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CASC 3 > Symptoms and Syndromes > Flashcards

Symptoms and Syndromes Flashcards

1
Q

Delerium Symptoms Triad

A
  • Acute confusion
    • Disorientation
    • Impaired memory
  • Disturbed consciousness
    • Disordered thoughts
    • Hallucinations usually visual
    • Vague paranoid delusions
  • Altered activity
    • Hypo/hyperactive
    • Sleep disturbances
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2
Q

Frontal Lobe Injury - Presentation

A
  • Emotional
    • Disinhibition/impulsivity
    • Emotional blunting
    • Aggression
  • Behavioural
    • Hyperorality/overeating
    • Perservative behaviours/speech
  • Cognitive
    • Memory problems
    • Difficulty with planning/learning new info
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3
Q

Frontotemporal Dementia Symptoms

A
  • Personality/behaviour change
  • Early decrease in interpersonal skills
  • Disinhibition
  • Hyperorality
  • Inflexibility
  • Poor hygeine
  • Affective flatterning
  • Echolalia/repetitive speech
  • Planning difficulties
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4
Q

Lewy Body Dementia - Key Symptoms

A
  • Fluctuating cognition
  • Short term memory less affected in early stages
  • Executive dysfunction
  • Visual hallucinations
  • EPSEs/parkinsonsism
  • Neuroleptic sensitivity
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5
Q

Autism Triad Symptoms

A
  • Social interaction
  • Language and communication
  • Restricted interests/repetitive behaviours
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6
Q

Dementia - 4 As Symptoms

A
  • Aphasia
  • Agnosia
  • Apraxia
  • Amnesia
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7
Q

Delerium Tremens - Onset and Symptoms

A
  • Peak onset 48 hours after last drink
  • Psychiatric symptoms
    • Disorientation
    • Hallucinations - usually visual lilliputian
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8
Q

Conduct Disorder Symptoms

A
  • Towards adults
  • Towards others
  • Towards objects
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9
Q

Alcoholic Hallucinosis - Symptoms and Onset

A
  • Typically seen in chronic alcoholics who abruptly stop drinking - onset within 24 hours
  • Auditory hallucinations elementary then –> voices
    • Heard in clear consciousness and whilst sober
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10
Q

Drug/Alcohol Dependence Criteria

A
  • Compulsive use
  • Difficulty controling use
  • Withdrawal state
  • Tolerance
  • Neglect of alternative pleasures
  • Persistence use despite evidence of harm
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11
Q

Opiate Withdrawal Onset and Duration

A
  • Onset within 6-24 hours after last use
  • Duration 5-7 days
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12
Q

Opiate Withdrawal Symptoms

A
  • Muscle aches
  • Abdominal cramps, diarrhoea, nausea + vomiting
  • Lacrimation/rhinnorhea
  • Restlessness/anxiety
  • Insomnia/yawning
  • Sweating
  • Goosebumps
  • Dilated pupils/blurry vision
  • Tachycardia/hypertension
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13
Q

Wernicke’s Encephalopathy Symptoms

A
  • Clouded consciousness
  • Ataxia
  • Nystagmus
  • Opthalmoplegia
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14
Q

Korsakoffs Psychosis - Symptoms

A
  • Retrograde/anterograde amnesia
  • Confabulation
  • Disorientation in time
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15
Q

Alcohol Withdrawal - Physical Symptoms

A
  • Tremor
  • Sweating
  • Insomnia
  • Tachycardia
  • Nausea and vomiting
  • Agitation
  • Generalised anxiety
  • Seizures
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16
Q

Refeeding Syndrome - Symptoms

A
  • Oedema
  • Constipation/diarrhoea
  • Vomiting
  • Lethargy
  • Seizures
  • Arrythmias
  • Heart failure
17
Q

Serotonin Syndrome - Somatic Symptoms

A
  • Myoclonus
  • Hyperreflexia
  • Tremor
  • Headache
18
Q

Serotonin Syndrome - Cognitive Symptoms

A
  • Agitation
  • Hypomania
  • Confusions
  • Hallucinations
  • Coma
19
Q

Serotonin Syndrome - Autonomic Symptoms

A
  • Shivering
  • Sweating
  • Hyperthermia
  • Vasoconstriction
  • Tachycardia
  • Nausea
  • Diarrhoea
20
Q

Serotonin Syndrome - Management

A
  • Stop causative drug
  • Medical admission
  • IV fluids
  • Cooling if needed
  • Monitor renal function as at risk due to rhabdomyolysis
    • Increased urine output
    • Urine alkanisation with sodium bicarbonate
  • Benzodiazepines for muscle rigidity/agitation/seizures
  • 5HT antagonists - cyproheptadine, mirtazapine, propanolol
21
Q

Delerium Tremens Incidence

A
  • 5% of all alcohol withdrawal episodes
22
Q

Serotonin Syndrome - Prognosis

A
  • Most cases resolve within 24h
  • Sometimes confusion may last a few days
23
Q

Korsakoff’s Psychosis - Risk from Wernicke’s Encephalopathy

A
  • 80% of untreated Wernicke’s Encephalopathy –> Korsakoff’s
24
Q

Hyperprolactinaemia - Levels and Management

A
  • Normal 0-530 mIU/L
  • Elevated 530-2500 mIU/L
    • Decrease dose
    • Switch to aripiprazole, quetiapine, clozapine
    • Augment with aripiprazole
    • Discuss risks/benefits
  • Very elevates >2500 mIU/L - refer to endorcinology to rule out a prolactinoma
25
Q

QTc Prolongation - Levels and Treatment

A
  • Normal:
    • <440 men, <470 women
  • Prolonged
    • 440-500 men, 470-500 women
      • Decrease dose
      • Switch antipsychotic
      • Repeat ECG
  • Very prolonged
    • >500
      • Stop drug
      • Send to A+E for monitoring and cardiology review
26
Q

Neuromuscular Syndrome - Symptoms/Features

A
  • Rigid muscles
  • Unstable HR/BP
  • Fever
  • Raised WCC/CK
  • Confusion
27
Q

NMS incidence and mortality

A
  • Incidence - <1/100
  • Mortality 10-20% overall (including out of hospital)
28
Q

NMS Immediate Management

A
  • Stop drug
  • Admission to medical unit
  • Monitor vitals and CK levels
  • IV fluids
  • Cooling
  • Benzos to relax muscles
  • D2 antagonists - bromocriptine
29
Q

NMS - Management After

A
  • Cautious reintroduction of antipsychotic starting at a low dose
  • Ideally from a different structural class
  • Low D2 affinity antipsychotics also better - Clozapine, Quetiapine

CASC 3 (7 decks)

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