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Annn Flashcards

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1
Q

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A

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2
Q

What is the definition of Schizophrenia?

A

Chronic psychiatric disorder with ≥6 months of psychotic symptoms and functional decline.

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3
Q

What is the common clinical presentation of Schizophrenia?

A

Delusions (persecutory, referential), hallucinations (auditory most common), disorganized speech/behavior, negative symptoms (flat affect, alogia, avolition).

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4
Q

What are the key features or key history points for Schizophrenia?

A

Onset & duration, functional decline, substance use, family history, risk to self/others.

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5
Q

What are the diagnostic criteria for Schizophrenia?

A

≥2 symptoms (≥1 must be delusions, hallucinations, or disorganized speech) for ≥6 months: delusions, hallucinations, disorganized speech, disorganized/catatonic behavior, negative symptoms.

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6
Q

What are the management priorities for Schizophrenia?

A

Rule out organic causes, antipsychotics (Risperidone, Olanzapine, Haloperidol), monitor metabolic side effects, psychosocial rehab, family therapy.

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7
Q

What are the high-yield facts about Schizophrenia?

A

Most common inpatient psych diagnosis at IMH. Schneider’s first-rank symptoms: thought insertion, withdrawal, broadcasting, commentary voices. High relapse risk if non-compliant.

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8
Q

What is the definition of Bipolar Disorder?

A

Mood disorder with alternating episodes of mania/hypomania and depression.

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9
Q

What is the common clinical presentation of Bipolar Disorder?

A

Mania: Elevated/irritable mood, ↓ sleep, pressured speech, grandiosity, risky behavior. Depression: Low mood, anhedonia, hopelessness.

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10
Q

What are the key features or key history points for Bipolar Disorder?

A

Past episodes of mania/depression, family history, substance/medication use, suicide risk assessment.

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11
Q

What are the diagnostic criteria for Bipolar Disorder?

A

Mania: ≥1 week of elevated/irritable mood & ↑ activity/energy, ≥3 symptoms (4 if irritable only). DIGFAST mnemonic.

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12
Q

What are the management priorities for Bipolar Disorder?

A

Acute mania: Lithium, Valproate, Antipsychotics. Depression: Lithium, Lamotrigine, cautious antidepressant use. ECT for severe/refractory. Psychoeducation, relapse prevention.

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13
Q

What are the high-yield facts about Bipolar Disorder?

A

Lithium = gold standard maintenance. High suicide risk in depressive phase. Misdiagnosed as MDD if mania not asked.

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14
Q

What is the definition of Major Depressive Disorder?

A

Depressive episode lasting ≥2 weeks causing significant distress/impairment.

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15
Q

What is the common clinical presentation of Major Depressive Disorder?

A

Persistent low mood, anhedonia, fatigue, sleep/appetite changes, guilt, poor concentration, suicidal ideation.

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16
Q

What are the key features or key history points for Major Depressive Disorder?

A

Duration, suicide risk, past episodes, organic causes (thyroid, anemia, meds, substance use).

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17
Q

What are the diagnostic criteria for Major Depressive Disorder?

A

≥5 symptoms for ≥2 weeks, one must be depressed mood or anhedonia. SIGECAPS mnemonic.

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18
Q

What are the management priorities for Major Depressive Disorder?

A

First-line: SSRIs (Sertraline, Fluoxetine), CBT. Severe/suicidal: inpatient admission, ECT. Treat comorbidities.

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19
Q

What are the high-yield facts about Major Depressive Disorder?

A

Suicide = leading cause of psychiatric inpatient death. Always rule out bipolar before giving antidepressants.

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20
Q

What is the definition of Borderline Personality Disorder?

A

Cluster B personality disorder with instability of affect, relationships, self-image, and impulse control.

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21
Q

What is the common clinical presentation of Borderline Personality Disorder?

A

Self-harm (cutting, overdosing), unstable relationships, mood swings, fear of abandonment.

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22
Q

What are the key features or key history points for Borderline Personality Disorder?

A

History of trauma/abuse, unstable relationships, self-harm history, impulsivity.

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23
Q

What are the diagnostic criteria for Borderline Personality Disorder?

A

≥5 of: abandonment fears, unstable relationships, identity disturbance, impulsivity, recurrent self-harm, affective instability, emptiness, intense anger, transient paranoia/dissociation.

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24
Q

What are the management priorities for Borderline Personality Disorder?

A

Crisis safety planning, avoid unnecessary meds, long-term DBT/psychotherapy, firm hospital boundaries.

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25
What are the high-yield facts about Borderline Personality Disorder?
Very common among younger ED patients. High risk of repeated self-harm and ED visits.
26
What is the definition of Obsessive-Compulsive Disorder?
Disorder of intrusive thoughts (obsessions) and repetitive behaviors (compulsions).
27
What is the common clinical presentation of Obsessive-Compulsive Disorder?
Repeated handwashing, checking, counting. Insight usually preserved.
28
What are the key features or key history points for Obsessive-Compulsive Disorder?
Nature/content of obsessions, daily duration, impact on function, level of insight.
29
What are the diagnostic criteria for Obsessive-Compulsive Disorder?
Obsessions/compulsions present, >1 hr/day or impair function, not due to substance/medical condition.
30
What are the management priorities for Obsessive-Compulsive Disorder?
High-dose SSRIs, CBT with ERP. Severe/refractory: clomipramine, DBS.
31
What are the high-yield facts about Obsessive-Compulsive Disorder?
Admission only if severe impairment. Differentiate from psychosis (OCD = preserved insight).
32
What is the definition of Dementia with Behavioral Disturbance?
Progressive cognitive decline interfering with daily function, often with agitation or psychosis.
33
What is the common clinical presentation of Dementia with Behavioral Disturbance?
Elderly with aggression, wandering, agitation, hallucinations, memory loss, disorientation.
34
What are the key features or key history points for Dementia with Behavioral Disturbance?
Onset/progression, ADLs, caregiver stress, past medical history, rule out delirium.
35
What are the diagnostic criteria for Dementia with Behavioral Disturbance?
Cognitive decline in ≥1 domain, interferes with independence, not delirium, not explained by other disorder.
36
What are the management priorities for Dementia with Behavioral Disturbance?
Rule out reversible causes (B12, thyroid, infection), supportive care, caregiver education, antipsychotics for aggression, avoid benzos.
37
What are the high-yield facts about Dementia with Behavioral Disturbance?
Common in elderly wards. Always rule out delirium before diagnosing dementia.
38
What is the definition of Schizoaffective Disorder?
Psychotic disorder with schizophrenia + mood symptoms, with ≥2 weeks of psychosis without mood symptoms.
39
What is the common clinical presentation of Schizoaffective Disorder?
Psychotic symptoms (delusions, hallucinations) + mood symptoms (mania or depression).
40
What are the key features or key history points for Schizoaffective Disorder?
Must have psychosis both during and outside mood episodes. Distinguish from schizophrenia and bipolar with psychosis.
41
What are the diagnostic criteria for Schizoaffective Disorder?
Meets criteria for schizophrenia + major mood episode. Delusions/hallucinations ≥2 weeks without mood.
42
What are the management priorities for Schizoaffective Disorder?
Antipsychotics mainstay, add mood stabilizers (mania) or antidepressants (depression). Psychotherapy and psychoeducation.
43
What are the high-yield facts about Schizoaffective Disorder?
Compare: Schizophrenia = psychosis dominates, Bipolar psychosis = only with mood episodes, Schizoaffective = both present with independent psychosis.
44
What is the definition of Suicidal Ideation/Attempts?
Thoughts, gestures, or behaviors with intent to end one’s life.
45
What is the common clinical presentation of Suicidal Ideation/Attempts?
Attempts: overdose, hanging, wrist cuts, jumping. May be linked to depression, BPD, adjustment disorder, or substance use.
46
What are the key features or key history points for Suicidal Ideation/Attempts?
Passive vs active SI, past attempts strongest predictor.
47
What are the diagnostic criteria for Suicidal Ideation/Attempts?
Assess ideation, intent, plan, means, protective factors. Use C-SSRS.
48
What are the management priorities for Suicidal Ideation/Attempts?
Admit if high risk, remove means, constant observation, treat underlying disorder.
49
What are the high-yield facts about Suicidal Ideation/Attempts?
Suicide = leading cause of psych inpatient death in Singapore.
50
What is the definition of Acute Psychosis?
Sudden onset of psychotic symptoms (delusions, hallucinations, disorganized behavior).
51
What is the common clinical presentation of Acute Psychosis?
First-episode schizophrenia, relapse, or substance-induced (meth, cannabis).
52
What are the key features or key history points for Acute Psychosis?
Brought in by family/police under MH(C&T) Act. May be unsafe.
53
What are the diagnostic criteria for Acute Psychosis?
Rule out organic causes first (labs, tox screen, infection, seizure).
54
What are the management priorities for Acute Psychosis?
Treat with antipsychotics, admit for stabilization.
55
What are the high-yield facts about Acute Psychosis?
Always exclude organic causes before diagnosing primary psychosis.
56
What is the definition of Violent/Aggressive Behavior?
Aggression due to psychosis, mania, intoxication, or delirium.
57
What is the common clinical presentation of Violent/Aggressive Behavior?
Shouting, threats, physical aggression.
58
What are the key features or key history points for Violent/Aggressive Behavior?
Secondary to psychiatric/organic illness, high risk to self/others.
59
What are the management priorities for Violent/Aggressive Behavior?
Verbal de-escalation → physical restraint → IM meds if needed.
60
What are the high-yield facts about Violent/Aggressive Behavior?
Always prioritize safety. Document use of restraint/medication.
61
What is the definition of Substance Use Disorders?
Problematic use of substances leading to impairment/distress.
62
What is the common clinical presentation of Substance Use Disorders?
Intoxication, withdrawal, psychosis (esp. meth, cannabis).
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What are the key features or key history points for Substance Use Disorders?
Common in young males in Singapore. Ask about last use, frequency.
64
What are the diagnostic criteria for Substance Use Disorders?
DSM-5: loss of control, cravings, continued use despite harm, withdrawal, tolerance.
65
What are the management priorities for Substance Use Disorders?
Acute: antipsychotics, benzos for alcohol withdrawal. Long-term: rehab, relapse prevention.
66
What are the high-yield facts about Substance Use Disorders?
Methamphetamine = most common drug-induced psychosis in Singapore.
67
What is the definition of Adjustment Disorder?
Emotional/behavioral symptoms within 3 months of a stressor, not meeting criteria for another disorder.
68
What is the common clinical presentation of Adjustment Disorder?
Suicidal gestures after breakup, financial stress, exams. Resolves when stressor managed.
69
What are the key features or key history points for Adjustment Disorder?
Clear link to identifiable stressor. Symptoms do not meet full MDD criteria.
70
What are the diagnostic criteria for Adjustment Disorder?
Symptoms start within 3 months, resolve ≤6 months after stressor ends.
71
What are the management priorities for Adjustment Disorder?
Supportive psychotherapy, problem-solving, short-term anxiolytics.
72
What are the high-yield facts about Adjustment Disorder?
Very common in IMH Emergency presentations.
73
What is the definition of Delirium?
Acute confusional state with fluctuating consciousness due to medical illness.
74
What is the common clinical presentation of Delirium?
Acute onset, fluctuating course, inattention, disorientation, visual hallucinations.
75
What are the key features or key history points for Delirium?
Medical emergency, esp. in elderly.
76
What are the diagnostic criteria for Delirium?
DSM-5: Disturbance in attention/awareness, develops over hours-days, fluctuates, evidence of underlying cause.
77
What are the management priorities for Delirium?
Treat underlying cause, haloperidol for agitation, avoid benzos unless alcohol withdrawal.
78
What are the high-yield facts about Delirium?
Reversible if caught early. Always rule out delirium before diagnosing dementia.
79
How does schizophrenia differ from bipolar disorder and schizoaffective disorder?
Schizophrenia = Psychosis dominates, mood symptoms not pervasive. Bipolar disorder = Mood episodes dominate, psychosis only during mood episodes. Schizoaffective disorder = Both psychotic and mood symptoms present, with ≥2 weeks of psychosis without mood.
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