Psychiatry Flashcards
What condition causes third person auditory hallucinations?
Schizophrenia
What does mesocortical dopamine hypoactivity cause?
Negative and cognitive symptoms in schizophrenia
What does subcortical dopamine hyperactivity cause?
Psychosis
What is the tuberoinfundibulnar dopamine pathway concerned with?
Prolactin release
What is the nigrostriatal dopamine pathway concerned with?
Extrapyramidal motor movements
What is another name for the subcortical and mesocortical dopamine pathways?
Mesolimbic system
What is the mesolimbic system concerned with?
Motivation and reward
Which of the dopamine pathways in the brain is dysregulated in schizophrenia?
Mesolimbic system
What does Da blockade in the mesolimbic system cause?
Depression
What does Da agonism in the mesolimbic system cause?
Pscyhosis
2 side effects of clozapine?
Agranulocytosis
Weight gain
Which atypical anti-depressant causes the most weight gain?
Olanzapine
Under what conditions can clozapine be prescribed?
By a consultant when the patient has tried 2 other anti-psychotics
Monitoring involved when a patient takes clozapine?
Once a week for the first 6/12
Once every 2 weeks for the next 6/12
Then every 4 weeks thereafter
One month after discontinuation
Limbic system functions?
Motivation Memory Olfaction Visceral afferents Emotion M2OVE
Brain changes in schizophrenia?
Reduced frontal lobe volume (and grey matter)
Enlarged lateral ventricles
Reduced grey matter in the temporal cortex
What is pressure of thought?
Varied ideas in abundance
What condition is pressure of thought characteristic of?
Mania (may also be seen in schizophrenia)
What will the patient report if they have poverty of thought?
Lack/ absence of thoughts
What is thought blocking?
Abrupt and complete interruption of stream (strongly associated with schizophrenia)
What is flight of ideas?
Quickly moving from one topic to another but there is a link
What is knight’s move?
Thinking where there does not appear to be a link between point A and point b
What is flight of ideas and knight’s move commonly seen in?
Bipolar during a manic phase
What drug can be used to treat extra-pyramidal side effects?
Procyclidine
What is the amygdala involved in?
The normal response to threat
What does the prefrontal cortex do in relation to the amygdala?
Dampens down the amygdala’s response to threat (if fewer connections, less effective)
What is the main management of OCD?
Mainly an SSRI and if there is a partial response at any points, consider CBT as an adjunct
IQ for borderline learning difficulty?
70-80ish
IQ for a mild learning difficulty?
50-69
IQ for a moderate learning difficulty?
35-49
IQ for a severe learning difficulty?
20-34
IQ for a profound learning difficulty?
<20
Beck’s triad?
Negative feelings about:
Self
World
Future
What type of symptoms can NMDA antagonists produce?
Psychotic symptoms
What benzodiazepine is used to treat alcohol withdrawal?
Chlordiazepoxide
When do alcohol withdrawal seizures occur?
Within 48 hours
When does delirium tremens occur with alcohol withdrawal?
Between 48 and 72 hours
What are lewy bodies?
Eosinophillic inclusions
What 2 conditions may Lewy Bodies be seen in?
Lewy body dementia
Parkinsons disease
Which psychiatry drug can cause a hypertensive crisis?
MAOIs
How do you treat a hypertensive crisis caused by MAOIs?
Phentolamine infusion
Name 5 things that can interact with MAOIs.
Tyramine containing foods Ephidrine Nasal decongestants TCAs Pethidine
What 2 types of patients should you avoid TCA’s in?
Those with cardiac problems or patients with suicidal intent
