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MBBS / MBChB finals > Psychiatry > Flashcards

Psychiatry Flashcards

1
Q

Why should antipsychotics not be prescribed in lewy body dementia

A

Precipitates severe parkinsonism in 60%

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2
Q

Features of vascular dementia

A 
Begins in 60s
Stepwise deterioration cognitive function
Focal neurology
Fits
Nocturnal confusion
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3
Q

Risk factors for vascular dementia

A 
Male
Smoking
Hypertension
DM
Hypercholesterolaemia
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4
Q

Features of frontotemporal dementia

A 
Disinhibition 
inattention 
antisocial behaviour 
personality change 
apathy 
Akinesia 
withdrawal
Memory loss disorientation occur late
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5
Q

Features of normal pressure hydrocephalus

A

Triad of dementia, gait disturbance and urinary incontinence

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6
Q

What is the most common type of dementia

A

Alzheimer’s disease

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7
Q

Features of Alzheimer’s disease

A 
Gradual progressive cognitive decline
Apathy
Labile mood
Altered personality
Paranoia
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8
Q

When may early onset Alzheimer’s occur

A

Down’s syndrome

Inheritance of amyloid precursor or presenillin proteins

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9
Q

Qs in the mini mental state examination

A 
> year, month, day, date, time
> country, county, town, building, floor
> Repeat - apple, penny, cup
> Calculation - start at 100 and subtract 7 (100, 93,86 ,79, 72)
Or spell world backwards - d l r o w
> Recall 3 words
> name - pencil and watch
> repeat 'no ifs ands or buts' 
> 3 stage command
> Read and obey a written command - close your eyes
> write a sentence 
> Copy intersecting pentagons
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10
Q

What is pseudodementia

A

Features of dementia caused by depression

Mood impairment precedes the cognitive symptoms

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11
Q

Within what timeframe do symptoms have to occur following a traumatic event for it to be classed at PTSD

A

6months

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12
Q

What are the 3 main symptoms of PTSD

A

Re-experiencing (Flashbacks and nightmares)
Avoidance
Hyperarousal

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13
Q

Side effects of tri-cyclic antidepressants

A 
Dry mouth 
Postural hypotension
Blurred vision 
Constipation
Urinary retention
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14
Q

Side effects of SSRIs

A

GI upset
Sweating
Erectile dysfunction
Anorgasmia

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15
Q

What foods interact with mono-amine oxidase inhibitors

A

Red wine
Cheese
(Tyramine)

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16
Q

What is the cheese reaction of MAO inhibitors

A

Ingestion of tyramine causes a hypertensive crisis.

Due to release of nor-adrenaline from storage vesicles

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17
Q

Potential risks of ECT

A

Amnesia
Memory loss
Induction of a cardiac arrhythmia
Musculoskeletal injury

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18
Q

What biochemical / haematological abnormalities are found in anorexia nervosa

A

Hypokalaemia
Low WCC
Hypercholesterolaemia
Hypochloraemic alkalosis

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19
Q

Organic causes of anxiety

A 
Hypoglycaemia 
Hyperthyroidism
Paroxysmal SVT
Alcohol withdrawal
Drug withdrawal
Drug intoxication
Phaeochromocytoma (rare)
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20
Q

Features of generalised anxiety disorder

A

Excessive worry present more days than its absent
For at least 6m
Occurs with a variety of events
Syx include tension, feeling of impending doom, restlessness, insomnia, fatigue, poor concentration, physical pains

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21
Q

Management of generalised anxiety disorder

A

Short term - beta blockers
CBT
Counselling / Relationship counselling

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22
Q

Symptoms of panic disorder

A 
Intense anxiety / fear
Palpitations 
Sweating 
Shaking 
SOB
Hyperventilation 
Derealisation
Fear of dying
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23
Q

Management of panic disorder

A

Antidepressants
Relaxation training
CBT
Counselling

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24
Q

What is an obsession

A

Stereotypical and purposeless words / phrases / thoughts that an individual cannot control or out out of their mind

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25
What is a compulsion
A repeated ritual
26
Features of obsessive compulsive disorder
Unpleasant obsessions and compulsions Often involving dirt, sex, harm to self or others or religion The patient realises the thoughts are their own
27
Management of obsessive compulsive disorder
SSRIs CBT Exposure therapy Social support
28
Features of PTSD
``` Follows exposure to serious traumatic event causing harm to self or others Reliving - flashbacks / nightmares Avoidance Sleep disturbance Reduced concentration Anxiety Irritability Hyper-vigilance ```
29
4 criteria of anorexia nervosa
BMI<17 Weight loss is self-induced Distorted body image Endocrine changes
30
Common symptoms of anorexia nervosa
``` Constipation Muscle cramps Tiredness Dizzy on standing Symptoms of anaemia- tiredness and breathlessness Amenorrhoea ```
31
What is a section 2 + how long is it for? | Who can request it
Admission for assessment 28days 2 drs - 1 section 12 approved
32
What is a section 3 + how long is it for? | Who can request it
Admission to treat 6 months 2 drs - 1 must be section 12 approved
33
What is a section 5 (2) + how long is it for? | Who can request it
Holding order for a patient already on the ward 72 hours 1 dr
34
What is a section 136 + how long is it for? | Who can request it
Police order to remove a person from a public place who is appearing to suffer from a mental disorder, to a place of safety. 72 hrs Police officer
35
To have capacity a person must:
Understand the relevant information Retain the information long enough to decide Be able to use info / weigh up Communicate their decision
36
What mental health sections can a patient appeal
Sections 2 + 3 (in England and Wales)
37
Physical illnesses commonly associated with depression
``` Chronic pain Cushing's syndrome Hypothyroidism Stroke Parkinson's MS Hyperparathyroidism ```
38
Organic causes of mania
Head injury MS Cushing's syndrome
39
Normal stages of bereavement
``` Numbness Pining Depression Recovery Normal up to 6m ```
40
What is othello syndrome
Patient believes their partner is cheating despite no evidence. Accusatory Stalking M > F
41
What is cotards syndrome
Severely depressed patients believe part of their body is dead or decaying
42
What is capgras syndrome
Patients believe a loved one has been replaced by a double
43
What is declerambault's syndrome
Patient believes someone is deeply in love with them. Usually someone famous F > M
44
What is agoraphobia
Phobic anxiety | Fear of being in places where escape may be difficult
45
Negative symptoms of schizophrenia
Psychomotor retardation Decreased speech Social withdrawal Loss of initiation
46
Schneiders 1st rank symptoms
Auditory hallucinations Broadcast of thought / thought withdrawal / insertion Controlled thoughts / actions = passivity Delusional perceptions echo of thoughts Inappropriate mood
47
What symptoms dominate in paranoid schizophrenia
Delusions
48
What symptoms dominate in hebephrenic schizophrenia
Affective symptoms Irresponsible and unpredictable behaviour Inappropriate mood
49
What symptoms dominate in catatonic schizophrenia
Motor symptoms Abnormal posturing Repetitive mannerisms Waxy flexibility
50
What is simple schizophrenia
Insidious onset Negative symptoms No delusions or hallucinations
51
What is seasonal affective disorder and its symptoms
Onset of depression at a particular season Symptoms of depression Plus carbohydrate craving, hypersomnia, weight gain
52
Symptoms of puerperal psychosis
``` Commonly 1st week post-partum Mood changes - mania, depression, confusion Irritability Sleeplessness Hallucination ```
53
Indications for electroconvulsive therapy
``` Severe suicidal thoughts Previous response to ECT Psychotic features Catatonic stupor Food refusal Depression refractory to antidepressants ```
54
Examples of typical anti-psychotics
Haloperidol Chlorpromazine Fluphenazine
55
Examples of atypical anti-psychotics
``` Olanzapine Quetiapine Aripriprazole Risperidone Amisulpride Clozapine ```
56
What is neuroleptic malignant syndrome
Rare Potentially fatal Sympathetic hyperactivity associated with antipsychotics
57
Symptoms of neuroleptic malignant syndrome
``` Fever Rigidity Confusion Fluctuating consciousness Sympathetic instability ``` Raised creatinine kinase Leucocytosis Deranged LFTs
58
Side effects of clozapine
``` Agranulocytosis Neutropenia Thromboembolism Myocarditis Cardiomyopathy ```
59
Side effects of tricyclic antidepressants
``` Dry mouth Blurred vision Tachycardia / arrhythmia Constipation Urinary retention Drowsiness ```
60
Side effects of SSRIs
``` Nausea Anorexia Dry mouth Diarrhoea Constipation Dyspepsia ```
61
Symptoms of serotonin syndrome
``` Myoclonus Nystagmus Headache Tremor Rigidity Seizure ```
62
Symptoms of lithium toxicity
``` Coarse tremor Diarrhoea Ataxia Twitching Dysarthria Confusion ```
63
Complications of vomiting in bulimia nervosa
``` Cardiac arrhythmia Renal impairment Muscular paralysis Tetany (hypocalcaemia) Swollen salivary glands Dental enamel erosion ```
64
Features of lewy body dementia
Day today fluctuating levels of cognitive function Visual hallucination Sleep disturbance Transient loss of consciousness Recurrent falls Parkinsonian features (Tremor, hypokinesia, rigidity, postural instability)

MBBS / MBChB finals (25 decks)

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