

Define delusion

A

Fixed belief that is not amenable to change in light of conflicting evidence

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22
Q

How long should your treat a first episode of MDE?

A

For at least 6-12 months after remission at the dose required to reach remission

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23
Q

What are the diagnostic criteria A for schizophrenia?

A

2 or more of the following, with at least one of 1, 2 or 3

  1. Hallucinations
  2. Delusions
  3. Disorganised speech
  4. Disorganised behaviour
  5. Negative symptoms
24
Q

Give a 1 line definition of the diagnostic criteria for schizoaffective disorder

A

Psychotic episode and mood episode occur together, with at least 2 weeks of delusions or hallucinations either before or after the mood episode

25
Q

Mnemonic for manic episode

A 
3 IS RAPID
3 or more of the following:
Inflated self-esteem
Sleepless
Risky behaviours
Active or agitated
Pressured speech
Ideas racing
Distractible
26
Q

Cymbalta
What is the generic name?
What class of drug is it?

A

Duloxetine

SNRI

27
Q

Acronym for Borderline personality disorder?

A 
RAPE A MISS
Relationships unstable
Anger
Paranoid ideation or depersonalisation
Emptiness
Abandonment
Mood swings
Impulsive
Suicidal or self-mutilation
Self image is unstable
28
Q

Effexor
What is the generic name?
What class of drug is it?

A

Venlafaxine

SNRI

29
Q

How long should your treat an episode of MDE if there have been 3 episodes in the past 5 years?

A

For at least 5 years after remission at the dose required to reach remission

30
Q

Acute pharmacological Mx of first episode psychosis?

A

Atypical antipsychotic eg
Olanzapine 5-10 mg nocte increasing to max 30mg
Risperidone 0.5-1 mg nocte increasing to max 6mg
Quetiapine 50-100mg BD, increasing to max sdfasdfds

31
Q

Give a 1 line definition of Bipolar II disorder

A

Lifetime occurrence of at least one MDE and at least one hypomanic episode, but never a manic episode
ie MDE + HME but not ME

32
Q

One line definition of Body dysmorphic disorder

A

Preoccupation with a real or perceived defect in physical appearance

33
Q

Define catatonic behaviour

A

Marked decrease in reactivity to the environment

34
Q

One line definition of Somatisation disorder

A

Unintentionally produced multiple symptoms over multiple systems (pain, GI, sexual and pseudoneurological Sx) beginning before 30yo

35
Q

Name 4 relative indications for ECT treatment in MDD?

A

Psychotic depression
Melancholic depression
Not eating
Suicidal ideation

36
Q

What does restricted affect mean?

A

Decreased range of affect eg decreased number of emotions displayed

37
Q

How long can a Treatment Order last under the Mental Health Act?

A

Up to 6 months for in-patient or 12 months for outpatient

38
Q

Acronym for antidepressant discontinuation syndrome

A 
FINISH
Flu-like symptoms 
Insomnia 
Nausea 
Imbalance 
Sensory disturbances 
Hyperarousal (anxiety/agitation)
39
Q

One line definition of Factitious Disorder

A

Intentional production of physical or psychological Sx in order to assume the sick role and in the absence of external incentives

40
Q

What are the characteristics of the catatonic subtype of schizophrenia?

A

2 or more of:

  • Motor immobility (cataplexy or stupour)
  • Excessive motor activity that is purposeless
  • Peculiarities of movement (posturing, stereotypies, mannerisms or grimacing)
  • Echolalia or echopraxia
41
Q

What are the characteristics of the undifferentiated subtype of schizophrenia?

A

Doesn’t fit into any other subtype (eg no prominent delusions, auditory hallucinations, disorganisation, negative symptoms or catatonia)

42
Q

Give a 1 line definition of cyclothymic disorder

A

2 years of hypomania and depressive periods, but without an episode of mania, hypomania or depression
ie No ME, HME or MDE

43
Q

What is the difference between a manic episode and a hypomanic episode

A
  • ME lasts at least 7 days vs 4 days

- ME is severe enough to impair functioning or there are psychotic features

44
Q

Avanza.
What is the generic name?
What class of drug is it?

A

Mirtazipine

Tetracyclic

45
Q

Give a 1 line definition of the diagnostic criteria for brief psychotic disorder

A

1-30 days of psychotic symptoms

46
Q

How long must a manic episode go on for by definition?

A

At least 1 week

47
Q

What aspects of affect must be assessed during the MSE?

A

Quality
Range
Reactivity
Congruence

48
Q

Mnemonic for neuroleptic malignant syndrome

A 
FEVER 
Fever 
Encephalopathy 
Vital sign instability 
Elevated WCC/CPK (creatine phosphokinase)
Rigidity
49
Q

How long can an Temporary Treatment Order last under the Mental Health Act?

A

Maximum of 28 days

50
Q

One line definition of Conversion Disorder

A

Unintentionally produced Sx affecting motor or sensory functions

51
Q

When does late-onset schizophrenia occur by definition?

A

Older than 40y

52
Q

What are the characteristics of the paranoid subtype of schizophrenia?

A

Prominent delusions or auditory hallucinations

53
Q

Give a 1 line definition of the diagnostic criteria for delusional disorder

A

One month or more of delusions, but no other psychotic symptoms

54
Q

Main side effects of Aricept

A

Nausea, LOA, bradycardia

55
Q

What is the lifetime prevalence of schizophrenia?

A

0.3 to 0.7%

Nick's MD3 (7 decks)

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