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TI year > Psychiatry > Flashcards

Psychiatry Flashcards

1
Q

Definitions

  • Delusion
  • Hallucination
  • Illusion
A

Delusion - fixed, false peculiar belief
Hallucination - Perception without an existing external stimulus
Illusion - misperception of an actual stimulus

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2
Q

Schizophrenia

  • Definition
  • Diagnosis
A

Disorder characterised by

Positive symptoms

  • Psychotic symptoms (hallucinations, delusions)
  • Disorganisation - (thought disorder, behavioural disturbances)

Negative symptoms
- (poverty of affect, thought and social interaction)

Risks - Family history, drug use

History
2 or more symptoms for 6 or more months + social or occupational dysfunction

Positive symptoms (DDDBH) (hallucinations, delusions, disorganised speech, bizarre behaviour, disordered thought)

Negative symptoms (AAAES) 
(flat affect, decrease emotional reactivity, property of speech, lack of purposeful actions, anhedonia)
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3
Q

Differential for Schizophrenia

A

Psychotic disorder (brief psychotic disorder, schizophreniform disorder, shcizophrenia, schizoaffective disorder (= schizophrenia _ major affective disorder - Bipolar, major depressive disorder)

Delusional disorder

Substance induced psychosis
Medical illness

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4
Q

Anticholinergic symptoms

Extra pyramidal symptoms

A

dry mouth, urinary retention, constipation
-can give benztropine to reduce this

EPS -
acute dystonia - benztropine
dyskinesia (psudoparkinsonism) - shuffling gait, cogwheel regiditiy. benztropine, dopamine agonsit
akinesia - decrease drug, propanolol, benzo, anticholinergic
Akathesia - decrease drug, change drug.
Tardive dyskinesia

Nueroleptic malignant syndroem - stop medicaiton

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5
Q

Atypical antipsychotic side effects

Resperidone, quetiapine, olanzapine, clozapine, aripiprazole

A

Fewer EPS and anticholinergic than typical antipsychotics

  • Weight gain, T2DM
  • somlonence, sedation
  • QT prolongation
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6
Q

Clozapine specific side effects

A
  1. -argranulocystosis (urget FBC w fever)
  2. constipation/bowel obstruction
  3. Cardiac - carditis, cardiomyopathy
  4. Increased secretions
  5. QT prolongation
  6. Weight gain, T2DM

-Smoking can increase your level

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7
Q

Neuroleptic malignant syndrome

A

Dopamine related

  • Fever, muscle rigidity, autonomic instability, elevated CK, WBC, clouded consciousness
  • STOP medication
  • ICU care
  • Dantrolene
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8
Q 
Side effects of 
SSRI 
Buspirone
BBlockers
benzos
A

SSRIs - nausea, GI upset, somnolence, sexual dysfunction, agitation

Buspirone - seizures

BBlockers - bradycardia, hypotension

Benzodiazepines - decrease sleep duration, risk of abuse/tolerence, dependence, disinhibition, confusion

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9
Q

Generalised Anxiety Disorder

A

Anxiety/excessive worrying for 6 or more months
+ 3 other symptoms
-restlessness, fatigue, difficulty concentration, irritability, muscle tension, disturbed sleep

Treatment

  • Benzos (short term)
  • SSRI, psychotherapy, lifestyle changes (long term) , venlafaxine, buspropion
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10
Q

Panic disorder

A
  • period of intense fear or discomfort in which at least 4 of the following smptoms peak within 10 mins
  • tachypnoea, chest pain, palpitations, diaphoresis,nausea, trembling, dizzines,s fear of dying, depersonalisation, hot flashes

(hyperventilation resulting in low O2 status)

Treatment
Short term - Benzos
Long term - CBT, SSRI, TCAs

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11
Q

DDX - panic disorder

A

Medical conditions - angina, MI, arrythmia, hyperthyroidism, pheochromocytoma
Psych - substance induced anxiety, GAD, PTSD

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12
Q

Major Depressive disorder

A

Mood one or more major depressive episodes.

Depressed mood or anhedonia (loss of pleasure) + 5 or more for 2 week period
-SIG E CAPS

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13
Q

Differential diagnosis - Depression

A

Mood disorder secondary to medical condition
(hypothyroidism, parkinsons, CNS neoplasm, stroke, dementia, parathyroid)
Substance induced mood disorder
Adjustment disorder w depressed mood
Normal bereavement
Dysthymia (milder, chronic depression, depressed mood >2 years)

Treatment

  • Medication
  • ECT (SE - post-ictal confusion, arrhythmias, headache, anterograde amnesia)
  • phototherapy (Seasonal pattern)
  • TMS
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14
Q

Serotonin syndrome

A 
Serotonin syndrome  (fever, myoclonus, hyperreflexia, metal status changes, cardiovascular collapse) 
--> leads to rhambdomyalisis, coma, death

DDx - drug withdrawal, anti-cholinergic toxicity, meningitis

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15
Q

SSRI side effects

A

Sexual dysfunction GI, nausea, agitation, insomnia, tremor, diarrhoea

Serotonin syndrome

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16
Q

Bupropion side effects

A

-decrease seizure thershold

17
Q

SNRI

A

vomiting, nasuea, weight, anorexia

18
Q

TCAs

A
  • cardiac arthymia
  • anticholinergic effects - dry mouth, constipation, urinary retention, sedation

toxicity - coma, cardiac arythmia, convulsions

19
Q

DIG FAST

A 
distractibility 
insomnia 
grandiosity 
flight of ideas/racing thoughts
activities/psychomotor agitation
sexual activity 
talkativeness/pressured speech
20
Q

Bipolar

A

Type 1 - at least 1 manic episode -
Type 2 - major depressive episode and one hypomanic episode

Manic episode - 1 week of persistently elevated, expansive or irritable mood + 3 DIG FAST symptoms. (can also have psychotic symptoms)

hypomania - similar, but not marked functional impairemnt or psychotic symptoms

Treatment
-Antipyschotics, lithium, valproate
mood stabalises

carbamazipine
valproic acid
lamotrigine

21
Q

Lithium side effects

A

Thirst, polyuria, DI, tremor, weight gain, hypothyroidism nausea, Diarrhea, seizures, teratogenicity, acne, vomiting

toxicity - ataxia, dysarthria, delirium, acute renal failure

  • Need to measure blood levels regularly
  • Cannot use in reduce renal function
22
Q

Carbamazepine

A

nausea, rask, leukopenia, AV block, teratogenicity

23
Q

Valproic acid

A

gi side effecs, tremor, sedation, alopcia, weight gain,

TI year (16 decks)

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