Psychiatry Flashcards
First line pharmacotherapy for depression
SSRIs
Antidepressants associated with hypertensive crisis
MAO-inhibitors
SE: galactorrhoea, impotence, menstrual dysfunction, decreased libido
Dopamine antagonists
A 17year old girl has left arm paralysis after her boyfriend dies in a car crash. No medical cause is found.
Conversion disorder
Name the defence mechanism: a mother who is angry at her husband yells at her child
Displacement
Name the defence mechanism: a girl who is upset with her best friend acts overly kind
Reaction formation
Name the defence mechanism: a man calmly describes a grisly murder
Isolation
Name the defence mechanism: a hospitalised 10 year old begins to wet his bed
Regression
Life threatening muscle rigidity; high fever; autonomic instability; confusion; elevated creatine phosphokinase
Neuroleptic malignant syndrome
Amenorrhoea, low body weight (<85%), bradycardia, abnormal body image in a young woman
Anorexia
A 35 year old man had recurrent episodes of palpitations, diaphoresis, and fear of impending doom
Panic disorder
The most serious side effect of clozapine
Agranulocytosis
21 year old man has 3 months of social withdrawal, worsening grades, flattened affect, and concrete thinking
Schizophreniform disorder
A diagnosis of schizophrenia requires >6 months of symptoms
Key side effects of atypical antipsychotics
Weight gain, T2DM, QT prolongation
A young weight lifter receives IV haloperidol and complains that his eyes are deviated sideways. Dx? Tx?
Acute dystonia (oculigyric crisis)
Tx: benztropine or diphenhydramine
Medication to avoid in patients with Hx alcohol withdrawal seizures
Neuroleptics (they can lower the seizure threshold)
A 13 year old boy has a history of theft, vandalism, and violence towards family pets
Conduct disorder.
Associated with antisocial personality disorder in adults
A 5 month old girl has reduced head growth, truncal discoordination, and decrease social interaction
Rett disorder
Loss of milestones is commonly described
A patient hasn’t slept for days, lost $20,000 gambling, is agitated and has pressured speech. Dx? Tx?
Acute mania
Tx: mood stabiliser e.g lithium
After a minor ‘fender bender’, a man wears a neck brace and request permanent disability
Malingering
A nurse presents with severe hypoglycaemia; blood analysis reveals no elevation in C-peptide
Factitious disorder
A patient spends most of his time acquiring cocaine despite losing his job and being threatened with legal charges
Substance use disorder
Medication to avoid in patients with PTSD
Benzodiazepines (have a high addiction potential)
Patients commonly have a history of substance abuse
A violent patient has vertical and horizontal nystagmus
Phencyclidine hydrochloride (PCP) intoxication
A woman who was abused as a child frequently feels outside of or detached from her body
Depersonalisation disorder
A schizophrenic patient takes haloperidol for 1 year and develops uncontrollable tongue movements. Dx? Tx?
Tardive dyskinesia
Tx: reduce /stop haloperidol
Change the antipsychotic e.g risperidone, clozapine
A man with major depressive disorder is counselled to avoid tyramine-rich foods with his new medication. What class of drugs is he taking?
MAO- inhibitors
Children must exhibit ADHD symptoms in …….
Two or more settings (e.g home and school)
Which congenital conditions are associated with autism spectrum disorder?
Rett syndrome, tuberous sclerosis, & fragile X syndrome
Conduct disorder - children or adults?
Children
Antisocial personality disorder is seen in children or adults?
Adults
Most common avoidable cause of intellectual disability in kids?
Fetal alcohol syndrome
Coprolalia - definition and association
Repetition of obscene words (a kind of vocal tic)
Associated with Tourette syndrome
Components of psychosis: delusions
Fixed false idiosyncratic belief
Component of psychosis: hallucinations
Perception without an existing external stimulus
Components of psychosis: illusion
Misperception of an actual external stimulus
Duration and characteristics of brief psychotic disorder (psychotic disorder)
> 1 day and <1 month
NB: same presentation as schizophrenia, but are usually preceded by stressors, have no prior episodes, are less likely to have negative symptoms & have better lifetime prognosis
Duration and characteristics of schizophreniform disorder (psychotic disorder)
1 month < < 6 months
NB: same presentation as schizophrenia but usually preceded by stressors, have no prior episodes, less likely to have negative symptoms, better lifetime prognosis
Duration and characteristics of schizophrenia (psychotic disorder)
> 6 months
Duration and characteristics of schizoaffective disorder (psychotic disorder)
Schizophrenia + major affective disorder (major depressive or bipolar affective disorder)
Characteristics of schizotypal disorder (personality disorder)
Magical thinking
Characteristic of schizoid disorder (personality’s disorder)
Loners
Characteristic of delusional disorder
Persistent NON-BIZARRE fixed delusions without disorganised thought process, hallucinations or negative symptoms of schizophrenia
Day to day functioning mostly unaffected
Subtypes of delusional disorder
Jealous, paranoid, somatic, erotomanic, grandiose
Examples of high potency typical antipsychotics
Haloperidol, fluphenazine
Examples of low potency typical antipsychotics
Thioridazine, chlorpromazine
Indications for typical antipsychotics
Psychotic disorders, acute mania, acute agitation, Tourette syndrome
Typical antipsychotics more effective in (positive/negative) symptoms of schizophrenia. Mechanism?
Positive
Primarily block D2 receptors
What do you consider if compliance to typical antipsychotics is an issue?
Depot preparations
