psychiatry Flashcards
things that are raised with Anorexia
raised cortisol, carotin, glucose, cholesterol, growth hormone
side effects of conventional anti-psychotics
1) acute dystonia(torticollis(neck spasms), oculogyric crisis(elevation of gaze bilaterally)
2) akathesia(restlessness)
3) tardive dyskinesia(involuntary movements of the face and jaw)
PTSD- triad
1) hyperarousal
2) avoidant behaviour
3) intrusive recollections
Section for guardianship(attend psych clinic in community and allow social worker access at home)
section 7
acute schizophrenia - first rank symptoms
- auditory hallucinations
- somatic hallucinations
- thought disorder(broadcast , withdrawal, insertion and interruption)
- delusional perception
- somatic passivity.
chronic schizophrenia symptoms
negative symptoms- poverty of thought, apathy, lack of volition, social withdrawal and loss of affect
anorexia nervosa signs
-distortion of body image and weight maintained below 17.5 BMI
somatization disorder
- 2 year history of multiple various physical symptoms of which no cause has been identified. Ongoing refusal to accept reassurance, regardless of negative test findings
- has a familial tendency
Hypochondrial disorder
-persistent belief of one serious illness
baby blues
mother becomes temporarily sad/emotional day 3-5 post-partum
postnatal depression
- present anytime during the first year
- peaks at 12 weeks
- treated like depression- mother and baby groups, CBT, SSRI
- monitored using edinburgh postnatal depression scale
echopraxia
automative imitation or repetition of another persons actions- involuntary
ambitendency
coexistence of mixed feelings
waxy flexibility
catatonic schizo-reduced response to external stimuli and tends to remain in a fixed immobile posture.
borderline personality disorder
- instability and impulsivity- fear of being abandoned(feel that boyfriend is leaving)
lithium therapeutic level and monitoring
0.4-1( on days 4-7 after treatment), then every week until dosage is constant for 4 weeks and every 3 months after
drug used when not responding to lithium bipolar
carbamazepine
ideal atypical depot injection
risperidone
hyperthermia, fluctuating level of consciousness, muscular rigidity and autonomic dysfunction(tachycardia, labile blood pressure), rigidity
- what condition
- which is the key cause
neuroleptic malignant syndrome
1st generation anti-psychotics
management of neuroleptic malignant syndrome
1) reduce dopamine- stop the dopamine antagonist(anti-psychotic meds), start dopamine agonists(bromocriptine)
2) cooling
3) dantrolene
on SSRI, becomes confused- key diagnosis
hyponatraemia-SIADH seen in SSRIs
dyslexia -phonemes
cannot process words that sound distinct in speech- p,b t and d
Hypomania Vs Mania
Hypomania- nothing grandiose, no psychosis
Mania- psychotic, needs hospital admission, has grandiose delusions(god, untouchable)
PHQ-9 minimum score for severe depression
severe depression -20
dyslexia -phonemes
cannot process words that sound distinct
screening phonemes for dysleksia- what test
GaPs - grammar and phonology screening
already tried 2 different SSRIs- what to try next
SNRI class- venlafaxine 75mg MR
what anti-depressant is safe in pregnancy
ssris
fugue
patient forgets their whole history
depersonalisation
out of body, response to stress
Dissociative identity disorder
takes multiple personalities(~multiple personality disorder)
malingering
purposefully fabricating /exaggerating symptoms for external gain.
drug used to reduce the craving for alcohol
acamprosate, naltrexone
paranoia and formication(feeling of ants crawling on the skin)- what withdrawal
cocaine
effects of stopping anti-depressants abruptly
- SNRIs- GI disturbances, vivid dreams and night mares, insomnia, somatic distress(headaches, sweating, lethargy).
- SSRI-light headedness, dizzyness, numbness and electric shock like symptoms.
bedsite tests of frontal lobe function(executive functioning)
1) verbal fluency(ask patients to recall as many words that start with a letter in 1 minute)- less than 10 is abnormal
2) Estimating- ask the patient to guess the height or weight of an object
3) response inhibition/motor preservation-ask patient to tap once when you tap twice and tap twice when you tap once. - tapping the same number- motor preservation/copying whatever you tap- echopraxia
4) clock drawing test
5) abstract thinking- relation between dog and cat.
age ect is not recommended in
5-11
first line medication for ADHD
methylphenidate(can only be started by child psych)
section 4
emergency application of detention in hospital for upto 72 hours.
