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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
Symptoms of bipolar mania
``` DIG FAST: Distractibility Irresponsibility Grandiose delusions Flight of ideas Agitation S: Sleep not needed Talkative ```
26
What is cyclothymic disorder
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.
27
Why Is it more likely that people with Autistic Spectrum Disorder cause criminal acts
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
28
Diagnosis of autism
``` 1. Struggles with communication TWO of the following: Repetition of movements and phrases Specific routines Restricted interests Highly sensitive to surroundings (change) ```
29
Extra-pyramidal side effects of antipsychotics
1. Parkinsonism 2. Acute Dystonia 3. Akasthesia (restlessness) 4. Tardive dyskinesia)
30
What warnings are there for antipsychotic uses in the elderly
1. Increased risk of stroke | 2. Increased risk of venous thromboembolism
31
What risks are associated with sertraline in the first trimester
Congenital heart defects
32
Name four risk factors for GAD
1. Aged 35-54 2. Divorced or separated 3. Living Alone 4. Being a lone parent
33
What side-effects are unique to amitryptaline
Anticholinergic effects: 1. Tachycardia 2. Dry Mouth 3. Mydriasis 4. Urinary retention
34
How long should symptoms last before a diagnosis of PTSD can be made
ONE MONTH
35
What physical characteristics are indicative of anorexia nervosa
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
What would be found on a blood test in anorexia nervosa
1. Hypokalaemia | 2. Hypercholesterolaemia
37
A patient comes in linking ideas that rhyme or word sound similarities, what is this symptom called and what conditions does this belong to
1. Clang associations Bipolar Schizophrenia
38
What is echolalia
Patient repeating words of the individual they talk to
39
What is neologism
Patient created new words or uses recognised words incorrectly
40
What is conversion disorder and what causes it
Loss of motor and sensory function Caused by stress
41
What is torticolis
Unilateral pain and deviation of the neck caused by antipsychotics as a side-effect
42
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
Lithium toxicity causing hypothyroidism
43
What is the tyramine cheese reaction
A side-effect of MAOIs where patients end up eating loads of cheese.
44
Side-effects of electroconculsion therapy
Headache Nausea Memory impairment Arrythmias
45
What is schizotypal personality disorder
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
What is school behaviour
1. Negative effect of schizophrenia
47
What is othello syndrome
Pathological jealousy delusion
48
Features of anorexia
``` G and Cs: RAISED GH IMPAIRED Glucose Tolerance Salivary GLANDS (Low FSH, LH, oestrogen and testosterone) RAISED Cortisol RAISED Cholesterol Carotinaemia ```
49
Hypochondriac vs somatisation
Somatisation: Symptoms hypoChondria = cancer (underlying malignancy)
50
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?
Start sertraline and lansoprazole As SSRI + NSAID = GI bleeding risk
51
Effects of SSRIs in third trimester of pregnancy
Persistent pulmonary hypertension
52
What are pseudo hallucinations
This is when the patient knows he is hallucinating and often come after a bereaveent
53
When is post-concussion syndrome seen
1. Even after minor head injuries
54
Features of post-concussion syndrome
1. Headache 2. Fatigue 3. Anxiety/depression 4. Dizziness Occur three months after injury
55
How do Benzodiazepines work
Enhance the effect of GABA by increasing frequency of chloride channels
56
Signs of SSRI discontinuation syndrome
Diarrhoea and GI related problems
57
Three features of PTSD
1. Re-experiencing 2. Avoidance 3. Hyperarousal (hypervigilence for threat, exaggerated startles) 4. Emotional numbing
58
When is watchful waiting used for PTSD
1. If symptoms last for less than 4 weeks
59
How are extrapyramidal side-effects of antipsychotics treated
1. Reversed with procyclidine (reverses dystonia)
60
How long should SSRIs be continued if the patient wants to stop them
6 months
61
What is a red-herring sign of tardive dyskinesia
Starting fluoxetine
62
How do antipsychotics work
D2 receptor antagonists
63
What are the 5 stages of grief reaction
1. Denial (pseudohallucinations) 2. Anger 3. Bargaining 4. Depression 5. Acceptance
64
What is atypical grief
1. Delayed grief (occurs 2 weeks after) | 2. Prolonged grief
65
When does atypical grief occur
Women and problematic relationships
66
What is dissociative disorder
1. Separating off certain memories from normal consciousness (e.g. DID)
67
What is Munchausen's syndrome
Intentional production of physical or psychological symptoms
68
What time frame after starting ineffective typical antipsychotics should atypical be started
6-8 weeks
69
Serious side-effects of atypical antipsychotics
1. Weight Gain 2. Excessive salivation 3. Agranulocytosis 4. Neutropenia 5. Myocarditis 6. Arrythmias
70
Short-term effects of ECT
1. Headache 2. Nausea 3. Short term memory loss 4. Arrythmias
71
How is hypomania treated in primary care setting
Referred to community mental health team
72
Time onset for alcohol withdrawal symptoms
6-12 hours
73
Time onset for alcohol withdrawal seizures
36 hours
74
Time onset for delirium tremens
72 hours
75
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?
Hypothyroidism Tiredness is unusual
76
Side-Effect of lorazepam
Anterograde amnesia
77
What is the first choice SSRI for adolescents and children
Fluoxetine
78
Flight of ideas vs Kinght's move
Flight of Ideas: no link between what they are saying | Knight's move: a discerniblelink
79
How is Tardive Dyskinesia treated
Tetrabenazine
80
What defines OCD
Obsessive behaviour for more than 2 hours.
81
What type of patients is OCD more common in
Males with strict upbringing
82
What is the most common defence mechanism seen in OCD
Undoing: Performing the reverse of unacceptable behaviour to counteract others.
83
What is projection and in which condition is this seen in
Defending themselves by attributing situations to others
84
What is displacement
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
Acute stress disorder vs post-traumatic disorder
ASD if less than month
86
What is the major defence mechanism in borderline personality disorder
SPLITTING: either speak highly or badly of someone Extreme
87
OCD treatment
Citalopram

year 3 (25 decks)

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