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General Psychiatry Flashcards

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1
Q

What are the features of schizophrenia?

A
  1. Hallucinations
  2. Delusions
  3. Disorganised Thinking / Speech
  4. Catatonia
  5. Negative Symptoms
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2
Q

What are the clusters of personality disorders?

A 
Cluster A (mad): schizotypal, schizoid, paranoid
Cluster B (bad): antisocial, histrionic, narcissistic, borderline
Cluster C (sad): OCPD, anxious-avoidant, reliant
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3
Q

What are the 5 axes of DSM V?

A

Axis I: principle disorder (e.g. depression, schizophrenia)
Axis II: personality and developmental disorders
Axis III: medical problems
Axis IV: psychosocial stressors
Axis V: global assessment of functioning

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4
Q

What are the features of depression?

A 
D - depressed mood
I - loss of interest
G - feelings of guilt
S - sleep disturbance
P - psychomotor agitation or retardation
A - appetite change
C - poor concentration
E - lack of energy
S - suicidal ideation
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5
Q

What are the features of borderline personality disorder?

A

Mood swings, transient paranoia or dissociation, impulsive behaviour, self-harm, suicidal ideation, unstable relationships, fear of abandonment

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6
Q

What is the presentation of serotonin syndrome and how is it treated?

A

Mental State: agitation, hypomania, confusion, hallucinations, coma
Autonomic: hyperthermia, tachycardia, nausea, diarrhoea
Neuromuscular: myoclonus, tremor, hyperreflexia, ataxia
Treatment: cessation of medication, supportive care, cyproheptadine

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7
Q

What are the features of Wernicke’s encephalopathy?

A

Ataxia
Opthalmoplegia
Confusion

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8
Q

What are the features of Korsakoff Syndrome?

A
  1. Anterograde amnesia
  2. Retrograde amnesia
  3. Confabulation
  4. Miminal content of conversation
  5. Lack of insight
  6. Apathy
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9
Q

What are Bowlby’s four attachment styles?

A

Type B: balanced & secure (most common)
Type A: anxious avoidant (second most common)
Type C: anxious ambivalent / preoccupied
Type D: disorganised

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10
Q

What are the domains of dysfunction in Autism Spectrum Disorder?

A

Deficit in social communication + interaction

Restricted, repetitive behaviour

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11
Q

What are the two components of ADHD?

A
  1. Inattention

2. Hyperactivity + Impulsivity

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12
Q

What are the commonly used bedside screening tests for cognitive function and when is each used?

A

MMSE: moderate cognitive deficit (no executive testing)
FAB: frontal lobe / executive dysfunction only
MoCA: mild cognitive impairment + executive dysfunction
ASAS-Cog: impairment in AD

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13
Q

What is the difference between a guardianship and an administration order?

A

Guardianship: lifestyle + medical decisions
Administration: financial + asset decisions

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14
Q

How is delirium managed?

A
  1. Treat underlying cause
  2. Reorioentation, behavioural intervention
  3. Sedation (haloperidol, quetiapine, olanzapine, lorazepam)
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15
Q

How can you distinguish delirium from dementia?

A

In delirium, patients tend to be more distractible and unable to focus or pay attention

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16
Q

What are the subtypes of Anorexia Nervosa?

A

Restricting type: dieting, fasting, excessive exercise

Binge-purge type: vomiting, laxatives, enemas

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17
Q

What is the difference between the binging-purging type of Anorexia Nervosa and Bullimia Nervosa?

A 
Anorexia = BMI <17
Bullimia = BMI normal or overweight
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18
Q

What is conversion disorder?

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A

1+ symptoms of altered motor/sensory function (e.g. mimic stroke) with no medical explanation

19
Q

How is conversion disorder managed?

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A
  1. Psychoeduation
  2. CBT + physical therapy
  3. Antidepressants, hypnosis
20
Q

What are the risk factors for suicide?

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A 
S - Male Sex
A - Age (biggest cause of death 15-24, highest rates >65)
D - Depression or other psychiatric disorder
P - Previous attempt
E - Excess alcohol or substance abuse
R - Rational thinking loss
S - Social supports lacking
O - Organised plan
N - No spouse
S - Sickness
21
Q

What are the components of the mental state examination?

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A 
A - Appearance
B - Behaviour
C - Conversation
A - Affect
P - Perception
C - Cognition
I - Insight
J - Judgement
R - RapportW
22
Q

What are the four symptom domains of mood disorders?

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A
  1. Mood
  2. Psychomotor activity
  3. Cognition
  4. Vegetative
23
Q

What is the difference between Bipolar I and Bipolar II?

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A

I: at least one manic episode
II: at least one hypomanic episode and one major depressive episode, without a manic episode

24
Q

What is the difference between mania and hypomania?

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A

Mania: 1 week, impairs functioning
Hypomania: 4 days, no marked impairment, no psychosis, no hospitalisation

25
What is a mixed episode?
Concurrent presence of depressive symptoms with manic symptoms (DSM-V = with mixed features)
26
What is the timeframe for adjustment disorder?
Onset within 3 months of stressor and don't persist >6 months after removal of stressor
27
What are the key features of Borderline Personality Disorder?
I - Instability of affect (mood swings) I - Interpersonal relationship issues (abandonment) I - Impulsivity (suicidal + self-harm behaviours) I - Identity disturbance (dissociation, paranoia)
28
What are the indications for CBT?
Mild-moderate depression, anxiety disorders, OCD, eating disorders, drug/alcohol dependence
29
Which patients are likely to respond well to CBT?
``` Willing and motivated to engage Internal locus of control Good insight Average intelligence Not psychotic or manic ```
30
What are the negative symptoms of schizophrenia?
``` Avolition (motivation) Anhedonia (pleasure) Apathy (interest) Affective blunting Alogia (speech) Asociality ```
31
What are the features of psychosis?
``` Hallucinations Delusions Formal thought disorder Catatonia (negative symptoms are in schizophrenia) ```
32
What is Freud's topographic theory of the mind?
Unconscious mind: not directly accessible Preconscious mind: ordinary memory Conscious mind: current awareness (10%, like iceberg)
33
What is Freud's structural theory of the mind?
Id: basic instinctual drives Superego: culture, ideals, spirituality, conscience Ego: conscious awareness, reconciles Id and Superego
34
List some immature ego defence mechanisms.
Acting out Wishful thinking Passive aggression
35
List some mature ego defence mechanisms.
``` Mindfulness Thought suppression Emotional self-regulation Distress tolerance Emotional self-sufficiency ```
36
List some pathological ego defence mechanisms.
Denial Distortion Inferiority / superiority complex
37
List some neurotic ego defence mechanisms.
``` Rationalisation Intellectualisation Regression Repression Upward / downward social comparisons ```
38
What are the features of substance dependence?
S - Social impairment H - High-risk use I - Impaired control P - Pharmacological tolerance and withdrawal
39
What are the features of alcohol withdrawal?
Autonomic hyperactivity: nausea, agitation, tremor, tachycardia, hypertension, palpitations, anxiety, insomnia Hallucinations Tonic-clonic seizures
40
What are the features of delirium tremens?
Change in consciousness + cognition (delirium) | Fever
41
What are the different specifies of depression?
``` with Melancholic Features with Atypical Features with Catatonia with Psychotic Features (mood congruent or incongruent) with Postpartum Onset with Anxious Distress with Mixed Features with Seasonal Pattern ```
42
What are the features of a schizotypal personality disorder?
Eccentric behaviour, beliefs, dress and language Lack close friends Often identify as 'psychic' or as having a 'sixth sense' May have anxiety and ideas of reference
43
What is Couvade syndrome?
A condition of male partners of pregnant women who experience indigestion, weight/appetite change, bloating constipation, abdominal pain, etc.

Psychiatry (3 decks)

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