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Revision from notes > Psychiatry > Flashcards

Psychiatry Flashcards

1
Q

Which SSRI should you give if you have cardiac problems?

A

Sertraline

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2
Q

Which SSRI should you give if you have epilepsy?

A

Citalopram

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3
Q

Core symptoms of depression?

A

MIE
Mood
Interest/pleasure
Energy

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4
Q

Other features to ask about in depression

A 
ACG - appetite, concentration, guilt
S- self confidence
S - sleep
S - self harm
S - suicidal thoughts
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5
Q

How long should you continue depression medications for?

A

Continue for 6-12 months after resolution of symptoms for 1st episode
If they have recurrent episodes - continue for 12-24 months after

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6
Q

Which anti-depressants should you avoid in older people?

A

TCAs - avoid in old people and people likely to OD

cardiac toxicity in overdoes

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7
Q

Medication good for bipolar depression

A

Lamotrigine

-generally avoid antidepressants in bipolar as can cause switch to hypomania/mania

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8
Q

Medication good for hypomania

A

Sodium valproate

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9
Q

Mirtazepine mechanism of action

A

NaSSA

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10
Q

May be used if patient has insomnia +/- poor appetite

A

Mirtazepine (sedative and weight gain)

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11
Q

Need to be careful about this with mirtazepine

A

Causes GI upset when taken with alcohol

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12
Q

Name 2 SNRIs

A

Venlafaxine, duloxetine

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13
Q

What is california rocket fuel

A

Mirtazepine and venlafaxine

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14
Q

How do you treat hypertensive crisis?

A

Phentolamine infusion

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15
Q

Name 3 irreversible MAOIs

A

Phenelzine
Tranylcypromine
Isocarboxazid

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16
Q

Name a reversible MAO

A

Moclobemide

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17
Q

What type of drug is trazadone?

A

SARI

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18
Q

What medications interact with lithium? DAAN

A

Diuretics
ACEi
ARBs
NSAIDs

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19
Q

Safe lithium levels

A

0.6-1.0
(when above 1.5 can get toxicity - coarse tremor, GI upset, blurred vision, coarse tremor, ataxia, drowsiness, confusion, LOC, seizures, coma, death)

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20
Q

Treatment of lithium toxicity

A

Stop lithium
IV fluids
Monitor renal function

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21
Q

Treatment of acute mania

A

Olanzapine

Sodium valproate

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22
Q

Lithium monitoring

A

Weekly until stable for 4 weeks
Then monthly for 6 months
Then 3-monthly

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23
Q

Clozapine monitoring

A

Weekly for first 18 weeks
Then fortnightly to make up to 1 year
Then monthly

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24
Q

First rank symptoms of schizophrenia

DTAP

A

Delusions
Thought disorder (insertion/withdrawal/broadcasting)
Auditory hallucinations
Passivity

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25
Q

What is Cotard syndrome?

A

When someone believes they are already dead

associated with severe depression

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26
Q

What is conversion disorder?

A

Typically involves loss of sensation or motor function

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27
Q

What is munchausen’s/factitious disorder?

A

When people deliberately fake their symptoms - charlotte black

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28
Q

What is malingering?

A

Faking symptoms for financial or other gain

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29
Q

Treatment of sleep paralysis

A

First line treatment - improve sleep hygiene!!!

clonazepam may be offered as very last resort

30
Q

How long do your symptoms need to be present for to diagnose panic disorder?

A

1 month

31
Q

If you have delusions/hallucinations AND mood symptoms, what should you consider?

A

Schizoaffective disorder

32
Q

Side effect of anaesthetic drugs?

A

Malignant hyperthermia

33
Q

When does tardive dyskinesia present?

A

Presents a long time after being on anti-psychotics

34
Q

What is tardive dyskinesia?

A

Involuntary movements - chewing and pouting of jaw are most common, also things like lip-smacking

35
Q

How does neuroleptic malignant syndrome present

A

Fever and muscle stiffness

36
Q

Short term side effect of ECT

A

Arrhythmias

37
Q

One of the most common side effects of clozapine

A

Constipation

38
Q

Lip smacking
Difficulty swallowing
Excessive blinking

A

Tardive dyskinesia

39
Q

Slight difference between atypicals and typical antipsychotics

A

Atypicals - very likely to cause weight gain

Typicals - extra-pyramidal side effects

40
Q

Side effect of benzodiazepines

A

Can cause anterograde amnesia - can’t remember new memories

41
Q

What happens if you miss clozapine for more than 48 hours

A

Need to re-titrate dose up again

42
Q

What happens if you combine sertraline with NSAID/aspirin?

A

Increased bleeding risk!! –> must give PPI

43
Q

Atypical with the fewest side effects

A

Aripiprazole

44
Q

Peak incidence of SYMPTOMS following alcohol withdrawal

A

6-12 hours

45
Q

Peak incidence of seizures following alcohol withdrawal

A

36 hours

46
Q

Peak incidence of delirium tremens

A

72 hours

47
Q

First line for alcohol withdrawal

A

Chlordiazepoxide

48
Q

How does lansoprazole work?

A

Inhibits the H+/K+ ATPase in gastric cells or something

49
Q

Delirium criteria

A 
ACDC
Attention
Cognition
Develops over hours usually + fluctuating
No other cause
50
Q

4AT

A

Alert
Acute
Name, DOB, current year, where are you
Attention -ask to list months bacwards

51
Q

Management of schizophrenia

A

Oral atypical psychotics are first line

CBT should also be offered

52
Q

Treatment for PTSD

A

Trauma-based CBT
Eye-movement desensitisation and reprocessing (EMDR)
Drugs not usually offered but paroxetine or mirtazepine can be used

53
Q

Five stages of grief? DABDA

A 
Denial
Anger
Bargaining
Depression
Acceptance
54
Q

What is regression

A

An ego defence where we revert to immature behaviour in setting of stress
e.g. manager loses deal so stamps on table

55
Q

Conductive disorder

A

Basically antisocial disorder in someone younger than 18

56
Q

What is oppositional defiant disorder

A

Like conductive/antisocial but far less extreme - no violation of the rights of others

57
Q

What is fixation?

A

Lack of progression through development - someone stays in child-like state of maturity (i think this was example when someone played videogames for ages)

58
Q

How do you work out units in a drink?

A

% x mls (divided by 1000)

59
Q

Low risk drinking

A

Less than 14 units per week

60
Q

Moderate risk drinking

A

14-35 units per week

61
Q

High risk drinking

A

> 35 units per week

62
Q

First line agent for alcohol relapse prevention

A

Naltrexone

63
Q

ADHD triad

A

Inattention
Hyperactivity
Impulsiveness

64
Q

Difference between mania and hypomania

A

Hypomania - no psychotic symptoms, features not significant enough to interfere with social or occupational hospitalisation

(hypomania - refer to community mental health)

65
Q

What does Sundowner syndrome refer to?

A

Features of dementia are often worse at night time

66
Q

Treatment of dementia

A

Donepezil, tacrine, rivastigmine, galantamine

acetylcholinersterase inhibitors

67
Q

Risk factors for Alzheimer’s disease?

A

Down syndrome
Previous head injury
Hypothyroidism

68
Q

Tayside rapid tranquilisation protocol

A

Lorazepam 1-2mg and/or haloperidol 5mg

69
Q

When can you apply to have compulsory treatment order removed?

A

Can apply to have it removed after 3 months

70
Q

Which section of adults with incapacity should you use to treat someone who doesn’t have capacity?

A

Section 47

71
Q

What does having capacity mean?

A

1) To be able to understand and retain information
2) to use that information to make a decision
3) To be able to communicate that decision

72
Q

What is memantine?

A

A partial NMDA agonist

Revision from notes (16 decks)

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