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Psychiatry for finals > High yield exam cram > Flashcards

High yield exam cram Flashcards

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1
Q

When can a power of attorney be put in place?

A

Before capacity is lost

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2
Q

When is a power of attorney activated?

A

When the patient looses capacity

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3
Q

When is a guardianship order used?

A

when a patient no longer has the ability to make decisions about their care and they do not have a power of attorney

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4
Q

what section of the mental health (care and treatment) act 2003 is nursing holding power?

A

299

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5
Q

How many hours can a patient be held for under the nursing holding powers (299) in SCOTLAND?

A

3 hours

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6
Q

What kind of nurse can use a nursing holding power (299)?

A

psych nurse

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7
Q

What section of the mental health act is an emergency detention certificate?

A

5(2)

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8
Q

Who can use an emergency detention certificate 5(2)?

A

FY2 and above

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9
Q

How long does an emergency detention certificate 5(2) last?

A

72 hours

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10
Q

What can be done under an emergency detention certificate 5(2)?

A

Assessment only (NO TREATMENT ALLOWED)

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11
Q

can an emergency detetion certificate 5(2) be appealed?

A

No

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12
Q

What section of the mental health act is a short term detention certificate?

A

Section 2

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13
Q

Who can put a short term detention certificate in place?

A

Psych consultants

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14
Q

how long does a short term detention certificate last for?

A

28 days

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15
Q

What can be done under a short term detention certificate?

A

Treatment

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16
Q

Can a short term detention certificate be appealed?

A

Yes

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17
Q

what section of the mental health act is a compulsory treatment order under?

A

Section 3

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18
Q

How is a compulsory treatment order obtained?

A

Consultants apply for it and then it goes through a tribunal

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19
Q

how long does a compulsory treatment order last?

A

6 months

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20
Q

Can a compulsory treatment order be extended?

A

Yes- by 6 months each time

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21
Q

What is a section 297

A

Police can remove somebody from a public space and take them to a place of safety

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22
Q

What does dispositional drug tolerance mean?

A

There is less drug reaching the active site

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23
Q

What does functional/pharmacodynamic drug tolerance mean?

A

The drug is reaching the active site but is unable to act upon it

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24
Q

Name the pleasure/reward centre of the brain

A

Ventral tegmental

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25
What is the mechanism of action of cocaine
Monoamine reuptake inhibitor
26
What is the mechanism of action of diazepines?
GABA agonists (promote all inhibitory systems causing relaxation)
27
Name an alcohol screening tool
CAGE/ FAST or CIW_AR
28
What are the features of wernickes encephalopathy?
confusion, ataxia, nystagmus, ophthalmoplegia
29
What are the features of korsakoffs?
Symptoms of Wernicke’s + memory loss (Alcohol induced ‘dementia’)
30
Which drug do you give in alcohol withdrawal to control anxiety and agitation
Chlordiazepoxide (benzo) or Lorazepam (benzo)
31
Which drug to you give to avoid/manage wernicke-korsakoffs?
Pabrinex (thiamine. vit B1)
32
which drug creates a deterrent effect when mixed with alcohol?
Disulfiram (Antabuse)
33
Which drug reduces the reward sensation associated with drinking alcohol?
Naltrexone
34
How long must symptoms persist for before a diagnosis of depression can be made?
Most of the day, nearly every day for >2 weeks
35
Name two tools used to assess depression
- Hamilton Depression Rating Score - Patient Health Questionnaire (PHQ-9)
36
How long must symptoms persist for before a diagnosis of mania or hypomania can be made?
>1 week
37
What is the difference between mania and hypomania?
Mania causes impaired functioning. Hypomania does not impair functioning.
38
What is the diagnostic criteria for bipolar I
At least 1 manic or mixed manic/depressive episode lasting >1 week
39
What is the diagnostic criteria for bipolar II?
At least 1 hypomanic + at least 1 depressive episode lasting >1 week
40
What is the difference between bipolar I and bipolar II
Bipolar I - severe form with manic episodes Bipolar II- milder form with hypomanic episodes
41
What is the diagnostic criteria for cyclothymia?
Persistent mood instability >2 years
42
What is cyclothymia?
Mood instability but not severe enough for a depression diagnosis
43
What psych disorder has the highest mortality
Anorexia Nervosa
44
What is the BMI required for an anorexia diagnosis?
<18.5
45
what weight within 6 months loss would raise suspicion of anorexia?
>20%
46
What is the average recovery time for anorexia?
6-7 years
47
name the antipsychotic drug that is often given to anorexic patients and explain why it is given
olanzapine (causes hunger and weight gain)
48
what is the difference between bulimia and binge eating disorder?
- Bulimia= binge/purge - Binge eating = no purge
49
What is the diagnostic criteria required for a personality disorder diagnosis?
personality difficulties for >2Y
50
Which attachment style is associated with personality disorders?
Disorganised attachment
51
What is surgency?
The liveliness of a baby
52
What is negative affectivity?
the extent to which a baby gets upset
53
what is effortful control?
How well behaviour can be supressed and controlled
54
what is the most common cause of psychosis?
Schizophrenia
55
What kind of drugs are used to treat schizophrenia?
Antipsychotics
56
how long must symptoms have persisted for in order to make a diagnosis of schizophrenia?
1 month
57
What is the diagnostic criteria for ADHD?
>6 months of inattention/hyperactivity
58
What type of drug is given to treat ADHD?
Stimulant
59
What is the difference between oppositional defiant disorder and conduct disorder?
Oppositional defiant Disorder - Usually <10 years old - Mostly related to mood Conduct Disorder - Usually >11 years old - Mostly related to behaviour (law breaking and violence/aggression)
60
What is the diagnostic criteria for a learning disorder?
IQ 2 or more standard deviations below the mean (IQ<70)
61
What is the diagnostic criteria for PTSD
Hyperarousal, flashbacks & avoidance persisting for more than 4 weeks after the traumatic incident
62
What does CBT aim to do?
Change negative patterns of thinking
63
Can CBT deal with issues from the past?
No
64
What do interpersonal therapies aim to do?
Help depressed people deal with issues within their relationships
65
What dies moticational interviewing aim to achieve?
Help people find the motivation to make a positive behavioural change
66
What is the main feature of Alzheimer's dementia?
Gradual loss of memory
67
What is the main feature of vascular dementia?
Stepwise decline in memory
68
What is the main feature of lewy body dementia?
non-threatening hallucinations
69
what is the main feature of fronto-temporal dementia (picks disease)?
Personality change
70
what would you see in the brain of a patient with alzherimer's dementia?
Amyloid Plaques & Tau tangles Atrophy
71
How is alzherimer's dementia treated?
Mild- treat with ACh inhibitors (donepezil) Moderate- (treat with glutamate receptor antagonists)
72
How is dementia assessesd?
MMSE
73
How is delerium assessed?
4AT
74
Which psych drugs cause agranulocytosis?
Carbamazepine and clozapine
75
Which psych drug reduces the seizure threshold?
Mirtazepine
76
Which psych drugs cause massive weight gain
Olanzepine and mirtazepine
77
Which psych drug causes a massive increase in serum cholesterol?
Mirtazepine
78
Which drug causes lactation
Risperidone
79
Which psych drugs have the biggest risk of extra-pyramidal side effects?
Typical antipsychotics e.g. haloperidol (Atypical antipsychotics still carry the risk but it is not as great)
80
how long can it take to feel the benefit of antidepressants?
2-4 weeks
81
What is the correct stepping up of antidepressive therapy?
SSRI SNRI SSRI/SNRI + Mirtazapine OR SSRI/SNRI Lithium/antipsychotic MOI TCA
82
What is a common side effect seen when initiating antidepressant therapy?
GI upset
83
How long should you wait to feel the effect of an antidepressant before you move on to something different?
4-8 weeks
84
How long should an antidepressant be taken for?
After the first depressive episode, continue medications for 6 months to a year After a second episode, continue medications for 2 years After a third episode, medication should be given for life
85
Patient is anxious, depressed AND has neuropathic pain. What are you giving?
Duloxetine
86
Describe how lithium levels should be checked
Check lithium 12 hours after 1st dose, weekly until levels stable then every 3 months. If dose changes, go back to weekly checks until stable.
87
What else should be checked if a patient is on lithium?
Check renal and thyroid every 6 months.
88
What lithium blood level should be aimed for?
0.6-1.2
89
Describe the lithium blood levels associated with mild, moderate and severe toxicity
- Mild toxicity = 1.5-2.0 - Moderate toxicity = 2.0-2.5 - Severe toxicity = >2.5

Psychiatry for finals (1 decks)

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