1
Q
what are the 5P’s of psychological formulation
A
Presenting - current presenting issue
Predisposing - patient’s history of MHx and what has led to this over lifetime
Precipitating - recent triggers
perpetuating - unhelpful coping strategies, what will maintain problem
protective - patient’s strength that can be drawn on
2
Q
what are the areas of the biopsychosocial model
A
bio - genetics, birth complications, pmhx, Dhx
Psych - trauma, abuse, self-esteem, mood + personality
Social - relationships, finances, stress, culture
3
Q
What is included in an MSE
A
ASEPTIC Risk
appearance + behaviour
speech
emotion
perception
thought
insight
cognition
risk to themselves and others
4
Q
Definition of mental health disorder
A
disorder of mind excluding alcohol and drugs
5
Q
Definition of psychosis
A
loss of touch with reality + impaire function
6
Q
Definition of neurosis
A
mood disorder with no reality loss, but impaired function
7
Q
Definition of hallucination
A
unreal interpretation of unreal stimulus
8
Q
Definition of illusion
A
unreal interpretation of a real stimulus
9
Q
Definition of delusion
A
fixed false and unshakeable belief out of keeps with social norms that cannot be changed despite evidence against
10
Q
Definition of delusion of perception
A
if A happend, B will happen - Pathognomic of schizophrenia
11
Q
Definition of flight of ideas
A
rapid stream of consciousness jumping between topics, but not pressured in speech
12
Q
Definition of formal though disorder
A
disordered pattern of speech as a result of disordered thought
13
Q
Definition of knight move
A
illogical jumps between topics - pressured
14
Q
Definition of tangentiality
A
deviates from a question and not returning
15
Q
Definition of circumstantiality
A
denoting from a question but returns back to answer - long winded
16
Q
when might speech be rapid
A
mania
17
Q
when might speech be in poverty
A
depression
dementia
18
Q
what is Munchausen syndrome
A
fabricating symptoms and investigations to play the sick role
19
Q
what is malingering
A
fabricating illness for a secondary gain - monetary etc
20
Q
what is folie a deux
A
shared delusion by 2 people at same time
treatment - seperate people
21
Q
what is clang association
A
rhyming/sounding similar flight of ideas
22
Q
what are neologisms
A
new words - made up
23
Q
what is echolalia
A
repeating what is said
24
Q
what is word salad
A
a bunch of words together that do not make sense
25
what is ideas of reference
widespread (tv, radio) message thought to be directed at self
26
what is depersonalisation
thinks they're not real - nilhilistic dellusion
27
what is derealisation
thinks world around them aren't real
28
what is an obesession
mental preoccuptation, pervasive and recurrent
29
what is a compulsion
urge and action on obsession to obtain relief
30
what are some though problems
insertion
withdrawal
broadcast
passivity
31
what is somatisation/somatiform disorder
medically unexplained symptoms
32
what is hypochondriasis
mental preoccupation that patient has ccancer (or severe illness) despite many negative tests
33
what is conversion disorder
neuro symptoms in absence of pathology therefore put down to pysch
34
when is persecutory delusion most common
schizophrenia
35
what is grandiose delusion associated with
mania
36
what is capgras syndrome
close relative/friend replaced with imposter
37
what is fregoli delusion
everyone is 1 person with masks
38
what is othello delusion
partner is unfaithful
39
what is De cleraumbault delusion
erotomania - stalking and one person is in love with with another person, despite often not knowing them
40
what is Ekbom delusion
delusional parasitiosis - firmly believe they are infested with insects/parasites despite no medical evidence
41
what is Cortard delusion
belief patient is dead and rotting
42
when was the mental health act and when was it updated
1983
2007
43
what are the reasons to detain someone under the MHA 1983
evidence of MH illness + risk to self/society
will benefit from admission
treatment is available
44
what are the principles of detainment in the MHA 1983
least restrictive
patient safet
increase well being
give effective treatment
45
what is MHA1983 section 2
28 day compulsory admission for assessment following a mental health act assessment - 2 doctors + AMHP
non-renewable
46
47
what is MHA 1983 S.3
6 month treatment order
ordered by 2 doctors and a AMHP
renewable 6months thereafter in 12 months
48
what is the MHA 1983 S.5(2)
72hour Dr holding power already in hospital voluntarily
followed by mental health act assessment
49
what is MHA 1983 S.4
detain patients for 72 hours in urgency - requires Dr and AMHP
followed by mental health act assessment
50
what is MHA 1983 S.5(4)
6 hour detaining power by a nurse for a patient already in hospital voluntary
followed by a mental health act assessment
51
what is MHA 1983 section. 135
police 24-36 hours admit police to access home
take to place of safety
follow by mental health act assessment
52
what is MHA 1983 Section 136
police 24 hours to remove someone with a suspected MHI from a public place and take them to a place of safety
followed by a mental health assessment
53
how long do antidepressants normally take to start working
within 4 weeks
54
how should you monitor antidepressants
baseline
then review within 2 weeks
one week 18-25 y/o
55
how long should antidepressants be continued
for 6 months after symptom improvement
and 2 years for recurrent depression
56
how long should antidepressants be weaned over
4 weeks
57
how do SSRIs work
serotonin presynaptic reuptake inhibitor
58
what can happen if antidepressants are stopped too quickly and what are the symptoms
serotonin discontinuation syndrome
FINISH
Flu like symptoms,
Insomnia,
Nausea,
Irritability,
Sensory disturbances - paraesthesia
Hyperarousal
59
when is sertraline offered
GAD
Depression
breast feeding
60
when is fluoxetin offered
CAMHS
61
what is the risk with citalopram
QT prolongation
62
what does paroxetine increase the risk of and when is it safe to use
discontinuation syndrome
breastfeeding safe
63
what are some side effects of SSRIs
GI symptoms - N+V, increase GI bleed risk with NSAIDs (co-prescribe PPI)
impotence and decreased libido
serotonin syndrome
ST prolongation
interaction with triptans
64
what are the risk of SSRIs in preganncy
first trimester - CHD - but not really
third trimester - persistent pulmonary hypertension
65
what is the mechanisms of action for SNRIs
noradrenaline reuptake inhibiton - presynaptic
and serotinin re-uptake inhibition
66
examples of SNRIs
duloxetine
venlafaxine
67
side effects of SNRIs
N+V
dry mouth
rhabdo
SIADH
68
examples of monoamine oxidase inhibitors and mechanism of action
prevents noradernaline, serotonin and adrenaline breakdown in CNS
selegiline
hydracarbazine
isocarboxazid
69
side effectis of MAOIs
HTN crisis with tyramine
serotonin syndrome
70
what is the mechanism of tricyclic antidepressants
serotonin, noradrenaline reuptake inhibition + antagonised ACh and histamine receptors = anticholinergic
71
examples of a sedative and non-sedative TCA
amitriptyline - sed
imipramine - non-sed
72
side effects of TCAs
ACh - can't see, pee, spit or shit
impotence
sedation
73
symptoms of a TCA overdose, diagnosis and treatment
confused, dry hot skin, ACh symptoms
ECG - wide QRS + QTc prolongation
IV Bicarb
74
what is the mechanism of action of mirtazipine
noradrengic and specific serotogenic anti depressant
75
side effects of mirtazipine
weight gain
sedation
76
when is mirtazipine recommended
when would benefit from side effects
on Warfarin/LMWH
77
what can cause serotonin syndrome
SSRIs
MAOI, tramadol
St John Wort
Metoclopramide
ondansetron
MDMA
amphetamines
78
symptoms of serotonin sydnrome
over hours:
hyperreflexia
clonus
dialted pupils
autonomic - HTN, tachy, flushing
79
treatment for serotonin syndrome
supportive
stop SSRI
benzodiazepine
+/- chlorpromazine
80
how do antipsychotics work
dopamin D2 receptro antagonist
decrease mesolimbic pathway and decrease +ve symptoms
may also decrease nigrostriatal pathway
81
how should antipsychotics be stopped
gradually over 3 months
prevent relapse
82
how often should antipyshcotics be reviewed
12 months
- FBC, UE, HbA1C, LFT, prolactin, BMI
83
how to change anti-depressants
some direct switch
when from flueoxetine gradual switch as long half life
cross taper - SSRI to mirtazipine
84
what are some examples of typical antipsychotics
haloperidol
chlorpromazine
85
what are typical antipsychotics associated with
extra-pyramidal side effects:
acute dystonic reaction
akathisia
parkinsonism
Tardive dyskinesia
86
what is acute dystonic reaction
rapid onset
oculogyric crisis - eyes involuntary up
torticolis
87
treatment of acute dystonia
IM/IV procyclidine
(anti-Ach)
Swithc to second gen
88
what is akathisia
rapid onset
LL motor restlessness
89
treatment of akithisia
PO propranolol
90
Treatment for parkinsonism
Doupa
91
what is tardive dyskinesia
years after starting
irregular uncoordinatd purposeless movements - normally of face
92
treatment of tardive dyskinesia
PO tetrabenzine
Swithc to second gen
93
what are some examples of atypical (2nd gen) antipsychotics
Risperidone
olanzipine
quetiapine
aripiprazole
clozapine
94
how do antipyshcotics cause lactation
blocking dopamine which inhibts prolactin - hyperprolactinaemia
leads to lactation, low libido, infertility
95
what are atypical antipsychotics associated with
metabolic syndrome
96
When is clozapine offered, side effects and retitration
last line after 2 different antipsychotics did not work
treats negative symptoms - mesocortical pathway
Side-effecst:
agranulocytosis
hypersalivation
weight gain
constipate
retittrate if dose missed >48 hours or if smoking status changes as increased metabolism
97
when is clozapine monitored
18 weeks weekly
16 weeks 2 weekly
then monthly
98
who are antipsychotics avoided in
parkinsons patients as can exacerbate symptoms
99
what are the symptoms of neuroleptic malignant syndrome
hyperthermia
rigidity
altered conscicousness
normal pupils
autonomic symptoms - tachy BP fluctuate
raised CK
100
treatment for neuroleptic malignant syndrome
A-E
stop anti-psychotic
benzos
dantrolene + bromocriptine (dopamine agonist)
101
complications of neuroleptic malignant syndrome
rhabdo
AKI
102
mechanism of action of Lithium
cAMP inhibitor
103
what does lithium interact with
NSAIDs (AKI)
diuretics (dehydration)
ACE-i
104
what is the therapeutic window of lithium
0.4-1
105
what are some of the effects of lithium toxicity
leukocytosis
diabetes insipidus
tremor - coarse
hypo T4
low hydration
increased thirst
increased urination
teratogenic
CV - ebsteins anomaly
oedema
nephrotoxic
106
when should lithium be monitored
12 hours after dose
weekly till stable then 3 monthly
107
give some examples of benzodiazepines
GABA agonist
chlordiazepoxide - mod
diazepam - short
lorazepam - long
108
side effecst of benzos
resp depression
sedation
amnesia
109
treatment of benzo overdose
IV flumenazil
110
example of anxiolytic
hypnotic - GABA agonist
zopiclone - insomnia
111
when is ECT indicated
suicidality
refractive depression
severe mania
catatonic schizophrenia
112
complications of ECT
amnesia (anterograde)
confusion
113
contraindications to ECT
MI in last 3 monhts
HTN
child <12
114
how does CBT work
change negative thoughts -b reaks into situation, thoughts, emotions, actions, physical therapy
115
how does dialectice behavioural therapy work
change negative thoughts and promote acceptance
116
what is required for a diagnosis of depression
>2 weeks
anhedonia
low mood + low energy
most days
117
risk factors for depression
bio - chronic pain, post partum, steroid use, hypothyroid
Psych - trauma, low self-esteem, abuse
social - bereavement, divorce, stress
118
symptoms of depression
suicide/self-harm
low interest
worthlessness
low energy
low concentration
low appetite
decreased sleep - early wake
119
bloods to test in depression
FBC
UE
TFT
prolactin
syphillis serology
B12
folate
120
questionnaires for depression
PHQ-9 - lower = better,
HADS - hospital
Edinburgh - post-natal
121
what are the scores for the PHQ-9
0-4 <5
5-9 - mild
10-14 - mod
>15 severe
122
treatment for mild depression
1) CBT + advice - 12-16 weeks
2) SSRI
123
treatment for mod-severe depression
SSRI + high intensity CBT
124
treatment for refractory/severe depression
consider ECT
125
what is adjustment disorder and what is the treatment
extreme reactive symptom s- post-stress <3 monhts
resolve with stressor removed
depressed, anxious
Treatment: psychotherapy, family therapy
126
what is seasonal affective disorder and treatment
recurrent and winter depression
light therapy and SSRI
127
what is dysthmia
subclinical depression >2 years
low intensity CBT
128
risk factors for self-harm
LGBTQ
female
EUPD
depression
bereavement
trauma/abuse
129
what is self-harm
intentional self-injury wuthout suicidal intent
130
what is suicide
person causing their own death
131
what are the risk factors for suicide
SAD PERSONS
sex - male
age - older + teens
depressed
PHx parasuicide (suicide mimick self-harm)
excessive alcohol/substance abuse
rational loss - psychosis
social support decreased
organised plan
non-married
sick/chronic illness
132
what are the risks of suicide recurrence/completion
makes effort to not be found
leaves note
plans death
no regret after
133
what is bipolar type 1
At least one episode of mania +/- depression
134
what is bipolar type 2
one major depressive episode + hypomania
no psychosis, no grandiosity
135
what is clyclothermia
alternating hypomania and mild depression
136
what is rapid cycling
>4 manic episodes in a year
137
what are risk factors for bipolar
FHx in first degree
stress
abuse/trauma
substance abuse
138
what can precipitate mania
benzos
SSRI
alcohol
LSD
139
what are the symptoms of mania
>7 days of:
irritable
distractable
insomnia
grandiose delusions
flight of ideas
activity increase
increased speech - pressure
thoughtless
increased risk taking
+/- hallucinations
signs of psychosis with impacted function
140
what are the symptoms of hypomania
>4 days of:
increased mood
mild distrractibility
decreased sleep and food need
no grandiosity
talktative
mild recklessness
no hallucinations
no psychosis and normal function
141
what are the referrals for mania and hypomania from a GP
urgent CMHT - mania
routine CMHT - hypomania
142
diagnosis of bipolar
clinical + depression bloods
143
acute treatment of bipolar
antipsychotic
stop SSRI
144
long term treatment of bipolar
lithium
145
treatment for depressive episodes in bipolar
antipsychotic
fluox + olanzapine
146
what is schizophrenia
dissociation from reality >28 days not due to substance abuse impairing perception, thoughts, mood and behaviour
147
which system is associated with positive symptoms
mesolimbic
148
which system is associated with negative symptoms
mesocortical
149
what are risk factors for schizophrenia
first degree FHx
smoking cannabis in youth
traumatic birth
MHI
trauma
abuse
150
what are the types of schizophrenia and which is most common
paranoid schizophrenia - MC - persecutory
hebephrenic schizophrenia - younf
simple
catatonic
undifferentiated
151
what are the Schneider first rank symptoms of schizophrenia
delusional perceptions
thought alienation - insertion, withdarwal, broadcast, echo word salad
3rd person auditory hallucinations - running commentary
passivity
152
what are the secondary symptoms of schizophrenia
non auditory hallucinations - visual, tactile
catatonia
dellusions
decreased insight
153
what are the psychoses differentials
drug induced
schizophrenia
depression
post-partum
huntingtons
syphillis
schizoaffective
drugs:
steroids
cocaine
meth
LSD
ecstasy
benzos
154
diagnosis of schizophrenia
bloods - FBC/UE/TFT/syphillis/B12 + folate/ urine toxicology/HbA1C
Needs:
>1 schneider or >2 secondary symptoms >28 days
155
treatment of schizophrenia
trial antipsychotic - 6-8 weeks then another, then clozapine
CBT, CMHT, crisis team
MHA 2 or 3 section
social worker
156
what is late onset schizophrenia
>45
better prognosis
persecutory delusions
treat low dose anti-psychotic
157
what are some negative symptoms of schixophrenia
affective flattening
alogia
anhedonia
avolition
158
poor prognosis of schixophrenia
young
no precipitating factor
insidious onset
withdrawn
poor premorbid function - low IQ
negative symptoms
no remission in 3 years
159
what is delusional disorder
isolated delusion >3 month - i.e. persecutory
absent global psychosis
CBT, SSRI
160
what is schizoaffective disorder
schizophrenia + >1 mood disorder (depression/bipolar 1 or 2)
Treatment - antipsychotic + mood treatment
161
what are the risk factors for anxiety disorders
Bio - genetics, stimulant drugs, palpitations, hyperthyroid, withdrawal
psych - MHx, trauma, abuse
social - stress, life event
162
what is GAD and how is it defined
pervasive, persistent non-specific anxiety >6 months
163
symptoms of GAD
muscle tension
irritable + insomnia
sweaty
low energy
restlesness
autonomic dysfunction - palpitations
SOB + tremor
164
diagnosis of GAD
Bloods - FBC, UE, TFT, glucose, urine test
GAD 7
HADS - hospital
165
scores from the GAD 7
5-9 mild
10 -14 mod
15+ severe
166
treatment for GAD
education
low intesnsity CBT
Higher intensity CBT + SSRI (sertraline)
propranolol for autonomic symptoms
167
how is a panic disorder defined
>1 month
4 x weekly spells of 10-30 mins of panic attacks (miserable)
168
symptoms of panic disorder
miserable
chest pain
choking
chills
169
diagnosis of panic disorder
panic disorder severity scale
PHQ-PD
170
treatment for panic disorder
self help CBT
higher intensity CBT _ SSRI
171
what is a simple/specific phobia
irrational extreme fear leading to avoidance + catastrophising
172
treatment for phobias
exposure response prevention therapy
173
how is OCD defined
> 2 weeks of >4days/week pervasive obsessions recurrently resulting in compulsions for relief
patient often recognises as unecessary but obssesed
174
symptoms of OCD
4 days/week for >2 weeks where obsessions feed compulsions for anxiety relief
no action = no relief
(handwash, check lights etc)
175
cylce of OCD
obsession
anxiety
compulsion
temporary relief
176
diagnosis of OCD
DSM-5/ICD-11
Yale Brown OCD scale - severity
177
treatment for OCD
ERP CBT
+SSRI
2) clomipramine
178
how long should an SSRI be given in OCD
taken for at least 12 weeks
and need to keep taking for up to a year
179
how is PTSD described
>28 days prolonged stress reaction to previously traumatic event
180
symptoms of PTSD
HEAR
hyperarousal
emotional blunting
avoidanace
reliving experience - dreams
181
diagnosis of PTSd
trauma screening questionnaire
182
treatment for PTSD
EMDR - eye movement desensitatisation and reprocessing
DO NOT USE IN COMBAT RELATED - 1st line trauma focussed CBT
+SSRI in severe cases
183
what is acute stress reaction
less than 28 days, self resolve
184
what causes addictive behaviours
act on mesolimbic reward dopamin pathway
185
what terms determine dependence
withdrawal symptoms - use substance to avoid symptoms
tolerance
narrow repetoire
craving
loss of control
rapid reinforcement - quick return to old life after stopping
primacy - takes precedence over physiological need
continued use despite harm
186
subtsance abuse versus misuse
abuse = excessuve use
misuse = secondary use
187
how does alcohol work in addiction
GABAergic CNS retardant -
trigger dopamine = happy, enhaces GABA = happy, inhibit glutamate = slow down
decrease GABA receptor sensitivity and increase glutamate number of glutamate receptros = tolerance
increase adipose mass
increase cortisol
lower coordination and RR
188
how does ICD-10 define alcohol dependence syndrome
12 months of >3 dependence symptoms
189
symptoms of alcohol intoxication
increased sexual arousal
ataxia
slurred speech
increased confidence
irritable
change GCS
vimiting
190
symptoms of alcohol withdrawal
6-12 = anxiety + fine tremor
24-48 (36)hours = seizures
72hours = delirum tremens, coarse tremor, change GCS
191
what are the CAGE questions
cut down
annoyed at others telling you to stop
guilty
eye opener - morning
192
diagnosis of alcohol addiction
Bloods - macrocytosis, increased GGT, increased carb-deficient transferrin, increased ALP, AST:ALT >1.5
193
questionnaires for alcohol diagnosis
CAGE - screen
AUDIT - diagnosis
194
acute management of alcohol withdrawal
IV chlordiazepoxide
Lorazepam if liver cirrhosis
195
long term withdrawal treatment of alcohol
naltrexone - opioid inhibitor = decrease pleasure
acamprosate - NDMA inhibitor = decrease craving
disulfiram - AAD inhibitor = induce hangover symptoms with alcohol (CI in pregnancy and alcohol use - severe hypo)
196
symptoms of opioid use
pain relief
constipated
euphoric
pinpoint pupil
197
side effect of opiod use
resp depression
198
symptoms of NDMA (ecstasy)
agotation
HTN
tachycardia
hyperthermia
hyponatraemia
low appetitie
199
treatment for ecstast overdose
supportive
dantrolene
200
symptoms of amphetamine (meth) use
increase domapine stimulation:
seizures
ischemic colitis
hyperthermia
201
symptoms of LSD use
hallucinogen - increase serotonin at prefrontal cortex
pscyhosis
impaired judgement
bad trip - panic attack
dilated pupil
hyperreflexia
hyperthermia
202
treatment for a bad trip with LSD
verbal de-escalation
lorazepam
203
what are the features of anorexia nervosa
BMI <17.5 with body dysmorphia
204
risk factors for anorexia nervosa
PHx fat
family history
EUPD
depression
trauma and abuse
bodybuilding/social media
205
what is extreme anorexia nervosa
<15
(17-17.5 Dx
16-17 mod
15-16 severe)
206
what are the symptoms of anorexia nervosa
low BMI
purging - laxative, vomiting
comdennation - exercise
deliberate weight loss
body dysmorphia
restrictive calories
dry think skin, lanugohair
arrhythmia, bradycradia, hypotension
impaired glucose tolerance, amenorrhoea (secondary hypo hypo)
osteopenia and muscle wasting
207
diagnosis of anorexia nervosa
SCOFF - screening - sick after food, lost control over food, one stone in last 3 months lost, food dominates life
bloods - all low except GH and cortisol
BP
ECG (decreased potassium)
208
treatment for anorexia nervosa
structured eating plan
supplement - Adcal D3, vitamins
community CBT
2) inpatient, fluoxetine
209
complications of anorexia nervosa
refeeding syndrome - monitor electrolytes
low everything, then you increase glucose intake, hence insulin elevation leads to potassium pushed into cells and extra sodium in body
infertile
amenorrhoea
osteoporosis
210
what is bulimia nervosa
episodes of binge eating followed by intentional vomiting or other purgative behaviours such as the use of laxatives or diuretics or exercising. at least 1 episode a week for 3 monhts of binge and purge
211
symptoms of bulimia
Russel sign - knuckle callouse from vomiting
GORD/reflux
parotitis
hallitosis
dental cavities
212
describe binging and purging in bulimia
alone < 2hours eating rapidly/uncontrollably full the feel guilty and out of control and then elimination in some way of the food
213
diagnosis of bulimia
VBG - hypokalaemia, hypocholoric metabolic alkalosis
SUSS -ve
SCOFF Q
214
treatment for bulimia
CBT
215
what is binge eating
planned binge eating episodes >3 months with overweight BMI
till uncontrollably full in private and very fast
guilt and distraught after
perceived loss of control
Treatment = CBT
216
what is a personality disorder
a chronic unwaivering behaviour pattern > 18 years old
217
what are the three categories of personality disorders
Type A - weird
Type B - Wild
Type C - worried
218
what are the three personality disorders in type A
Weird:
Paranoid
schizotypal
schizoid
219
what is paranoid personality disorder
sensitive
unforgiven
takes attacks of character seriously
220
what is schizotypal personality disorder
innapropriate affect
magical thinking
ideas of reference
odd behaviour
phoebe buffay
221
what is schizoid personality disorder
cold
solitude
low libido
thinks world uncaring
batman
222
what are the personaltiy types in B
Wild:
narcissitic
histrionic
EUPD
antisocial
223
what is narcissistic personality disorder
believe lifes a competition
grandios
entitles
224
what is histrionic personality disorder
craves centre of attention
flirtatious
consdier relationships closer than they are
225
what is EUPD
crave sympathy
impulsive acts - self-harm
poor relationship history
226
what is anticosical personality disorder
repeated unlwaful violent acts
remorseless
animal cruelty
<18 conduct disorder
227
what are the types of C personality disorders
Worried:
OCPD
avoidant
dependent
228
what is OCPD
strict time regulation - inflexible
refuses to delegate
perfectionist
229
what is avoidant personality disorder
craves companionship + intimacy
afraid of rejection
230
what is dependent personality disorder
want others to make big decisions for them
submissive
231
Diagnosis of personality disorders
Minnesota multiple personality inventory
232
treatment for personality disorders
dialectical behavioural therapy - encourage acceptance and change thought perception
233
what are some psychiatric emergencies
NMS
serotonin syndrome
lithium toxicity
alchol overuse
234
complication of alcohol overuse
wernickes (reversible)
Korsakoff pyshcosis (irreversible)
235
how to remember symptoms of alcohol overuse
COAT RACK
Wernicke:
confusion
opthalmoplegia
ataxic
thiamine
Koraskoff:
retrograde memory impaired
anterograde memory impaired
confabulation
236
treatment for Wernickes (+MRI finding)
IV/IM pabrinex
MRI reversible cytotoxic oedema
237
treatment for korsakoffs (MRI finding)
popabrinex
MRI - mammillary bodies + thalamic atrophy
238
what is catatonia and what is it associated with
abrupt cessation in speech and moevemtn
akinetic, mutism, malignant types
mania and schizophrenia
239
what is learning disability based on and classes
IQ
>100 normal
50-70 mild
35-49 mod
20-34 severe
<10 profound
240
causes of learning disability
ASD
ADHD
genetic - T.21, Fragile X
TORCH
241
what is ASD
spectrum of severity with impaired and persistent communication and social interaction problems
242
how does ASD first manifest
<3 years with restrictive, repetitive infelxible behaviours
243
symptoms of ASD
decreased speech, empathy and isolation (no shared play)
conceret thinking
specific knowledge
tics
emotional cues difficulty
ritualistic behaviour
learning difficulty
stims - hand flapping
244
diagnosis of ASD
m-CHAT
specialist
245
treatment for ASD
supportive
SENCO
TEACHH
JASPER
246
what is ADHD
6-12 manifesting with
hyperactvitiy
impulsivity
and inattention
>2 envirnoments
247
siagnosis of ADHD
DIVA-5
248
treatment for ADHD
watch and wait
then - methylphenidate stimulant
249
risks with stimulants
RBBB (RVH) - baseline ECG
monitor growth 6 monthly can decrease appetitie
250
what are tics associated with
ASD
ADHD
PANDAS
tourettes >1 year severe + multiple complex tics
251
what is PANDAS
paed autoimmuneneuro psych disorders after strep infection
OCD/Tics
252
what is a sleep disorder, defined and treatment
insomnia
>3 days/week
zopiclone
253
what is narcolepsy defined by + treatment
CHESS
cataplexy (collapse after high emotion)
hallucination (visual)
excessive daytime sleepiness
sleep paralysis
sleep difficulty
modanifil (CNS stimulant) + sleep hygiene
254
what features define gender dysphoria
>2 for >6 months:
incongruent natural and physical apperance (distress)
strong desire to have opposite genitalia
stong desire to be opposite gender
strong desire to be treated like othergender
has feelings like opposite gender
desire to change genitalia/secondary sex characteristics
Phase 3A medicine
flashcards
Decks in class (16)
# Cards
-
100 most common drugs in GP218
-
Gynae FC from PPT215
-
Paediatric FC from ppt774
-
COTE FC from ppt93
-
Neurology FC from ppt8
-
Key Obstetric notes198
-
key gynae notes140
-
Key breast medicine notes49
-
key paeds notes295
-
key paeds notes cont.361
-
GP random things21
-
key psych notes254
-
Key neuro notes312
-
key gerries notes135
-
Key sexual health notes133
-
Key public health notes145
