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Psychiatry > Psychiatry - conditions > Flashcards

Psychiatry - conditions Flashcards

1
Q

What are the 5 types of thought alienation?

A

thought insertion, withdrawal, broadcase, echo and block

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2
Q

What is the difference between perceptual symtpoms?

illusion, hallucination, delusion, delusional perception

A

illusion = misperception of stimulus
hallucination = sensory experience in absence of stimulus
delusion = fixed idea, can’t be shaken
delusion perception = delusion formed from an actual perception

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3
Q

What is akathisia?

A

the sensation of feeling restless

- often side effects of antipsychotics

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4
Q

What is somatic passivity?

A

The belief someone is doing something to you

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5
Q

What is incongruity of affect?

A

When a person’s face doesn’t match the emotion

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6
Q

What is conversion and belle indifference?

A

Conversion is developing a physical deficit in response to trauma
Belle indifference is conversion but the patient accepts it

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7
Q

Name some symptoms of EUPD

A

manipulative, unstable moods, splitting and dissociate, struggle with identity, background of poor attachement/abuse, unstable relationships

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8
Q

What is the threshold for admission for an eating disorder?

A

BMI = 13

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9
Q

Name 2 typical and 2 atypical antipsychotics

A

Typical - haloperidol, chlorpromazine

Atypical - olanzapine, quetiapine, clozapine, risperidone

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10
Q

What is the treatment for PTSD?

A

< 4 weeks = watch and wait
4 weeks - 3months = trauma focused therapy
Psycholgical - EMDR, trauma focused CBT
Pharmalogical - SSRI, MOAI, amitriptyline
mirtazapine
sleeping tablets

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11
Q

What are the diagnostic criteria for PTSD?

A

Trauma, happened <6 months ago, intrusive memories

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12
Q

What is the treatment for OCD?

A

Psychological - CBT with ERP (exposure and response prevention)
Pharmacological - SSRI (e.g. sertraline, paroxetine)

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13
Q

Name the 6 types of schizophrenia

A

Hebephrenic/disoragnised -thought disorder and flat affect
Paranoid - hallucinations and delusions (no though disorder)
Catatonic - immobile/agitated/purposeless movement
Undifferentiated
Residual - chronic negative symptoms
Simple - insidous and progressive negative symptoms, no history of psychotic symptoms

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14
Q

What is the difference between delusional disorder and schizophrenia?

A

DD - delusions are stable over time, main symptom is delusions
S - get a decrease in functioning, delusions and hallucinations

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15
Q

What is clozapine and when it is used?

A 
Atypical antipsychotic (D1 and D2 antagonist) - used in resistant schizophrenia 
- need FBC before starting and every 4 weeks
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16
Q

What are the first and second rank symptoms of schizophrenia?

A

First - thought alienation, 3rd party auditory hallucinations, delusional perseption, passivity phenomona
Second - delusions, 2nd party auditory hallucinations, thought disorder, negative symptoms, catatonic behaviour

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17
Q

What is needed to diagnose bipolar?

A

1 episode of depression and mania (needs to last at least a week)
>1 mood change with at least one being mania (repeated episodes of mania or hypomania are also bipolar)

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18
Q

How do you treat bipolar?

A 
Acute - lorazepam/diazepam 
lithium 
valporate (anticonvulsant)
carbamazepine 
lamotrigine 
olanzapine

CBT

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19
Q

Which medications would you use to treat bipolar?

A

Lithium - decreases cAMP, therefore increases monoamines

carbamazepine, lamotrigeine

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20
Q

What is dysthmyia?

A

mild depression

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21
Q

What is depressive stupor?

A

being sleepy a lot

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22
Q

What is cyclothmyia?

A

mild bipolar

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23
Q

What are some ‘thoughts’ symptoms?

A 
thought insertion, withdrawal, broadcast, echo, block 
Concrete thinking (ASD, psychosis)
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24
Q

What are some ‘expression’ symptoms?

A

loosening of association (lack of logical asssociation between thoughts = incoherent thoughts)
Circumstantiality (talking at length around a subject but returns)
Perseveration (repetition of a word - organic/frontal)
Tangential (does not return to the topic)
Confabulation (give a false account to fill a memory gap - Korsakov’s)

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25
Q

What are some ‘passivity’ symptoms?

A

Somantic passivity
Made acts, feelings, drives
Catatonia
Stupor (loss of activity with no response to stumuli)
Psychomotor retardation (slowing of thoughts and movements)

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26
Q

What are some ‘mood’ symptoms?

A 
flight of ideas
neologists (use of made up words)
pressure of speech
poverty of speech
anhedonia
flattening of affect (reduced emotional expression)
incongruity of affect (mismatch)
obsession (unwanted recurrent thought)
compulsion (irrestibile urge to behave in a certain way)
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27
Q

What is depersonalisation and derealisation?

A

Depersonalisation - thoughts and feelings do not seem to belong to oneself
Derealisation - feeling as if you are looking at yourself from outside

28
Q

What is sterotypy?

A

persistent repetition of a behaviour without cause

29
Q

What are the positive symptoms of psychosis?

A

delusions, disorder thoughts/speech, hallucinations

- these respond well to meds

30
Q

What are the negative symptoms of psychosis?

A

flat/blunted affect, poverty of speech, lack of motivation, poor ability to function
- respond less well to meds

31
Q

Other than schizophrenia, what are other types of psychosis?

A

acute and transient psychosis, persistent delusional disorder, schizoaffective disorder, puerperal psychosis, organic psychosis

32
Q

How would you treat psychosis?

A

Antipsychotics
family therapy, CBT
family intervention/carer support, employment/activity/education, support with engagment/benefits

33
Q

How do you treat all psychiatric conditions?

A

Biopsychosocial model

34
Q

What are the 5 types of antidepressants ?- give 2 examples and SE for each

A

*Selective Serotonin Reuptake Inhibitors - fluoxetine, sertraline, citalopram
SE: abdominal pain, suicide, sexual dysfunction
*Tricyclic antidepressants - amitriptyline, trazadone
SE: sedation, anticholinergic, arrhythmias
*Serotonin noradrenaline reuptake inhibitors - venlafaxine, duloxetine
SE: suicidality, serotonin syndrome, sexual dysfunction
*Tetracyclic - mirtazapine
SE: sedation, weight gain
*Monoamine oxidase inhibitors - phemalzine, moclobemide
SE: hypertensive crises related to tyrosine in cheese, red wine etc.

35
Q

How would you treat ADHD?

A

methylphenidate (ritalin)

atomoxetine

36
Q

What are primary care psychological interventions?

A

counselling, psychoeducation, CT

37
Q

What is secondary care psychological interventions?

A

dialectic behavioural therapy, psychoanalytic psychotherpay, group therapy, family therapy

38
Q

Which personality disorders are under cluster A?

A

Odd or eccentric
Paranoid - suspicion and mistrust
Schizoid - lack of interest, detached, apathy, restricted emotional expression
Schizotypal - extreme disconfort with social interaction, distorted cofnition and perceptions

39
Q

Which personality disorders come under cluster B?

A

Dramatic, emotional, erratic
Antisocial - lack of empathy, increased self-image, manipulative, impulsive, aggressive
Borderline
Histronic - attention seeking, excessive emotions
Narcissistic - grandiosity, need for admiration, lack of empathy

40
Q

Which personality disorders come under cluster C?

A

Avoidant - social inhibition and inadequacy, extreme sensitivity to negative evaluation
Dependant - psychological need to be cared for by others
Obsessive-compulsive/anakastic - conformity to rules, perfectionism, exlusion of leisure and friendship

41
Q

Which treatment is the least effective to protect against mania?

A

lamotrigeine is the least effective to protect against mania

42
Q

What are some SE of antipsychotics?

A

amennorhea, impaired glucose tolerance, dyslipdaemia, increased cerebrovascular incidence

43
Q

What are the types of couple therapy?

A

couple couselling

sensate focus

44
Q

What is a nihlistic delusion/cotard syndrome/somatic delusion

A

nihilistic - delusion of being dead
Cotard - walking corpse
Somatic delusion - relating to bodily functions

45
Q

What is a delusion of reference?

A

strongly held belief of reference e.g. believing they caused an earthquake they saw on the news

46
Q

What is capgas syndrome?

A

Believing spouse is imposter

47
Q

What is fregoli syndrome?

A

Believing someone is in disguise

48
Q

What are risk factors for anxiety?

A

Being aged 35-54
Being divorced or seperated
Living alone or as a lone parent

49
Q

How would you medically treat anxiety?

A

SSRI - sertraline, fluoxetine
SNRI - venlafaxine, duloxetine
pregabalin
Benzodiazapines

50
Q

What are extracampine hallucinations?

A

Feeling of a human prescence

51
Q

What are functional hallucinations?

A

triggered by a stimulus in the same modality

52
Q

What are hypnagognic and hypogognic hallucinations?

A

hypnagognic - as falling asleep

hypogognic - as waking up

53
Q

What is the risk of schizophrenia in idential twins if one is diagnosed?

A

1 in 2

54
Q

How do you assess for postnatal depression?

A

Edingburgh scale

55
Q

How to you monitor when a person is on clozapine?

A

FBC - before starting and every 4 weeks
electrocardiogram and ask about signs of heart failure
- monitoring for myocarditis and cardiomyopathy
SE: amenorrhea, constipation, erectile dysfunction

56
Q

What are complications of transmale hormone therapies?

A 
polycythemia (high RBC), elevated LFT
weight gain, acne. sleep apnea
male pattern baldness 
worsening of underlying manic or psychotic 
high BP, DM, CVD
57
Q

What are the complications of transfemale hormone therapies?

A

estrogen-sensitive cancer (e.g. breast cancer), thrombosis, embolism, macroprolactinoma

58
Q

What is one symptom of depression especially common in older people?

A

somatization

59
Q

What are different types of delusions?

A

polythematic or monothematic
primary (no proceding reasons, likely to be schizophrenia)
secondary (e.g. depressed person feeling worthless)
mood congruent or incongruent

60
Q

What are some common delusions in psychotic depression?

A

nihilistic delusion

61
Q

What is a personality disorder?

A

acquired ingrained personality type leads to maladaptive patterns of behaviour resulting in functional impairment in relationship or society

62
Q

What is conduct disorder?

A

antisocial behaviour in childhood/adolescence

  1. long lasting
  2. violates others rights
  3. against expected norms
  4. distrupts own or family’s life
63
Q

What are the transtheoretical apprach and core model in eating disorders?

A

transdiagnostic = don’t fit diagnosis so focus on symptoms and attitudes (faiburn et al 2003)
core model = low self-esteem and perfectionism leads to need for control (slade 1982)

64
Q

What are the types of eating disorders?

A

anorexia nervosa (BMI <17.5, restricting and purging)
Bulimia nervosa (1/week for 3 months)
Binge eating disorder (1/week for 3 months)
other specficied feeding and eating disorders (atypical anorexia, bulimia nervosa, binge-eating and purging disorder, night eating syndrome)

65
Q

How would you treat eating disorders?

A

CBT

family therapy in adolescents

Psychiatry (7 decks)

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