Psychiatry Flashcards

1
Q

Symptoms of generalised anxiety

A

W.A.T.C.H.E.R.S

  • Worry
  • Anxiety
  • Tension in muscles
  • Concentration difficulty
  • Hyper-arousal (irritability)
  • Energy loss
  • Restlessness
  • Sleep distrubances
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2
Q

Kubler-Ross dying process: stages

A
"Death Always Brings Great Acceptance":
Denial
Anger
Bargaining
Grieving
Acceptance
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3
Q

Borderline personality traits

A

PRAISE:

Paranoid ideas
Relationship instability
Affective instability/ Abandonment fears/ Angry outbursts
Impulsiveness/ Identity disturbance
Suicidal behaviour/ Self-harming behaviour
Emptiness

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4
Q

Bipolar mania symtpoms

A

MANIAC

Mouth (pressure of speech)/ Moodl
Activity increased
Naughty (disinhibition)
Insomnia
Attention (distractability)
Confidence (grandiose ideas
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5
Q

Physical illnesses mimicking anxiety disorders

A

“Physical Health Hazards That Appear Panciky”:

Phaeochromocytoma
Hyperthyroidism
Hypoglycaemia
Temporal lobe epilepsy
Alcohol
Paroxysmal arrhythmias
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6
Q

Depression: major depression criteria

A

DEAD SWAMP:
Depressed mood most of the day
Energy loss or fatigue
Anhedonia
Death thoughts (recurrent), suicidal ideation or attempts
Sleep disturbances (insomnia, hypersomnia)
Worthlessness or excessive guilt
Appetite or weight change
Mentation decreased (ability to think or concentrate, indecisiveness)
Psychomotor agitation or retardation

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7
Q

Schizophrenia- negative features

A
A's
Avolition (low motivation)
Asocial behaviour
Anhedonia
Alogia (poverty of speech)
Affect blunted
Attention deficits
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8
Q

Impotence causes

A

PLANE:

Psychogenic: performance anxiety
Libido: decreased with androgen deficiency, drugs
Autonomic neuropathy: impede blood flow redirection
Nitric oxide deficiency: impaired synthesis, decreased blood pressure
Erectile reserve: can’t maintain an erection

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9
Q

Eating disorder screening questions

A

Mnemonic: SCOFF

Make yourself SICK when you feel uncomfortably full?
Worry you have lost CONTROL over how much you eat?
Recently lost more than 14 pounds within three months?
ONE stone’s worth of weight
Believe you are FAT when others say you are too thin?
Would you say that FOOD dominates your life?

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10
Q

Symptoms anorexia

A

FEEDD

Fear of weight gain
Endocrine disturbance
Emaciated BMI <17.5kg/m2
Deliberate weight loss
Distorted body image
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11
Q

Alcohol withdrawal: clinical symptoms

A
HITS
H- Hallucinations (visual, tactile)
I- Increased vital signs and insomnia
T- Tremens (delirium tremens) lethal
S- Shaking, Sweating, Seizures, Stomach pain (nausea/vomiting)
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12
Q

ICD-10 criteria for anorexia diagnosis

A

FEED

Fear of weight gain
Endocrine disturbance
Emaciated
Deliberate weight loss
Distored body image
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13
Q

ICD-10 criteria for bulimia nervosa diagnosis

A

‘Bulimia Patients Fear Obesity’

Behaviours to prevent weight gain (compensatory)

Pre-occupation with eating (sense of compulsion)

Fear of fatness (including self perception of being too fat)

Overeating (at least two episodes a week over a period of 3 months)

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14
Q

Screening for alcohol dependence

A

The CAGE questionnaire

Cut down: Have you ever felt you needed to Cut down on your drinking?

Annoyed: Have people Annoyed you by criticizing your drinking?

Guilty: Have you ever felt Guilty about drinking?

Eye-opener: Have you ever felt you needed a drink first thing in the morning (Eye-opener) to steady your nerves or to get rid of a hangover?

Two “yes” responses indicate that the possibility of alcoholism should be investigated further

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15
Q

Clinical features of delirium

A

DELIRIUM

Disordered thinking
Euphoric, fearful, depressed, angry
Language impaired
Illusions, delusions, hallucinations
Reversal of sleep-wake cycle
Inattention
Unaware/ disoriented
Memory deficits
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16
Q

Physical features of Down’s syndrome

A

PROBLEMS

Palpebral fissure
Round face
Occipital and nasal flattening
Brushfield spots
Brachycephaly
Low-set ears 
Epicanthic folds
Mouth open and protruding tongue 
Strabismus 
Single Palmer crease
Sandal gap deformity
17
Q

Symptoms of normal pressure hydrocephalus

A

Wet, wobbly, confused

Urinary incontinence, ataxia, dementia

18
Q

Somatoform disorders

A

PUSHy Somatoform

Persistent somatoform pain disorder
Undifferentiated 
Somatization disorder
Hypochondriacal disorder
Somatoform autonomic dysfunction
19
Q

Side effects of ECT

A

PC DAMS

Peripheral nerve palsies
Cardiac arrhythmias, Confusion
Dental and oral trauma
Anaesthetic risks - N&amp;V, sore throat
Muscular aches and headaches
Short-term memory impairment, status epilepticus
20
Q

Anti-depressant a) first and second line b) in bulimia nervosa c) IHD/post MI d) post natally (breast feeding) e) OCD

A

a) SSRI eg citalopram, sertraline
b) fluoxetine
c) sertraline
d) paroxetine
e) fluoxetine, sertraline, citalopram

21
Q

Clinical features of OCD

A

FORD Car

Failure to resist - at least one obsession or compulsion

Originate from patients mind - recognise they’re not influenced by others

Repetitive and Distressing - must be acknowledged by patient as excessive or unreasonable

Carrying out the obsessive thought or compulsive act is not in itself pleasurable but reduces anxiety levels.

22
Q

Contraindications to ECT

A

MARS

MI <3 months ago, or Major unstable fracture
Aneurysm (cerebral)
Raised ICP
Stroke <1 month ago, history of Severe epilepticus, Severe anaesthetic risk

23
Q

Define delirium tremens and its features

A

Withdrawal delirium develops between 24hours and 1 week after alcohol cessation.

Characterised by

Cognitive impairment
Visual disturbance - hallucination/illusions
Autonomic instability
Marked tremor
Paranoid delusions
24
Q

Key features and treatment of delirium tremens

A

Dehydration and electrolyte disturbances

Benzodiazepines, haloperidol, IV pabrinex