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FINALS: PASSMED/QUESMED > Psych > Flashcards

Psych Flashcards

1
Q

What should be considered in elderly patients with new onset psychosis?

A

Organic cause -> CT head

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1
Q

Patients ≤ 25 years who have been started on an SSRI should be reviewed when?

A

after 1 week

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2
Q

What is flight of ideas?

A

Jumping from idea to idea with links between these

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3
Q

What is Knights move?

A

Jumping from idea to idea with no links between these

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4
Q

What is the risk of SSRI in third trimester?

A

Persistent pulmonary HTN

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5
Q

What is a C/I to triptans for migraines?

A

Patients taking SSRI

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6
Q

Patients under 25 starting an SSRI should be reviewed when?

A

After 1 week

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7
Q

When do you get alcohol withdrawal symptoms, seizures and delirium?

A

symptoms: 6-12 hours
seizures: 36 hours
delirium tremens: 72 hours

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8
Q

Management of OCD?

A
  1. SSRI
  2. Clomipramine
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9
Q

OCD vs OCPD?

A

OCD must have functional component/impact of daily life

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10
Q

Management of SSRIs before ECT?

A

Dose should be reduced but not stopped

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11
Q

When should lithium levels be checked after a change in dose?

A

One week after change and then weekly until levels are stable

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12
Q

Signs of alcohol addiction

A

Attempted and failure of abstinence, compulsion to drink, narrowing of drinking repertoire, increased tolerance to alcohol, alcohol is priority over oth e r aspects of life, physical withdrawal when alcohol is stopped

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13
Q

Why can antipsychotics cause elevated prolactin?

A

Prolactin release from lactotrophs is inhibited by dopamine released from the hypothalamus. Therefore, when this inhibition is lifted, prolactin release is increased

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14
Q

How can patients appeal against being sectioned?

A

Appeal must be applied for in writing to a mental health tribunal within 14 days o f detention

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15
Q

How does activated charcoal work?

A

Activated charcoal works by providing a large surface area to absorb a potential poison and stop it from being absorbed by the GI tract;

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16
Q

Lithium toxicity may be precipitated by what?

A

NSAIDs

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17
Q

Management of PTSD?

A
  • Trauma focused CBT
  • EMDR
  • Venlafaxine/SSRI
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18
Q

Triggers for lithium toxicity

A

Dehydration
Infection
Renal failure
ACE/ARB
NSAID
Diuretic

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19
Q

How long should symptoms be present for with PTSD?

A

4 weeks

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20
Q

What is the management of lithium toxicity?

A

Mild/Moderate: IV Fluid resus
Severe: Haemodialysis

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21
Q

Bipolar I vs Bipolar II

A

Bipolar I - mania and depression
Bipolar II - hypomania and depression

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22
Q

Purposefully causing symptoms such as hypoglycaemia?

A

Munchausen syndrome

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23
Q

Hypomania in the community?

A

Routine referral to community mental health

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24
Q

How do you define chronic insomnia?

A

Trouble falling asleep/staying asleep for 3 months or longer

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25
Q

What are risk factors for insomnia?

A
  • Increasing age
  • Female gender
  • Lower educational attainment
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26
Q

Which medications can cause insomnia?

A

Corticosteroids

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27
Q

OCD vs psychosis?

A

OCD will have a level of insight of their actions

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28
Q

What can be protective factors against completed suicide ideation?

A
  • Social support
  • Religious beliefs
  • Having children at home
  • Regretting an attempt
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29
Q

What are common PTSD symptoms?

A
  • Flashbacks/nightmares
  • Avoiding people or situations
  • Hypervigilance/Sleep problems
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30
Q

Schizoid vs schizotypal PD?

A

Schizotypical will also have unusual beliefs/magical thinking

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31
Q

How should SSRI dose be stopped?

A

Over a 4 week period

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32
Q

What ophthalmic feature is associated with Charles Bonnet?

A

Age related MD

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33
Q

Flight of idea vs tangentiality?

A

In flight of ideas, they would answer the question then jump to another idea whereas in tangentiality, they would not answer the question

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34
Q

Sweating, tremor, confusion and hyperreflexia?

A

Serotonin syndrome

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35
Q

Which medications can cause serotonin syndrome?

A
  • MAO
  • SSRIs + Tramadol/St Johns Wort
  • Ecstasy
  • Amphetamines
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36
Q

Which medications can be used as mood stabilizers?

A
  • Lithium
  • Sodium valproate
  • Carbamazepine
37
Q

5 stages of grief

A
  • Denial
  • Anger
  • Bargaining
  • Depression
  • Acceptance
38
Q

What is an hallucination?

A

Abnormal perception in the absence of external stimulus

39
Q

Which deaths should be referred to coroner?

A
  • Unknown cause of death
  • Death was violent or suspicious
  • Accidental death
  • Death due to self neglect
  • Death related to employment/industrial disease
  • Death during operation
40
Q

What are risk factors for NMS?

A
  • Use of neuroleptic medication
  • High dose medication
  • Depot
  • Previous NMS
41
Q

Which receptor is blocked in NMS?

A

Dopamine

42
Q

What are principles of the mental capacity act?

A
  • Assume capacity
  • Decisions made in best interests
  • Help can be provided to make decision for themselves
  • People with capacity can make unwise decisions
  • Decisions made should be with the least restrictive option
43
Q

Who can be a representative party for patients when no relatives during mental capacity discussions?

A

Independent Mental Capacity Advocates

44
Q

What is an advanced decision?

A

Legally bound document allowing someone to state treatment they would not want in the future if they lack capacity to make the decision

45
Q

What is panic disorder?

A

Regular, sudden or unexpected attacks of panic or fear

46
Q

What questionnaires can be used for anxiety?

A
  • Beck Anxiety Inventory
  • Hamilton Anxiety scale
  • General health questionnaire
47
Q

Signs of anorexia on examination

A
  • Bradycardia
  • Lanugo hair
  • Dry skin
  • Evidence of self harm
  • Acid erosion
  • Hypotension
48
Q

What is a community treatment order?

A

Service user has to meet certain supervised conditions in the community, if they fail to do this, they may be recalled to hospital

49
Q

Risk of using antipsychotics in elderly?

A
  • Stroke
  • VTE
50
Q

Recurrent vomiting can cause what?

A
  • Russell sign
  • Erosion of teeth
51
Q

Clozapine S/E

A
  • Agranulocytosis
  • Reduced seizure threshold
  • Constipation
  • Dose must be adjusted if smoking if started/stopped
52
Q

What assessment tools can be used for depression?

A
  • HAD scale
  • PHQ-9 scale
53
Q

Section 2

A
  • Admission for upto 28 days
  • AMHP
54
Q

Section 3

A

Treatment for 6 months
- 2 doctors and AMHP

55
Q

Section 4

A
  • 72 hours order
  • GP and AMHP
56
Q

Section 5(2)

A

Detained for 72 hours by doctor

57
Q

Section 5(4)

A

Detained for 6 hours by nurse

58
Q

Section 17(A)

A

Community treatment order

59
Q

Section 135

A

Police order to retrieve someone from home to place of safety

60
Q

Section 136

A

Police order to bring someone from public place to a place of safety

61
Q

What is the most important prognostic indicator in paracetamol overdose?

A

Arterial PH

62
Q

What is indication for liver transplant in paracetamol overdose?

A

pH < 7.3 more than 24 hours after transplant

63
Q

What kind of reaction does N-acetylcysteine cause?

A

Anaphylactoid - non-IgE mediated mast cell release

64
Q

What is high in anorexia?

A
  • Growth hormone
  • Glucose
  • Salivary glands -> parotidomegaly
  • Cortisol
  • Cholesterol
  • Carotenaemia
65
Q

When can paracetamol overdose become high risk to develop liver failure?

A
  • Chronic alcoholic
  • HIV
  • Anorexia
  • Taking P450 inducers
66
Q

Lead pipe rigidity is a sign of what?

A

Neuroleptic malignant syndrome

67
Q

What is a Fregoli delusion?

A

Belief that everyone is the same person/strangers are familiar

68
Q

What is a capgras delusion?

A

Relative/Friend has been replaced by an imposter

69
Q

What are C/I to using anti-cholinesterase inhibitors?

A
  • prolonged QT
  • 2nd/3rd degree heart block
  • Sinus bradycardia

Use Cognitive stimulation therapy instead

70
Q

What is logoclonia?

A

Where the patient gets stuck on a particular word and repeats it

71
Q

What is Ekbom syndrome?

A

Believe they are infested with parasites

72
Q

What test is used to assess muscle wasting in patients with anorexia?

A

Sit-up-squad-stand test

73
Q

Postpartum depression has to be within when?

A

12 months after birth

74
Q

Stopping of voluntary movement or staying still in an unusual position

A

Catatonia

75
Q

Serotonin syndrome vs NMS

A

Serotonin: faster onset, increased reflexes, dilated pupils
NMS: slower onset, decreased reflexes, normal pupils

76
Q

Social phobia vs agoraphobia

A

Agoraphobia - fear of open spaces + crowds / difficulty of immediate easy escape to a safe place
Social Phobia - feat of scrutiny in small groups e.g. public speaking

77
Q

Lithium can cause a benign what?

A

Leucocytosis - raised WCC

78
Q

Antipsychotics can increase the risk of what?

A

Stroke

79
Q

Symptoms of aspirin overdose?

A
  • Hyperventilation
  • Tinnitus
  • Sweating
  • N+V
  • Seizures
  • Causes respiratory alkalosis then metabolic acidosis
80
Q

Conversion disorder?

A

Neuro symptoms without any underlying cause

81
Q

Tahycardia, HTN, CNS stimulate, GI upset?

A

Think opioid withdrawal

82
Q

What is agnosia?

A

Inability to recognise people, objects or places which were once known

83
Q

Confusion screen bloods

A

FBC, U&E, LFTs, CRP/ESR, Ca2+, TFTs, B12, folate, syphilis, HIV

84
Q

ophthalmoplegia, ataxia, and confusion

A

Wernickes

85
Q

Personality disorders

A

Cluster A - Paranoid, schizoid, schizotypal
Cluster B - Antisocial, EUPD, Histrionic, Narcissistic
Cluster C - OCPD, Avoidant, Dependent

86
Q

Fregoli delusion

A

Different people are the same person

87
Q

How long should treatment for SSRI be continued before thinking about switching?

A

4 weeks - younger
6 weeks - elderly

88
Q

What is schizoaffective disorder?

A

Schizophrenia with mood disturbance e.g. depression/mania

89
Q
A

FINALS: PASSMED/QUESMED (22 decks)

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