Psychiatry Flashcards

Question

What is used to manage acute dystonia? (2)

Answer 1

Procyclidine and benztropine IV

Answer 2

Beta blockers, benzodiazepines

Answer 3

Tetrabenazine

Answer 4

Aripiprazole

Answer 5

Agranulocytosis | Full blood count weekly for 18 weeks

Answer 6

``` Lead pipe rigidity Onset over days to weeks Decreased reflexes Hypertension Tachycardia Hyperthermia ```

Answer 7

Stop causative agent IV fluids, cooling blankets Benzodiazepines Dantrolene (muscle relaxant)

Answer 8

Capgras - Belief that a close relative/spouse has been replaced by an imposter Fregoli - Belief that various people they meet are actually the same person Intermetamorphosis - Belief that people swap identities with each other whilst maintaining the same appearance Subjective doubles - Belief that there is a doppelgänger of themselves carrying out independent actions

Answer 9

Delusional jealousy

Answer 10

Sudden interruption of a train of thought leads to the affected person stopping talking suddenly. When they start talking again it is a completely unrelated topic.

Answer 11

Withdrawal Insertion Broadcast Block

Answer 12

A false, unshakeable idea or belief that is out of keeping with the patient's educational, cultural and social background.

Answer 13

Mutism, negativism, echolalia Echopraxia, waxy flexibility Withdrawal

Answer 14

Obsession - Anxiety inducing urges or images that arise persistently, repeatedly and uninvited Compulsion - Performing repetitive behaviours to provide temporary relief from obsessions

Answer 15

Short term - Increased GABA - anxiolytic and sedative Increased Dopamine - Please and stimulant Long term - Down-regulated GABA and up-regulated excitatory glutamate

Answer 16

``` Male Young adult Genetic factors Antisocial behaviour Lack of facial flushing Life stressors Single/Separated/Divorced Family history Drug misuse ```

Answer 17

Macrocytic anaemia Raised Gamma glutamyl transpeptidase (GGT) Raised carbohydrate deficient transferrin (CDT) ALT and AST - raised if liver damage is present Blood alcohol - raised if recently been drinking

Answer 18

``` Palmar erythema Spider naevi Clubbing Oesophageal varices Dupytren's contracture Gynaecomastia Caput medusa ```

Answer 19

IV Naloxone

Answer 20

Paranoid disorder - excessive sense of own importance, blames others for mistakes and problems, conspiracy theories, mistrusts others Schizoid personality disorder - emotionally cold, find little pleasure in any activities, solitary and introspective, indifferent to others expectations

Answer 21

Borderline personality disorder - Uncertain about personal or sexual identity, forms intense, unstable relationships, rejection issues, recurrent suicidal/self harm threats Impulsive - impulsive and lack self control, sudden outbursts of anger Dissocial - Disregard for people's feelings and social norms, lack of guilt, low threshold for anger and violence Histrionic - Exaggerated emotions, craves attention, shallow personality, easily influenced by others/circumstance

Answer 22

Dependent - Feel unable to cope and make decisions on their own, fear of being alone, puts needs of those they are dependent on above their own Anakastic - Rigid, stubborn, excessively well organised. Perfectionist, insist people do things their way Anxious/avoidant - Persistent tension/apprehension, low self esteem, avoid situations with criticism or rejection

Answer 23

Dialectal Behavioural Therapy

Answer 24

Seen in depression - | Pessimistic thoughts about self, the world and the future

Answer 25

Obsessions and/or compulsions That are time consuming (>1 hour a day) Must be present most days over at least two weeks The symptoms must be distressing and interfere with activities Typically manifests in adolescence

Answer 26

Benzodiazepines -Diazepam, lorazepam Non-benzodiazepine hypnotic - Zopiclone 5HT agonist - Busprione

Answer 27

``` PATHOS Problems for more than a month Alone at the time of the overdose Time - planned for more than 3 hours Hopeless about the future Sad most of the time before the overdose ```

Answer 28

Paranoid - Most common with delusions and auditory hallucinations Catatonic -Psychomotor disturbances, rigidity, posturing echopraxia and echolalia Hebephrenic - Early onset with poor prognosis. Irresponsible, unpredictable behaviour, mood inappropriate and affect incongruous Residual - Previously another subtype but currently presenting with negative symptoms and cognitive impairment

Answer 29

``` Female Good social support In a relationship No negatie symptoms Intelligence/high level of education Low stress Paranoid subtype Late onset Acute onset No substance misuse ```

Answer 30

Bipolar I - One or more manic or mixed episode and one or more major depressive episode Bipolar II - Recurrent major depressive episodes and hypomanic episodes Cyclothymic disorder - Chronic mood fluctuation over at least two years with episodes of depression and hypomania, Insufficient severity for other subtypes

Answer 31

Thyroid and renal function Every 3 months in the first year then every 6 months

Answer 32

Leukocytosis Insipidus diabetes Tremor/Teratogenic (Ebstein's anomaly) Hypothyroidism

Answer 33

Inhibits GABA transaminase to increase levels of GABA

Answer 34

``` Vomiting Alopecia Liver toxicity Pancreatitis/Pancytopenia Retention of fat Oedema Appetite increase Tremor/teratogenicity Enzyme inducer ```

Answer 35

Minor - small fingers and toes | Major - Cleft palate, spina bifida

Answer 36

Mesolimbic - Positive symptoms Mesocortical - Negative symptoms Nigrostriatal - Extrapyramidal symptoms Tuberoinfundibular - Hyperprolactinaemia

Answer 37

Significant physical abnormalities Suicide risk BMI <13.5

Answer 38

Structured eating plan | Psychotherapy

Answer 39

``` Low subcutaneous fat Low energy levels, poor concentration Orthostatic hypotension Bradycardia Lanugo - fine body hair Dry skin and nails Longterm - osteoporosis ```

Answer 40

``` Carotinaemia Hypercholesterolaemia Excess salivary gland excretion Growth hormone Glucose ```

Answer 41

A patient, who has their liberty deprived, has an independent representative to act upon their behalf That the deprivation of their liberty is reviewed on a regular basis That the patient – or their representative has a legal basis on which to challenge the deprivation of liberty through the court of protection

Answer 42

The Mental Capacity Act

Answer 43

An Assessment Order– Allows a patient to be sectioned for up to 28 days. Must be signed by 2 doctors and an ASW. One of the doctors has to have previously known the patient. It allows patients to be treated against their will as it is considered to be part of the assessment.

Answer 44

Treatment orders – Last for 6 months. The ASW must seek the consent of the nearest relative, and the patient cannot be detained if this relative objects. The doctor has to state the category of mental illness the patient is thought to be suffering from. Treatment can be given – but after 3 months, either: The patient has to consent to treatment or third doctor has to review the patient and give their consent for treatment to be given

Answer 45

Emergency order– admission for emergency treatment. Lasts up to 72 hours. Must be signed by a doctor and ASW. Cannot treat against the patient’s will with this order – just used for assessment.

Answer 46

Compulsory detention of patient who has come to hospital voluntarily. 5(2) is performed by a doctor and lasts up to 72 hours 5(4) is performed by a nurse and lasts up to 6 hours

Answer 47

A police officer may enter the patient’s premises and remove a person to a ‘place of safety’ for up to 72 hours. Can only be used if a social worker has obtained a warrant. Cannot treat against the patient’s will.

Answer 48

A policer officer may remove a patient from a public space to a 'place of safety' for up to 72 hours. It does not require a warrant.

Answer 49

``` Active listening Empathy Rapport Influence Change ```

Answer 50

Eye movement desensitisation and reprocessing