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Final year > Psychiatry > Flashcards

Psychiatry Flashcards

1
Q

Tardive dyskinesia

A

Involuntary muscle movements - usually tongue, lips, trunk and extremities. May be described as choreoathetoid.

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2
Q

Medication likely to cause tardive dyskinesia

A

Long-term anti-dopamine meds such as antipsychotics (particularly typical), metoclopramide, prochlorperazine, carbamezapine and phenytoin

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3
Q

Serotonin syndrome symptoms

A

3 or more of the following: ataxia, diarrhoea, hyper-reflexia, agitation, tremor, clonus or changes in mental status

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4
Q

Complications of serotonin syndrome

A

Seizures, renal failure, resp failure, rhabdomyolysis or arrythmias.

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5
Q

Treatment of serotonin syndrome

A

Usually supportive - resolves

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6
Q

What is akathisia?

A

Restlessness - inability of the patient to remain motionless. Usually caused by anti-psychotics

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7
Q

Acute dystonia

A

Intermittent or sustained contractions affecting any muscles (usually caused by neuroleptic medication)

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8
Q

Neuroleptic malignant syndrome

A

Associated with the use of antipsychotics. Hypethermia (>38), muscle rigidity, change in consciousness and autonomic instability.

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9
Q

Neuroleptic malignant syndrome treatment

A

Remove causative medication. Cooling the patient or using dantrolene/bromocriptine is necessary. Resolves 1-2 weeks but can be life-threatening.

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10
Q

Key symptoms of depression (ICD-10)

A

2 of: Persistent low mood, loss of interest/pleasure and fatigue/low energy

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11
Q

Other symptoms of depression (ICD-10)

A

Disturbed sleep, poor concentration/indecisiveness, low self confidence, changed appetite, suicidal thoughts/acts, agitation/slowing of movement, guilt/self blame

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12
Q

Negative symptoms of schizophrenia

A

Blunted affect, social withdrawal, apathy and anhedonia, speech reduced and slowness in thought and movement

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13
Q

Effect of prominent Negative symptoms on schizophrenia prognosis

A

Unfavourable

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14
Q

Delusions of passivity

A

Person feels that their actions, feelings or impulses are being controlled by an external force

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15
Q

Main management for OCD

A

CBT including exposure response therapy and/or SSRI

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16
Q

Best therapy for bereavement related depression

A

Interpersonal therapy - CBT is less useful if their is a key trigger

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17
Q

Dangerous dosulepin side effect

A

Cardiac conduction defects and arrythmias

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18
Q

Criteria for substance dependence

A

3 or more of the following:
Strong desire or sense of compulsion to take substance
Difficulty controlling substance taking behaviours in onset, termination or level of use
Physiological withdrawal state without substance
Increased tolerance
Progressive neglect of alternate pleasures/interests - increase time devoted to substance
Persisting with substance use despite evidence of it causing harm

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19
Q

Traits of avoidant personality disorder

A

Socially inhibited, sensitive to rejection and timid with overwhelming fears of inadequacy

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20
Q

Traits of dependent personality disorder

A

Low self-confidence, submissive, clingy and excessive need for nurture

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21
Q

Traits of schizotypal personality disorder

A

Odd thought patterns, interpersonal awkwardness and odd appearance

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22
Q

Traits of schizoid personality disorder

A

Voluntary social exclusion and limited emotional expression

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23
Q

Minimum symptom length for PTSD

A

1 month

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24
Q

Symptoms of acute stress disorder

A

Persistently heightened awareness, difficulty sleeping, flashbacks, and interference of thoughts with activities of daily living

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25
Q

Adjustment disorder criteria

A

An identifiable stressor, a maladaptive response to this which interferes with ADLs, symptoms started within 3 months of stressor and must not meet the criteria for any other psych disorder

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26
Q

Panic disorder symptoms

A

SOB, chest pain, diaphoresis, nausea, choking, abdo distress and feelings of impending doom

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27
Q

Treatment of acute dystonia (post-anti-psychotics)

A

Anti-cholinergics

28
Q

Most appropriate sleep medication in learning difficulties

A

Melatonin - they often have chronic sleep/wake cycle disturbances

29
Q

What is social learning?

A

Where patterns of behaviour are acquired by watching other people and assimilating their actions into the behaviour repetoire. Often when people repeat behaviours seen by their parents as a child.

30
Q

Schneider’s first rank symptoms

A

Delusional perception
Auditory hallucinations
Delusions of thought interference
Passivity phenomenon or delusions of control

31
Q

Tourette’s syndrome

A

Multiple motor tics plus one or more vocal tics (throat clearing and grunting count). Motor tics usually develop first and is more common in men

32
Q

Conduct disorder

A

Mental disorder causing persistent and repetitive pattern of behaviour which violates either the basic rights of others or goes against the age-developmental norms. Can develop into dissocial personality disorder at 18

33
Q

Neologisms

A

New words made up by patient

34
Q

What is splitting in borderline personality disorder?

A

Patient distinguishes between 2 groups of people - ones they like and trust and one they do not

35
Q

Are morning erections maintained in psychological causes of ED?

A

Yes, difficulty is just during sexual encounters. Loss of morning erections implies organic cause

36
Q

SSRI side effects

A

Restlessness, insomnia, generalised agitation (akathisia), GI upset, increased risk of fracture and sexual dysfunction

37
Q

SSRI with lowest rate of antimuscarinic side effects

A

Fluoxetine

38
Q

What are postpartum blues?

A

Fatigue/tearfulness/depressed affect that develops 2-3 days post birth and resolves without treatment within 10-14 days. Occurs in 50% of women

39
Q

Usual age of onset for schizophrenia

A

Late teens/early 20s in men and late 20s/early 30s in women

40
Q

Schizophrenia prodrome

A

Social withdrawal, unusual beliefs and deterioration in hygiene/social/occupational functioning

41
Q

Difference between hallucinations and illusions

A

Hallucinations are perceptions of stimuli that aren’t there whereas illusions are incorrect perceptions of stimuli that are there

42
Q

Symptoms of mania

A 
Must have elevated mood for 1 week + 3 or more of:
Increased activity/physical restlessness
Increased talkativeness
Flight of ideas/racing thoughts
Loss of social inhibiton
Decreased sleep requirement
Inflated self esteem/grandiosity
Distractibility/changing activity or plans
Reckless/risky behavious
Marked sexual energy
With/without delusions/hallucinations
43
Q

Deficiency of which vitamin causes Korsakoff’s?

A

Vitamin B1 - thiamine. Results in bilateral loss of the mammilary bodies in the brain.

44
Q

What is Korsakoff’s?

A

Severe deficiency of vit B1 resulting in bilateral loss of the mammillary bodies. Often due to chronic alcoholism. Causes anterograde amnesia and confabulations.

45
Q

Effects of thiamine deficiency

A

Korsakoff’s dementia, beriberi, polyneuritis, symmetrical muscle wasting and dilated cardio-myopathy

46
Q

Indications for ECT

A

Major depression with high risk of suicide, psychotic features, catatonic stupor, food refusal/severe weight loss/dehydration, refractory to antidepressants or previous response to ECT.

47
Q

Treatment for delirium

A

Treat underlying cause, reorientate, reassure and optimise environment

48
Q

What is a section 4?

A

Used in emergencies when only one doctor available and section 2, 3 or 5(2) would cause delay. Lasts 72 hours.

49
Q

Learning disability classification IQ ranges

A

Mild 50-69
Moderate 35-49
Severe 20-34
Profound is less than 20

50
Q

Length of time to class as psychosis

A

4 weeks

51
Q

Length of time to class as depression

A

2 weeks

52
Q

Length of time to class as mania

A

1 week

53
Q

Length of time to class as hypomania

A

4 days

54
Q

Cluster A personality disorders

A

Odd/eccentric: Schizoid, schizotypal and paranoid

55
Q

Cluster B personality disorders

A

Dramatic/eratic/emotional: Antisocial, EUPD, Histrionic, Narcissistic

56
Q

Cluster C personality disorders

A

Anxious: Avoidant, Dependent and Obsessive-compulsive

57
Q

Traits of histrionic personality disorder

A

Dramatic, attention-seeking and manipulative

58
Q

What is dissociation?

A

An immature ego defence where one’s personal identity is temporarily and drastically modified to avoid the distress of a given situation,

59
Q

Most common type of hallucination in schizophrenia

A

Auditory - normally malevolent voices

60
Q

Positive symptoms in schizophrenia (THREAD)

A

T Thinking may become disturbed, neologism usage
H Hallucinations may occur, usually auditory
R Reduced contact with reality, the natural barrier between subjective and objective deteriorates
E Emotional control may be disturbed with inappropriate laughter or anger (incongruous affect)
A Arousal may lead to worsening of symptoms
D Delusions may occur

61
Q

Discontinuation symptoms

A

Rebound anxiety, depressive symptoms, flu-like symptoms, dizziness, nausea or sleep-disturbance

62
Q

Early side effects of SSRI treatment

A

worsening of anxiety, agitation and sleep problems

63
Q

First line drug for OCD

A

Sertraline

64
Q

Which symptom differentiates delirium from dementia

A

Reduced level of consciousness

65
Q

Core features of ADHD

A

Inattenion, hyperactivity abd impulsiveness

66
Q

First line treatment in mild-moderate depression

A

Low intensity psychological intervention or CBT such as computerised CBT

67
Q

Indications for ECT

A

Severe depression, catatonia and prolonged/severe mania

Final year (18 decks)

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