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Behaviour_Part2 > Psychiatry > Flashcards

Psychiatry Flashcards

1
Q

Is there a critical period to develop attachment between mother and child?

A

NONNNN

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2
Q

What are the 4 pillars of action on drug-related harm?

A
  1. Screening
  2. Referral to treatment
  3. Brief interventions
  4. Harm reduction
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3
Q

What are the types of PD in cluster C?

A

(Worried Cluster)

  1. Avoidant
  2. Dependent
  3. Obsessive-compulsive
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4
Q

What are the types of PD in cluster A?

A

(Weird Cluster)

  1. Paranoid
  2. Schizoid
  3. Schizotypal
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5
Q

What is the first line pharmacological treatment of generalized anxiety disorder?

A
  • SSRI
  • SNRI
  • Pregabalin
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6
Q

What is the second line pharmacological treatment of generalized anxiety disorder?

A
  • Benzodiazepine
  • Buproprion XL
  • Buspirone
  • Imipramine
  • Hydroxyzine
  • Quetiapine XR
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7
Q

What drugs can have a deathly withdrawal effect?

A
  1. Alcohol
  2. Benzo
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8
Q

What are the screening questions of an alcohol use disorder?

A

CAGE

  1. Have you ever felt you should cut down on your drinking?
  2. Have people annoyed you by criticising your drinking?
  3. Have you ever felt bad or guilty about your drinking?
  4. Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover (eye-opener)?
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9
Q

What are the 7 reasons to hospitalize someone with an eating disorder?

A
  1. Precipitous or extreme weight loss
  2. Hypokalemia- Hyponatremia –Hypoglycemia
  3. Pulse (< 40/50 bpm); EKG; Orthostatic hypotension (BP decreases by ≥20/Pulse increases by ≥20)
  4. Elevated liver enzymes
  5. Hypothermia ( ≤ 35.0°)
  6. Weakness; Fainting
  7. Total fasting; Refusing to drink
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10
Q

What medication can be used for nightmares in PTSD?

A

Prazosin

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11
Q

Does medication work better than CBT?

A

They are the same, depends on the patient preference

  • CBT: longer to work, lower relapse rate
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12
Q

What are the risks of antidepressent medication during pregnancy?

A
  • Small association with autism
  • Miscarriage (3%)
  • Neonatal adaptation syndrome
  • Persistent pulmonary hypertension (very small)
  • Preterm birth (smaller increase)
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13
Q

What are the risks for the child of an untreated postpartum depression?

A

Neonatal developmental delay

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14
Q

What are the risk of an untreated depression during pregnancy?

A
  • Stillbirth
  • Major congenital anomaly
  • LBW or SGA
  • Preterm birth
  • Poor maternal adaptation
  • Admission to NICU
  • Neonatal developmental delay
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15
Q

What are the 6 symptoms that raise the risk of suicide?

A
  1. High Anxiety
  2. Severe Insomnia
  3. Panic Attacks
  4. Low Concentration
  5. Anhedonia
  6. Alcohol Abuse
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16
Q

What is the first line pharmacological treatment of PTSD?

A
  • SNRI
  • SSRI
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17
Q

What are the hallmark of addiction?

A

4 “C”

  1. Loss of CONTROL
  2. COMPULSIVE use
  3. CRAVING
  4. Continued use despite adverse CONSEQUENCES
18
Q

What are the types of PD in cluster B?

A

(Wild Cluster)

  1. Antisocial
  2. Borderline
  3. Histrionic
  4. Narcissistic
19
Q

What is the second line pharmacological treatment of PTSD?

A
  • Mirtazapine
  • Phenelzine
20
Q

What is the second line pharmacological treatment of social anxiety?

A
  • Benzodiazepine
  • Gabapentin
  • Phenelzine
21
Q

What are the criterias BPD?

A
  1. Impulsivity in two areas (not self-harm) – ex. spending, sex, drugs, binge eating
  2. Recurrent suicidality and/or self-harm – suicide attempts, cutting oneself
  3. Transient paranoia or dissociation – feeling like people are watching or want to hurt the person, feeling disconnected from themselves or reality, like things are a dream
  4. Affective instability – mood fluctuates quickly, frequently (multiple times per day), and often in response to external cues
  5. Chronical emptiness – feel completely alone and hollow
  6. Anger – frequently feels and acts on anger with shouting and fighting
  7. Identity disturbance – constantly changing goals, values, opinions, preferences
  8. Frantic efforts to avoid abandonment – afraid of being abandoned, clings on to others
  9. Unstable and intense relationships – idealize and devalues others, frequently breaking up and getting back together, many short relationships
22
Q

What medication can be used for flashbacks in PTSD?

A

Naltrexone

23
Q

What is the first line pharmacological treatment of social anxiety?

A
  • SSRI
  • SNRI
  • Pregabalin
24
Q

What are the risks of antidepressant treatment postpartum on the child?

A

Little or no evidence of severe side effects

25
What is the second line pharmacological treatment of panic disorder?
* Benzodiazepine * Clomipramine * Imipramine * Mirtazapine
26
What is the treatement of a benzo addiction?
1. Switching to long-acting benzodiazepine 1. Peer support 1. Individual or group psychotherapy 2. CBT 3. Motivational interviewing
27
What medication can we use for performance anxiety?
Propranolol (3rd line treatment)
28
What are the adverse effects of benzodiazepines?
* drowsiness * confusion * dizziness * trembling * impaired coordination * vision problems * grogginess * feelings of depression * headache
29
What is the acute treatment of alcohol withdrawal?
1. Vital parameters 2. Thiamine 3. Benzodiazepine 4. Beta blockers 5. Haloperidol
30
What is the first line pharmacological treatment of panic disorder?
* SSRI * SNRI
31
When is CBT better than medication?
* Health anxiety * Specific phobia * PTSD
32
What is the first step in management of postpartum depression?
**Rule-out bipolar disorder** (history of mania?)
33
What are the Educ’alcohol recommendations?
1. 2 drinks per day max 10 per week for women 2. 3 drinks per day max 15 per week for men 3. 3 drinks max per day on special occasions for women 4. 4 drinks max per day on special occasions for men 5. At least one day per week where no alcohol is consumed
34
What are the diagnosis criteria of ADHD?
1. Persistent inattention and/or **hyperactivity-impulsivity** 2. Present prior to age **12 years** 3. Present in **two or more settings** (e.g. home, school, work, with friends or relatives etc…) 4. Interferes with/reduces quality of social, academic or **occupational functioning** 5. Not better explained by another mental disorder (e.g. mood disorder, anxiety disorder, dissociative disorder, personality disorder, substance intoxication or withdrawal)
35
What are the diagnosis criteria of ASD?
1. Persistent deficits in **social communication** and social interaction 2. **Restricted, repetitive patterns** of behavior, interests, or activities 3. Present in the **early developmental period** 4. Causes clinically significant **impairment in functioning** 5. Not better explained by intellectual disability or global developmental delay
36
What are the most common psychiatric disorders associated with suicide?
* Mood disorders * Alcohol use disorder
37
What are the suicidal risk factors?
* Made * Age \>60 * Depression * **Previous attempts (BEST PREDICTOR)** * Ethanol use * Rational thinking loss (delusions, hallucinations...) * Suicide in the family * Organized plan * No social support * Serious illness, intractable pain
38
What are the criteria for Depression?
\> 5 \> 2 weeks **MSIGECAPS** * _**M**ood: Depressed_ * **S**leep: Increased or decreased * _**I**nterest: Decreased_ * **G**uilt * **E**nergy: Decreased * **C**oncentration: Decreased * **A**ppetite: Increased or decreased * **P**sychomotor: Agitation/retardation * **S**uicidal ideation
39
What are the criteria for **mania**?
**\> 3****GST PAID** * **G**randiosity * **S**leep (decreased need) * **T**alkative * **P**leasurable activities with painful consequences * **A**ctivity increased * **I**deas (flight of) * **D**istractible
40
How long does a post-partum blues last?
* Begins **2-4 days post-partum** * **10 days** usualy
41
How long does a post-partum depression last?
* Onset during pregnancy or within 4 weeks post-partum * 2-6 months, up to 1 year
42
Are SSRI safe during pregnancy?
**Yes** except **Paroxetine** (conflicting evidence)

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