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Finals Studying - Condensed > Psych > Flashcards

Psych Flashcards

1
Q

thyroid abnormality in anorexia

A

low T3 (all else norm)

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2
Q

schizotypal personality disorder

A

lack close friends other than family

have odd & eccentric beliefs

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3
Q

schizoid personality disorder

A

lack close friends
no interest in sexual relationships
indifferent to praise
NO odd behaviours or beliefs

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4
Q

paranoid PD

A

cant confide in others
question loyalty of friends
see hidden meanings in benign things

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5
Q

histrionic PD

A

crave centre of attention
sexually inappropriate or suggestible
relationships presumed more intimate than they are

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6
Q

antisocial PD

A 
break the law
deceptive - always lying
impulsive - cant plan ahead
disregard for safety of others
lack of remorse
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7
Q

avoidant PD

A

avoids social situations for fear of being disliked
fears of embarrassment etc in relationships
views self as inept or inferior to others

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8
Q

borderline PD

A

unstable relationships
always making attempts to avoid abandonment
recurrent suidical behavior
chronic emptiness

unstable self image

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9
Q

narcissitic PD

A 
\++ self importance
sense of entitlement 
lack of empathy 
need for admiration 
chronic envy
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10
Q

role of frontal lobe

A

executive functioning
personality
voluntary movement
expressive language (brocas)

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11
Q

role of parietal lobe

A

2 point discrimination
reading
writing
knowing right from left

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12
Q

role of temporal lobe

A

memory
hearing
receptive language (wernickes)

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13
Q

role of occipital lobe

A

primary visual cortex

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14
Q

passivity phenomenen

A

the feeling of being the Mx or control of other people

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15
Q

delusion definition

A

a fixed false belief

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16
Q

persecutory delusion

A

false belief of being malevolently treated in some way

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17
Q

somatic delusion

A

false belief of having a physical defect or medical condition

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18
Q

loosening of associations

A

muddled talk that is illogical.

talks freely but no info given.

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19
Q

knight’s move thinking

A

pt jumps from subject to subject with no apparent link

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20
Q

flight of ideas

A

pt jumps from subject to subject but words are associated with rhyme / can see slight connection

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21
Q

tangential thinking

A

pt moves from point to point and never comes back to the question being asked

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22
Q

circumstantiality

A

pt gives excessive detail when answering q, but does eventually come back to answer it

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23
Q

how long should a depressive ep last for it to be called depression

A

2w

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24
Q

core symptoms of depression

A

low mood
loss of pleasure/interest in activities
low energy

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25
Q

additional features of depression

A 
disturbed sleep 
unreasonable guilt 
feelings of worthlessness 
reduced concentration 
change in appetite 
loss of confidence 
suicidal behaviour
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26
Q

Mx mild depression

A

no anti-depressants

behavioural changes e.g. sleep hygiene

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27
Q

criteria for moderate depression

A

at least 2 core symptoms + additional symptoms

total at least 6

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28
Q

criteria for severe depression

A

all 3 core symptoms + additional symptoms

total at least 8

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29
Q

somatic depression

A

increased appetite
changes in sleep
lack of energy
aches and pains

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30
Q

cotards syndrome

A

delusion belief that they are dead or non-existent

seen in severe depression

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31
Q

psychotic depression

A

usually 2nd person derogatory delusions (worthlessness)

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32
Q

Mx depression

A

SSRI or SNRI

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33
Q

ECT indications

A

catatonia
severe depression refractory to meds
psychotic symptoms

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34
Q

how long should someone take anti-depressant for

A

at least 6m

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35
Q

neurotransmitter causes sedation

A

reduced histamine

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36
Q

woman hearing things, but knew it was inside her head

A

pseudo-hallucination

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37
Q

neurotransmitter reduced in depression

A

serotonin

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38
Q

man who says he is losing memory and doesnt like going out because of this. low mood and wife died. MMSE 28/3- - DDx?

A

depression

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39
Q

how long must GAD symptoms be present for diagnosis

A

6m

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40
Q

Mx GAD

A
  1. CBT +/- SSRI (sertraline)

Drugs also 1st line are:

  • SNRI
  • atypical antidepressants
  • pregabalin
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41
Q

how long must stay on meds for in GAD

A

18m if responding to Tx

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42
Q

Mx panic disorder

A

CBT or drug treatment
1. SSRI

if not responding after 12w, give TCA (clomipramine, imipramine)

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43
Q

Mx social phobia

A

SSRI + CBT with emphasis on exposure

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44
Q

Mx specific phobia

A

exposure therapy

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45
Q

features of PTSD

A
  1. flashbacks
  2. nightmares
  3. emotional numbing
  4. dissociation
  5. re-enactment
  6. increased arousal
  7. avoidance
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46
Q

timeline of PTSD

A 
<48h = acute stress reaction 
<4w = acute stress disorder
<3m = acute PTSD 
>3m = chronic PTSD
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47
Q

Mx PTSD

A

NOT debriefing
<4w = watchful waiting

  1. Trauma focussed CBT or Eye movement Desensitisation + Reprogramming
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48
Q

how long do OCD symptoms need to be present for Dx

A

2w

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49
Q

Mx OCD

A

CBT - Exposure and Response Prevention

Drugs - SSRI, TCA (clomipramine)

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50
Q

Neurotransmitter changes in GAD

A

decreased GABA
decreased serotonin
increased noradrenaline

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51
Q

Persistent sexual thoughts about woman at his church, more he thinks about it, worse it gets, keeps telling you he is in a happy marriage - Dx?

A

OCD

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52
Q

Boy doesn’t like doing presentations, drinking more and more on nights out - Dx?

A

social phobia

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53
Q

Woman anxious, phoning her parents all the time - Dx?

A

GAD

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54
Q

Totally random panic attacks, tingling in fingers, sweating, palpitations - Dx?

A

panic disorder

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55
Q

Mind racing with worries and drinks alcohol to calm -Dx?

A

GAD

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56
Q

pathology of SCZ

A

increased mesolimbic dopamine

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57
Q

heritability of SCZ

A

80%

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58
Q

-ve symptoms of SCZ

A 
apathy 
incongruity 
catatonia 
anhedonia (inability to derive pleasure) 
avolition (poor motivation)
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59
Q

How many 2nd gen anti-psychotics should be tried before putting pt on Clozapine

A

2

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60
Q

delusional perception

A

normal object is perceived with delusional insight

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61
Q

how long must symptoms of SCZ be present for diagnosis

A

1m

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62
Q

who can help with explaining diagnosis to schizophrenic’s parents?

A

community psychiatric nurse

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63
Q

paraphrenia

A

late onset SCZ (>65)

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64
Q

Woman with prominent negative symptoms of schizophrenia, social withdrawal etc - who should she see

A

OT

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65
Q

Dismantling electrical equipment because of fear of recording - Dx?

A

SCZ

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66
Q

symptoms of hypomania

A

increased talkativeness
decreased need for sleepy
increased sexual energy
mild spending sprees

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67
Q

how long do hypomania symptoms need to last for diagnosis

A

4 d

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68
Q

symptoms of mania

A 
flight of ideas
grandiose delusions
pressure of speech 
reduced need for sleep 
loss of normal social inhibitions 
distractability 
marked sexual indiscretions
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69
Q

how long do mania symptoms need to last for diagnosis

A

1w

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70
Q

Mx acute mania

A
  1. aripiprazole or olanzapine

2. haloperidol or lorazepam

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71
Q

long term Mx bipolar

A

mood stabiliser:

  1. Lithium carbonate
  2. sodium valproate
  3. carbamazepine
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72
Q

Mx depression in bipolar

A

fluoxetine

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73
Q

Dx of anorexia nervosa

A

wt loss at least 15% below expected weight for age and height
self-perception of being too fat
self-induced wt loss
widespread endocrine disorder

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74
Q

subtypes of anorexia nervosa

A

restrictive

binging/purging

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75
Q

BMI categories for anorexia nervosa

A

low risk: 17.5-16
mod risk: 16-15
high risk: 15-13
v high risk: <13

76
Q

effect of anorexia on K levels

A

low

77
Q

effect of anorexia on FSH and LH

A

low

78
Q

effect of anorexia on oestrogen and testosterone

A

low

79
Q

effect of anorexia on cortisol

A

increased

80
Q

effect of anorexia on GH

A

increased

81
Q

effect of anorexia on cholesterol

A

increased

82
Q

Dx of bulimia nervosa

A

recurrent episodes of overeating
preoccupation with eating and strong desire or compulsion to eat
counter-acts episodes of eating with self-induced vomiting or purging

83
Q

refeeding syndrome

A

the metabolic abnormalities that occur when feeding a person following a period of starvation

84
Q

metabolic abnormalities in refeeding syndrome

A

hypokalaemia
hypophosphataemia
hypomagnesaemia

85
Q

prevention of refeeding syndrome

A

if person hasnt eaten for >5 days, for first 2 days re-feed them at less than 50% of their daily requirements

86
Q

complication of hypomagnesaemia

A

torsades de pointes

87
Q

binge drinker, self-harm repeatedly, overly sexual/lots of brief relationships - PD?

A

borderline PD

88
Q

irritable, callous, no responsibility, expects family to do everything - PD?

A

dissocial PD

89
Q

biggest risk factor for borderline PD

A

sexual abuse

90
Q

man who works really hard, doesn’t spend any money on his wife - PD?

A

Obsessive Compulsive PD

91
Q

neurotransmitter affected in anorexia

A

reduced serotonin

92
Q

ECG abnormality in anorexia

A

prolonged QT

93
Q

criteria of dependence

A 
strong desire to take substance
difficulty controlling use 
physiological withdrawal state 
tolerance 
neglect of other pleasures 
persistence despite evidence of harm
94
Q

role of the pre-frontal cortex

A

sets goals and focusses attention (last to develop), thats why young people are more impulsive

95
Q

what causes symptoms of alcohol withdrawal (neurotransmitters)

A

++ glutamate
and
– GABA

96
Q

high risk alcohol drinking (units)

A

> 35 units/wk

97
Q

how many hrs after stopping alcohol do symptoms of withdrawal start

A

6-12h

98
Q

how many hrs after stopping alcohol do symptoms of withdrawal peak

A

24-48h

99
Q

what complication happens 36h after stopping alcohol

A

generalised seizures

100
Q

what complication happens 72h after stopping alcohol

A

delirium tremens

101
Q

delirium tremens presentation

A 
agitation 
fever 
confusion 
disorientation 
paranoia 
hallucinations
102
Q

cause of wernickes encephalopathy

A

thiamine deficiency (B1)

103
Q

presentation wernickes encephalopathy

A
  1. confusion
  2. ataxia
  3. opthalmoplegia
104
Q

complication of wernicke’s encephalopathy

A

korsakoff’s syndrome

105
Q

dexotification definition

A

the process of becoming alcohol/substance free

106
Q

medicines given for alcohol detox

A 
Chlordiazepoxide or Diazepam 
\+ 
Pabrinex (IV thiamine) 
\+ 
hydration
107
Q

medication given for alcohol relapse prevention

A
  1. Naltrexone
  2. Acamprostate
  3. Disulfiram
108
Q

signs of opiate intoxification

A

pinpoint pupils
resp depression
euphoria

109
Q

opioid replacement therapy

A

Methadone or Buprenorphine (no decrease in dose)

110
Q

opioid detoxification therapy

A

Methadone or Buprenorphine (decrease dose gradually to get them drug free)

111
Q

Mx BZD overdose

A

Flumazenil (ONLY iatrogenic overdose)

112
Q

BZD detoxification

A

Chlordiazepoxide or Diazepam

- reduce dose every 2-3w in steps

113
Q

BZD detoxification

A

Chlordiazepoxide or Diazepam

- reduce dose every 2-3w in steps

114
Q

side effects of diazepam and chlordiazepoxide

A

eye irritation
tremor
urinary retention

115
Q

borderline LD - IQ and mental age

A

IQ 70-84

Mental age 12-15y

116
Q

mild LD - IQ and mental age

A

IQ 50-69

Mental age 9-12y

117
Q

moderate LD - IQ and mental age

A

IQ 35-49

Mental age 6-9y

118
Q

severe LD - IQ and mental age

A

IQ 20-34

Mental age 3-6y

119
Q

profound LD - IQ and mental age

A

IQ <20

Mental age <3y

120
Q

triad of ADHD

A

inattention
hyperactivity
impulsivity

  • has to be developmentally inappropriate, impairing, pervasive and long-standing
121
Q

test for ADHD

A

no test! clinical Dx

122
Q

Mx ADHD

A

psychological

  1. classroom training and parent training
  2. social skills training

pharmacological

  1. methylphenidate (ritalin)
  2. lisdexamfetamine
  3. dexamfetamine
123
Q

What Ix needs to be done prior to starting ADHD meds and why

A

ECG - all ADHD drugs can be cardiotoxic

124
Q

Triad of ASD

A

language impairment
abnormal thought and behaviour
qualitative impairment in social interaction

125
Q

Asperger’s syndrome

A

autistic features without aloneness or linguistic difficulty

126
Q

person w learning difficulties, doesn’t understand what psych pills are for - whos best to see?

A

community mental health nurse or community psychiatric nurse

127
Q

person w learning difficulties and cant communicate, who is best to see

A

SALT

128
Q

boy running out in front of cars, learning difficulties, trouble with the police, inattention - Dx?

A

ADHD

129
Q

criteria to detain under MHA

A
  1. mental disorder (mental illness, LD, PD)
  2. pt has impaired decision making with regards to Tx of mental disorder
  3. pt at risk to self or others
  4. less restrictive measures not appropriate
  5. necessary
130
Q

power of attorney

A

under the AWI act
can only be granted when a person has capacity
- looks after financial/welfare things

131
Q

welfare guardian

A

under the AWI act
can only be granted when the person has already lost capacity
- looks after financial/welfare things

132
Q

who can use place of safety order

A

police

133
Q

can police go into someones house for place of safety order

A

no -need a warrant

place of safety only applies if person is in a public place

134
Q

how long can someone de detained in place of safety

A

24h

135
Q

how long does nurse’s holding power last

A

2h

136
Q

who can order emergency detention

A

FY2 or above

137
Q

MHO approval needed for emergency detention ?

A

no

138
Q

how long does emergency detention last for

A

72h

139
Q

does pt have right of appeal in emergency detention

A

no

140
Q

who can order short term detention

A

Approved Medical Practitioner (need MHO approval)

141
Q

how long does short term detention last for

A

28d

142
Q

does pt have right of appeal in short term detention

A

yes (only before 14d)

143
Q

does short term detention authorise Tx

A

yes

144
Q

does emergency detention authorise Tx

A

no

145
Q

who can order CTO

A

need either 2 AMPs or 1 AMP and 1 GP

146
Q

what does a CTO require first before it is placed

A

tribunal

147
Q

what happens in proposed CTO if pt too unwell to find their own solicitor

A

curator adalatum is used

148
Q

how long does CTO last for

A

up to 6m

149
Q

what is a T2 form

A

used when the patient can give consent to Tx under CTO

150
Q

what is a T3 form

A

used when the patient cannot give consent to Tx under CTO

151
Q

examples of SNRI

A

venlafaxine

duloxetine

152
Q

1st line SSRI post-MI

A

sertraline

153
Q

1st line SSRI in children/adolescents

A

fluoxetine

154
Q

s/e of SSRI

A

GI upset
increased risk of GI bleed
hyponatraemia

155
Q

ECG complication on citalopram

A

QT prolongation

156
Q

s/e of TCAs

A

anticholinergic effects

QT prolongation

157
Q

examples of MAOI

A

phenlezine

isocarboxazid

158
Q

s/e of MAOIs

A

anticholinergic effects

hypertensive reaction with tyramine containing foods e.g. cheese, broad beans

159
Q

EPSEs and timings of presentation from typical antipsychotics

A

acute dystonic reaction (hours-days) - muscle spams

parkinsonism (days-mths) - bradykinesia, tremor, rigidity

akathisia (months) - restlessness

tardive dyskinesia (yrs) - purposeless repetitive movements

160
Q

examples of typical antipsychotics

A

haloperiodl

chlorpromazine

161
Q

medication always co-prescribed with typical antipsychotics

A

prochlorperazine

162
Q

s/e of antipsychotics

A 
anti-cholinergic effects 
sedation 
prolonged QT 
reduced seizure threshold 
increased risk of VTE and stroke
163
Q

examples of atypical antipsychotics

A 
risperidone
quetiapine 
aripiprazole 
olanzapine 
clozapine
164
Q

atypical antipsychotic causing wt gain

A

olanzapine

165
Q

s/e of atypical antipsychotics

A

wt gain

metabolic syndrome

166
Q

antipsychotic causing prolonged QT (torsade de pointes)

A

haloperidol

167
Q

antipsychotic that causes photosensitivity

A

chlorpromazine

168
Q

s/e of clozapine

A 
agranulocytosis 
reduced seizure threshold 
constipation 
myocarditis 
hypersalivation
169
Q

monitoring of clozapine

A

weekly for 1st 6m
fornightly for 2nd 6m
monthly therafter
one mth after cessation

170
Q

what must pt not do whilst on clozapine

A

stop or start smoking

171
Q

person on olanzapinedevelops dry mouth, what transmitter is responsible

A

ACh

172
Q

diaebtic pt has psychosis, what Tx do they get

A

typical antipsychotic - not atypical bcos they cause metabolic syndrome and pt already has diabetes.

173
Q

therapeutic range of lithium

A
  1. 4-1.0 mmol/Li

i. e. NARROW

174
Q

monitoring lithium levels

A

check levels weekly and after each dose change until conc stable
once established check evry 3m - 12h post dose

175
Q

what blood tests are checked when pt on lithium, and how often

A

every 6m - renal and thyroid function

176
Q

s/e of lithium

A 
n+v 
metallic taste in mouth 
worsening of psoriasis 
nephrotoxicity 
hypothyroidism 
wt gain 
idiopathic intracranial HTN 
fine tremor 
hair loss
177
Q

ECG abnormality on lithium

A

T wave flattening

178
Q

psychaitrists role

A

diagnosis, prescription, Use of MHA and AWI, advocacy

179
Q

who can help old man who wants to move into a care home

A

Social worker

180
Q

taxi driver getting lost, giving the wrong change - Dx

A

alzheimers

181
Q

Which disease has a degenerated nucleus basalis of Meynert (NBM)

A

Alzheimers and Parkinsons

182
Q

man who wants to kill himself - what part of MSE does this come under

A

thought content

183
Q

man has flight of ideas - what part of MSE does this come under

A

thought form

184
Q

man picked up phone during interview - what part of MSE does this come under

A

behaviour

185
Q

man cant complete the MMSE - what part of MSE does this come under

A

cognition

186
Q

man happy when talking about his cats - what part of MSE does this come under

A

affect

Finals Studying - Condensed (22 decks)

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