Psychiatry Flashcards
Third person auditory hallucinations
Schizophrenia
Mesocortical dopamine hypoactivity
Negative and cognitive symptoms in schizophrenia
Subcortical dopamine hyperactivity
Psychosis
Tuberoinfundibular dopamine pathway
Associated with prolactin release
Nigrostriatal dopamine pathway
Extra-pyramidal motor movements
Subcortical and Mesocortical dopamine pathway
= Mesolimbic system
Motivation and reward
Mesolimbic dopamine blockade results in
Depression
Dopamine agonism results in
Psychosis
3 side effects of clozapine
Agranulocytosis
Cardiomyostitis
Weight gain
Prescribing clozapine
Need to try 2 other anti-psychotics
Must be consultant to prescribe
Limbic system functions
M2OVE Motivation Memory Olfaction Visceral Afferents Emotion
Brain changes in schizophrenia
Reduced frontal lobe volume
Enlarged lateral ventricles
Reduced grey matter in the temporal cortex
Pressure of thought
Varied ideas in abundance
Poverty of thought
Patient reports lack/absence of thoughts
Thought blocking
Abrupt and complete interruption of stream of thought
Strongly associated with schizophrenia
Flight of ideas
Quickly moving from one topic to another
Seen in manic phase
Treat EPSE with…
Procyclidine
Amygdala role
Normal response to threat
Pre-frontal cortex role
Dampens down amygdala response to threat
Management of OCD
- Try two different SSRIs
- SSRI + TCA
- SSRI + TCA (chlomipramine)
Consider CBT as an adjuvant
Learning disabilities IQ Thresholds
Borderline 70-80ish Mild 50-69 Moderate 49-35 Severe 20-34 Profound <20
Beck’s Triad
-VE feelings about self, world and future
NMDA antagonists produce…
Psychotic symptoms
Management of alcohol withdrawal
Use Chlordiazepoxide
Start at 30mg QD, reduce very gradually
When do alcohol withdrawal seizures occur?
48 hours
Delirium tremens in alcohol withdrawal occurs?
Between 48-72 hours
Lewy Bodies are
Eosinophilic inclusions
Risk with MAO-i
Hypertensive crisis
Precipitated by high levels of tyramine
Treatment of MAO-i Hypertensive Crisis
Phentolamine infusion
When to avoid TCAs?
Cardiac problems
Patients with suicidal intent
