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Yr 5 - Psych > Revision - Anorexia, Personality Disorders, Anxiety Disorders, Learning Disabilities & Affective Disorders > Flashcards

Revision - Anorexia, Personality Disorders, Anxiety Disorders, Learning Disabilities & Affective Disorders Flashcards

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1
Q

What BMI anorexia nervosa (AN)?

A

<17.5

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2
Q

What metabolic disturbance is typically seen in AN?

A

Metabolic alkalosis

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3
Q

Blood test results in AN?

A

1) Low sex hormones

2) Hypercholesterolaemia

3) Metabolic alkalosis

4) Raised GH & cortisol

5) Deranged electrolytes – typically low calcium, magnesium, phosphate and potassium

6) Leukopenia

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4
Q

What drug can be administered as a preventative method for refeeding sydrome?

A

Pabrinex

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5
Q

What 2 ECG signs are seen in AN?

A

1) bradycardia

2) prolonged QTc

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6
Q

What age at presentation is a negative prognostic marker for AN?

A

> 20

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7
Q

1st line mx of BN?

A

CBT

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8
Q

How is age of menarche implicated in EDs?

A

Younger age of menarche linked to increased risk

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9
Q

What are the 3 clusters of personality disorders?

A

A, B & C

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10
Q

What typically defines a Type A personality disorder?

A

Odd or eccentric behaviours

You find it difficult to relate to other people.

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11
Q

What are the 3 types of Type A personality disorder?

A

1) paranoid

2) schizoid

3) schizotypal

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12
Q

What characterises a paranoid personality disorder?

A

Irrational suspicion & mistrust of others

Hypersensitivity to criticism

Reluctance to confide in others due to fear of information being used maliciously against them

Preoccupied with unfounded beliefs about perceived conspiracies against themselves

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13
Q

What typically defines a Type B personality disorder?

A

Cluster B personality disorders are grouped based on those who find it difficult to control their emotions. You might be viewed as unpredictable by others.

Characterised by dramatic, emotional, or erratic behaviors

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14
Q

What are the 4 types of Type B personality disorders?

A

1) Antisocial

2) Borderline

3) Histrionic

4) Narcissistic

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15
Q

What characterises hisitrionic PD?

A

Predominantly characterized by attention-seeking behaviors and excessive displays of emotion.

  • Individuals may display inappropriate sexual behaviors.
  • Their emotional expressions tend to be shallow, dramatic, and often perceived as exaggerated.
  • They often perceive relationships as being more intimate than they truly are, reflecting a distorted perception of interpersonal boundaries.
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16
Q

Which type of PD features the need to be at the centre of attention and having to perform for others to maintain that attention?

A

Histrionic

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17
Q

Which type of PD features feelings that they are special and need others to recognise this or else they get upset?

A

Narcissistic

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18
Q

What typically defines a Type C personality disorder?

A

People with cluster C personality disorders have strong feelings of fear or anxiety.

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19
Q

What are the 3 types of Type C PD?

A

1) Dependent

2) Avoidant

3) Obsessive compulsive

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20
Q

OCPD vs OCD?

A

OCPD:
- The patient perceives them as rational and desirable
- Not associated with recurrent, intrusive thoughts or rituals

OCD:
- The symptoms are distressing for the patient
- Is associated with recurrent, intrusive thoughts or rituals

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21
Q

What type of PD features unrealistic expectations of how things should be done by themselves and others, and catastrophising about what will happen if these expectations are not met?

A

OCPD

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22
Q

What is ‘trait anxiety’?

A

Your propensity to experience the anxiety response when exposed to a stressor.

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23
Q

What is ‘state anxiety’?

A

Simply the state of feeling anxious

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24
Q

What are 5 processes thought to drive a spiral of anxiety?

A

1) Avoidance

2) Attentional and cognitive bias

3) Anxious rumination

4) Low self-worth

5) Poor sleep

25
Q

How long must symptoms be present for for a diagnosis of GAD?

A

6 months

26
Q

What is the key feature of phobic anxiety disorders?

A

Avoidance of that situation

27
Q

What phobia is concurrent in 30-50% of panic disorder cases?

A

Agoraphobia

28
Q

Stepwise treatment algorithm for mx of anxiety disordes?

A

1) Psychoeducation, sleep hygiene, and self-guided cognitive-based therapy (CBT)/ relaxation techniques

2) CBT

3) Pharmacological (equal 1st line with CBT)

29
Q

What drug is 1st line in management of anxiety disorders?

A

SSRIs

30
Q

4 key features of PTSD?

A

1) hyperarousal (i.e. heightened perception of threat)

2) re-experiencing/flashbacks

3) avoidance

4) distress

31
Q

Management options for PTSD?

A

1) Trauma focused CBT

2) Eye-Movement Desensitization and Reprocessing (EMDR) therapy

3) Pharmacological: SSRI or venlafaxine (possible adjunctive antipsychotic)

32
Q

When should you not diagnose panic disorder?

A

If 2ary to depression

33
Q

How long must symptoms be present for to make a diagnosis of PTSD?

A

4 weeks

34
Q

What is the SSRI of choice in people with unstable angina or recent myocardial infarction?

A

Sertraline

35
Q

If CBT or EMDR therapy are ineffective in PTSD, what are the first line drug treatments?

A

venlafaxine or an SSRI

36
Q

What SSRI is 1st line in GAD?

A

Sertraline

37
Q

2nd line in GAD if 1st SSRI not effective?

A

Try another SSRI, or SNRI

38
Q

What are 4 predisposing conditions for autism?

A

1) Fragile X syndrome

2) Infantile spasms/West syndrome

3) Congenital rubella

4) Tuberous sclerosis

39
Q

What % of people with autism also have ADHD?

A

50%

40
Q

What IQ defines a learning disability?

A

<70

41
Q

What is the most common cause of learning disability?

A

Down’s syndrome

42
Q

Potential complications of Down’s Syndrome?

A
  • Abnormalities of internal organs e.g. ASD, VSD, oesophageal atresia

– Cataracts

– Hypothyroidism

– Chest infection

– Transient leukaemia

– Epilepsy

– Alzheimer’s Dementia

43
Q

What is the leading preventable non-genetic cause of LD?

A

Foetal alcohol syndrome

44
Q

What are the characteristic facial features in FAS?

A

Low nasal bridge
Thin upper lip
Flat midface and short nose
Short palpebral fissures
Epicanthal folds
Indistinct/smooth philtrum
Micrognathia

45
Q

What is the most common inherited cause of LD?

A

Fragile X syndrome

46
Q

What genetic mutation is seen in Fragile X syndrome?

A

CGG trinucleotide repeat on the FMR1 gene on the X chromosome

47
Q

What signs and symptoms are seen in FXS?

A

Long, narrow face
Large, protruding ears
Intellectual impairment (mild to profound)
Post-pubertal macroorchidism (large testes)
Social anxiety
Autistic spectrum features
Delayed motor milestones
Speech and language delay
Prominent jaw & forehead
Mitral valve prolapse

48
Q

What cardiac defect is seen in Fragile X?

A

Mirtal valve prolapse

49
Q

What may depressive features in people with LD also indicate the onset of?

A

Dementia

50
Q

What cancer can notably cause low mood?

A

Pancreatic cancer

51
Q

If antidepressants alone do not work in severe depression, what can they be augmented with?

A

Lithium

52
Q

What can a ‘manic switch’ sometimes be induced by?

A

1) Someone with BAD taking antidepressants to treat a depressive episode

2) Stressful life events

3) Physical illness

4) Illicit substance misuse

53
Q

What is the gold standard medication for bipolar disorder?

A

Lithium

54
Q

What PHQ-9 score indicates ‘more severe’ depression?

A

≥16 –> combination of CBT & antidepressants

55
Q

How can lithium affect WCC?

A

Can cause a benign leucocytosis

56
Q

1st line mx of ‘less severe’ depression? (i.e. PHQ-9 <16)

A

Guided self help interventions (then CBT)

57
Q

Mx of symptoms of hypomania in primary care?

A

Routine referral to CMHT

58
Q
A

Yr 5 - Psych (4 decks)

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