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MRCPSYCH_Paper B_MENTOR & More_Dr. ART > PTSD, ASR, AD and complex PTSD > Flashcards

PTSD, ASR, AD and complex PTSD Flashcards

1
Q

Mnemonic for PTSD in ICD 11

A

TRAUMA

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2
Q

esessial features for PTSD on ICD 11?

A

TRAUMA for Several weeks

T- Trauma (short or long-lasting but extremely threatening)
R-Re experiencing
A-Avoiding
U-Unpleasant Change
M-Marked Arousal
A-Adjustment issue

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3
Q

Emotional expeirences with PTSD?

A

Anger
Sadness
Shame
Guilt (even survivor guilt)
Humiliation

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4
Q

Common symptomatic presentation of PTSD?

A

Dysphoria
Dissociative symptoms
Somatic complaints
Suicidal ideation & behaviours
Social withdrawal
Substance abuse to avoid re-exper. or manage emotion
Anxiety symptoms

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5
Q

dysphoria symptoms in PTSD include

A

‘loss of interest’, ‘emotional detachment’, ‘difficulty concentrating’, ‘irritability’, ‘sleep disturbance’

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6
Q

Anxiety symptoms in PTSD

A

panics
OC responds to memories or reminders

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7
Q

when can PTSD onset being

A

any time after the trauma during life time

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8
Q

when can PTSD onset being typically

A

within 3 months

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9
Q

Is actue stress reation coded with PTSD in ICD 11?

A

no!
(Problem associated with harmful events)

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10
Q

why actute stress related is separted from PTSD?

A

to emphasise that an acute stress reaction is a normal reaction with no pathology

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11
Q

Mnemonic for Acute Stress Reaction in ICD 11?

A

SHOCK

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12
Q

Essential features of Acute stress reaction?

A

SHOCK

S-Symptoms like (emotional, somatic, cognitive or behavioural and autonomic)
H-Hypo-flash backs
O-Over within days (1 month)
C- Circumstance of trauma same as PTSD
K-knows how to adapt later

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13
Q

Main difference between PTSD and acute distress reaction?

A

The latter is associated with symptoms subsiding within 1 month

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14
Q

Mnemonic for Adjustment disorder (AD) in ICD 11

A

ADJUST

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15
Q

Essential features of Adjustment disorder (AD) in ICD 11

A

ADJUST

A-Adaptive problem
D-Distress
J-Justification not (for symptoms)
U-Underlying factor happened in 3 months
S- Signficant Impairmenet
T- Temporary, resolves within 6 months

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16
Q

Difference between PTSD & AD?

A

Trauma is much much much severe in PTSD
Though symptoms could be similar in both

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17
Q

Similarity between PTSD & AD?

A

Rumination about stressor (w/out nightmares & flashbacks)
Avoidance of triggers and reminders
Somatic, cognitive and emotional symptoms

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18
Q

when do AD symptoms resolve according to ICD 11?

A

within 6 months

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19
Q

Mnemonic for Complex PTSD in ICD 11

A

COMPLEX

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20
Q

Essential features of Complex PTSD in ICD 11

A

COMPLEX

C-Core Features of PTSD
O-Occurring or re occurring Trauma
M-Mood disturbance
P-Personal relationships issues
L-Loss of self
E-Emotional dysregulation
X-Xpereinc distress

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21
Q

what are core features of PTSD according to ICD 11?

A

-Re experience
-Avoidance
-Hyperarousal

22
Q

what does hyperarousal include in ICD 11?

A

Hypervigilance
Enhanced startle

23
Q

difference between PTSD and complex PTSD in startles?

A

Unlike in PTSD, startles in complex PTSD might be diminished rather than enhanced.

24
Q

what are core features that are required to differentiate Complex PTSD from PTSD?

A

-Emotional dysregulation
-Negativity about self
-Interpersonal issues

25
Q

Is psychological debriefing allowed in PTSD?

A

No not recommended

26
Q

PTSD less than one month in children and young

A

active monitoring

27
Q

PTSD at least 1 months in children and young

A

Trauma-focused CBT

28
Q

PTSD for 3 months in 7-17 years old who not responded to or refused Trauma-focused CBT?

A

EMDR

29
Q

what is EMDR

A

Eye Movement Desensitization & Reprocessing

30
Q

Drugs in PTSD >18 years old

A

no! Do not offer

31
Q

PTSD 1st line Rx in adults

A

Trauma-focused CBT

32
Q

when EMDR is 1st line Rx in PTSD in adults?

A

if the trauma is not combat related and patient prefers it over CBT

33
Q

when is computerized CBT 1st line treatment in PTSD in adults

A

if there is not significant risk of harm ( to self or others)
If PTSD is not severe

34
Q

Which drug class is recommended to avoid in prevention of PTSD in adults?

A

Benzodiazepam

35
Q

why benzo are not recommended in PTSD prevention?

A

worse overall severity
significantly increased risk of developing PTSD with use after recent trauma
worse psychotherapy outcomes
aggression
depression
substance use

36
Q

when can we use Drugs in PTSD?

A

if they have preference for drugs

37
Q

what drugs can be used in PTSD?

A

Venlafaxine & SSRIs

38
Q

is drug treatment the 1st line treatment in PTSD?

A

Nope

39
Q

What SSRIs are best for PTSD in case preferred?

A

Paroxetine & Fluxetine

40
Q

when one can consider adding antipsychotics for PTSD?

A

if not enough response to other treatment (pharma & non-pharma)
disabling symptoms
psychotic symptoms

41
Q

waht antipsychotics are used when needed in PTSD?

A

Risperidone

42
Q

what off-license Rx is used for nightmares in PTSD

A

Prazosin

43
Q

what is prazosin

A

Alpha-1 adrenergic receptor antagonist

44
Q

what does Prazosin do?

A

reduces andrenaline activity ===» reduces arounsal and anxiety

45
Q

what is the signficant of nightmares in PTSD

A

-Resistant to treat generally
-Associated with suicidality

46
Q

Fluoxetine Rx in PTSD : Dose (MAUDSLEY 14th)

A

up to 60 mg might be required

47
Q

Fluoxetine Rx in PTSD: Duration (MAUDSLEY 14th)

A

at least 6 months after remission

48
Q

Fluoxetine Rx in PTSD : Response time (MAUDSLEY 14th)

A

within 8 weeks but maybe 12 weeks

49
Q

Risk factor of PTSD in children and adolescent

A

those attending emergency departments
in forensic settings
or among refugee/asylum seekers.

The Maudsley

50
Q

what risks are youg people are associated with in PTSD?

A
  • self-harm (50%)
    -Suicide attempt (20%)
    -Functionally impaired

MRCPSYCH_Paper B_MENTOR & More_Dr. ART (62 decks)

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