Psychiatry SB document Flashcards
How do auditory hallucinations in depression differ from those in schizophrenia
Depression - 2nd person derogatory
Schizophrenia - 3rd person
What is psychomotor retardation and which condition is it seen in
Movements may be slowed and the voice quiet and monotonous
Seen in Severe depression
What is the diagnostic criteria for Moderate Depression
at least 2 of the 3 core features
additional symptoms must be present to give a total of 6
What is the diagnostic criteria for Severe Depression
all 3 of the core features
additional symptoms must be present to give a total of 8
What is mood reactivity in the context of Atypical Depression
mood brightens in response to positive events
Which syndrome should you think of from the phrase Nihilistic Delusions
Cotard Syndrome
What is dysthymia
Chronic and prolonged depression which is not severe enough to satisfy the criteria for a depressive episode
When is the average age of onset of bipolar disorder
Late teens or early 20’s
What must a patient have had to be placed in the Bipolar I category
At least 1 episode of Mania
What must a patient have had to be placed in the Bipolar II category
At least 1 episode of Hypomania, having never met the criteria for mania
Manic episodes can arise with or without psychotic symptoms - what are these
Delusions
Hallucinations
What is a contraindication to use of SSRI’s
Mani
Name 4 contraindications to use of TCA’s
recent MI
arrhythmias
severe liver disease
mania
Why should anti-depressants be used with caution in epileptic patients
They lower the seizure threshold
What is the triad of symptoms suggesting serotonin syndrome
Neuromuscular abnormalities
Altered consciousness level Autonomic instability
What is a cardiovascular disease which can occur as a side effect of Clozapine use
Myocarditis
How long does Acute Dystonia take to occur when a patient is put on anti-psychotics
72 hours
Why do extra-pyramidal side effects occur with anti-psychotics
An excess of acetylcholine and relative deficiency of dopamine
How long does Akathisia take to occur when a patient is put on anti-psychotics
within 6-10 days
What types of Schizophrenia indicate use of ECT
Catatonia
Positive psychotic symptoms
Schizoaffective disorder
What is the Hachinski Ischaemic Score used for
To differentiate between Vascular and Alzheimers Dementia
What is the treatment for Alcohol Related Dementia
Pabrinex and Thiamine
How long is treatment indicated for someone with Generalised Anxiety Disorder
At least 18 months
How long is treatment indicated for someone with Generalised Anxiety Disorder
At least 6 months
What is the timescale after a traumatic event for an acute stress reaction
48 hours
What is the timescale after a traumatic event for acute stress disorder
4 weeks
What is the timescale after a traumatic event for acute PTSD
3 months
What is the timescale after a traumatic event for chronic PTSD
over 3 months
How long is treatment indicated for OCD and PTSD
At least 12 months
What are the first line psychological and drug therapies for PTSD
Eye Movement Desensitisation and Reprocessing (EMDR)
SSRI
What are the first rank symptoms of Schizophrenia
Auditory hallucinations (3rd person)
Thought disorders
Passivity
Delusions
What is the diagnostic triad of ADHD
Inattention
Hyperactivity
Impulsivity
Name 2 first line drugs for ADHD
Methylphenidate (Ritalin)
Dexamfetamine
What is currently the only licenced anti-psychotic drug for treatment of Schizoaffective disorder
Paliperidone
Where is there reduced grey matter in Schizophrenia
temporal cortex
medial temporal lobe
frontal lobe
What are the 1st and 2nd line treatments for Schizophrenia
1st line - Risperidone (atypical)
2nd line - Aripiprazole (atypical)
Which mutation holds a high risk of Schizophrenia
22q11
Which drug can 3x increase your chance of developing Schizophrenia
Cannabis
What is your risk of developing Schizophrenia if your monozygotic twin has it
50%
What is your risk of developing Schizophrenia if your parents both have it and if only one parent has it
both - 50%
one - 10%
