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Psychiatry > Passmed > Flashcards

Passmed Flashcards

1
Q

What SSRI causes increased QT ? What anti-psych causes increased QT?

A

Citalopram

Haloperidol

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2
Q

What SSRI do you use for post-MI depression?

A

Sertraline

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3
Q

What antidepressant do you give children and adults first line?

A

Fluoxetine

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4
Q

What antidepressant can cause congenital malformations?

A

Paroxetine

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5
Q

What do you never give with SSRIs? Why?

A

MAOis - increased risk for serotonin syndrome

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6
Q

What is erotomania?

A

Delusion famous person loves them

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7
Q

How do you manage mania in primary care?

A

Refer urgently to CMHT

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8
Q

Examples of tarditive kinesia

A

Blink excessively, pout, chewing

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9
Q

Blood gases for bulimia

A

Hypochloremic metabolic alkalosis

Hypokalaemia as well

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10
Q

Metabolic side effects of antipsych

A

Dislipidaemia, glycemic, DM

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11
Q

Manage patients with poor compliance to oral anti-psych

A

Switch to once a month injections

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12
Q

Manage antidepressants before ECT

A

Reduce dose but don’t stop

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13
Q

Peak for seizures and delirium after alcohol withdrawal

A

36 hours

72 hours

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14
Q

How do you diagnose schizophrenia?

A 
2 of: 
Delusions, hallucinations, disorganized speech, disorganized / catatonic behaviour, negative symptoms
1 has to be one of the first 3
Ongoing for 6+ months 
Not explained by any other condition
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15
Q

5 subtypes of schiz

A
  1. Paranoid (+ symptoms)
  2. Disorganized (hebenephric)
  3. Catatonic
  4. Undifferentiated
  5. Residual
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16
Q

What are features of paranoid schizophrenia?

A

Positive symptoms: delusions, hallucinations, thought disorder/disorganized speech

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17
Q

What are the features of disorganized schizophrenia?

A

Disorganized speech, behaviour, flat/inappropriate affect

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18
Q

What are the features of catatonic schizophrenia?

A

Immobile, maintained rigid posture, resist movement
Echolalia/praxis
Rocking, nail biting

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19
Q

3 spectrum schiz disorders

A
  1. Schizoaffective: schiz + bipolar
  2. Schizopheniform: shorter duration
  3. Schizotypal: impacted social/interpersonal skills, magical thinking, bizzare fantasies
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20
Q

Features of alcohol withdrawal by hour

A

6-12: anxiety, tremor, tachycardia, sweat

36: seizures
72: delirium, coarse tremor, tachycardia, hallucinations, fever

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21
Q

Acute management of alcohol withdrawal

A

BZD: chlordiazepoxide / diazepam (lorazepam if hepatic failure)

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22
Q

Maintaining alcohol abstinence treat

A

Disulfram: causes severe reaction if they drink - throw up!!
Acamprosate: reduces craving

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23
Q

Features of opioid misuse

A

Pinpoint pupils, needle marks, rhinorrhea, watering eyes, yawning

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24
Q

Opioid overdose treat

A

IV/IM naloxone

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25
Q

Manage opioid dependence with what drugs

A
  1. Methadone

2. Buprenorphine

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26
Q

How long do you monitor opioid dependence treatment

A

4 weeks in hospital or 12 weeks if in community

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27
Q

ECT is useful for

A

Severe depression

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28
Q

Absolute contraindication to ECT

A

ICP increased

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29
Q

Side effects of ECT

A

Headache, nausea, memory problems, cardiac arrhythmia

30
Q

Othello’s syndrome

A

Partner is cheating no proof

31
Q

What is Wernick’s encephalopathy?

A

Neuropsychiatric disorder caused by thiamine deficiency (B1)

32
Q

Who gets Wernicke’s?

A

Alcoholics, extreme throw up, stomach cancer, dietary deficiency

33
Q

Wernicke’s triad

A
  1. Opthalmoplegia/nystagmus
  2. Ataxia
  3. Confusion
34
Q

2 other features of Wernicke’s

A

Petechial haemorrhages in brain

Peripheral sensory neuropathy

35
Q

Tests for Wernicke’s

A

Decreased RBC transketolase

MRI

36
Q

What is korsakoff’s ?

A

Wernicke’s +:
Anterograde amnesia
Retrograde amnesia
Confabulation

37
Q

What is impaired in Wernicke’s / Korsakoff’s?

A

Medial thalamus and mammillary of hypothalamus

38
Q

Treat akathisia

A

Propanolol

39
Q

Treat acute dystonia

A

Procyclidine

40
Q

Treat tar dive dyskinesia

A

Tetrabenazine

41
Q

Severe OCD treat

A

SSRI and CBT

42
Q

Lithium with increased WBC

A

Normal - leave it !

43
Q

How long do you continue antidepressants for?

A

6 months

44
Q

ECT is clinically indicated for who?

A

A catatonic patient with severe depression

45
Q

TCAs cause _____ incontinence

A

Overflow

46
Q

Having a high/low IQ is linked to a good prognosis for schizophrenia

A

High

47
Q

AMTS for dementia has to be

A

8

48
Q

Next steps when you suspect dementia

A

Blood tests to rule out B12 and folate and thyroid function
Urine dip
Referral to memory clinic

49
Q

What ECG finding is more common in patients with severe anorexia?

A

Prolonged QT - due to hypokalaemia

50
Q

Alzheimer’s post-mortem

A

Widespread cerebral atrophy

51
Q

How long does it take for antidepressants to work?

A

2-4 weeks

52
Q

What is the mechanism of action for atypical antipsychotics?

A

Inhibition of 5HT2 and D2 receptors

53
Q

St. John’s wort on COCP

A

Reduces the effect due to enzyme induction

54
Q

Which dopaminergic areas does haloperidol act on?

A

Mesolimbic and mesocortical

55
Q

________ pathway is responsible for the positive symptoms of schizophrenia and the ________ pathway is responsible for the negative symptoms

A

Mesolimbic, mesocortical

56
Q

Relative risk calculation

A

Experimental event rate/control event rate

57
Q

Orthostatic hypotension is a side effect of which anti-psychotic drugs?

A

Typical

58
Q

Single most important screening test before starting olanzapine

A

Blood glucose

59
Q

Don’t use BZD in

A

Panic disorder

60
Q

Don’t use propanolol in

A

Anxiety disorder

61
Q

What drug reduces your seizure threshold?

A

Clozapine

62
Q

Side effects of anti-psychotic medications

A

Sedation, weight gain, reduced seizure, increased QT, increased prolactin, impaired glucose, neuroleptic

63
Q

SNRIs can cause what?

A

Hypertension

64
Q

SSRIs side effect to look for

A

Hyponaturemia

65
Q

Lithium measure when?

A

12 hours post dose
Weekly after starting or changing dose until levels are stable
Then 3 monthly

66
Q

Patient comes in with dizziness, increased anxiety, and electric shocks

A

SSRI discontinuation

67
Q

Can you stop SSRIs all at once?

A

No, need to over 4 week period

68
Q

Patient comes in with elevated levels of clozapine, what can cause this?

A

Smoking cessation

69
Q

Clozapine GI symptom

A

Chronic constipation

70
Q

Flight of ideas is characteristic of

A

Mania

71
Q

Lithium endocrine

A

Hyperparathyroid and hypothyroid

Psychiatry (22 decks)

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