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MCQs > Psychscene Miscellaneous > Flashcards

Psychscene Miscellaneous Flashcards

1
Q

Structural classes of antipsychotics?

A
  1. Phenothiazines 2. Butyrophenones 3. Thioxanthines 4. Substituted Benzamides Dibenzazepine 5. Dibenzodiazepine 6. Thienobenzadiazepine 7. Dibenzothiazepine 8. Benzisoxazole
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2
Q

Phenothiazines?

A

ChlorPromazine FluPhenazine

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3
Q

Butyrophenones?

A

Haloperidol - D2 blockade

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4
Q

ThioXanthines?

A

FlupenthiXol

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5
Q

Dibenzodiazepine?

A

Clozapine

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6
Q

Thienobenzodiazepine?

A

Olanzapine

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7
Q

Dibenzothiazepine?

A

Quetiapine

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8
Q

Benzisoxazole

A

Risperidone

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9
Q

Piperazine

A

Trifluoperazine

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10
Q

Piperidine

A

Thioridazine

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11
Q

Benzamide?

A

Sulpride

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12
Q

Mechanism of Haloperidol?

A

D2 blockade

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13
Q

Mechanism of Sulpride?

A

D3 presynaptic antagonist at low doses, D2 post synaptic antagonist at high doses

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14
Q

Why is Sulpride different from the others?

A

It does not follow the pharmacokinetic principles of the other antipsychotics so it is… -water soluble/poorly fat soluble -poorly absorbed -doesn’t cross the BBB as well as the others

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15
Q

D2D - What do SSRIs do to Cytochrome P450?

A

Inhibit it. So it can raise plasma levels of Haloperidol

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16
Q

D2D - What does smoking do to enzymes?

A

Enzyme induction. Therefore it lowers plasma concentrations of antipsychotics.

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17
Q

Safe antipsychotics in pregnancy?

A

Haloperidol (no good reason) Atypicals

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18
Q

Mechanism of Risperidone?

A

5HT2:D2 antagonist A1 blockade leads to FIRST DOSE HYPOTENSION.

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19
Q

Mechanism of Olanzapine?

A

5HT2:D2 antagonist H1 blockade causes SEDATION

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20
Q

Mechanism of Quetiapine?

A

5HT2:D2 antagonist H1 blockade causes SEDATION

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21
Q

Mechanism of Clozapine?

A

D4 & D1 antagonist. Highest affinity for 5HT2 than other antipsychotics. D2 receptor occupancy of 50-60% at therapeutic levels.

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22
Q

Mechanism of Aripiprazole?

A

D2 Partial agonist, 5HT1 partial agonist 5HT2a antagonist

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23
Q

What causes EPSEs?

A

High (>80%) central D2 receptor occupancy.

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24
Q

How can you treat EPSEs?

A

Anticholinergics or dose reduction

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25
Q

What is dystonia?

A

Muscle spasms - occur when starting antipsychotics. Can be treated with IV/IM anticholinergics Can be prevented by co-administering anticholinergics for 4-7 days of initiation.

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26
Q

What is akathisia?

A

Motor restlessness/inability to sit still.

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27
Q

What causes akathisia?

A

Decreased D2 activity in the basal ganglia. Rating scale - BAS - Barnes Akathisia Scale.

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28
Q

How do you treat akathisia?

A

B blockers Benzos

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29
Q

MacArthur Violence Risk Assessment Study

A

ETOH and drug use accounted for increased incidence of violence, for 20 weeks post discharge.

If they didn’t use drugs or ETOH, acute inpatients were NO MORE LIKELY THAN CONTROLS TO COMMIT VIOLENCE.

30
Q

VIOLENCE RATING SCALES

A

V’s and S’s

VRAG

HCR-20-historical clinical risk

VRS

Static 99-sexual recidivism

SORAG-sex offender risk appraisal

31
Q

Mens Rea

Actus Rea

A

To be convicted prosecution needs to prove :

guilty mind,

guilty action

32
Q

Sane Automatism

Vs

Insane Automatism

A

Sane Automatism - person reacting to external factor (consussion, spasm, killing someone while SNEEZING)

Insane Automatism - person reacting to internal factor (disease of the mind)

33
Q

Provocation

A
  • when a person commits a crime due to a preceding act
  • PARTIAL DEFENCE - only reduces murder charges to manslaughter
  • crime caused by provocation, committed in the heat of passion under an irresistable urge, without being determined by reason
34
Q

Malice Afterthought

Vs

Furor Brevis

A

Malice Afterthought - under the sway of reason

Furor Brevis - deaf to the voice of reason even though the act was intentional

35
Q

Catatonia

A

Karl Kahlbaum

36
Q

Vaillants Defense Mechanisms

A

I - PATHOLOGICAL

II - IMMATURE

III - NEUROTIC

IV - MATURE

37
Q
A
38
Q

Sublimation

A

MATURE

  • transform unhelpful emotions into constructive behaviour
  • play sport to deal with aggression
39
Q

Displacement

A
  • NEUROTIC DEFENCE
  • shift impulse onto something or someone else (less threatening target)
  • redirecting emotion from the real object to a different one
40
Q

Doing and Undoing

A
  • NEUROTIC
  • after doing something regretable, trying to undo it
41
Q

Externilization

A
  • projecting your own internal characteristics onto others
  • perceiving others as argumentative when YOU are the argumentative one
42
Q

Isolation

A

-seperating ones thoughts from their feelings

43
Q

Projection

A
  • IMMATURE
  • primitive form of paranoia
  • attributing your own unwanted thoughts or desires onto another
  • hypervigilant, injustice collecting
44
Q

Raven’s Progressive Matrices

A

Non Verbal Intelligence

45
Q

Ray Osterrieth Test

A

VISUAL MEMORY

WORKING MEMORY

EXECUTIVE FAMILY

46
Q

WISCONSIN CARD SORTING TEST

A

EXECUTIVE FUNCTIONING

abstraction, set shifting, attention

47
Q

EEG in CJD

A

PSWC - periodic sharp wave complexes

diffuse slowing and…

FIRDA - fronal rhythmic delta activity

48
Q

EEG in HSE

A

UNILATERAL/BILATERAL PERIODIC SHARP WAVES

FOCAL/LATERALIZED SEIZURE + ENCEPHALITIS

49
Q

EEG IN HUNTINGTONS

A

Slow, gradual EEG slowing

50
Q

EEG in Metabolic/Hepatic Encephalopathy

A

TRIPHASIC WAVES

51
Q

EEG IN MYOCLONIC EPILEPSY

A

3-6 Hz, POLYSPIKE AND WAVE

52
Q

CYP enzymes?

A

CYP 1A2

CYP 2D6

CYP 3A4

CYP 2C9

CYP 2C19

53
Q
A
54
Q

Sodium Valproate interactions

A
  • highly protein bound (poor volume of distribution).
  • displaces other drugs that are protein bound (and so, there will be more free drug in the blood stream)
  • other protein bound drugs include :

CARBAMAZEPINE

WARFARIN

PHENYTOIN

TOPIRAMATE

Therefore if you give valproate with any of these, their drug levels will go up.

55
Q

Intraversion/Extroversion

A

JUNG

introversion - orientation in life through subjective psychosis content

extraversion - concentration of interest on external object

56
Q

Models of Personality

A

Big 5

Eysenck’s 3

Cattell’s 16 PF

MMPI

Myers Briggs

Jungian Analytical Psychology

57
Q

Analytical Psychology (Jungian)

A

Anima and Animus

feminine side of a man, masculine side of the woman (unconcious)

Archetypes (the mother, the child, the trickster)

Collective Unconcious

“To have a complex”

58
Q

Myer Briggs Type Indicator

A

self report

INFJ/ENFP

based on jungian analysis

59
Q

16PF

A

CATTELL

clinical instrument used by professionals

60
Q
A
61
Q

Working Memory

A
  • hold info temporarily
  • used for reasoning and decision making
62
Q

Sensory Memory

A

-recall great detail about a complex stimulus immediately following the presentation but for like a second.

no manipulation of memory

-immediately transferred to working memory

63
Q

Working Memory

BADDELEY AND HITCH

A

Working memory has…

  • phonological loop - way of remembering auditory information (like phone numbers) and consists of a short term pholological loop (rapid decay) and an articulatory loop that can revive the memory trace
  • visuospatial scratchpad - information about position and properties of objects are stored.
  • central executive to disperse attention between them and also links working memory to the long term memory
64
Q

Long term memory

A

final stage

semi permanent

infinite capacity

divided into IMPLICIT and EXPLICIT

65
Q

Explicit Memory

A
  • semantic or episodic
  • semantic are abstract and fact based
  • episodic are event based
66
Q

Implicit Memory

A

-procedural memory for motor tasks

67
Q

BIOPSYCHOSOCIAL MODEL

A

ENGEL

68
Q

D

A
69
Q

DIATHESIS-STRESS MODEL OF PSYCHOPATHOLOGY

A

AARON BECK

70
Q

GENETIC DETERMINISM

A

AUGUST WEISMANN, 1890

71
Q

PATIENT CENTERED CARE

A

BROWN AND STEWART

Remember “Stuart Brown* is very patient centered

MCQs (3 decks)

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