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MD Finals > Psychiatry > Flashcards

Psychiatry Flashcards

1
Q

What are some common side effects of ECT?

A

Reversible memory loss - retrograde>anterograde
Tension headache
Nausea
Transient muscle pain

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2
Q

What are some less common side effects of ECT?

A

Skin burns

Prolonged seizure

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3
Q

What features in a psychiatric history would correlate with increased risk of harm?

A

Previous self harm/harm.
Suicide attempts - more serious if planned, precautions taken to avoid discovered, help sought after, note left.
Recent actions.
Recent major stress.

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4
Q

What features in a mental state would correlate with increased risk of harm?

A

Suicidal or violent thoughts
Significant mood disturbance.
Psychotic symptoms.

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5
Q

How can you formulate a risk assessment?

A

What are the risks?
How probable?
How intermediate and long lasting?
What can be done to reduce risk and what may affect probability?

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6
Q

When would a psychodynamic psychotherapy be used?

A

Anxiety disorders.
Weekly for up to years.
Focuses on changing current behaviours and feeling by analysing past experiences.

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7
Q

Interpersonal therapy.

A

Depressive disorders.
Weekly up to 4 months.
Focuses on understanding problematic interpersonal relationships.
Enable better control over mood and behaviour.

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8
Q

CBT.

A

OCD, phobia, anxiety.
6 weeks to 6 months.
Aims to change distorted, harmful, irrational or ineffective beliefs. Teach skills and strategies.

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9
Q

Motivational interviewing.

A

Substance abuse, depressive disorders.

2-4 sessions.

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10
Q

What are the risk factors for completed suicide?

A

Male, unemployed, isolated, mental or psysical illness, drugs, alcohol.
Current mental state.
Planned, final acts, secrecy.

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11
Q

What is ‘impaired control’ in substance dependancy?

A

Using in larger or longer amounts than intended.
Repeated failed attempts to cut down.
Desire to obtain and use.

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12
Q

What is ‘social impairment’ in substance dependancy?

A

Problems fufilling at work, school or social obligations

Reduced social and recreational activities

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13
Q

What is ‘risky use’ in substance dependancy?

A

Use in physically hazardous situations - driving a car

Use despite knowledge of physical problem - alcohol and cirrhosis

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14
Q

What is ‘pharmacological factors’ in substance dependancy?

A

Drug tolerance - need to increase dose to achieve affect

Withdrawl - substance dependant collection of symptoms that appear after cessation of prolonged drug use

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15
Q

What is the main active component of cannabis?

A

THC

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16
Q

What are the clinical features of cannabis?

A 
Intoxication
Anxiety or panic
Red eyes
Munchies  
Dry mouth
Tachycaria and increase BP
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17
Q

What are the clinical features of cannabis withdrawl?

A 
Unstable mood
Depression
Agression
Sweating
Headache
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18
Q

What is benzodiazepine rebound phenomena?

A

Re-emergence of symptoms absent or prev controlled after med stopped for a few days

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19
Q

What is the clinical features of benzodiazepine overdose?

A 
ANS
Sweating
N,V and anorexia 
HTN 
Tremors 
Seizure
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20
Q

What is the management for benzo dependance?

A

Psychotherapy
Dose tapering
Seizure prophylaxis - carbamazepine

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21
Q

How does cocaine work?

A

Increases dopamine in the synaptic cleft

Inhibits Na channels - LA action

22
Q

What is the treatment for nicotine addiction?

A

Councelling and support
Nicotine replacement therapy
Vareniciline - reduces potitive symptoms and prevents withdrawl
Bupropion - reduces cravings and withdrawl symptpms

23
Q

How does caffeine work?

A

Increased cAMP.

24
Q

What is ADHD?

A

Characterised by inattention, hyperactivity, and impulsivity.
Interferes with social and academic functioning.
Last for at least 6 months.
Occurs before the age of 7.
Present in multiple settings.

25
Q

What is the pathology in ADHD?

A

Decreased dopamine.

26
Q

What are the risk factors for ADHD?

A

Genetic predisposition.
Prematurity.
Exposure to alcohol inutero.

27
Q

What are the symptoms of ADHD?

A 
Short attention span. 
Hyperactivity. 
Constant failure in school. 
Inability to sit through cartoons. 
Disobediance.
28
Q

What is the management of ADHD?

A

Behavioural - First line for preschool and adjuncts for school age.
Socio-education measures.
Parent training.

Methylphenidate - Ritalin.
Increases dopamine.
First line >6 year

29
Q

What is the effects of Ritalin?

A

Increased mental performance.
Improved concentration.
Congnition.
Fine motor skills.

30
Q

What are the main side effects of Ritalin?

A

Sympathic effects - dry mouth, sweating.
Epileptogenic potential.
Decreased growth rate (reversible if stopped).
Titrate slowly.

31
Q

What drug is second line therapy?

A

Atomoxetine.

32
Q

What is ASD?

A

Neurodevelopment disorder.
Evident before 2-3 yers of age.
Spectrum ranges from Kanners - Aspergers.

33
Q

What are the risk factors for ASD development?

A

Geneticcs
Toxin exposure
Prenatal infections

34
Q

What are the core features of ASD?

A

Persistent impairment in social and communication.

Restricted, sterotypical patterns of behaviour.

35
Q

What are some additional features of ASD?

A

Intellectual impairment
Language impairment.
Motor abnormalities.

Epilepsy
Pica
Retts Syndrome.

36
Q

Childhood autism/Kanners Syndrome.

A 
Impaired language. 
Impaired intelligence. 
No eye contact with parents. 
Reduced emotional response. 
Repetitive movements. 
Distrubed by small changed in surroundings.
37
Q

Aspergers Syndrome.

A

Normal language and cognitive development.
Normal or high IQ.
Exceptional skills/interests in specific areas.
Reduced ability to empathise.

38
Q

Retts Syndrome.

A

Normal development until 7-24 months then onset.
Loss of motor, cognitive and language competancies.
Hand wringing.

39
Q

Hellers Dementia.

A

Childhood dintingerative disorders.

Normal development then loss of acquired skills within several months.

40
Q

What is the management of ASD?

A 
Behaviour and educational management 
Competance training 
Structures
Set limits
Medical treatment for co-morbidities.
41
Q

What are the indicators of poor prognosis in ASD?

A

Severe core symptoms.
Low IQ.
Poor or absent language skills.
Late initiation of treatment.

42
Q

PSTD.

A 
Symptoms  which  last >1 month following >1 traumatic event. 
Intrusive thoughts. 
Distressing dreams 
Flashbacks. 
Physiological  reactions 
Avoiding memories/reminders
Negative mood 
Detatchment 
Impact on fucntioning
43
Q

What is the management for PTSD?

A

CBT - exposure ot trauma focuses, eye movement

SSRI, SNRI

44
Q

What is word salad?

A

Incoherant thinking expressed as a sequence of words without logical connections.

45
Q

What is neologisms?

A

The creation of new words with idiosyncratic meaning

46
Q

What is echolalia?

A

Repition of speech

47
Q

What is clang association?

A

Use of words based on rhyme patterns rather than meaning

48
Q

What is circumstantial speech?

A

Non linear thought expressed as a long winded manner of explanation, before expressing the central idea

49
Q

What is thought blocking?

A

An objective observation of abrupt ending in a thought process, sudden interuption in speech

50
Q

What are first rank symptoms?

A

Thought insertion or withdrawl
Delusions of control
Delusional perceptions
3rd person auditory hallucinations

MD Finals (7 decks)

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