Psychiatry Flashcards
What questionnaire is used to screen for depression?
PHQ-9
What are the 3 core symptoms of depression?
How long should these symptoms be present for and how frequently?
Persistent low mood, Loss of interest or pleasure, Fatigue or low energy
For at least 2 weeks on most days, most of the time
Which blood tests should be considered when managing depression? (7)
FBC, U&Es, LFTs, TFTs, glucose, bone profile, ESR
What differentials should you consider when diagnosing depression? (8)
Grief, anxiety, bipolar, premenstrual dysphoric disorder, substance misuse
Neurological conditions
Hypothyroidism
OSA
What are some psychiatric differentials for anxiety?
What are some medical differentials for anxiety?
Adjustment disorder, OCD, PTSD, depression, anorexia, substance misuse, somatoform
Cardiac or pulmonary disease, hyperthyroidism, anaemia, infection, IBS, phaeochromocytoma
What are the symptoms of serotonin syndrome?
Hyperreflexia, hypertension, hyperthermia, tachycardia, agitation, sweating, irritability, diarrhoea, dilated pupils
What are the symptoms of discontinuation syndrome?
Headaches, dizziness, nausea, hypomania, electric shock sensations
What are 4 core symptoms of schizophrenia?
Auditory hallucinations
Broadcasting thoughts
Control (delusions of control or passivity)
Delusions
What are some psychological differentials for psychosis? (6)
What are some medical differentials for psychosis? (7)
Schizophrenia, schizoaffective disorder, bipolar, depression, substance misuse, PTSD
Epilepsy, dementia, B12 deficiency, thyroid disease, medication, SLE, sepsis
Which of the antipsychotics are most likely to cause:
- Hyperprolactinaemia
- Weight gain
- Prolonged QTc
- Risperidone
- Olanzapine
- Quetiapine
What are the main side effects of antipsychotics? (5)
What is the monitoring for those on antipsychotics?
Hyperprolactinaemia, extra-pyramidal symptoms, metabolic syndrome, arrythmias, drowsiness
Bloods - glucose, HbA1c, lipids, prolactin
BMI, waist cirucmference, pulse, BP
What are the symptoms of neurleptic malignant syndrome?
What is the general management? (5)
Hyperthermia, hypertension, hyperreflexia, tachycardia, sweating, irritability, tremor
IV fluids, active cooling, dopamine agonist, benzos for agitation, ICU support
What is required for an application to for section 2 or 3 under MHA?
How long do each of these sections last?
What is the appeal process?
AMHP, two doctors (one whom is section 12 approved)
2 - up to 28 days, can appeal within first 14 days
3 - 6 months (must be reassessed after 3 months), can appeal at any time
What are the symptoms of a manic episode of bipolar disorder? (7)
Distractibility Irritability Grandiose ideas Flight of ideas Activity increase Sleep deficit Talkativeness
What medication is used during the acute phase of manic?
What medication is used long-term for bipolar?
What medication is used for depressive phase in bipolar?
What social management should you consider?
Antipsychotics
Lithium
Quetiapine, olanzapine, lamotrigine, fluoxetine with olanzapine
Care plan and lasting power of attorney
When are lithium levels measured?
What are the long-term effects of lithium? (3)
What two blood tests are monitored? How often?
After 5 days, weekly and when stable, every 3 months
Renal toxicity, diabetes insipidus, hypothyroidism
U&Es, TFTs - every 6 months
What is included in the criteria for dependency? (5)
Craving, tolerance, withdrawal, salience, loss of control
What questions should you remember to ask when taking a alcohol history? (3)
Any physical symptoms e.g. jaundice, seizures
Any contact with police
Any admission due to alcohol
What are the 3 main categories of symptoms in those with ASD?
Problems with communication
Difficulties with social relationships
Absorbing and narrow interests
When should you refer a young person to the autism team or paediatrics?
<3 with regression of language or social skills
>3 with regression in language
Any age with regression in motor skills
What options are there in the management of ASD?
- Biological
- Psychological
- Social
- SSRIs, risperidone (aggressive), melatonin (sleep)
- CBT, behaviour management, specific autism programmes
- Carers, respite care, educational support
What are the causes of irreversible dementia?
What are the causes of reversible dementia?
Alzheimer’s, vascular dementia, DLB, frontotemporal
Substance misuse, hypothyroidism, SOL, normal pressure hydrocephalus, pellagra, syphyllis, B12 or folate deficiency
What cognitive assessment tools are there for assessing dementia?
10-CS
6CIT
Memory Impairment Screen (MIS)
What are behavioural and psychological symptoms of dementia? (5)
What should be considered first when managing BPSDs?
Hallucinations, agitation, anxiety, delusions, aggression
Non-pharmacological interventions e.g. aromatherapy,, music therapy
