Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 4 Medicine > Week 2 - Psychosis > Flashcards

Week 2 - Psychosis Flashcards

1
Q

What is the treatment of first time psychosis?

A

Oral antipsychotic medication
+
Psychological interventions
(eg. family interventions / individual CBT)
- 1 / 2 sessions to help them understand the illness and coping mechanisms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are common side effects of antipsychotic medications?

A
  • Raised prolactin
  • Diabetes
  • Sedation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What investigations should be done before initiating antipsychotics?

A 
Weight 
Waist circumference 
Pulse 
BP 
Fasting BM 
HbA1c 
Blood lipid profile 
Prolactin leves 
Assessment of any movement disorders 
Assessment of nutritional status, diet and level of physical activity
ECG (under specific circumstances - eg. when starting quetiapine)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is involved in a section 2?

A

Detainment for assessment of a mental health disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is involved in a section 3?

A

Detainment for treatment of a mental health disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How long can you be held under a section 2?

A

Up to 28 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What conditions are antipsychotics used in?

A
  • Schizophrenia
  • Schizoaffective disorder
  • Bipolar disorder
  • Severe depression with psychosis
  • Augmenting agent in treatment resistant depression and anxiety disorders
  • Behavioural and psychological symptoms of dementia (BPSD)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the two groups of antipsychotics?

A
  • Typicals

- Atypicals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How do antipsychotics work?

A

The target the dopamine pathways in the brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the two types of typical antipsychotics?

A

High potency (eg. haloperidol)

Low potency (eg. chlorpromazine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

When are typical antipsychotics used?

A

In long and short acting depots

When patients are unable to tolerate atypical antipsychotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are common side effects of typical antipsychotics?

A

Sedation

Hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is a side effect of amisulpiride?

A

Hyperprolactinaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How do atypical antipsychotics work?

A

Serotonin-dopamine 2 antagonists (SDAs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What type of medication is risperidone?

A

Atypical antipsychotic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the side effects of risperidone?

A

Extrapyramidal side effects at high doses

Hyperprolactinaemia

Weight gain and sedation at high doses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What type of medication is olanzapine?

A

An atypical antipsychotic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How is olanzapine given?

A

Short acting IM injection

/

Regular / immediate release tablets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the side effect of olanzapine?

A

Marked weight gain

Sedation

Hyper

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What investigations should you do before starting olanzapine?

A

Fasting glucose

Fasting lipids

(these should be monitored during use)

21
Q

What type of medication is quetiapine?

A

Atypical antipsychotic

22
Q

What is low-dose quetiapine used for?

A

Augment antidepressants in unipolar depression

23
Q

What is mid-dose quetiapine used for (eg. 100-300mg)?

A

Mood stabilising

24
Q

What is high dose quetiapine used for?

A

As an antipsychotic

25
Q

What is a common side effect quetiapine?

A

Orthostatic hypotension

Prolonged QTC interval

Some weight gain

Som hypertriglyceridemia, hypercholesterolemia and hyperglycaemia

26
Q

What investigations should you do before starting quetiapine?

A

Baseline ECG

27
Q

What type of medication is aripiprazole?

A

Atypical antipsychotic

28
Q

What forms is aripirazole available in?

A

long-acting IM depot

Tablets

29
Q

What side effects can aripiprazole cause?

A

Agitation

30
Q

What type of medication is clozapine?

A

Atypical antipsychotic

31
Q

What forms is clozapine available in?

A

Tablet form

32
Q

When is clozapine used?

A

Treatment resistant psychosis

33
Q

What are the side effects of clozapine?

A

Agranulocytosis and neutropenia
(FBC must be monitored regularly when taking)

Increased risk of seizures (may require a co-prescribed anticonvulsant)

Sedation

Weight gain

Deranged LFTs

Increased risk of hypertriglyceridaemia, hypercholesterolaemia and hyperglycaemia

34
Q

What are the symptoms of neuroleptic malignant syndrome?

A
  • Autonomic dysfunction
  • Severe muscle rigidity - High fever
  • Confusion
  • Raised WBCs and LFTs
35
Q

What symptoms of autonomic dysfunction do you get in neuroleptic malignant syndrome?

A
  • Hyperthermia
  • Hypertension
  • Hyperreflexia
  • Tachycardia
  • Tremor
  • Agitation
  • Irritability
  • Sweating
36
Q

What are the severe complications of neuroleptic malignant syndrome?

A
  • Rhabdomylosis (from muscle breakdown)
  • Hyperkalaemia
  • Kidney failure
  • Seizures
37
Q

Is neuroleptic malignant syndrome fatal?

A

Yes

Mortality rate around 10%

38
Q

What is the treatment of neuroleptic malignant syndrome?

A
  • Discontinue medication
  • ICU (circulatory / ventilator support)
  • Active cooling (hyperthermia)
  • Dantrolene / Bromocriptine / Amantadine (Ridgidity)
  • Benzodiazepines (agitation)
  • Aggressive IV hydration with diuresis
39
Q

What is a section 135?

A

A warrant to gain access to premises to remove patient to a place of safety

40
Q

Who can section under 135?

A

One doctor, AMHP and police

41
Q

What is a section 136?

A

Allows police to remove person from public place to place of safety

42
Q

Who can section under 136?

A

Police

43
Q

How long does a section 3 last?

A

6 months

treatment can be given for the first 3 months, then consent is required or a second opinion

44
Q

What is a section 4?

A

Emergency admission for assessment

45
Q

How long does a section 4 last?

A

72 hours

46
Q

What is a section 5(2&4)?

A

Emergency holding order (patient already admitted to hospital on an informal basis)

47
Q

What is the difference between a section 5(2) and 5(4)

A

5(2): lasts 72 hours, applied for by a doctor

5(3): 6 hours, applied for by a nurse

48
Q

What causes positive symptoms of psychosis?

A

Overactivity of dopamine in the mesolimbic pathway of the brain

Year 4 Medicine (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions