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Finals Revision > Psychiatry > Flashcards

Psychiatry Flashcards

1
Q

What is dementia?

A

An umbrella term for conditions of the brain that cause a disturbance of higher mental functions

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2
Q

What are the 4 main types of dementia?

A

Alzheimers, vascular, lewy body and frontotemporal

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3
Q

What are important investigations to do for dementia in primary care and why?

A

Bloods (FBC, U&Es, LFTs, calcium, glucose, TFTs, vitamin b12 and folate) to rule out organic, treatable causes of memory loss

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4
Q

What tests are used for cognitive screening in dementia?

A

MOCA, MMSE, Addenbrooks

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5
Q

What dementia is commonest?

A

Alzheimers

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6
Q

What is seen macroscopically with regard to the brain in Alzheimers?

A

Cerebral atrophy, particularly of the cortex and hippocampus

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7
Q

What is seen micoscopically with regard to the brain in Alzheimers?

A

Cortical plaques due to beta amyloid protein

Neurofibrally tangles caused by Tau protein

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8
Q

What is seen biochemically in Alzheimers?

A

Reduced acetylcholine

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9
Q

What are symptoms of Alzheimers?

A

Usually begin after 60 years. Memory loss with evidence of varying change in planning, reasoning, speech and orientation

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10
Q

How does Alzheimers progress?

A

Slowly and gradually over time

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11
Q

What is the pathogenesis of vascular dementia?

A

Vascular events (multiple infarcts, small vessel disease, single infarct) leading to degeneration. Commonly affects white matter, grey nucleus, thalamus and striatum

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12
Q

What are risk factors for vascular dementia?

A

Cardiovascular disease, hypertension, stroke

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13
Q

What are symptoms of vascular dementia?

A

Cognitive impairment, functional deficits, mood disorders, psychosis, delusions, emotional lability

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14
Q

How doe vascular dementia progress?

A

Stepwise degeneration

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15
Q

What is the pathogenesis of Lewy Body Dementia?

A

Spherical lewy body proteins, composed of alpha synuclin, deposited around the brain. More widespread deposits than in PD

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16
Q

What are symptoms of Lewy Body Dementia?

A

Visual hallucinations, parkinsonism, fluctuation in cognitive ability, sleep disorders, problems with multitasking

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17
Q

How does Lewy Body Dementia progress?

A

Rapidly

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18
Q

What is the commonest cause of dementia in under 65s?

A

Frontotemporal

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19
Q

What is the pathogenesis of frontotemporal dementia?

A

Neuron damage and death in the frontal and temporal lobes. Atrophy due to deposition of abnormal proteins

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20
Q

What are the 3 main types of frontotemporal dementia?

A

Picks disease, semantic and non-fluent

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21
Q

How does Picks disease present?

A

Altered emotional responsiveness, apathy, disinhibition, impulsivity, progressive decline in interpersonal skills

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22
Q

What are Pick bodies and how are they seen?

A

Spherical aggregations of Tau protein, seen on silver stain

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23
Q

What is the non-pharmacological management of dementia?

A

Behaviour management, cognitive stimulation, recreational activities

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24
Q

What drugs are available for Alzheimers disease?

A 
Cholinesterase inhibitors (Donepezil, galantamine, rivastigmine)
NMDA agonists (memantine) if severe
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25
Q

What drugs are sometimes used for lewy body dementia?

A

Donepezil, rivastigmine

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26
Q

What are side effects of cholinesterase inhibitors?

A

diarrhoea, vomiting, deranged LFTs, incontinence, headache, dizziness

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27
Q

What is the effect of depression on life expectancy?

A

Reduces it by 5-10 years

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28
Q

What are risk factors for depression?

A

Genetics, female gender, personality, early life experiences, stressors, physical illness, drugs

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29
Q

What are the core symptoms of depression?

A

Low mood
Anhedonia
Anergia

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30
Q

What are additional symptoms of depression?

A

Loss of confidence, guilt, recurrent thoughts of death, self harm, suicidal intent, reduced concentration, sleep disturbance, change in appetite

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31
Q

What is seen in MSE of a person with depression?

A

Appearance & behaviour = may be variable
Speech = reduced rate, volume, intonation, low pitch
Mood & affect = low
Thoughts = slow, poverty of thought, obsessions, ruminating, thoughts of guilt/death
Perception = hallucinations - mood congruent (persecutory)
Cognition = poor memory, slow thinking
Insight = typically preserved

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32
Q

What is dysthymia?

A

Chronic low mood that does not fit definition of recurrent depression. Tired and depressed for months at a time, unable to cope with demands of life

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33
Q

What non pharmacological treatment is helpful in depression?

A

CBT, sleep hygiene, physical activity

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34
Q

What is the first line drug for depression?

A

SSRI

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35
Q

What are examples of SSRIs?

A

Fluoxetine, sertaline, citalopram, paroxetine, escitalopram

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36
Q

How do SSRIs work?

A

Prevent pre-synaptic uptake of 5-HT

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37
Q

What are common side effects of SSRIs?

A

GI upset, GI bleeding, rebound anxiety as drug started, increased suicide risk, insomnia, mania

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38
Q

What do SSRIs interact with?

A

NSAIDs (use PPI), warfarin, heparin, triptans

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39
Q

What are discontinuation side effects of SSRIs?

A

Mood disturbance, restlessness, GI upset

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40
Q

How is switching from one SSRI to another achieved?

A

Withdraw the first drug then start the new drug

In fluoxetine - withdraw first then wait 4-7 days before starting new drug (long half life)

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41
Q

How is switching from an SSRI to venlafaxine/TCA achieved?

A

Cross tapering of both doses

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42
Q

What SSRI is used in pregnancy?

A

Sertraline

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43
Q

What SSRI is used in children?

A

Fluoxetine

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44
Q

What SSRI is used post-MI?

A

Sertraline

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45
Q

What are examples of tricyclic antidepressants?

A

Amitriptyline, clomipramine, imipramine

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46
Q

How do TCAs work?

A

Block serotonin and noradrenaline transporters to prevent reuptake
Also antagonise muscarinic, histamine and adrenergic receptors

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47
Q

What are the indications for TCAs?

A

Depression (2nd line)

Panic disorder, OCD

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48
Q

What are contraindications for TCAs?

A

MI, arrythmia, liver disease, porphyria, mania in bipolar

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49
Q

What are side effects of TCAs?

A

Constipation, dry mouth, blurred vision, urinary retention, sedation

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50
Q

How does TCA overdose present?

A

Arrhythmia, seizure, coma

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51
Q

What blood gas is seen in a TCA overdose?

A

Metabolic acidosis

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52
Q

What ECG changes are seen in TCA overdose?

A

Sinus tachycardia and widening of QRS

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53
Q

How is TCA overdose managed?

A

IV bicarbonate to fix acid/base balance

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54
Q

What drug is considered to be ‘TCA like’?

A

Trazadone

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55
Q

What are examples of monoamine oxidase inhibitors?

A

Phenelzine, moclobemide, isocarboxazid

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56
Q

How do MAOIs work?

A

Inhibits monoamine oxidase to prevent neurotransmitter breakdown

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57
Q

When are MAOIs used?

A

Atypical depression

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58
Q

What are side effects of MAOIs?

A

Postural hypotension, hypertensive crisis

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59
Q

What may precipitate hypertensive crisis in MAOIs?

A

Tyramine containing foods (eg. cheese, yoghurt, yeast, meat)

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60
Q

What are examples of SNRIs?

A

Venlafaxine, duloxetine

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61
Q

What is the mode of action of SNRIs?

A

Inhibit serotonin and noradrenaline reuptake

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62
Q

What is the indication for SNRIs?

A

Severe depression

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63
Q

When are SNRIs contraindicated?

A

Hypertension, arrythmia

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64
Q

What are side effects of SNRIs?

A

Nausea, dry mouth, GI upset, drowsiness, urinary retention, tachycardia, vasodilation

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65
Q

What is an example of a NaSSA?

A

Mirtazapine

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66
Q

What is the mode of action of mirtazapine?

A

Antagonist of noradrenaline, serotonin and histamine receptors

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67
Q

When is mitrazapine used?

A

2nd line in depression

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68
Q

What are side effects of mirtazapine?

A

Dry mouth, GI upset, increased appetite and weight gain, sedation, agranulocytosis

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69
Q

What are symptoms of mania?

A

Elevated mood, increased energy levels, overactivity, pressure of speech, decreased need for sleep, disinhibition, grandiose ideas, tasking risks, overspending, delusions, hallucinations

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70
Q

What is hypomania?

A

Milder elevation of mood with no psychosis

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71
Q

What is rapid cycling of mood?

A

4 or more episodes of mania in 1 year. Can be interspersed with periods of wellness

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72
Q

How is bipolar disorder defined?

A

Two or more episodes of mania +/- depression

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73
Q

What is the average age of onset of bipolar disorder?

A

21

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74
Q

What is bipolar 1?

A

More pronounced mania

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75
Q

What is bipolar 2?

A

Hypomania, severe depression more common

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76
Q

What are risk factors for bipolar disorder?

A

Genetics, stressors, childbirth, drugs

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77
Q

What is the lifetime risk of suicide with bipolar disorder?

A

12-15%

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78
Q

What symptoms are mood stabilisers generally better at treating in bipolar?

A

Manic rather than depressive

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79
Q

What are examples of drugs used for mood stabilising?

A

Litihium, lamotrigine, sodium valproate, olanzapine, aripiprazole

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80
Q

How does lithium work?

A

Mechanism unclear - may interact with cation transport, glutamate or cAMP

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81
Q

What are indications for lithium?

A

Bipolar disorder, treatment resistant depression, schizoaffective disorder

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82
Q

What are cautions for lithium?

A

Hyponatraemia, renal impairement, dementia

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83
Q

What are short term side effects of lithium?

A

GI upset, fine tremor, muscle weakness, polyuria and polydipsia

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84
Q

What are long term effects of lithium?

A

Oedema, weight gain, diabetes insipidus, renal damage, tardive dyskinesia, teratogenicity

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85
Q

What ECG changes are seen with long term lithium use?

A

T wave flattening

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86
Q

What is the teratogenic condition associated with lithium?

A

Ebsteins anomaly

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87
Q

At what levels does lithium toxicity occur?

A

> 1.5mmol/L

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88
Q

What are symptoms of lithium toxicity?

A

GI upset, CNS upset, psychosis, collapse, death

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89
Q

How is lithium toxicity treated?

A

Fluid resuscitation, haemodialysis, sodium bicarbonate

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90
Q

What does lithium interact with?

A

NSAIDs, ACEis, thiazides, carbemazepine

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91
Q

What is the therapeutic window of lithium?

A

0.4-1mmol/L

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92
Q

How often should lithium be monitored until a stable dose is reached?

A

Weekly

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93
Q

How often should lithium be monitored for the first year?

A

Every 3 months

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94
Q

How often should lithium be monitored after the first year?

A

Every 6 months

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95
Q

How do anti-convulsants work in bipolar?

A

Potentiate GABA transmission to stabilise mood

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96
Q

What are indications for anti-convulsants in bipolar?

A

Bipolar disorder, patients unresponsive to lithium alone

97
Q

What are cautions of anti-convulsants?

A

Risk of bleeding, osteoporosis, steven-johnsons-syndrome, hepatic/renal impairement

98
Q

What are the side effects of anti-convulsants?

A

GI upset, weight gain, rash, ataxia, hair loss, DIC,pancreatitis, teratogenicity

99
Q

What is the first line treatment for prophylaxis of bipolar disorder?

A

Lithium

100
Q

What is the second line treatment for prophylaxis of bipolar disorder?

A

Lithium & valproate

101
Q

If lithium is not well tolerated, what drug can be used for monotherapy in prophylaxis of bipolar?

A

Valproate, olanzapine, quetiapine

102
Q

What drugs should be stopped during an episode of mania?

A

Anti-depressants

103
Q

What drugs can be added to prophylactic treatment in an episode of mania?

A

Anti-psychotic - olanzapine/quetiapine/risperidone

104
Q

What drugs are used on top of prophylaxis for bipolar depression?

A

Fluoxetine + olanzapine OR
Quetiapine OR
Lamotrigine

105
Q

What is the definition of psychosis?

A

Inability to distinguish between subjective experience and reality, characterised by a lack of insight

106
Q

What are hallucinations?

A

Sensations occurring without any stimulus. May be audtiory, visual, gustatory, tactile

107
Q

What are pseudohallucinations?

A

Sensations occurring without any stimulus but patient retains insight that stimulus is in mind

108
Q

What are delusions?

A

Beliefs held strongly irrespective of counter argument

109
Q

What is passivity?

A

Delusion of control/one is no longer in control of their own body

110
Q

What is though interference?

A

Withdrawal, insertion and broadcasting of thoughts

111
Q

What is flight of ideas?

A

Speech jumps topic to topic due to rhyming etc

112
Q

What is knights move thinking?

A

Speech jumps from topic to topic with no clear relation between topics

113
Q

What is tangential thinking?

A

Wandering from topic to topic and never answering the orignal questions

114
Q

What is circumstantiality?

A

Wandering away from original question and answering with unnecessary detail

115
Q

What are neologisms?

A

Made up words

116
Q

What is the differential diagnosis of psychosis?

A

Schizophrenia, psychoactive substance misuse, mania, severe depression, schizoaffective disordr, delirium, dementia

117
Q

What is schizophrenia?

A

Common relapsing remitting condition wtih characteristic distortions of thought, perception, behaviour and emotion

118
Q

What are risk factors for schizophrenia?

A

Family history, genetics, neurodevelopmental delay, race, cannabis use

119
Q

What is the prevalence of schizophrenia?

A

1%

120
Q

When are the peak incidences of schizophrenia?

A

Males 15-25

Females 25-35

121
Q

What are Schneiders first rank symptoms?

A

Auditory hallucinations - usually 3rd person
Delusions of though interference - insertion/broadcasting/withdrawal
Delusions of control - passivity phenomena
Delusional perception - delusional belief arising from normal perception

122
Q

What are the positive symptoms of schizophrenia?

A

Delusions, hallucinations, thought disorder

123
Q

What are the negative symptoms of schizophrenia?

A

Apathy, avolition, poverty of speech, blunting

124
Q

What symptoms in schizophrenia respond better to treatment?

A

Positive symptoms

125
Q

How long do symptoms need to go on for in schizophrenia before a diagnosis can be made?

A

One month

126
Q

What are good prognostic indicators in schizophrenia?

A

Older age at onset, female sex, marked mood disturbance

127
Q

What are bad prognostic factors in schizophrenia?

A

Long duration of untreated psychosis, insidious onset, early onset, cognitive impairment, enlarged ventricles

128
Q

What is the first line treatment for schizophrenia?

A

Oral atypical antipsychotics

129
Q

What are other important parts of treating schizophrenia?

A

CBT

Cardiovascular risk modification

130
Q

What are examples of typical antipsychotics?

A

Haloperidol, Chlorpromazine, prochloperazine, levomopromazine, flupentixol

131
Q

How do typical antipsychotics work?

A

Block dopamine D2 receptors

Antagonise M1, H1 and alpha1 receptors

132
Q

What are typical antipsychotics with a higher affinity for the D2 receptor (e.g. haloperidol) more likely to cause?

A

Extra-pyramidal side effects

133
Q

What are indications for typical antipsychotics?

A

Schizophrenia, mania, psychotic depression, acute anxiety, delirium

134
Q

What are cautions for use of typical antipsychotics?

A

CVS disease, hepatic/renal impairement, epilepsy, Parkinsons

135
Q

What are contraindications for typical antipsychotics?

A

CNS depression, phaeochromocytoma

136
Q

What are extra-pyramidal side effects of typical antipsychotics?

A

Parkinsonism, acute dystonias, akathisia, tardive dyskinesia

137
Q

What are some other side effects of typical antipsychotics?

A

Drowsiness, apathy, agitation, insomnia, weight gain, photosensitivity, anticholinergic side effects (e.g. dry mouth, urinary retention)

138
Q

When does neuroleptic malignant syndrome occur?

A

Within 10 days of starting a new neuroleptic

139
Q

How does neuroleptic malignant syndrome present?

A

Pyrexia, rigidity, tachycardia, raised CK

140
Q

How is neuroleptic malignant syndrome treated?

A

Stop antipsychotic
IV Fluids
Benzodiazepines, dantrolene, bromocriptine

141
Q

What are examples of atypical antipsychotics?

A

Olanzapine, quetiapine, risperidone, aripiprazole, clozapine

142
Q

What is the mechanism of action of atypical antipsychotics?

A

Dopamine and serotonin receptor antagonism

143
Q

What are the indications for atypical antipsychotics?

A

Schizophrenia, mania, psychotic depression

144
Q

What are contraindications to atypical antipsychotic use?

A

Phaeochromocytoma, PRL secreting tumours

145
Q

Are EPSEs more or less common in atypical antipsychotics?

A

Less common

146
Q

What EPSE may aripiprazole cause?

A

Akathisia

147
Q

What is akathisia?

A

Feeling of inner restlessness

148
Q

What are side effects of atypical antipsychotics?

A

Hyperprolactinaemia, weight gain, metabolic syndrome, hyperglycaemia, diabetes, increased stroke risk

149
Q

What is the notable side effect of clozapine?

A

Agranulocytosis

150
Q

When clozapine therapy is initiated, how often should bloods be monitored?

A

Every 2 weeks for 6 months

151
Q

After 6 months, how often should clozapine be monitored?

A

4 weekly

152
Q

After stopping clozapine, when should bloods be taken?

A

1 month after

153
Q

What bloods should be checked on initiation of an antipsychotic?

A

FBC, U&Es, LFTs, lipids, glucose, PRL

154
Q

What other investigations should be done on initiation of an antipsychotic?

A

BP, ECG, cardiovascular risk assessment

155
Q

How many antipsychotics should be trialled before initiation of clozapine?

A

2

156
Q

What part of the brain is the emotional filter?

A

Amygdala

157
Q

What effect does acute anxiety have on hormones?

A

Increased cortisol and catecholamines

158
Q

What are physical symptoms of anxiety?

A

Sweating, hot flushes, shaking, muscle tension, numbness, tingling, dry mouth, palpitatons, chest pain

159
Q

What are cognitive symptoms of anxiety?

A

Fear of losing control, on edge, mentally tense, difficulty concentrating, mind going blank, depersonalisation, hypervigilence, metaworry

160
Q

When is anxiety pathological?

A

When it is in extent or out of context

161
Q

What is generalised anxiety disorder?

A

Generalised and persistent anxiety not restricted to one environment and not due to substances

162
Q

When is the usual onset of GAD?

A

20-40 years, commoner in females, chronic fluctuating course

163
Q

How is GAD treated non-pharmacologically?

A

Education, psychological interventions

164
Q

How is GAD treated medically?

A

SSRI (sertaline), venlafaxine

Betablockers for symptom relief

165
Q

What is panic disorder?

A

Recurrent attacks of severe anxiety which are not restricted to one environment and are therefore unpredictable

166
Q

When is the usual onset of panic disorder?

A

From mid 20s, chronic waxing and waning course

167
Q

How is panic disorder treated?

A

CBT

SSRIs - try TCAs 2nd line (imipramine)

168
Q

What are the 3 main phobias?

A

Agoraphobia
Specific phobia
Social phobia

169
Q

What is agoraphobia?

A

Cluster of phobias encompassing fear of leaving home, entering shops, crowds etc

170
Q

What is specific phobia?

A

Marked or persistent fear that is excessive or unreasonable (e.g. flying, needles) Exposure causes an immediate anxiety response

171
Q

What is social phobia?

A

Persistent fear of social/performance situations where the person is exposed to unfamiliar people/scrutiny from others

172
Q

How are phobias treated?

A

CBT

SSRIs, moclobemide

173
Q

What is OCD?

A

Common, chronic, disabling condition marked by obsessions and compulsions. Percieved by patient as non-sensical

174
Q

What is the prevalence of OCD?

A

2-3%

175
Q

When is the average age of onset of OCD?

A

20 years

176
Q

What are obsessions in OCD?

A

Recurrent, unwanted, intrusive thoughts/memories/impulses. Unwanted, usually resisted

177
Q

What are common obsessions in OCD?

A

Contamination, fear of harm, order, symmetry, sexual or violent thoughts

178
Q

What are compulsions in OCD?

A

Repetitive, senseless behaviours that individuals feel driven to perform to reduce anxiety

179
Q

What compulsions are common in OCD?

A

Checking, cleaning, mental compulsions

180
Q

What does neuroimaging in OCD show?

A

Increased blood flow in orbitofrontal cortex and caudate nucleus

181
Q

What is the treatment of OCD?

A

CBT, SSRI, clomipramine

182
Q

What is type 1 trauma?

A

Single incident (e.g. rape, earthquake, RTA)

183
Q

What is type 2 trauma?

A

Complex trauma (e.g. sexual abuse, genocide, hostage)

184
Q

What are features of PTSD?

A

Re-experiencing (flashbacks, nightmares, intrusive images), avoidance, hyperarousal, emotional numbing, anger, anxiety

185
Q

What is the neurobiology seen in PTSD?

A

Paradoxically low cortisol
Hippocampal atrophy
Increased amygdala activity

186
Q

Which type of trauma is more likely to cause PTSD?

A

Type 2 trauma

187
Q

How is PTSD managed non pharmacologically?

A

CBT

Eye movement desensitisation and reprocssing (EMDR)

188
Q

How is PTSD managed pharmacologically?

A

SSRIs, mirtazapine, amitriptyline, prazosin, atypical antipsychotics, mood stabilisers

189
Q

What is the hippocampus important for?

A

Memory

190
Q

What is a personality disorder?

A

Enduring pattern of inner experience and behaviour that deviates markedly from the expectations of the individuals culture

191
Q

What are the 3 clusters of personality disorders?

A

Cluster A = odd and eccentric
Cluster B = dramatic eratic and emotional
Cluster C = anxious and fearful

192
Q

What personality disorders are in cluster A?

A

Paranoid
Schizoid
Schizotypal

193
Q

‘Suspicious of others, has a preoccupation with conspiracy theories and thinks his friends are always criticising him’

A

Paranoid

194
Q

‘Few friends and emotionally cold. Indifferent to any praise. Shows no interest in companionship or sexual activity’

A

Schizoid

195
Q

‘Odd thinking and eccentric behaviour. Unusual perceptions, no real close friends. Suspicious of those around her’

A

Schizotypal

196
Q

What personality disorders are in cluster B?

A

Antisocial, borderline, histrionic, narcissistic

197
Q

‘Boy who has scammed his friends out of money and set 3 cars on fire. Thinks its funny, shows no remorse’

A

Antisocial

198
Q

‘Short temper who has had 5 boyfriends in the last year. Disinhibition, loves taking coke and sleeping aroud. Has attempted suicide multiple times’

A

Borderline

199
Q

‘Has seduced her friends dad at a party and loves being the centre of attention. Very shallow emotions’

A

Histrionic

200
Q

‘Self important and a preoccupation with power and success. Chronically jealous of others. Arrogant. Will use people to achieve needs’

A

Narcissistic

201
Q

What personality disorders are in cluster C?

A

Avoidant, dependent, Obsessive Compulsive

202
Q

‘Views self as inferior. Does socialise with others but would love to. Feels inadequate’

A

Avoidant

203
Q

‘Clings to boyfriend, cannot care for themselves, excessive need to be taken care of’

A

Dependent

204
Q

‘Obsessed with rules, lists, order. Perfectionism that hampers with completing tasks. Stingy. Does not see issue with stubborness’

A

Obsessive compulsive

205
Q

How is borderline PD managed?

A

Dialectical behaviour therapy (DBT)

206
Q

How can avoidant PD be managed?

A

Social skills training

207
Q

How can haloperidol affect an ECG?

A

QT prolongation

208
Q

What biochemical side effect can SSRIs cause?

A

Hyponatraemia

209
Q

What benzodiazepine is used for alcohol withdrawal?

A

Chlordiazepoxide

210
Q

What is paraphrenia?

A

Paranoid delusions occuring later in life (60+) - very late onset schizophrenia

211
Q

What is the heritability of schizophrenia?

A

80%

212
Q

What is the biggest risk factor for borderline personality disorder?

A

Sexual abuse

213
Q

What neurotransmitter is found in aversive and defensive systems?

A

Serotonin

214
Q

Which psychiatric disorder has the highest mortality rate?

A

Anorexia

215
Q

What is a borderline LD an IQ of?

A

Around 70

216
Q

What is a mild LD IQ?

A

50-69

217
Q

What is a moderate LD IQ?

A

35-49

218
Q

What is a severe LD IQ?

A

20-34

219
Q

What is a profound LD IQ?

A

Less than 20

220
Q

Which neurotransmitter is involved in appetitive and approach systems?

A

Dopamine

221
Q

What abnormality of the HPA axis do you get in depression?

A

Adrenal enlargment

Increased cortisol and increased ACTH

222
Q

‘Spect scan shows reduced attenuation throughout brain’

A

Vascular dementia

223
Q

Which learning disability has the highest risk of schizophrenia?

A

Velocardiofacial syndrome

224
Q

Patient complains of sore/immobile neck following administration of antipsychotic

A

Acute dystonia

225
Q

Which antipsychotics are associated with metabolic syndrome?

A

Atypical antipsychotics

226
Q

Patient has taken antipsychotic for years and has excessive blinking

A

Tardive dyskinesia

227
Q

What are short term side effects of ECT?

A

Headache, nausea, memory loss just prior to ECT, arrhythmias

228
Q

What are long term side effects of ECT?

A

Memory loss

229
Q

What causes the positive symptoms of schizophrenia?

A

Overactivity of the mesolimbic system

230
Q

What causes the negative symptoms of schizphrenia?

A

Underactivity of the mesocortical system

231
Q

What drug is useful for akathisia?

A

Propranolol

232
Q

What drug is useful for acute dystonia?

A

Procyclodine

233
Q

How do benzodiazepines work?

A

Enhance GABA

234
Q

What is oculogyric crisis an example of?

A

Acute dystonia

235
Q

What are indications for ECT?

A

Catatonia
Severe or prolonged mania
Severe depression

236
Q

When do seizures occur in alcoholics?

A

36 hours into withdrawal

237
Q

When do delirium tremens occur in alcoholics?

A

72 hours into withdrawal

238
Q

What do atypical antipsychotics increase the risk of in the elderly?

A

Stroke and VTE

Finals Revision (22 decks)

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