Psychiatry Flashcards
What is the diagnosis: fever, muscle rigidity, altered mental status and autonomic dysfunction
Neuroleptic malignant syndrome (NMS)
What is Serotonin syndrome?
Syndrome caused by initiation or dose increase of a serotonergic agent characterised by:
- altered mental state, agitation, tremor, shivering, diarrhoea, hyperreflexia, myoclonus, ataxia, hyperthermia
What is the diagnosis?
- rapid onset and progression of hyperreflexia, agitation/restlessness, altered mental state, myoclonus, sweating
Serotonin Syndrome (SS)
How do Serotonin syndrome and Neuroleptic malignant syndrome differ in presentation:
NMS - ass. with antipsychotics, slow onset and progression, severe ‘lead pipe’ rigidity, bradykinesia
SS - ass. with serotonergic agents, rapid onset and progression, less severe muscle rigidity, hyperkinesia
What is Neuroleptic Malignant Syndrome (NMS)?
A rare and life threatening idiosyncratic reaction to anti-psychotics (and other meds) characterised by:
- fever
- muscular rigidity
- altered mental status
- autonomic dysfunction
What is the ICD-10 definition of harmful usage of a substance?
A pattern of psychoactive substance use that is causing damage to health. The damage may be physical or mental
What factors constitute dependence according to ICD-10?
- a strong desire to take the drug
- difficulties controlling its use
- persisting in its use despite harmful consequences
- a higher priority given to drug use rather than other activities/obligations
- increased tolerance
- sometimes a physical withdrawal state
What is used for Maintenance for opiate dependence?
Methadone
Buprenorphine
What is the ICD-10 definition of harmful usage of a substance?
A pattern of psychoactive substance use that is causing damage to health. The damage may be physical or mental
What factors constitute dependence according to ICD-10?
- a strong desire to take the drug
- difficulties controlling its use
- persisting in its use despite harmful consequences
- a higher priority given to drug use rather than other activities/obligations
- increased tolerance
- sometimes a physical withdrawal state
What is used for Maintenance for opiate dependence?
Methadone
Buprenorphine
What are the main characteristics of Wernicke Encephalopathy?
Acute confusional state
Opthalmoplegia
Ataxic gait
(Nystagmus)
What is the cause of Wernickes encephalopathy?
Thiamine (B1) deficiency
Part of a larger group of diseases due to thiamine deficiency called Beriberi
What drug is used to treat an overdose of benzodiazipines?
Flumazenil
What is somatisation disorder?
Multiple physical symptoms present for at least two years
Patient refuses to accept reassurance or negative test results
What is the disorder?
Multiple physical symptoms for two years with no organic cause found with patient refusing to accept the negative results
Somatisation Disorder
What is Hypochondrial disorder?
Persistent belief in the presence of an underlying serious disease eg cancer
Patient refuses to accept reassurance or negative test results
What is the diagnosis?
Patient persistently believes they have cancer despite negative test results
Hypochondrial Disorder
What is conversion disorder?
Typically involves loss of motor or sensory function
The patient doesn’t consciously feign the symptoms (factitious disorder) or seek material gain (malingering)
What is malingering?
Fraudulent simulation or exaggeration of symptoms with the intention of financial or other gain
What is Factitious disorder?
Aka Munchausen’s
The intentional production of physical or psychological symptoms
What is Dissociative Disorder?
Process of separating off certain memories from normal consciousness
Psychiatric symptoms eg amnesia, fugue, stupor
What is Fugue?
A loss of awareness of one’s identity, often coupled with flight from one’s usual environment, associated with certain forms of hysteria and epilepsy
What is given in an overdose of tricyclics?
IV bicarbonate
