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year 3 > Psychiatry For Rampton SSC > Flashcards

Psychiatry For Rampton SSC Flashcards

1
Q

What causes positive symptoms in schizophrenia

A
  1. Increased dopaminergic activity in the mesolimbic pathway
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2
Q

How do anti-psychotics effect the tuberoinfundibulnar pathway

A

Found in the pituitary glands and can cause secretions of prolactin as a side-effect.

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3
Q

Where are the mesolimbic and mesocortiyal pathways found

A

Prefrontal cortex

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4
Q

Where are negative symptoms of schizophrenia found (pathway)

A

Mesocortical pathway.

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5
Q

What is tardive dyskinesia

A

This is the involuntary, repetitive movement of the face (lip smacking, grimacing and tongue movements) that develop after long use of antipsychotics (this is in typical antipsychotics)

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6
Q

What antipsychotic usually causes tardive dyskinesia

A

haloperidol or risperidone

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7
Q

What can worsen the prognosis of schizophrenia

A
  1. Fmaily history of schizophrenia only
  2. Early onset
  3. Gradual onset
  4. Negative symptoms
  5. Male sex
  6. Many relapses
  7. Poor society functioning
  8. Substance abuse
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8
Q

What is the most common form of substance abuse in people with schizophrenia

A

Tobacco causes it alleviates cognitive deficits in schizophrenia

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9
Q

What is thought-blocking

A

Seen commonly in schizophrenia

Thought blocking is a thought disorder where a person’s train of thought suddenly ceases, there is a pause, and they randomly initiate conversation on completely unrelated topics. During the pause, which can last seconds to a few minutes, some patients have described the phenomenon as a complete cessation of cognition or a complete and unexpected emptying of the mind. Sometimes, this phenomenon is attributed by the patient to their delusions or hallucinations. For example, a patient may say a spirit or another person is stealing his/her thoughts.

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10
Q

What is schizoaffective disorder

A
  1. Schizophrenia combined with a mood disorder (depression, bipolar etc).
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11
Q

Psychological signs in PTSD

A
  1. Nightmares
  2. Flashbacks
  3. Intrusive thoughts
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12
Q

Behavioural signs in PTSD

A
  1. Avoidance of situations
  2. Hyperarousal
  3. Trouble sleeping
  4. Irritability
  5. Emotional outbursts
  6. Children do not show distress

LASTS FOR MORE THAN 1 months

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13
Q

What does somaticisation disorder commonly associate with

A

Depressive disorders

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14
Q

What is factitious disorder

A

Where a person is exaggerating their symptoms or producing them

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15
Q

What is functional neurological symptom disorder

A

Where patients experience neurological symptoms despite normal neuroanatomy (e.g. non-epileptic seizures)

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16
Q

What is the risk assessment for suicide

A

SAD PERSONS
S: Male
A: Younger than 19/ older than 45
D: Depression

P: Previous attempt
E: Excess Alcohol 
R: Rational Thinking Loss
S: Separated/ Single
O: Organised Plan
N: No social support
S: Sickness
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17
Q

Risk factors for suicide

A
  1. Stigmatised groups
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18
Q

What is the Thematic Apperception Test

A

The Thematic Apperception (not appreciation) Test (TAT), also called the picture interpretation technique, is a projective test that instructs the patient to compose a narrative that goes along with provided pictures/cartoons of people. It allows the psychologist to reveal the patient’s underlying motives, thoughts, and concerns they may not express directly when asked.

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19
Q

What is the Rorschach test

A

Inkblot tests to see psychological interpretation

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20
Q

What is ‘flooding’

A

Used to treat PHOBIAS and ANXIETY: re-introduced painful memories under controlled environment s

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21
Q

What is the ‘milieu therapy’

A

Used for patients with personality disorders, behaviour problems and schizophrenia

When a patient is low-functioning and disorganized and is put in a facility that has a lot of structure, involves group meetings, provides a safe environment, employs token economy, and rewards patients for good behavior (corrective feedback), then such a therapy is called milieu therapy. During their time in the facility, patients are encouraged to be responsible for themselves as well others.

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22
Q

A patient can no longer look down after taking haloperidol, what has happened and how should we treat it

A
  1. Oculogyric crisis

Give Diphenhydramine

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23
Q

Bipolar I vs Bipolar II

A

Bipolar one goes to extremes of mania, Bipolar two never goes to the extremes and so is hypomanic (more subtle)

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24
Q

What is used to treat bipolarism

A

Lithium

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25
Q

Symptoms of bipolar mania

A 
DIG FAST:
Distractibility 
Irresponsibility 
Grandiose delusions
Flight of ideas
Agitation
S: Sleep not needed
Talkative
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26
Q

What is cyclothymic disorder

A

Person has slow transitions from mild depression to emotional highs for at least 2 years

Hypomanic episodes last 4 consecutive days whereas manic mood lasts 1 week.

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27
Q

Why Is it more likely that people with Autistic Spectrum Disorder cause criminal acts

A
  1. Physical and psychological isolation can cause intrusive thoughts, daydreams and fantasies
  2. Violence and aggressions if disturbed or preventing them from spending time on special interests
  3. Lack of empathy and compulsions
  4. Compulsion
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28
Q

Diagnosis of autism

A 
1. Struggles with communication 
TWO of the following:
Repetition of movements and phrases
Specific routines
Restricted interests
Highly sensitive to surroundings (change)
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29
Q

Extra-pyramidal side effects of antipsychotics

A
  1. Parkinsonism
  2. Acute Dystonia
  3. Akasthesia (restlessness)
  4. Tardive dyskinesia)
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30
Q

What warnings are there for antipsychotic uses in the elderly

A
  1. Increased risk of stroke

2. Increased risk of venous thromboembolism

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31
Q

What risks are associated with sertraline in the first trimester

A

Congenital heart defects

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32
Q

Name four risk factors for GAD

A
  1. Aged 35-54
  2. Divorced or separated
  3. Living Alone
  4. Being a lone parent
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33
Q

What side-effects are unique to amitryptaline

A

Anticholinergic effects:

  1. Tachycardia
  2. Dry Mouth
  3. Mydriasis
  4. Urinary retention
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34
Q

How long should symptoms last before a diagnosis of PTSD can be made

A

ONE MONTH

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35
Q

What physical characteristics are indicative of anorexia nervosa

A
  1. Languo hair (fine downy hair growth as loss of body fat)
  2. Failure of secondary characteristics
  3. Bradycardia
  4. Cold-intolerance
  5. Yellow tinge on skin hypercarotenaemia
36
Q

What would be found on a blood test in anorexia nervosa

A
  1. Hypokalaemia

2. Hypercholesterolaemia

37
Q

A patient comes in linking ideas that rhyme or word sound similarities, what is this symptom called and what conditions does this belong to

A
  1. Clang associations

Bipolar
Schizophrenia

38
Q

What is echolalia

A

Patient repeating words of the individual they talk to

39
Q

What is neologism

A

Patient created new words or uses recognised words incorrectly

40
Q

What is conversion disorder and what causes it

A

Loss of motor and sensory function

Caused by stress

41
Q

What is torticolis

A

Unilateral pain and deviation of the neck caused by antipsychotics as a side-effect

42
Q

A 34-year old lady has been diagnosed with bipolar disorder for 8 months and was taking lithium carbonate, she noticed that she had reduced appetite and constipation, what has caused these symptoms

A

Lithium toxicity causing hypothyroidism

43
Q

What is the tyramine cheese reaction

A

A side-effect of MAOIs where patients end up eating loads of cheese.

44
Q

Side-effects of electroconculsion therapy

A

Headache
Nausea
Memory impairment
Arrythmias

45
Q

What is schizotypal personality disorder

A
  1. Odd beliefs and magical thinking
  2. Perceptual disturbances
  3. Paranoid ideation
  4. Odd eccentric behaviour
  5. No close friends
  6. Odd speech without being incoherent
46
Q

What is school behaviour

A
  1. Negative effect of schizophrenia
47
Q

What is othello syndrome

A

Pathological jealousy delusion

48
Q

Features of anorexia

A 
G and Cs:
RAISED GH
IMPAIRED Glucose Tolerance
Salivary GLANDS (Low FSH, LH, oestrogen and testosterone)
RAISED Cortisol
RAISED Cholesterol
Carotinaemia
49
Q

Hypochondriac vs somatisation

A

Somatisation: Symptoms

hypoChondria = cancer (underlying malignancy)

50
Q

A 64-year-old woman presents as she is feeling down and sleeping poorly. After speaking to the patient and using a validated symptom measure you decide she has moderate depression. She has a past history of ischaemic heart disease and currently takes aspirin, ramipril and simvastatin. What is the most appropriate course of action?

A

Start sertraline and lansoprazole

As SSRI + NSAID = GI bleeding risk

51
Q

Effects of SSRIs in third trimester of pregnancy

A

Persistent pulmonary hypertension

52
Q

What are pseudo hallucinations

A

This is when the patient knows he is hallucinating and often come after a bereaveent

53
Q

When is post-concussion syndrome seen

A
  1. Even after minor head injuries
54
Q

Features of post-concussion syndrome

A
  1. Headache
  2. Fatigue
  3. Anxiety/depression
  4. Dizziness

Occur three months after injury

55
Q

How do Benzodiazepines work

A

Enhance the effect of GABA by increasing frequency of chloride channels

56
Q

Signs of SSRI discontinuation syndrome

A

Diarrhoea and GI related problems

57
Q

Three features of PTSD

A
  1. Re-experiencing
  2. Avoidance
  3. Hyperarousal (hypervigilence for threat, exaggerated startles)
  4. Emotional numbing
58
Q

When is watchful waiting used for PTSD

A
  1. If symptoms last for less than 4 weeks
59
Q

How are extrapyramidal side-effects of antipsychotics treated

A
  1. Reversed with procyclidine (reverses dystonia)
60
Q

How long should SSRIs be continued if the patient wants to stop them

A

6 months

61
Q

What is a red-herring sign of tardive dyskinesia

A

Starting fluoxetine

62
Q

How do antipsychotics work

A

D2 receptor antagonists

63
Q

What are the 5 stages of grief reaction

A
  1. Denial (pseudohallucinations)
  2. Anger
  3. Bargaining
  4. Depression
  5. Acceptance
64
Q

What is atypical grief

A
  1. Delayed grief (occurs 2 weeks after)

2. Prolonged grief

65
Q

When does atypical grief occur

A

Women and problematic relationships

66
Q

What is dissociative disorder

A
  1. Separating off certain memories from normal consciousness (e.g. DID)
67
Q

What is Munchausen’s syndrome

A

Intentional production of physical or psychological symptoms

68
Q

What time frame after starting ineffective typical antipsychotics should atypical be started

A

6-8 weeks

69
Q

Serious side-effects of atypical antipsychotics

A
  1. Weight Gain
  2. Excessive salivation
  3. Agranulocytosis
  4. Neutropenia
  5. Myocarditis
  6. Arrythmias
70
Q

Short-term effects of ECT

A
  1. Headache
  2. Nausea
  3. Short term memory loss
  4. Arrythmias
71
Q

How is hypomania treated in primary care setting

A

Referred to community mental health team

72
Q

Time onset for alcohol withdrawal symptoms

A

6-12 hours

73
Q

Time onset for alcohol withdrawal seizures

A

36 hours

74
Q

Time onset for delirium tremens

A

72 hours

75
Q

A 14-year-old patient presents to her GP complaining of unexpected weight gain and tiredness. She has been in contact with mental health services recently for treatment of anorexia nervosa.

Which of the following is the most likely cause of these symptoms?

A

Hypothyroidism

Tiredness is unusual

76
Q

Side-Effect of lorazepam

A

Anterograde amnesia

77
Q

What is the first choice SSRI for adolescents and children

A

Fluoxetine

78
Q

Flight of ideas vs Kinght’s move

A

Flight of Ideas: no link between what they are saying

Knight’s move: a discerniblelink

79
Q

How is Tardive Dyskinesia treated

A

Tetrabenazine

80
Q

What defines OCD

A

Obsessive behaviour for more than 2 hours.

81
Q

What type of patients is OCD more common in

A

Males with strict upbringing

82
Q

What is the most common defence mechanism seen in OCD

A

Undoing: Performing the reverse of unacceptable behaviour to counteract others.

83
Q

What is projection and in which condition is this seen in

A

Defending themselves by attributing situations to others

84
Q

What is displacement

A

Where the subject of an emotion is different to the victim the emotion is in response to:

For example, a man pounds his fist on the desk, rather than talking to his boss.

85
Q

Acute stress disorder vs post-traumatic disorder

A

ASD if less than month

86
Q

What is the major defence mechanism in borderline personality disorder

A

SPLITTING: either speak highly or badly of someone

Extreme

87
Q

OCD treatment

A

Citalopram

year 3 (25 decks)

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