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Specialities > Psychiatry > Flashcards

Psychiatry Flashcards

1
Q

What are the symptoms of benzodiazepine withdrawal?

A
  • Insomina
  • Irritability
  • Anxiety
  • Tremor
  • Loss of appetite
  • Tinnitus
  • Perspiration
  • Perceptual disturbances
  • Seizures
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2
Q

What is neologism?

A

Inventing words, or using a recognised word in the wrong context. Can be a feature of schizophrenia

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3
Q

What is the minimum duration for a depressive episode?

A

2 weeks

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4
Q

What is perseveration?

A

Repeating the same words/answers

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5
Q

What is echolalia?

A

Repeating exactly what someone has said

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6
Q

What is word salad?

A

Disorganised speech, sentences that do not make sense.

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7
Q

What is clang speech?

A

Using rhyming words

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8
Q

Describe antisocial personality disorder?

A
  • Failure to conform to social norms with respect to lawful behavior
  • Deception - repeatedly lying, use of aliases or conning others for personal profit or pleasure
  • Impulsiveness
  • Irritatibily and aggressiveness
  • Reckless disregard for safety of self or others
  • Lack of remorse
  • Consistent irresponsibility
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9
Q

Describe the features of avoidant personality disorder?

A
  • Avoidance of occupational activities which involve signifiant interpersonal contact due to fears of criticism or rejection
  • Unwillingness to be involved unless certain of being liked
  • Preoccupation with ideas that they are being criticised or rejected in social situations
  • Restraint in intimate relationships due to the fear of being ridiculed
  • Reluctance to take personal risks due to fears of embarrassment
  • Views self as inept and inferior to others
  • Social isolation accompanied by a craving for social contact
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10
Q

Describe the features of borderline personality disorder?

A
  • Efforts to avoid real or imagined abandonment
  • Unstable interpersonal relationships which alternate between idealisation and devaulation
  • Unstable self image
  • Impulsitiviy in potentially self-damaging area (spending, sex, substance abuse)
  • Recurrent suicidal behaviour
  • Affective instability
  • Chronic feelings of emptiness
  • Difficulty controlling temper
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11
Q

Describe the features of dependent personality disorder?

A
  • Difficulty making everyday decisions without excessive reassurance from others
  • Need for others to assume responsibility for major areas of their life
  • Difficulty in expressing disagreement with other due to fears of losing support
  • Lack of initiative
  • Unrealistic fears of being left to care for themselves
  • Urgent search for another relationship as a source of care and support when one ends
  • Extensive efforts to obtain support from others
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12
Q

Describe the features of histrionic personality disorder?

A
  • Inappropriate sexual seductiveness
  • Ned to be the centre of attention
  • Rapidly shifting and shallow expression of emotions
  • Suggestibillity
  • Physical appearance used for attention seeking purposes
  • Impressionistic speech lacking detail
  • Self dramatisation
  • Relationships considered to be more intimate than they are
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13
Q

What are the features of narcissistic personality disorder?

A
  • Grandiose sense of self importance
  • Preoccupation with fantasies of unlimited success, power, or beauty
  • Sense of entitlement
  • Taking advantage of others to achieve own needs
  • Lack of empathy
  • Excessive need for admiration
  • Chronic envy
  • Arrogant and haughty attitude
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14
Q

What are the features of paranoid personality disorder?

A
  • Hypersensitivity and an unforgiving attitude when insulted
  • Unwarranted tendency to question the loyalty of friends
  • Reluctance to confide in others
  • Preoccupation with conspirational beliefs and hidden meaning
  • Unwarranted tendency to perceive attacks on their character.
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15
Q

What are the features of schizoid personality disorder?

A
  • Indifference to praise and criticism
  • Preference for solitary activities
  • Lack of interest in sexual interactions
  • Lack of desire for companionship
  • Emotional coldness
  • Few interests
  • Few friends or confidants other than family
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16
Q

What are the features of schizotypal personality disorder?

A
  • Ideas of reference (differ from delusions in that some insight is retained)
  • Odd beliefs and magical thinking
  • Unusual perceptual disturbances
  • Paranoid ideation and suspiciousness
  • Odd, eccentric behaviour
  • Lack of close friends other than family members
  • Inappropriate affect
  • Odd speech without being incoherent
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17
Q

In alcohol withdrawal, when would you:

  • Start experiencing symptoms
  • Seizures
  • Delirium tremens
A

Symptoms: 6-12 hours
Seziures: 36 hours
Delirium tremens: 72 hours

18
Q

What is the first-line mx of alcohol withdrawal?

A

Benzo’s, eg. chlordiazepoxide

19
Q

Name a screening tool in assessing depression?

A

PHQ-9

20
Q

What is the risk of developing schizophrenia if:

  • Monozygotic twin affected
  • Parent affected
  • Sibling affected
  • No relatives affected
A
  • Monozygotic twin affected: 50%
  • Parent affected: 10-15%
  • Sibling affected: 10%
  • No relatives affected: 1%
21
Q

Other than family history, what are the risk factors for psychotic disorders?

A
  • Black Caribbean
  • Migration
  • Urban environment
  • Cannabis use
22
Q

What is (S)omatisation disorder?

A
  • Multiple physical (S)YMPTOMS present for at least 2 years

- Refuses to accept reassurance or negative test results

23
Q

What is hypo(C)hondrial disorder?

A
  • Persistent belief in the presence of an underlying serious DISEASE, e.g. (C)ancer
  • Patient again refuses to accept reassurance or negative test results
24
Q

What is conversion disorder?

A
  • Typically involves loss of motor or sensory function
    the patient doesn’t consciously feign the symptoms (factitious disorder) or seek material gain (malingering)
  • Patients may be indifferent to their apparent disorder - la belle indifference - although this has not been backed up by some studies
25
Q

What is dissociative disorder?

A

Dissociation is a process of ‘separating off’ certain memories from normal consciousness

  • In contrast to conversion disorder involves psychiatric symptoms e.g. Amnesia, fugue, stupor
  • Dissociative identity disorder (DID) is the new term for multiple personality disorder as is the most severe form of dissociative disorder
26
Q

What are the symptoms of SSRI discontinuation?

Which drug is particularly high incidence?

A

Paroxetine

  • Increased mood change
  • Restlessness
  • Difficulty sleeping
  • Unsteadiness
  • Sweathing
  • GI symptoms
  • Paraesthesia
27
Q

What drugs interact with SSRIs?

A
  • NSAIDs (if necessary, co-prescribe a PPI)
  • Warfarin/heparin - Avoid SSRIs and consider mirtazapine
  • Aspirin
  • Triptans
28
Q

What is post-concussion syndrome? Features?

A

Seen after even minor head trauma

  • Headache
  • Fatigue
  • Anxiety/depression
  • Dizziness
29
Q

What is the SSRI of choice in children and adolescents?

A

Fluoxetine

30
Q

What is the mechanism of action of benzodiazepines?

A

Enhance the effect of (inhibatory) GABA by increasing the FREQUENCY of chloride channels.

31
Q

What is the mechanism of action of barbiturates?

A

Enhance the effect of (inhibatory) GABA by increasing the DURATION of chloride channels

32
Q

Why would you avoid prescription of antipsychotics in the elderly?

A

Increased risk of stroke and VTE

33
Q

What is the first-line drug treatment in GAD?

A

SSRI - Sertraline

34
Q

What are the common side-effects of TCAs?

A
  • Drowsiness
  • Dry mouth
  • Blurred vision
  • Constipation
  • Urinary retention
35
Q

If a patient makes a good response to antidepressant therapy how long should they continue on it? Why?

A

6 months after remission

Reduces the risk of relapse

NB. Gradually reduce dose over 4 weeks (Not necessary with fluoxetine)

36
Q

What investigation is important to rule out organic causes in new, sudden onset psychosis in elderly patients?

A

CT head - exclude tumour, stroke or CNS infection

37
Q

What are the adverse effects of atypical antipsychotics? (NB. first-line in schizophrenia, e.g. clozapine)

A

Weight gain
Clozapine - Agranulocytosis

Elderly patients: Stroke (esp olanzapine and risperidone), VTE

38
Q

What are hypnogogic and hypnopompic hallucinations?

A

Hypnogogic: Occurring from wakefulness to sleeping
Hypnopompic: occurring from sleeping to waking

39
Q

Give 4 risk factors and 2 protective factors for the development of GAD?

A

4 RF:

  • Aged 35-54
  • Being divorced or separated
  • Living alone
  • Being a lone parent

Protective:

  • Aged 16-24
  • Being married or cohabiting
40
Q

What two tricyclics are most dangerous in overdose?

A
  • Amitriptyline

- Dosulepin (dothiepin)

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