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Psych Flashcards

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1
Q

What is transient global amnesia?

A

A neurological condition characterised by a temporary but total disruption of both short and long term memory. Other cognitive functions are preserved

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2
Q

Give 3 questionnaires used for depression severity

A

PHQ-9
HADS
BDI-II

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3
Q

What is 1st line in moderate-severe depression?

A

CBT and SSRI/SNRI

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4
Q

How should an antidepressant be stopped?

A

Reduce the dose/frequency gradually over a 4 week period (not necessary for fluoxetine)

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5
Q

How long does it take for the effects of antidepressants to be seen

A

2 weeks

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6
Q

How long should you give somebody on an antidepressant with inadequate response?

A

6-8 weeks then consider switching

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7
Q

Give some features of serotonin syndrome

A 
Confusion
Delirium 
Shivering 
Sweating 
Changes in blood pressure 
Myoclonus
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8
Q

What drug class is citalopram?

A

SSRI

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9
Q

If somebody presents with new onset palpitations and feeling on edge, what is the 1st line next step management?

A

48hr holter ECG

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10
Q

What is 1st line drug management of Alzheimers?

A

Acetylcholinesterase inhibitors e.g. donepezil, galantamine, rivastigmine

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11
Q

When are drugs like donepezil and rivastigmine contraindicated in Alzheimers?

A

Long QT syndrome, sinus bradycardia (less than 50), 2nd/3rd degree heart block

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12
Q

What is 1st line in treating MND?

A

Riluzole (anti-glutamate) - potentiates movement

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13
Q

How does autoimmune encephalitis present?

A

VIRAL ILLNESS prior to symptom onset (demyelination)

Confusion
Seizures
Movement disorders
Behavioural changes 
Emotional lability
Cognitive impairment 
Reduced Conscious level
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14
Q

How do you treat autoimmune encephalitis?

A

Steroids and IV IgG/Plasma exchange

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15
Q

What is cotard delusion

A

Belief that the patient is dead, non-existant or rotting

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16
Q

What pathological findings are seen in the brain in Alzheimers?

A

Beta-amyloid plaques
Neurofibrillary tangles
Hyperphosphorylated TAU proteins

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17
Q

What symptoms does Lewy Body dementia classically present with?

A

Triad of:

  1. REM sleep disorder
  2. History of falls
  3. Lilliputian hallucinations
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18
Q

What antipsychotic should be switched to if patients experience prolactinaemia from other antispsychotics

A

Aripiprazole

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19
Q

Why do patients commonly experience prolactinaemia from antipsychotics e.g. rispiridone/haliperodol

A

They are dopamine receptor antagonists

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20
Q

Which SSRIs are most appropriate in breastfeeding?

A

Sertraline and paroxetine

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21
Q

What are 1st line in ACUTE mania mangement?

A

Antipsychotics e.g. haloperidol, risperidone, quetiapine

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22
Q

What is 1st line in long term management of bipolar?

A

Lithium

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23
Q

How long must symptoms of anxiety be present to diagnose GAD?

A

6 months

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24
Q

How long must depression symptoms be there to diagnose depression

A

2 weeks

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25
What are the criteria for mild depression
2 core symptoms and 1 biological symptom
26
What is 1st line for mild depression?
Low intensity psychological intervention - guided self help or group CBT
27
What features are associated with better prognosis in schizophrenia?
``` High IQ Sudden onset Obvious precipitating factor Strong support network Positive symptoms predominant ```
28
What is 1st line in schizophrenia?
Atypical antipsychotics e.g. risperidone
29
When should clozapine (atypical antipsychotic) be started in schizophrenia
When schizophrenia has not responded to 6-8 week courses of 2 different antipsychotics
30
How do you treat Delirium tremens?
Chlordiazeproxide Fluids Pabrinex Anti-emetics
31
What can be used to treat the somatic symptoms of anxiety? e.g. tremor in hands
Beta blockers
32
What is fronto-temporal dementia also known as?
Pick's disease
33
What are the pathology findings in FT dementia?
Intracellular TAU protiens | Atrophy of frontal and temporal lobes
34
What class of drug is venlafaxine?
SNRI
35
What does SNRI stand for?
Serotonin and noradrenaline reuptake inhibitor
36
Give some short term side effects of ECT
``` Headache Nausea Short term memory impairment Memory loss of events prior to ECT Cardiac arrhythmia ```
37
What is Munchausen's syndrome?
Purposefully causing symptoms e.g. taking too much insulin to cause hypos
38
What is an oculogyric crisis?
Involuntary upward deviation of the eyes with restlessness and agitation. It is a dystonic reaction to certain drugs e.g. antipsychotics
39
How do you treat an oculogyric crisis?
IV antimuscarinic e.g. benztropine/procyclidine
40
If a patient responds well to SSRI treatment, how long should they stay on them to prevent relapse?
6 months
41
What class of drug is amitryptyline?
Tricyclic antidepressants
42
What is the general threshold age for personality disorder diagnosis?
18 years old
43
If CBT or EMDR are ineffective in PTSD, what drug treatments are first line?
Venlafaxine or an SNRI
44
What drug classes increase the risk of serotonin syndrome when taking an SSRI
MAOIs | Triptans
45
What is tardive kinesia? How does it present?
A late onset extrapyramidal side effect of long term antipsychotic use. Presents with chewing, jaw pouting, excessive blinking
46
What do you need to check before starting someone on venlafaxine?
Blood pressure, SNRIs are associated with development of hypertension
47
What should be monitored before starting citalopram?
ECG due to an increased risk of QT prolongation / ventricular arrhythmias
48
What is an electrolyte abnormality seen in SSRI usage
Hyponatraemia
49
What is the risk of SSRIs in the 1st trimester?
Congenital heart defects
50
What is the risk of SSRIs in the 3rd trimester?
Persistent pulmonary hypertension of the newborn
51
What is the peak incidence of seizures after alcohol withdrawal?
36 hours
52
What is the peak incidence of DT after alcohol withdrawal
72 hrs
53
What is the 1st line treatment for delirium?
Haloperidol 0.5mg (or olanzepine) | Except for in Parkinson's
54
What is the 1st line treatment for delirium in Parkinson's?
Low dose lorazepam Haloperidol can worsen parkinson symptoms
55
What drug can be used to treat tardive dyskinesia?
Tetrabenazine
56
What class of drug can cause urinary retention?
Tricyclic antidepressants e.g. amitryptyline
57
What is the hallmark sign of refeeding syndrome?
Hypophosphataemia
58
What is section 135 of the MHA?
Section 135 is an order allowing the police to forcefully enter a property of a person believed to be mentally ill, in order to allow a mental health assessment.
59
What is section 136 of the MHA?
allowing the police to remove a person from a public place who is believed to be mentally ill, to take them to a "place of safety" for a mental health assessment.
60
What is 1st line in those seeking to maintain abstinence from alcohol?
Acamprosate
61
What happens to cortisol and GH in anorexia nervosa?
They are raised
62
What is cholesterol like in anorexia nervosa
Raised
63
What are the 1st rank symptoms of schizophrenia?
Delusional perceptions Auditory hallucinations Delusions of thought Passivity phenomenon

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