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Phase 3A Medicine > Psychiatry > Flashcards

Psychiatry Flashcards

1
Q

What factors make up a formulation?

A

Predisposing
Precipitating
Perpetuating
Protective

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2
Q

What topics would you ask about in a psychiatric history?

A 
Presenting complaint
History of presenting complaint
Past psychiatric history
Past medical history
Drug history/Allergies
Family history
Social history
Forensic history
Personal history
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3
Q

What would you ask about in personal history?

A

Birth - any problems with the birth or as a baby?
Early development - attachment issues? slow developmental milestones
School - social/academic, failure to succeed, why?
Home environment - traumatic events
Qualifications
Relationships and children
Work

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4
Q

What would you ask about in forensic history?

A

Juvenile crime
Court appearances, convictions, length of sentence
Against person/property? Prison experience

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5
Q

MSE - appearance and behaviour

A

Visual description of patient. Eye contact, rapport, self-care, dress, psychomotor agitation/retardation, abnormal movements, distractibility, perplexity, cooperation, over familiar

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6
Q

MSE - speech

A

Speed - slow, fast, hesitant, pressured, flight of ideas
Volume - loud ,soft, muttered, shouted
Language - accented, dysphasia
Neologisms, punning

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7
Q

MSE - affect/mood

A

Mood - subjective (patient’s own words/views)

Affect - objective (euthymic, elated, sad, irritable)

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8
Q

MSE - thoughts and delusions

A

Content - obsession, preoccupation, delusions (unshakeable beliefs), or overvalued ideas?
Form - circumstantial, tangential, looseness of association,
stream - poverty, racing, preservative, thought insertion/withdrawal/broadcast

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9
Q

MSE - perceptions and hallucinations

A

5 senses - auditory, visual, tactile, gustatory, olfactory
True auditory hallucination - voice not in head, sounds like it’s coming from the room
Auditory - content? 2nd/3rd person? command?

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10
Q

MSE cognition

A

AMT/MOCA

orientation in time, place and to person

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11
Q

Symptoms of mania

A 
Pressure of speech
Flight of ideas
Over-familiar
Disinhibited
Punning/neologism
2nd person auditory hallucinations
Grandiose delusions
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12
Q

Symptoms of a depressive disorder

A 
Low mood
Tearful
Reduced energy (anhedonia)
Reduced motivation
Early morning wakening
Loss of appetite/weight loss
Reduced concentration/enjoyment
Reduced self-care
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13
Q

Symptoms of psychosis

A

Persecutory delusions
3rd person auditory hallucinations
Running commentary
Though insertion/withdrawal/broadcast

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14
Q

Hallucination

A

A perception in the absence of external stimuli

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15
Q

Hypnogogic

A

hallucinations experienced when falling asleep

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16
Q

Hypnopompic

A

hallucinations experienced when waking up

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17
Q

Reflex hallucination

A

“when you write, I can hear your pen pressing on my heart”

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18
Q

Extracampine hallucinations

A

hallucinations outside the realm of what is feasible

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19
Q

Over-valued idea

A

a belief or concept that is out of keeping with reality but can be challenged

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20
Q

Delusion

A

a false belief firmly maintained in spite of indisputable and obvious proof to the contrary - not shared with other members of patient’s culture/subculture
Types: persecutory, grandiose, nihilistic

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21
Q

Illusions

A

misinterpretation of actual external stimuli

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22
Q

Misidentification delusions

A

capgras - someone replaced by an imposter
fregoli - various people are the same person
subjective doubles - dopplegangers

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23
Q

Delusional perception

A

a delusion formed from a real perception e.g. “I heard dogs barking last night and from then on I knew that I was going to be the next prime minister”

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24
Q

Thought insertion

A

belief that thoughts are being inserted into your head by an external agency

25
Thought withdrawal
belief that thoughts are being removed from your head by an external agency
26
Though broadcast
belief that everyone around you can hear your thoughts
27
Thought echo
head thoughts echoed in your head or out loud
28
Thought block
when a person can't pick up a train of thought again after losing it
29
Concrete thinking
taking thoughts very literally (can't understand metaphors)
30
Loosening of association
when someone has such a loss of connectivity between their thoughts that it is very difficult to understand what they are saying (seen in severe mania)
31
Circumstantiality
when a person is asked a question that will talk around different subjects until getting to the answer
32
Perseveration
the answer to an initial question is correct but further questions will all receive the same answer which won't make sense
33
Confabulation
The misrepresentation of memory wherein holes in recollection are filled in by manufactured tellings that the person believes to be the truth
34
Somatic passivity
delusional belief that physical sensations are being caused by an external agency
35
Made act/feel/drive
belief that actions/feelings/drive are being influenced by an external agency
36
Psychomotor retardation
slowing down of thoughts and movements
37
Pressure of speech
the urge to speak is so overwhelming that you have to keep on speaking - often interrupt
38
Flight of ideas
thoughts move very quickly, thoughts and ideas connected
39
Anhedonia
loss of pleasure in activities used to find enjoyable (key symptom of depression)
40
Incongruity of affect
when a person's affect doesn't fit with what they are saying e.g. laughing whilst talking about the death of a loved one (associated with thought disorders)
41
Blunting of affect
where there is little change in facial expression, non-responsive (seen in depression/schizophrenia)
42
Conversion disorder
When the brain manages an emotional trauma by converting it into a physical symptom e.g. unexplained blindness
43
Belle indifference
When a person suffers from a conversion disorder by is completely indifferent to it
44
Depersonalisation
where a person's consciousness is removed from the forefront and their actions become mechanical, as if on auto-pilot
45
Derealisation
when it feels like nothing is real
46
Dissociation
when a person removes their consciousness from a situation, can be conscious or unconscious (e.g. trauma)
47
Obsession
thought component of OCD recurrent unrelenting thought thought recognised as own
48
Compulsion
action component of OCD | recurrent action e.g. hand-washing
49
Akathisia
urge to move, common side-effect of anti-psychotic medication
50
Core symptoms of depression
Low mood Loss of energy (anergia) Loss of enjoyment (anhedonia)
51
Physical symptoms of depression
Change in sleep (characteristically early morning waking) Change in appetite Change in libido
52
Psychological symptoms of depression
``` Diurnal mood variation Agitation Loss of confidence Loss of concentration Guilt Hopelessness Suicidal ideation ```
53
Classification of mild depression
Core symptoms + 2-3 others
54
Classification of moderate depression
Core symptoms + 4 others + functioning affected
55
Classification of severe depression
without psychotic symptoms - several symptoms, suicidal, marked loss of functioning with psychotic symptoms - typically mood congruent (nihilistic and guilty delusions, derogatory voices)
56
Symptoms of hypomania | hypomania vs mania
``` Elevated mood (can be euphoric/dysphoric/angry) Increased energy Increased talkativeness (POS) Poor concentration Mild reckless behaviour e.g. overspending Sociability/overfamiliarity Increased libido/sexual disinhibition Increased confidence Decreased need for sleep Change in appetite ```
57
Symptoms of mania | hypomania vs mania
``` Extreme elation - uncontrollable Over activity Pressure of speech Impaired judgement Extreme risk-taking behaviour e.g. spending spree, booking holidays Social disinhibition Inflated self-esteem, grandiosity Addition of psychotic symptoms Mood incongruent ```
58
Cyclothymia
A less severe version of bipolar which involves cycling between hypomania and moderate depression
59
What are the 1st rank symptoms of schizophrenia?
Thought alienation Passivity phenomena 3rd person auditory hallucinations Delusional perception

Phase 3A Medicine (2 decks)

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