Formative Learning Points Flashcards by Andrew Love

What is a primary symptom of schizophrenia ?

Thought disorder (insertion, broadcast etc)
Hallucinatory voices
Delusions of control,influence or passivity
Persistent inappropriate delusions

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What are secondary symptoms of schizophrenia?

Persistent hallucinations in any modality
Breaks or interpolations in train of thought
Catatonic behaviour
Negative symptoms

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What are the positive symptoms of Schizophrenia

Things that are their that shouldn’t be there

Hallucinations
Delusions
Disordered thinking

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What are negative symptoms of schizophrenia?

things that are missing

Apathy
Lack of interest
Lack of emotions

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What are nihilistic delusions?

Delusions regarding non existing on the self/the world

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What is the SCAN classification?

Schedules for clinical assessment in neuropsychiatry

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What is the SCID anagram

Severe combined immunotherapy

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What is conduct disorder?

Intentional dissocial behaviour

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What is somnambulism

Sleep walking

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What is a MAOI?

Monoamine oxidase inhibitor- used to treat………

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What is the adult support and protection (Scotland) Act 2007?

Vulnerability adult, allows social protection not social protection

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What is the mental health act 2007?

The legislation that applies in England and Wales

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What is the interpersonal map?

Represents self and peers, used in schema therapy (better for personality disorders)
Shows underlying beliefs/systems

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What are the two screening tools used to assess alcohol consumption?

CAGE

FAST (fast alcohol screening tool)

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What is the BDI therapy

Becks depression inventory?

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What is the MADRS screening scale?

Montgomery and asberg depression scale

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How do you monitor lithium levels?

Aiming for blood level between 0.6 and 1.2
Steady state achieved after 5 days, check 12 hours after last dose (taken at night)
Once stable check concentration every 3 months
Check TSH and creatinine every 6 months

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What is an assessment order?

Court order requests the assessment of a patient in custody

What is a guardianship order?

Act on a patients behalf when capacity impaired. Only put in place after the the incident and the patient does not have power of attorney

What is a place of safety order?

Police use it to remove people from a public place

What is a restriction order?

Court restricts movements of an individual

What is dysthymia?

Recurrent mild (sub clinical) depression

What is akathisia?

Unpleasant sensation of restlessness

What is Catatonia

Immobility, stupor

What is dysarthria

Difficulty articulating speech

What is dystonia?

Involuntary muscle spasms/contractions

What is agraphia?

Inability to write

What is dyscalculia

Difficulty with numbers

What is alexithymia

Sub clinical emotional blindness

What is Anergia?

Lack of energy

What is cyclothymia?

Relatively mild mood fluctuations

What is poverty of thought?

Thought disorder

What is an idea of reference?

Believing that causal events, remarks and occurrences which happen every day illogically relate to oneself (people laughing at you when they’re not)

What is a delusional perception?

A delusion where you relate something to something else with no relation e.g. I’ve seen a seagull in the park, therefore I must dig up margret thatcher

What is confabulation?

Making up elaborate stories to fill bits of memory that have been lost. Patients believe these stories

What is agoraphobia?

Fear of large crowds

What psychiatric drugs are contraindicated by pregnancy

Lithium- Mood Stabiliser Valproic acid (depakote)- Anticonvulsant Benzodiazipines not brilliant but used

Summarise the psychotherapies used to treat disorders?

CBT- operates on the principal that thoughts, feelings and behaviours are intertwined. Aims to stop thoughts that influence behaviours and feelings and vice versa Behaviour activation- Focuses on the negative behaviours of diseases and the unintended consequences they cause Interpersonal therapy-Effective for mood and personality disorders. Patient constructs an interpersonal map and aims to reduce symptoms and increase interpersonal skills Motivational interviewing- considers the cycle of change to help get patients to take the initiative and make a change

What do you do before starting someone on Lithium?

Baseline U&E's, TSH and pregnancy test

What are the side effects of lithium?

GI distress- reduced appetite, N+V, diarrhoea Thyroid abnormalities Nonsignificant leukocytosis Polyuria/polydypsia secondary to ADH antagonism Hair loss, Acne Cognitive slowing

What are the stages and signs of lithium toxicity?

Mild 1.5-2.0- vomiting, diarrhoea, ataxia, dizziness, slurred speech, nystagmus Moderate 2.0-2.5- N+V, anorexia, blurred vision, clonic limb movements, convulsions, delirium, syncope Severe>2.5- generalised convulsions, renal failure and oliguria (barely passing urine)

What are the different though disorders that may occur in schizophrenia?

Thought Insertion- someone is making you think their thoughts Thought broadcasting- everyone else knows your thoughts Thought blocking- Someone slows thinking Thought withdrawal- someone takes your thoughts

What is the process of treatment in depression?

SSRI- first line Combined SSRI and SSRI or SSRI and SNRI- second line Keep on drugs, also take lithium- third line Keep on drugs and take atypical antipsychotic- 4th Electroconvulsive therapy- last line