Pyschiatry Flashcards
What is the best option for people who’s symptoms of schizophrenia are well controlled on their current antipsychotic but have poor oral compliance?
Monthly IM depot injections
What is the cutoff for acute stress disorder vs PTSD?
Acute stress reaction occurs within 4 weeks of traumatic event, PTSD is diagnosed when symptoms occur after 4 weeks
PTSD management?
Trauma-focussed CBT and EMDR therapy
What is mania defined as?
Persistently elevated mood state with psychotic symptoms
What are the first rank symptoms of schizophrenia?
-Auditory hallucinations ( 2 or more voices discussing patient in 3rd person, thought echo, voices commenting on behaviour)
-Thought disorders ( insertion, withdrawal, broadcasting)
-Passivity phenomena (Body sensations controlled by external influences, actions and feelings can be influenced by external forces)
-Delusional perceptions ( Object is perceived and then there is delusional insight into the meaning e.g. the bus stopped for me that means i am God)
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What type of delusions come with Othello syndrome?
Jealousy - partner is being unfaithful
Difference between somatisation disorder and Hypochondriasis?
Somatisation is Symptoms
hypoChondria is Cancer
Difference between tangentiality and circumstantiality?
Tangentiality - always on tangents, never answers question
Circumstantiality - goes on tangents for ages before eventually getting to point of question
What electrolyte imbalance are SSRI’s associated with?
Hyponatraemia
What are the 7 S’s of SSRI side effects?
- Stomach upset
- Sexual dysfunction
- Serotonin syndrome - hyperthermia, muscle rigidity, flushing, diarrhea
- Sleep difficulties
- Suicidal thoughts
- Stress
- Size increase / weight gain
Who should citalopram not be prescribed to?
People with congenital long QT syndrome
Common features of PTSD?
Re-experiencing - flashbacks
Avoidance - people or situations
Hyperarousal e.g. hypervigilance and sleep problems
Mechanism of typical antipsychotics?
Dopamine D2 receptor antagonists
Adverse effects of typical antipsychotics
Extrapyramidal side effects and hyperprolactinaemia
Examples of typical antipsychotics?
Haloperidol
Chlopromazine
Examples of atypical antipsychotics?
Clozapine
Risperidone
Olanzapine
What is a section 2 used for?
Detainment for up to 28 days for mental state assessment
What is a section 3 used for
Detainment for up to 6 months for treatment of mental condition
Risk of zopiclone use in the elderly?
Increased risk of falls
Mirtazapine characteristic side effect?
Increase in appetite
Flight of ideas is a feature of?
Mania
Schizoid personality disorder characteristics?
Prefer to be alone, don’t like relationships, low libido, indifferent to praise or criticism
What class of antidepressants can cause urinary retention?
Trycyclics e.g. amitriptyline
How is depression categorised?
Mild - 2/3 core symptoms and at least 2 other symptoms
Moderate - at least 2/3 core symptoms and 3/4 other symptoms
Severe- All 3 core symptoms and at least 4 other symptoms .
How to calculate alcohol units?
Volume in mls x ABV then divide result by 1000
Common side effect of clozapine?
Constipation/intestinal obstruction
When should levels be re-checked after commencing lithium therapy?
1 week - 12 hours after last dose
Difference between type 1 and type 2 bbipolar disorder?
Type 1 assc with mania and type 2 assc with hypomania
Poor prognostic indicators in schizophrenia?
Low IQ
Sudden onset
Prodromal social withdrawal
Side effects of tricyclic antidepressants?
Dry mouth
Weight gain
Dizziness
Prolonged QT
Urinary retention
Which atypical antipsychotic has the most tolerable side effect profile?
Aripiprazole - should give to those with prolactin elevation
What is conversion disorder?
Typically involves loss of motor or sensory function, may be caused by stress
Features of Anorexia?
Most levels are lowered
G’s and C’s are raised: Growth hormone, Glucose, salivary Glands, Cortisol, Cholesterol, Carotinaemia
Mechanism of benzodiazipines?
Enhance the effect of GABA
Which antipsychotic drug reduces seizure threshold, making seizures more likely?
Clozapine
Which antipsychotic drug reduces seizure threshold, making seizures more likely?
Clozapine
What medications should be avoided on SSRIs?
Triptans e.g. sumatriptan
What is Akathisia and what causes it?
Sense of inner restlessness and inability to keep still
Usually an extra-pyramidal side effect of antipsychotic use
SNRI’s such as venlafaxine are associated with development of?
HTN
Management of oculogyric crisis?
Procyclidine
