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Psychiatry Flashcards

1
Q

Pathophysiology of Depression

A

Monoamine Deficiency Hypothesis

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2
Q

Medical Management of Depression

A
  1. SSRI
    (Try at least 2 different SSRIs)
  2. Try TCA or SNRI - again try two from each class
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3
Q

Management of Depression

A

Antidepressant +/- psychological intervention e.g. CBT

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4
Q

Presentation of Generalised Anxiety Disorder

A

Anxiety not related to the situation
Recognised by person as irrational
Physical symptoms

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5
Q

Physical symptoms in GAD

A

Palpitations
Sweating
Shortness of breath
Problems concentrating

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6
Q

Investigation in GAD

A

FBC and TFT

Ruling out hyperthyroidism as cause for anxiety

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7
Q

Management of GAD

A

SSRI
CBT/behavioural therapy
B-blocker for anxiety

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8
Q

Presentation of PTSD

A

Intrusive images
Avoidance of situation **
Emotional detachment

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9
Q

Management of PTSD

A

Rapid eye movement desensitisation

High dose SSRI

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10
Q

Exception in the management of PTSD

A

CANNOT use REMD in combat PTSD

Mx: focused CBT

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11
Q

Complications of PTSD

A

Depression

Substance abuse

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12
Q

SSRI used in PTSD

A

Sertraline

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13
Q

Presentation of Panic Disorder

A

Attacks of severe anxiety
These are recurrent and unexpected
Can be triggered in susceptible individuals

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14
Q

Management of Panic Disorder

A

TCA/SSRI to reduce anxiety load

Able to then do CBT

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15
Q

Presentation of Agoraphobia

A

Fear of being in large spaces/places with lots of people

Prominent avoidance of situation

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16
Q

Management of Agoraphobia

A

Behavioural therapies

Anxiolytics

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17
Q

Management of Specific Phobias

A

Graded exposure therapy

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18
Q

Presentation of Depressive Psychosis

A

Delusions of self-worthlessness

2nd person auditory hallucinations

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19
Q

Associations with Delirium

A

Cognitive deficit
Drugs
Emergency Surgery

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20
Q

Presentation of Delirium

A

Nocturnal worsening
Fluctuating course
Hallucinations

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21
Q

Investigation of Delirium

A

4AT screening test

Bloods to look for cause e.g. infection

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22
Q

What should be avoided in delirium?

A

Benzodiazepines

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23
Q

What can be useful in hyperactive delirium?

A

Haloperidol

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24
Q

Cluster A Personality Disorders

A

Schizoid PD

Paranoid PD

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25
Cluster B Personality Disorders
Borderline Histrionic Anti-Social
26
Cluster C Personality Disorders
Dependent Obsessive Compulsive Avoidant
27
What type of PD is Schizoid PD?
Cluster A = odd and eccentric
28
What type of PD is Paranoid PD?
Cluster A = odd and eccentric
29
What type of PD is Borderline PD?
Cluster B = dramatic and emotional
30
What type of PD is Histrionic PD?
Cluster B = dramatic and emotional
31
What type of PD is Anti-Social PD?
Cluster B = dramatic and emotional
32
What type of PD is Dependent PD?
Cluster C = anxious and avoidant
33
What type of PD is Obsessive Compulsive PD?
Cluster C = anxious and avoidant
34
What type of PD is Avoidant PD?
Cluster C = anxious and avoidant
35
Key features of schizoid PD
Detachment from personal relationships | Takes pleasure in few things
36
Key feature of paranoid PD
Unjustified doubt and paranoia
37
Key feature of borderline PD
Unstable interpersonal relationships
38
Key features of anti-social PD
Cannot read expression properly - interpret neutral as aggressive/malicious Lack of remorse for actions
39
Key feature of histrionic PD
Cannot cope with not being the centre of attention
40
Key feature of dependent PD
Inability to make simple decisions
41
Key features of obsessive compulsive PD
OCD tendencies, not the same level of compulsions to produce a neutralising effect Perfectionism resulting in problems with task completion Hoarding
42
Key feature of avoidant PD
Fear of rejection so avoids social situations
43
Presentation of ADD (4)
Inattention Hyperactivity Attention deficit Cannot follow instructions
44
Associations with ADD
Boys | Prenatal exposure to cannabis
45
Investigation of suspected ADD
School observation | Parent report
46
Management of ADD
Parental techniques | Methylphenidate = Ritalin
47
IQ Thresholds for Intellectual Disability
``` 69-50 = mild 49-35 = moderate 34-20 = severe <20 = profound ```
48
Presentation of Intellectual Disability (3)
Depends on severity Delayed speech Reading and writing problems Delayed development
49
Aetiology of Intellectual Disability
Trisomy 21 Trisomy 13 - Patau Trisomy 18 - Edward's
50
Management of Intellectual Disability
Social and educational support
51
Core features of ASD (2)
Inflexibility of thought Social problems e.g. problems with interaction and communication
52
Other presentations of ASD
May have sensory differences
53
Management of ASD
Cannot treat core symptoms Modify learning environment Reduce stresses
54
Use of incapacity act
Treating physical disorder for someone who has a mental disorder Includes delirium
55
Incapacity act process
Section 47 certificate
56
Incapacity act | Examples of exceptional cases and process
Abortion, sterilisation, ECT in someone with a mental disorder Requires a section 48 which includes independent opinion and court order
57
Use of Mental Health Act
Treating mental disorder
58
Emergency detention Process Conditions
Section 5(2) Allows person to be held for up to 72 hours Can only be assessed
59
Who can fill out emergency detention?
FY2 or higher | Ideally mental health officer
60
Who can revoke emergency detention?
Psychiatrist
61
Short term detention Process Conditions
Section 2 Allows person to be held for 28 days Assessment and treatment Can appeal against short term detention
62
Who can fill out short term detention?
Psychiatrist and MHO
63
Compulsory Treatment Order Process Conditions
Section 3 Application made to tribunal, they decide whether granted Lasts for 6 months
64
Re-applying for CTP
Can last up to 6 months Can extend for another 6 months Then for periods of 12 months at a time

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