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Phase 3A > Psychiatry > Flashcards

Psychiatry Flashcards

1
Q

What are the three core symptoms of depression?

A

Low mood
Anergia (loss of energy)
Anhedonia (loss of pleasure)

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2
Q

What are other symptoms of depression?

A 
Change in sleep
Change in appetite
Weight loss
Change in libido
Diurnal mood variation
Agitation
Loss of confidence
Loss of concentration
Guilt
Hopelessness
Suicidal ideation
Reduced self esteem
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3
Q

Define paranoid

A

Suspicious, preoccupied with conspiratorial explanations, distrusts others, holds grudges

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4
Q

Define schizoid

A

Emotionally ‘cold’, lacks interest in others, rich fantasy world

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5
Q

Define schizotypal

A

Extreme social discomfort, distorted cognitions and perceptions

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6
Q

Define antisocial

A

Criminals, aggressive, lack of empathy, impulsive, lack of guilt, manipulative

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7
Q

Define borderline

A

Mood swings, self-harm and impulsivity, self-image problems, often history of abuse

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8
Q

Define histrionic

A

Attention seeking behaviour and excessive emotions

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9
Q

Define narcissistic

A

Grandiosity, need for admiration and a perceived lack of empathy

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10
Q

Define dependent

A

Passive, clingy, need to be cared for by other people, feels helpless when not in relationship

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11
Q

Define avoidant

A

Social inhibition and inadequacy, extreme sensitivity to negative evaluation

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12
Q

Define obsessive compulsive (anankastic)

A

Worries and doubts, perfectionism, sensitive to criticism, pedantry

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13
Q

Difference between avoidant and schizoid?

A

Schizoid VOLUNTARILY withdraw from social situations

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14
Q

Criteria for mild, moderate and severe depression

A

Mild: 2 core + 2 others
Moderate: 2 core + 3-4 others
Severe: 3 core + 4+ others

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15
Q

Risk factors for depression

A

Genetic
Childhood experiences
Social circumstances

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16
Q

Assessment for depression

A

PHQ-9

HADs

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17
Q

Management for depression

A

1st line: SSRI - sertraline, citalopram, fluoxetine
2nd line: alternate SSRI
3rd line: Mirtazapine, SNRI - venlafxine/duloxetine

18
Q

Define baby blues

A

Common transient
3-7 days after birth - may last 2 weeks
Tearful, anxious and irritable
Tx: Reassurance and support

19
Q

Define post-natal depression

A

10% of all women
Start within a month and peaks at 3 months
Tx: Reassurance and support
CBT, SSRIs - sertraline

20
Q

Define puerperal psychosis

A

Rare
2-3 weeks after birth - risk to mother and baby
Severe mood swings and disordered perception - psychosis
Hospital admission
Mood stabiliser, antidepressant, ECT
Psychotic symptoms - antipsychotics/long-acting benzodiazepine

21
Q

First rank symptoms for Schizophrenia

A

Hallucinations - 3rd person
Delusional perception
Thought disorders - withdrawal, insertion, broadcasting
Passivity phenomena

22
Q

Management for schizophrenia

A

1st line: 2nd generation antipsychotics - risperidone, olanzapine, quetiapine, paliperidone, arirpiprazole

2nd line: 1st generation antipsychotics - haloperidol, chlorpromazine

3rd line: Clozapine

23
Q

Side effects of 1st generation anti-psychotics

A

extrapyramidal side effects

Dystonia
Dyskinesia
Akasthesia
Parkinsonism

24
Q

Side effects of 2nd generation anti-psychotics

A 
Weight gain
Diabetes
Hyperglycaemia
Dyslipidaemia
Stroke
Drowsiness
25
Q

Side effects of clozapine

A 
Agranulocytosis
Reduced seizure threshold
Myocarditis
Weight gain
Neutropenia
Parkinson's
26
Q

Treatment for dystonia

A

Procycladine

27
Q

Treatment for dyskinesia

A

Tetrabenazine

28
Q

Treatment for Parkinsonism

A

Procyladine

29
Q

Treatment for akasthesia

A

Propanolol +/- cyproheptadine

30
Q

Define schizoaffective disorder

A

Confusion and affective mood disorder
Pt experiences both symptoms of a mood disorder (mania or depression) and schizophrenia (hallucinations/delusions) at the same time
Tx: Antipsychotic and mood stabiliser

31
Q

Define generalised anxiety disorder (GAD)

A

Anxiety that is generalised + persistent. ‘Excessive worry’ + feelings of apprehension about every day events/problems

32
Q

Risk factors for generalised anxiety disorder

A

35-54 years old
Female > Male
Divorced/separated
Live alone/lone parent

33
Q

Clinical features for generalised anxiety disorder

A 
Restlessness
Irritability
Easily fatigued
Difficulty concentrating
Muscle tension
Sleep disturbance
34
Q

Other features of generalised anxiety disorder

A 
Heart palpitations
Increased HR
Sweating
Dry mouth
Insomnia
Difficulty breathing
Chest pain
Nausea and vomiting
Numbness
Dizzy
Depersonalisation
Fear of dying
35
Q

Management for generalised anxiety disorder

A 
Exercise
Meditation
Relaxation techniques
CBT
Behavioural therapy
SSRI - first line
Benzodiazepine (Addictive)
Propanolol - for somatic symptoms such as tremor and sweating
36
Q

Define PTSD

A

Severe psychological disturbance following a traumatic event. Characterised by involuntary re-experiencing elements of the event

37
Q

Causes of PTSD

A

Fear response
Neurophysical changes
Genetic
Reduced hippocampal volume

38
Q

Risk factors for PTSD

A 
low education
lower social class
female
Previous family history
Previous traumatic events
39
Q

Symptoms for PTSD

A

Flashblacks, nightmares
Avoidance
Hypervilgilance
Emotional numbing

40
Q

Treatment for PTSD

A

CBT
Eye movement desensitisation and reprocessing (EMDR)
Sertraline and mirtazapine

Phase 3A (10 decks)

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