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psychiatry Flashcards

1
Q

symptoms of depression

A 
A SAD FACES
appetite (loss/gin)
sleep (insomnia/hypersomnia)
anhedonia
dysphoria
fatigue
agitation or retardation
concentration (diminished ability of)
esteem (feeling of guilt or worthlessness)
suicide/self harm
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2
Q

symptoms of mania

A 
FIDGET
flight of ideas
insomnia
distractability
grandiose ideas and inflated self esteem
energy
 - enhanced libido  -often leading to disinhibition 
    and inappropriate behaviour
 - impaired judgement/poor decision 
      making/gross over spending
talkativeness - rapid pressured speech
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3
Q

symptoms of mania

A 
FIDGET +/- psychosis
flight of ideas
insomnia
distractibility
grandiose ideas and inflated self esteem
energy (enhanced libido, impaired judgment/poor decision making/gross over spending
talkativeness - rapid, pressured speech
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4
Q

management of depression

A 
SSRI - citalopram
SNRI  -venlafaxine
if psychotic symptoms - lorazepam, olanzapine
electroconvulsive therapy
pscychotherapy
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5
Q

management of BPAD

A

acute with agitation - rapid acting antipsychotic (olanzapine) or benzodiazepine (lorazepam)
without agitation - mood stabiliser (lithium, valporate, carbamazepine, lamotrogine)
depression - lithium
CBT
psychotherapy

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6
Q

define bipolar affective disorder

A

Bipolar disorder is a recurrent and sometimes chronic mental illness marked by alternating periods of abnormal mood elevation and depression associated with a change or impairment in functioning.

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7
Q

what are the first rank symptoms of schizophrenia

A

auditory hallucinations
delusions of thought interference
passivity phenomenon/delusion of control
delusional perception

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8
Q

what are some second rank symptoms of schizophrenia

A

hallucinations
negative symptoms (apathy, anergia, anhedonia)
change in personal behaviour (loss of interest, aimlessness, social withdrawal)
incoherent/irrelevant speech
catatonia - stupor, waxy flexibility, mutism, negativism

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9
Q

how is schizophrenia diagnosed

A

at least 1 first rank symptom or 2 second rank symptoms clearly present for at least the majority of the time for the past month

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10
Q

management of schizophrenia

A

first episode - benzodiazepine e.g. lorazepam
long term
atypical antipsychotics (mixed dopamine and serotonin antagonist) e.g. clozapine, olanzapine, haloperidol
CBT
family therapy
dynamic psychotherapy

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11
Q

define a specific phobia

A

anxiety provoked by specific situation or objects which are perceived to be more dangerous than they actually are and leads to anticipatory anxiety and avoidance

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12
Q

define a delusion

A

a belief that is not true/unlikely and cannot be explained by the persons cultural or religious beliefs

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13
Q

management options for specific phobias

A

phobic learning history
Stimulus exposure > anxiety >relaxation > decreased anxiety
Fear & Avoidance Hierarchy (FAH)
Subjective Units of Distress Scale (SUD)

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14
Q

manage of social phobia

A

CBT
SSRI
MAOI
short term: benzos, propranolol

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15
Q

define generalised anxiety disorder

A

Anxiety is free floating, not restricted to any circumstance.

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16
Q

drug management of generalised anxiety disorder

A

sertraline
venlafaxine
pregablin

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17
Q

non drug treatments for generalised anxiety disorder

A

relaxation training
exposure therapy
CBT
physical exercise

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18
Q

define panic disorder

A

several severe attacks of autonomic anxiety within a month

characterised by fear of death/suffocating and an urgent desire to flee

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19
Q

management of panic disorder

A

SSRI (fluoxetine)
CBT
anxiety and relaxation training

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20
Q

symptoms of anxiety

A

restlessness
sense of dread
difficulty concentrating

sweating
dry mouth
chest pain

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21
Q

define agoraphobia

A

an anxiety disorder characterized by symptoms of anxiety in situations where the person perceives their environment to be unsafe with no easy way to escape

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22
Q

management of agoraphobia

A

SSRIs
anxiolytics
CBT
behaviour therapy

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23
Q

define PTSD

A

a delayed response disorder that arises within 6 months of experiencing stressful event/trauma of an exceptional threatening or catastrophic nature
characterised by flashbacks and nightmares

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24
Q

Management of PTSD

A

trauma focused CBT
SSRI
tricyclics
EMDR (eye movement desensitisation and reprocessing)

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25
Q

symptoms of PTSD

A

flashbacks
nightmares
hyperarousal - anxiety, irritability, insomnia, numbness and emotional detachment

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26
Q

define OCD

A

recurrent intrusive thoughts, images, ruminations, and impulses that are ego syntonic (acknowledged as unreasonable or excessive, and there are attempts to resist) resulting in compulsions (ritualistic motor acts)

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27
Q

management of OCD

A

CBT
ERP - exposure response prevention
SSRI
clomipramine (a TCA)

28
Q

types of personality disorders

A 
paranoid
schizoid
schizotypal
antisocial
borderline (emotionally unstable)
histrionic
narcissistic
avoidant
dependent
OCD
29
Q

borderline personality disorder

A

Instability of interpersonal relationships, self-image, and impulsivity; intense anger and affective instability; recurrent suicidal behaviour/gestures; impulsive behaviour with potential for self-harm.

30
Q

antisocial personality disorder

A

Disregard for and violation of rights of others beginning at age 15; impulsivity; deceitfulness; lack of remorse; engages in acts that are illegal or show disrespect for social norms

31
Q

management of personality disorders

A

dialectical behaviour therapy
patient communication and relationship management strategies
low dose anti psychotics e.g. haloperidol
SSRI
psychotherapy

32
Q

define learning disability

A

life long condition with 3 aspects:

1) reduced ability to understand new/complex information or to learn a new skill
2) reduced ability to cope independently
3) a condition which started before age 18 with a lasting effect on the individual’s development

33
Q

causes of learning disability

A

genetics: down’s. fragile x
infective: rubella (antenatal), meningitis, encephalitis (post natal)
trauma: birth asphyxia, head trauma

34
Q

mental health disorders associated with learning diabilities

A 
depression
schizophrenia
anxiety
delirium and early onset dementia
ADHD
35
Q

triad of impairments in autistic spectrum disorder

A

qualitative impairment in reciprocal social interaction
poor communication
restricted, stereotyped and repetitive repertoire of interests and activates

36
Q

physical health impairments associated with learning difficulties

A

GORD
epilepsy
hearing and vision impairment
heart abnormalities

37
Q

describe the spectrum of substance misuse

A

recreational use
acute intoxication ( recovery is usually complete, impaired judgment, euphoria/dysphoria, reduced/heighted consciousness)
harmful substance use (damage to the physical or mental health of the user)
dependence syndrome

38
Q

define dependence syndrome

A

use of the substance takes on a much higher priority for a given individual than other behaviours that once had greater value - the desire to take such substance is often strong and overpowering

39
Q

diagnosis of dependence syndrome

A

3 or more of the following 5:
desire or sense of compulsion
difficulty in controlling substance taking behaviour
evidence of tolerance
neglect of alternative pleasures or interests
use despite clear evidence of overtly harmful consequences

40
Q

withdrawal symptoms of benzodiazepines

A 
agitation
irritability
diaphoresis
nausea
hallucinations
41
Q

withdrawal symptoms of opiods

A 
rhinitis
lacrimation
diaphoresis
diarrhoea
tachycardia
42
Q

symptoms of delirium tremens

A 
cognitive impairment
hallucinations
tremor
tachycardia
fever
43
Q

substances that cause psychosis

A

alcohol, cannabis, ecstasy, cocaine

44
Q

symptoms of psychotic disorder

A

vivid hallucinations
misidentifications
paranoid delusions
delusions of reference

45
Q

management of opioid withdrawal

A

methadone

buprenorphine

46
Q

management of amphetamines withdrawal

A

no effective pharmacological treatment

CBT and contingency management

47
Q

define medically unexplained symptoms

A

symptoms for which no medical cause can be found
either due to it being unknown, uncertain or disputed
does not necessarily imply the cause is psychological e.g. stress headaches

48
Q

define somatoform MUS

A

any mental disorder that manifests as physical symptoms that suggest illness or injury, but cannot be explained fully by a general medical condition

49
Q

define malingering MUS

A

Malingering is falsification or profound exaggeration of illness (physical or mental) to gain external benefits such as avoiding work or responsibility, seeking drugs, avoiding trial (law), seeking attention, avoiding military services, leave from school, paid leave from a job

50
Q

define factitious MUS

A

they know they are producing the symptoms but they do not know why

51
Q

management of MUS

A

CBT

anti depressants

52
Q

red flags in perinatal depression

A

change in mental state/new symptoms
new thoughts of self harm
new or persistent expression of incompetency as a mother

53
Q

define tokophobia

A 
primary = fear of childbirth that pre-dated pregnancy
secondary = fear after a traumatic or distressing delivery
54
Q

consequences of post natal depression

A

poor mother child relationship may lead to delayed cognitive, social and emotional development, poor language skills

55
Q

presentation of postpartum psychosis

A

mostly affective: elation and depression
delusions and hallucinations
confusion and perplexity
wide fluctuations in intensity of symptoms

56
Q

risk factors for antenatal depression

A

maternal anxiety
life stress
domestic violence
unintended pregnancy

57
Q

risk factors for postnatal depression

A

history of depression
lack of support
poor relationship with partner

58
Q

Define ADHD

A

neurodevelopmental disorder in which symptoms of inattention, hyperactivity and impulsivity significantly interfere with daily functioning

59
Q

Presentation of ADHD in children/adolescence

A

academic impairment
poor social interaction
smoking/alcohol/drug use

60
Q

presentation of ADHD in adults

A

chaotic, disorganised lifestyle

conflicts at work (late, mistakes, etc.)

61
Q

management of ADHD

A

stimulants (DA and NA reuptake inhibitors)

1st line = methylphenidate
2nd line = Dexamphetamine
both available as immediate or slow releases

non-stimulants (NA Reuptake Inhibitor)
Atomoxetine

62
Q

define bulimia nervosa

A

recurrent episodes of binge eating, with compensatory behaviours
and overvalued ideas about ‘ideal’ body shape and weight

63
Q

define anorexia nervosa

A

wt loss leading to a body weight at least 15% below the normal or expected weight for age and height

64
Q

what are the types of detentions under the mental health act

A 
emergency detention (72hrs)
short term detention (28 days)
compulsory treatment order (6 months)
65
Q

differential for depression

A

delirium/dementia
dysthymia
BPAD
negative symptoms schizophrenia

66
Q

MoA of SSRIs and TCA

A

SSRI: Inhibition of reuptake of serotonin at the serotonin reuptake pump of the synaptic cleft therefore increasing circulation levels

TCA: Stops the reuptake of monoamines by binding to monoamine pump at pre-synaptic cleft
The reduced reuptake of norepinephrine and/or serotonin combats depression

67
Q

side effect of antipsychotic

A

metabolic syndrome (wt gain, insulin resistance, dyslipidaemia),
seizures
myocarditis,

Extra pyramidal side effects (dystonia, parkinsonism, akathisia, tardive dyskinesia)
due to antagonizing dopamine D2 receptors

finals (13 decks)

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