Psychiatry Flashcards

Question

List clinical features of bulimia nervosa

Answer 1

``` Storage of food Eating large quantities Vomiting, calluses on hands (Russell's sign) Tetanic muscles Swollen salivary glands Endocrine disturbance ```

Answer 2

``` CBT, family therapy Diet management, food diary Treat complications OCP can boost oestrogen SSRI may help ```

Answer 3

Psychological: worry, panic, irritability, reduced concentration, restlessness, distractability CNS: numbness, tingling, fatigue, insomnia, dizziness, headache, tremor Autonomic: palpitations, chest pain, hyperventilation, xerostomia, nausea, vomit "lump in throat" "butterflies" "ringing" nail-biting thumb-sucking

Answer 4

6 months or more

Answer 5

Lifestyle - exercise, relaxation, meditation, avoid caffeine and anxiogens CBT, mindfulness Graded exposure desensitisation Hypnosis

Answer 6

``` Anxiolytics (diazepam for less than 6 weeks) SSRI (fluoxetine) Pregabalin Paroxetine for social anxiety Venlafaxine ```

Answer 7

Panic lasts up to 45 mins and peak anxiety occurs around 10 mins

Answer 8

``` Hyperventilation Restlessness Palpitations Sweating Fear, horror Helplessness Numbness Features of GAD ```

Answer 9

Perception that people/self are unreal or automated | e.g. body like cotton wool

Answer 10

Perception that one is detached from reality

Answer 11

Irrational fear that is uncontrollable, causing anxiety and avoidant behaviour

Answer 12

Classical: fear develops after stimulus caused emotional shock Imagined: fear develops in childhood/development

Answer 13

Graded exposure desensitisation Flooding (not routinely done) CBT Paroxetine for social phobia

Answer 14

Obsessions are stereotyped, purposeless behaviours that are unwanted Compulsions are repeated rituals that reduce anxiety when performed

Answer 15

``` Constant checking Repetitive thoughts and actions Superstitions Perfectionism Anxiety ```

Answer 16

CBT, exposure response therapy SSRI (fluoxetine) TCA (clomipramine) Deep brain stimulation

Answer 17

Protracted response to stressful event/trauma, diagnosed 3 months after the event

Answer 18

``` Natural/human disasters, war Accidents Witness death Sexual assault Kidnap ```

Answer 19

``` Nightmares Flashbacks Insomnia Panic disorder signs become chronic Emotional numbing Detachment Avoidant behaviour Hyperarousal, hypervigilance ```

Answer 20

``` Focused psychotherapy, CBT EMDR Correct stress hormone dysregulation SSRI (paroxetine) TCA (amitryptilline) BZD's Venlafaxine ```

Answer 21

Perceptual experience that does not match reality

Answer 22

Fixed firm belief that is illogical and not amenable to change in the face of evidence to the contrary

Answer 23

Psychotic illness involving cognitive and behavioural disturbance

Answer 24

Increased dopaminergic neurotransmission and activity

Answer 25

Early cannabis use Altered neurobiology and development Abnormal brain architecture Genetics (NRG-1 on c8, dysbindin on c6)

Answer 26

Enlarged lateral ventricles Reduced cortical volume, esp frontal lobe Reduced hippocampal volume

Answer 27

Psychosis (hallucinations, delusions, thought disorder) | -ve symptoms (lack of volition, social withdrawal, apathy, self-neglect, blunted mood/affect)

Answer 28

``` Psychosocial intervention, CBT, family therapy Antipsychotic Acute management (de-escalate, oral/IM haloperidol +/- lorazepam) ```

Answer 29

``` Strong desire for the substance Difficulty controlling use of substance Physiological withdrawal state Neglect other pleasure Persist with substance despite evidence of harm ```

Answer 30

``` Difficult social circumstances Inherited vulnerability Unemployment Depression, anxiety, PTSD Childhood abuse ```

Answer 31

``` Amphetamine Mephedrone Phencyclidine Cocaine MDMA ```

Answer 32

``` Cannabis Solvents LSD Mescaline Ketamine ```

Answer 33

``` Heroin Morphine Codeine Dihydrocodeine Methadone Benzodiazepines ```

Answer 34

``` Disturbed cognition Altered consciousness and perception Dangerous/odd behaviour Arrests for larceny Injection site abscesses/infection Requests for drugs Withdrawal symptoms ```

Answer 35

Detox: methadone, bruprenorphine Maintenance: lofexidine Relapse prevention: naltrexone, acamprosate Psychotherapy

Answer 36

Risky: 15-35 u/week regularly | High risk: more than 35 u/week regularly

Answer 37

``` Life revolves around drink Restlessness Irritability, sweaty Jaundice Memory impairment Neuropathy Fits, falls Hallucination Bleeding (varices, MW tears) Anaemia Arrhythmias Hypertension Withdrawal/delirium tremens ```

Answer 38

``` Tachycardia Hypotension Tremor Fits Hallucinations Aggressiveness, violence ```

Answer 39

Cut-down prompts? Awareness? Guilty about drinking? Eye-opener in the morning? Tolerance? Worry? Eye-openers? Amnesia? Cut-down attempts?

Answer 40

Parenteral thiamine Oral diazepam/chlordiazepoxide Prophylaxis - B blocker, carbamazepine, phenytoin

Answer 41

Psychotherapy, CBT, AA meetings Relapse prevention (naltrexone) Post-detox abstinence, acamprosate

Answer 42

When personality is abnormal/deviates from social or cultural norm and causes harm to self and/or others

Answer 43

Distrust of others and their motives, constantly suspicious and reluctant to confide or share info Mad Eye Moody

Answer 44

Detached from social relationships and restricted range of emotion Severus Snape

Answer 45

Excessive emotionality and attention-seeking behaviour | Draco Malfoy

Answer 46

Disregard for rights and health of others with lack of remorse for others' feelings Bellatrix Lestrange

Answer 47

Pattern of unstable relationships, self-esteem with fluctuating mood Lavender Brown

Answer 48

Inflated sense of self-importance with deep need for admiration, often with underlying fragile self-esteem Luscious Malfoy

Answer 49

Social inhibition and feelings of personal inadequacy | Neville Longbottom

Answer 50

Need to be in care or with people, leading to clinging/submissive behaviour Ron Weasley

Answer 51

Preoccupation with perfection and orderliness with little flexibility Dolores Umbridge

Answer 52

Acute confusional state with cognitive impairment and fluctuating course

Answer 53

``` Elderly in hospital Head injury Infection Alcohol excess, withdrawal Sleep deprivation Unfamiliar environment Surgery Drugs (BZD, opioids, anticonvulsants, digoxin, levodopa, illicit drugs) ```

Answer 54

``` Inattention Abnormal perception and mood Worse at night Impaired memory Incoherent speech Hallucinations Fear, terror ```

Answer 55

4AT (Alertness, Attention, AMT4 (age, dob, place, year), Acute onset)

Answer 56

Treat underlying cause Optimise environment and review drugs Haloperidol/risperidone if severe (oral/IM) BZD if alcohol withdrawal

Answer 57

IQ between 50 and 70 | Useful development of language, LD noticed in school

Answer 58

IQ between 35 and 49 | Most can talk and get by but basic function

Answer 59

IQ between 20 and 34 | Limited social activity

Answer 60

IQ less than 20 | Simple speech is difficult, need special counselling and schooling

Answer 61

Brain trauma Antenatal trouble (infection, alcohol, hypoxia, hypothyroidism) Genetics (Down's, fragile X)

Answer 62

``` Sensory/motor disability Epilepsy Incontinence Below expected intellect, struggle at school Abnormal behaviour in public ```

Answer 63

Speech and language therapy Support nutrition, care, learning, social areas Antipsychotic may lower seizure threshold Behavioural therapy

Answer 64

Behavioural disorder incorporating triad of inattention, hyperactivity and impulsive behaviour

Answer 65

Reduced frontal lobe function Premature birth Genetics Smoking/alcohol during pregnancy

Answer 66

``` Unable to focus/listen to detail Unable to follow instructions or finish tasks Restlessness Disorganised Forgetfulness Insomnia Mood disorder Family stress ```

Answer 67

``` Cognitive and behavioural therapy Parental education School support Stimulant drugs (methylphenidate (Ritalin) or dexamfetamine) Atomoxetine Antidepressant TCA Antipsychotic ```

Answer 68

Lifelong developmental disorder affecting social interaction, communication and behaviour

Answer 69

Unaware of feelings/existence of others (treat people like furniture) Abnormal response to hurt Impaired imitation Lack of empathy

Answer 70

``` Limited facial expressions and gestures Avoids gaze No social smiles or babbling in infancy Stiffens when held, doesn't like to be hugged Lack of speech No interest in stories or fantasy play Repetitive speech Doesn't pick up on social cues/sarcasm ```

Answer 71

``` Stereotypical movements Preoccupied with parts of objects Inflexible thoughts Distress over changes in environment Routine Precision, fixative behaviour ```

Answer 72

6 or more symptoms, including 2 from social interaction, 1 from behaviour, 1 from communication