Psych quick fire Flashcards

Question

Treatment for schizophrenia?

Answer 1

Atypical antipsychotics (risperidone and quetiapine) + Offer CBT If other medications don't work - Clozapine

Answer 2

Side effects: agranulocytosis, constipation, seizure

Answer 3

Strong family history Social withdrawal in the prodromal phase Low IQ Early age of onset Gradual onset of symptoms

Answer 4

PIDD Persistent - happen consistently over various situations Impairment - causes dysfunction in social life or work life Duration - characteristics are stable over time and not transient Distress - causes distress to either patient or people around

Answer 5

1) Odd and eccentric Paranoid - question loyalty of friends Schizoid - solo dolo Schizotypal - unusual behaviour, lack of close friends 2) Dramatic, emotional and erratic Borderline - recurrent suicidal actions, unstable relationships Antisocial - lack of remorse Narcissistic - chronic envy Histrionic - centre of attention, inappropriate sexual seduction 3) Anxious and fearful Dependent Avoidant Obsessive compulsive

Answer 6

Psychological therapies e.g. dialetical behavioural therapy (talking therapy), CBT Psychotherapy (Drugs can be given to cluster A e.g haloperidol)

Answer 7

Stroke and VTE

Answer 8

Extrapyramidal symptoms - PATAN - Parkinsonism (resting tremor, rigidity) - Akathisia (restlessness) - Tardive dyskinesia (involuntary movements of head, limbs trunk - CHEWING, grimacing of mouth and protruding tongue) - Acute dystonia - involuntary sustained muscle contractions (torticollis, oculogyric crisis) - Neuroleptic malignant syndrome - muscular rigidity, fever, sweating, (high CK) Hyperprolactinemia Antimuscarinic - dry mouth, burred vision, constipation Weight gain Neuroleptic malignant syndrome - pyrexia, hyperrigidity Diabetes Prolonged QT interval

Answer 9

FBC - particularly looking out for agranulocytosis/neutropenia Lipids and weight - antipsychotics can cause weight gain Fasting blood glucose - can cause impaired glucose tolerance ECG and cardiovascular risk assessment - can cause QT prolongation or heart block Prolactin - can cause hyperprolactinemia Baseline BP - blocking of alpha 1 adrenergic receptors can cause orthostatic hypotension

Answer 10

Temporal lobe epilsepsy Vitamin B12 deficiency Cushing's SLE MS Renal failure Huntington's disease

Answer 11

Cocaine Corticosteroids Dopamine agonists Hallucinogens Antidepressants

Answer 12

Epidemiology 19-34 males Divorced, widowed Unemployed/retired Living alone/social isolation Recent adverse life events e.g. relationship breakdown, personal/family health problems, financial difficulties Clinical Psychiatric illnesses particularly SCHIZOPHRENIA AND DEPRESSION Alcohol dependence Previous deliberate self harm Family history of depression, alcohol dependence or suicide

Answer 13

Auditory → Could be elementary e.g. buzzing or whistling sounds or complex e.g. voices heard in 1st, 2nd or 3rd person Visual → More commonly in people with brain disturbances e.g. dementia, delirium, epilepsy Somatic → Tactile (being touched, formication - insects crawling on skin associated with cocaine use or alcohol withdrawal), thermal, visceral (organs stretching or throbbing), kinaesthetic (false perception of limbs vibrating) Olfactory and gustatory (commonly occur together) → Make sure to rule out temporal lobe epilepsy and other organic brain diseases (dementia, delirium, tumours) Sleep related - Hypnopompic (hallucinations occurring as you’re waking up), Hypnagogic (hallucinations occurring as you’re going to sleep)

Answer 14

A state in which someone is awake but does not seem to respond to other people and their environment. (Can affect movement, speech and behaviour) - usually extreme muscular tone or rigidity. Catatonic rigidity - Maintaining a fixed position and resisting all attempts to be moved Catatonic posturing - Adopting and maintaining and unusual or bizarre position Catatonic negativism - Resistance to all instructions given (may even do the opposite of what is asked) Catatonic waxy flexibility - Can be moulded into a position that is maintained Catatonic stupor - Presentation of akinesis (lack of voluntary movement), mutism and extreme unresponsiveness in an otherwise alert patient.

Answer 15

Persecutory delusion - Are you afraid that someone is trying to harm or poison you? Grandiose delusion - Do you believe you have special abilities or powers? (believing one is powerful) Delusions of reference - Have you ever felt that people on TV or on the radio are talking directly to you? (unrelated events/people are giving them a special message) Delusions of control (somatic) - Does it seem as though you are being controlled by an external force? Erotomanic delusion - Do you believe that someone is in love with you? (Nihilistic delusion - Do you believe you are dead or that the world has ended?)

Answer 16

(multireceptor blocking effects like antipsychotics) Anticholinergic - dry mouth, constipation, urinary retention Alpha blockers - orthostatic hypotension Histamine blockage - weight gain Cardiotoxic - Arrhythmias, QT prolongation, heart block

Answer 17

6-12 hours - tremor, sweating, tachycardia anxiety 36 hours - peak incidence of seizures 48 hours - peak incidence of delirium tremens (coarse tremor, confusion, hallucination, delusions), fever

Answer 18

Benzodiazepine (long acting) e.g. First line - chlordiazepoxide 2nd line - diazepam Liver impairment - lorazepam Anti-craving - Acamprosate (safe with alcohol)

Answer 19

Anterograde amnesia

Answer 20

PLAITS Perspiration Loss of appetite Anxiety Insomnia Irritability Tremor Tinnitus Seizures

Answer 21

NSAIDS - increased risk of GI bleeding (give PPI) MAO inhibitors - increased risk of serotonin syndrome (Phenelzine) Triptan - increased risk of serotonin syndrome Aspirin Warfarin/heparin (give mirtazapine rather than SSRI - but has side effect of increase in appetite)

Answer 22

Usually caused by 5 HT agonist drugs e.g. triptans, antiemetics like ondansetron. (or MAOI interactions) Sx - Clonus - Hyperreflexia - Hypertonoia - Tremors - Seizures - Hypertension, tachycardia - Confusion, anxiety - Sweating Tx: Cyproheptadine

Answer 23

SSRI dose should be gradually reduced over a 4 week period Discontinuation sx GI sx: abdominal pain, cramping, diarrhoea, vomiting Sweating Difficulty sleeping Restlessness Paraesthesia

Answer 24

Citalopram

Answer 25

Buprenorphine - sublingual tablet

Answer 26

GI symptoms - vomiting and diarrhoea (early symptom which resolves with time) Hyponatremia Sweating Headache Insomnia Agitation (As they are not cardiotoxic -- they are the antidepressant of choice in cardiac disease)

Answer 27

Nausea and vomiting Diarrhoea Fine tremor Nephrotoxicity- nephrogenic DI, CKD Hypothyroidism Weight gain Polydipsia, polyuria Idiopathic intracranial hypertension Hyperparathyroidism and resultant hypercalcemia (it can precipitate a benign leucocytosis - no concern - slightly raised WBC)

Answer 28

- After starting lithium - every week 12 hours post dose - Once established - every 3 months - After a change in dose - lithium levels should be taken a week later and every week after until levels stable Lithium levels >1.5 mmol/L is considered toxic

Answer 29

Torticollis Oculogyric crisis (involuntary upward deviation of the eyes) (muscle spasm of the face, neck, tongue and back) Usually a side effect of a D2 receptor blocking drug e.g. antipsychotics. As dopamine is blocked, acetylcholine activity becomes excessive which causes sustained muscle contractions. (usually dopamine and acetylcholine in the basal ganglia are balanced) Treated with procyclidine (anticholinergic)

Answer 30

Typical - Extrapyramidal mainly Atypical - Metabolic syndromes mainly e.g. weight gain, diabetes

Answer 31

Antipsychotics (can heighten risk of cardiovascular events e.g stroke)

Answer 32

Congenital heart defects

Answer 33

Where speech is organised around the sound of words for example rhymes (rather than their meaning). E.g. I wrote the goat overload boat my float tote

Answer 34

A newly made word which only has meaning to the person who created it but is unrecognised by/nonsensical to others.

Answer 35

A symptom where a person repeats words, phrases, thoughts or actions beyond the point where they are relevant or appropriate, often due to a failure of the brain to shift focus or stop a behaviour.

Answer 36

- Short history and rapid onset - Biological symptoms e.g. weight loss, sleep disturbance - Global memory loss (dementia usually causes recent memory loss)

Answer 37

The intentional production (feigning) of symptoms to assume a patient role

Answer 38

Persistent belief in the presence of an underlying serious DISEASE e.g. cancer (not symptom) - patient refuses to accept reassurance or negative test results (somatisation disorder is experiencing multiple SYMPTOMS)

Answer 39

- Admission for assessment for up to 28 days (NOT renewable) - Psychiatrist + 1 doctor + Approved mental health professional (treatment can be given against a patient's wishes) (Designed for people in need of an assessment for a mental disorder, and due to their presentation and possible risks, it is felt it needs to take place in a hospital setting)

Answer 40

- Admission for treatment for up to 6 months (can be renewed for a further 6 months then for periods of 1 year at a time) Approved mental health professional + 2 doctors (treatment can be given against a patient's wishes) (done following initial assessment under section 2 or if patient alr known by psychiatry services)

Answer 41

An admission for assessment in cases of emergency --- valid for 72 hours (from time patient is admitted) (used when section 2 involves unacceptable delay)

Answer 42

A patient who is a voluntary patient in hospital can be legally detained by a doctor for 72 hours.

Answer 43

A patient who is a voluntary patient in hospital can be legally detained by a nurse for 6 hours.

Answer 44

Supervised community treatment Patients are given leave under this section --> conditions can be placed e.g. where they can go and whether it will be for a fixed period of time The clinician can revoke the leave and make the patient go back to the hospital. Or if the patient doesn't go back to the hospital at the end of their leave, they can be made to go back.

Answer 45

Used by the police to enter a private property and remove a person that appears to have a mental health disorder and take them to a place of safety where they can be assessed.

Answer 46

Used by the police to remove someone that appears to have a mental health disorder from a public place and take them to a place of safety where they can be assessed. This lasts for 24 hours.

Answer 47

A condition characterised by the persistent belief that a family member or close friend is an imposter.

Answer 48

A delusional belief that a stranger is actually someone familiar in disguise. (believing different people are actually a single person in disguise) e.g. A woman in a psychiatric woman believes that all the nurses on the ward are actually her abusive brother in disguise.

Answer 49

A group of health problems that increase your risk of T2DM or conditions that affect the heart or blood vessels. This is linked to insulin resistance. Rf - Obesity - High saturated fat diet - Lack of exercise - Smoking - Alcohol - Hispanic or south asian background - Increased age

Answer 50

Mirtazapine

Answer 51

Due to their risk of interacting with different types of food and medication. (They irreversibly bind to monoamine oxidase A --> leading to a build up of amines which can cause hypertensive crisis) Interactions Dietary e.g cheese, soya bean, degraded protein (smoked fish, chicken liver) Drugs e.g. adrenaline, noradrenaline, L-dopa, dopamine, cocaine Early sign of throbbing headache

Answer 52

A chronically depressed mood that is seldom sever enough to satisfy formal criteria for a depressive episode.

Answer 53

Characterised by alternating periods of mild elation and mild depression (mild bipolar disorder)

Answer 54

1) Increased waist circumference 2) High blood pressure 3) High triglycerides 4) Low HDL cholesterol 5) High fasting blood glucose 3/5 need to be present to diagnose metabolic syndrome

Answer 55

Atypical antipsychotics (increase appetite) Corticosteroids (contribute to insulin resistance) Antihypertensives - diuretics and beta blockers can raise blood sugar levels (Treatment will be largely lifestyle - stop smoking, limit alcohol intake, exercise more, have a healthy balanced diet, Medication - diabetes drugs, ACE, statins)

Answer 56

a) Procyclidine b) Tetrabenazine

Answer 57

NSAIDS Diuretics Ace inhibitors SSRI - paroxetine, fluoxetine Carbamazepine, phenytoin

Answer 58

Smoking cessation Alcohol bingeing

Answer 59

A transient disorder that develops in an individual without any apparent mental disorder in response to exceptional physical and mental stress that usually subsides within hours or days. Presentation Initial - disorientation, altered consciousness Followed by - withdrawal from surrounding situation or agitation. Signs of panic are present -tachycardia, sweating, flushing. (This can then develop into an acute stress disorder then PTSD)

Psych quick fire Flashcards

(85 cards)