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BDS3 BAMS Diseases of Human Systems > Psychiatry - Mood Disorders and Psychoses > Flashcards

Psychiatry - Mood Disorders and Psychoses Flashcards

1
Q

How can mood disorders present to the dentist

A 
oral effects (somatiform disorders)
patient's general demeanor
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2
Q

What are the oral effects of mood disorders that may present to the dentist

A

dysaesthesias

facial pain

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3
Q

What is the mood disorder spectrum

A

normal mood goes from elation, normal mood, dysthymia

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4
Q

What are common symptoms of depression

A 
low mood
reduced interest and motivation
lethargy and tiredness
sleep disturbance
appetite disturbance
poor concentration 
loss of confidence and self esteem
recurrent thoughts of death and suicide
unreasonable self reproach and guilt
any form of anxiety
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5
Q

What is bipolar 1

A

mania

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6
Q

What is bipolar 2

A

cyclothymia

hypomania

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7
Q

What are mania and hypomania symptoms

A

increased productivity and feeling of wellbein
reduced need for sleep
gradual reduction in social functioning and occupational functioning
increase in reckless behavior
followed by period of depression

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8
Q

What can treatment of mood disorders be split into

A

pyschological
drug treatment
physical

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9
Q

What is psychological treatment of mood disorders

A

cognitive therapy

interpersonal psychotherapies

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10
Q

What is the drug treatment for mood disorders

A

usually 2 yr tx
antidepressant
mood stabilising

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11
Q

What is the physical treatment of mood disorders

A

exercise
phototherapy
ECT

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12
Q

What are the acute phase antidepressants

A

selective serotonin reuptake inhibitors
venalfaxine/mirtazepine
tricyclic anti depressants
monoamine oxidase inhibitor

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13
Q

What are mood stabilizing drugs

A

lithium
carbamazepine
valproate
lamotrigine

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14
Q

Why is lithium not really used anymore

A

has potential interaction and toxicity problems

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15
Q

Why is the patient taking an anti depressant

A

treating depression
treating anxiety disorders
pain relief
help psychological treatments

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16
Q

What are the original types of tricyclic antidepressants

A

amitriptyline
nortriptyline
dosulepin

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17
Q

What are the new tricyclic antidepressants

A

imipramine

doxepine

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18
Q

What are the side effects of tricyclic antidepressants

A

dry mouth
sedation
weight gain

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19
Q

What should tricyclic anti depressants be used in caution with

A

glaucoma

prostatism

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20
Q

What type of drugs are SSRIs

A

prozac

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21
Q

What are the different types of prozac type SSRi drugs

A

fluoxetine
paroxetine
fluvoxamine

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22
Q

What are the side effects of SSRIs

A

acute anxiety disorders
some patients similar to TCA - sedation, dry mouth
GI upset

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23
Q

What is the issue with citalopram and sertraline SSRIs

A

citalopram

sertraline

24
Q

What are MAOI

A

monoamine oxidase inhibitors

25
Q

What are the 3 monoamine oxidase inhibitors

A

phenelzine
isocarboxazid
selegeline

26
Q

What are the interactions of MAOI

A

indirect acting sympathomimetic amines
enhanced VC effect
cough and cold remedies

foodstuffs - tyramine containing, alcohol, low alcohol bovril/oxo/marmite, cheese, herring, beans

27
Q

What are other drugs used as antidepressants that are usually prescribed by psychiatrist not GP

A

venlafaxine (mixed SRI/NRI)
mirtazapine (complex 5HT actions presynaptic alpha2 antagonist)
nefazadone (SSRI/5HT blockade)
reboxetine (SNRI)

28
Q

What are drugs used in mood disorders

A

lithium - mood stabiliser
carbamezapine/lamotrigine/valproate - mood stabiliser
antipsychotic medicines to treat episodes of mania

29
Q

Which should drugs should be avoided with lithium

A

avoid NSAID and METRONIDAZOLE

30
Q

What are the antipsychotic medicines used for bipolar mood disorders

A

aripiprazole
olanzapine
quetiapine
risperidone

31
Q

What is the direct drug effects of antidepressant drug tremtntes

A

dry mouth - caries (lithium)
sedation
facial dyskinesias

32
Q

What is psychoses

A

perceptual abnormaliteit

33
Q

What illnesses may we see psychoses

A

manic depression
schizophrenia
korsakoff psychosis (alcohol induced brain degeneration)

34
Q

What are drug effects of psychoses

A

dry mouth
drug interactions
dyskinesias - tonic or dystonia (tardive)

35
Q

What is schizophrenia

A

thought disorder

fundamental and characteristic distortions of thinking and perception

various types of delusion - sometimes bizarre
auditory hallucinations

36
Q

What is the etiology of schizophrenia

A

dopaminergic neurotransmission
genetic susceptibility - multigene
environmental - perinatal risk factors
drug abuse - cocaine, amphetamine, ecstasy, opiate (cannabis and alcohol)

37
Q

What’s the management for schizophrenia

A

psychological therapy

drug therapy

38
Q

What is the psychological therapy for schizophrenia management

A

CBT
cognitive remediation
family intervention

39
Q

What is the drug therapy for schizophrenia management

A

oral or depot IM injection - compliance, frequency of requirement

dopamine antagonist drugs
atypical antipsychotics - less likely to cause extrapyramidal side effects

40
Q

What are the issues with dopamine antagonist drugs

A

cause ‘extrapyramindal’ side effects, dry mouth and sedation

41
Q

What are the anti psychotics

A

butryophenones
phenothiazines
thioxanthenes
new ‘atypical’ antipsychotics

42
Q

What is the butryrophenones

A

haloperidol

droperidol

43
Q

What are the phenothiazines

A

chlorpromazine, thioridazine

prochlorperazine, fluphenazine

44
Q

What are the thioxanthenes

A

flupenthixol, zucopenthixol

45
Q

What are the new atypical antipsychotics

A

sulpiride, respirions, clozapine, quetiapine, aripiprazole

olanzapine

46
Q

What are the extrapyramidal side effects of antipsychotics

A

akathisia
dystonia
parkinsonism
tardive dyskinesia

47
Q

What is akathisia

A

feeling of restlessness, making it hard to sit down r hold still
symptoms include tapping your finger, rocking and crossing and uncrossing your legs

48
Q

What is dystonia

A

muscles involuntary contract and concord elating to painful positions or movements

49
Q

What is parkinsonism

A

the same symptoms as someone with parkinsons disease but your symptoms are caused by medications, not by the disease

may include tremor, slower thought processes, slower movements, rigid muscles, difficulty speaking and facial stiffness

50
Q

What is tardive diskinesia

A

uncontrollable facial movements such as sucking or chewing, lip smacking, sticking your tongue out or blinking your eyes repeatedly
do not go away if medicine is stopped

51
Q

How can extrapyradimal symptoms be treated

A

need to restore some balance
can use an atypical antipsychotic instead
can use beta blockers (non selective)
can use anticholinergics

52
Q

What are the the different types of eating disorders

A

anorexia nervosa
bulimia
comfort eating

53
Q

What is anorexia nervosa

A

altered perception of body image
don’t eat
may see oral effects of malnutrition

54
Q

What is bulimia

A

normal weight - binge / vomit
comfort eat
dental erosion and oesophageal stricture issues
comfort eating

55
Q

What is the core psychopathology of eating disorders

A

fear of being fat

self perception of being too fat

56
Q

What are other behaviors aimed at losing weight

A

self induced vomiting
excessive exercise
use of laxatives, appetite suppressants, diuretics

57
Q

What are symptoms of borderline personality disorders

A 
deep fear
unstable relationships 
changes in self image
stress paranoia 
impulsive behaviour
suicidal threats
excessive mood swings
feelings of solitude

BDS3 BAMS Diseases of Human Systems (11 decks)

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