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Exam Revision > Psychiatry > Flashcards

Psychiatry Flashcards

1
Q

which neurotransmitter is overactive in schizophrenia

A

dopamine

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2
Q

brain changes in schizophrenia

A

ventricular enlargement

decreased frontal lobe + grey matter volume (decreased grey matter due to less SYNAPSES not neurones)

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3
Q

neurotransmitter involved in adverse/defensive system

A

serotonin

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4
Q

neurotransmitter involved in appetitive/approach

A

dopamine

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5
Q

reward pathway

A

mesolimbic

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6
Q

what is mesocortical system responsible for

A

motivation + emotion

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7
Q

mechanism of psychosis

A

overactivity of dopamine in mesocortical + mesolimbic systems

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8
Q

brain changes in social anxiety

A

increased amygdala activity

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9
Q

brain changes in depression

A

decreased hippocampal volume

smaller frontal lobes

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10
Q

brain changes in panic attack

A

increased metabolism in parahippocampal gyrus

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11
Q

depressions effect on cortisol

A

increased cortisol

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12
Q

psychosis differentials

A

schizophrenia
mania
delirium
dementia

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13
Q

effect of anti-psychotics blocking alpha adrenergic receptors

A

postural hypotension

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14
Q

components of mental state exam

A 
appearance
behaviour 
speech 
mood
affect
thought
perception 
cognition 
insight
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15
Q

function of D1 receptor

A

stimulates cAMP

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16
Q

function of D2 receptor

A

inhibits adenyl cyclase
inhibits voltage activated calcium channels
opens potassium channels

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17
Q

1st rank symptoms schizophrenia

A

delusional perceptions
auditory hallucinations
thought insertion/broadcasting/withdrawal
passivity phenomena

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18
Q

how should you take a patient off citalopram

A

gradually decrease dose over 4 weeks

not necessary with fluoxetine as it has a longer half life

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19
Q

symptoms of SSRI discontinuation syndrome

A

diarrhoea, vomiting, abdo pain

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20
Q

PHQ 9 score

A

assess severity of depression

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21
Q

SADPERSONs score

A

assess suicide risk

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22
Q

what drug can cause anterograde amnesia

A

lorazepam

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23
Q

Korsakoff

A

amnesia and confabulation caused by B1 deficiency

-

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24
Q

what is needed for all surgical procedures

A

written consent

25
Q

is consent needed for an emergency procedure

A

NO!!

necessary to preserve live

26
Q

tx acute mania

A

antipsychotic

27
Q

tx delerium

A

antipsychotic

28
Q

what drug worsening delirium

A

benzodiazepines

29
Q

triad of symptoms in depression

A

low mood, anhedonia, anergia

30
Q

what is needed to confirm a diagnosis of depression

A

symptoms present for > 2 weeks

  • low mood
  • anhedonia
  • anergia
  • loss of confidence/self esteem
  • sleep disturbance - early morning wakening
  • recurrent thoughts of death/suicide
  • unreasonable feelings of guilt
  • decreased appetite + weight loss
31
Q

somatic syndrome

A

type of depression where 4 of the following are present:

  • anhedonia
  • lack of emotional response
  • early morning wakening
  • depression worse in the morning
  • loss of appetite/weight
  • loss of libido
  • retardation/agitation
32
Q

atypical depression

A 
mood that brightens in response to positive events 
\+ 2 of:
- weight gain/increased appetite 
- hypersomnia 
- leaden paralysis
33
Q

dysthymia

A

persistent mild symptoms of depression - worse at times of stress
lack of pleasure in life but can still cope
present on more days than not

34
Q

maternity blues

A

post partum emotional lability, irritability, tearfulness
2-3 days post partum
resolves in a few days

35
Q

post natal depression

A

within 1 month of delivery

36
Q

when is ECT recommended

A

severe long term depression that has not responded to treatment

37
Q

criteria for hypomania

A

Increased mood for longer than 4 days

  • increased activity
  • talkativeness
  • increased libido
  • decreased need for sleep
  • decreased concentration
38
Q

criteria for mania

A

increased mood for longer than 1 week

  • increased activity
  • increased libido
  • increased self esteem
  • decreased need for sleep
  • decreased social inhibitions
  • decreased concentration
  • reckless behaviour
  • flight of ideas + pressure of speech
39
Q

what is rapid cycling

A

4 or more manic episodes in one year

Tx sodium valproate

40
Q

what is schizoaffective disorder

A

some features of schizophrenia + some of mood disorder but not enough for one diagnosis alone

41
Q

cyclothymia

A

persistent instability of mood

- numerous episodes of mild depression + mild elation

42
Q

what is mixed affective state

A

manic + depressive symptoms within the course of a day present for >2 weeks

43
Q

first line acute mania

A

haloperidol/ olanzapine / quetiapine

44
Q

how long must a person have symptoms for to be classified as generalised anxiety disorder

A

most days for 6 months

- symptoms must be non controllable, cause significant distress + functional impairment

45
Q

tx of phobias

A

gradual exposure over time
or
flooding - exposure to fear suddenly

46
Q

tx PTSD

A

CBT

eye movement desensitisation + reprocessing

47
Q

tx OCD

A

exposure to obsessional stimuli + prevention of compulsions

SSRI + CBT

48
Q

symptoms of alcohol withdrawal

A 
restlessness/ tremor 
sweating 
anxiety 
N+V
loss of appetite 
insomnia 
tachycardia + hypertension

delerium temens – peaks after 2 days of abstinence

49
Q

tx of alcohol withdrawal symptoms

A

chlordiazepoxide

50
Q

what drug reduces alcohol cravings

A

acamprostate

51
Q

hachinski score >7

A

vascular dementia

52
Q

how are lewy bodies detected

A

immunochemical staining for ubiquitin protein

53
Q

features of benzodiazepine withdrawal

A 
tinnitus
insomnia 
irritability 
tremor
sweating / anxiety 
loss of appetite
seizures
altered perception
54
Q

stopping of voluntary movement or staying still in an unusual position

A

catatonia

55
Q

1st line therapy offered to children/young people with anorexia

A

family based therapy

56
Q

complications of bulimia

A

hypokalaemia

metabolic alkalosis

57
Q

factors that contribute to poor prognosis in schizophrenia

A 
strong family history
gradual onset
low IQ
premorbid history of social withdrawal
lack of obvious precipitant
58
Q

risk of getting shizophrenia if a twin has it

A

50%

59
Q

ECT side effects

A 
headache
nausea
short term memory impairment
memory loss of events prior to ECT
cardiac arrhythmia

Exam Revision (32 decks)

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