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MEDICINE FINALS > PSYCH > Flashcards

PSYCH Flashcards

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1
Q

When does delirium tremens present?

A

2-3 days post alcohol consumption

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2
Q

What symptoms do you get with delirium tremens? (5)

A
  1. delirium -> fluctuating consciousness/aggression
  2. hallucinations
  3. coarse tremor
  4. fever
  5. tachycardia
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3
Q

How do you treat delirium tremens?

A

Chlordiazepoxide
+ thiamine

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4
Q

When is the peak incidence of seizures post alcohol withdrawal?

A

36 hour

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5
Q

When would symptoms of alcohol withdrawal first start?

A

6-12 hours after last drink

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6
Q

What are the symptoms of Wernicke’s encephalopathy?

A

confusion
ophthalmoplegia
ataxia

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7
Q

What are the symptoms of Korsakoff’s psychosis?

A

Retrograde amnesia
Anterograde amnesia
Confabulation

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8
Q

How would you screen for alcohol misuse?

A

CAGE
C - have you felt that you should cut down?
A - do you get annoyed when people tell you to stop?
G - do you ever feel guilty
E - do you ever need an eyeopener in the morning?

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9
Q

What are 3 pharmacological drugs that help to maintain alcohol abstinence?

A
  • Disulfiram →
    unpleasant reaction if drink, doesn’t stop craving
    – Acamprosate → reduces cravings
    – Naltrexone → decreases
    pleasurable effects of drinking alcohol
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10
Q

What is the ICD-10 criteria for diagnosing mild/moderate/severe depression?

A

mild = 4 symptoms
moderate = 5-6 symptoms
severe= 7+ symptoms

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11
Q

What are the 3 main features of depression?

A

low mood
anhedonia
anergia

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12
Q

Give 4 common side effects of SSRIs?

A
  • nausea/vomiting
  • loss of appetite
  • agitation
  • loss of libido
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13
Q

Give 4 common side effects of TCA

A
  • dry mouth
  • constipation
  • drowsiness
  • weight gain
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14
Q

Give 4 withdrawal symptoms of antidepressants

A
  • restlessness/agitation
  • altered feeling ( irritable/anxious/panic)
  • altered sensation (electric shock)
  • dizzy
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15
Q

What is generalised anxiety disorder?

A

Excessive anxiety and worry, more days than not, for at least 6 months about multiple different aspects

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16
Q

Give 4 symptoms of GAD?

A
  • restlessness
  • easily fatigued
  • sleep disturbance
  • difficulty concentrating
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17
Q

What is panic disorder?

A

Sudden onset anxiety + at least 4 symptoms of:
- SOB
- palpitations
- shakiness
- nausea
- fear of dying

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18
Q

How is panic disorder treated?

A

Propranolol 40mg OD

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19
Q

What scoring system is used to assess for depression/anxiety?

A

Depression - PHQ-9
Anxiety - GAD-7

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20
Q

What is the difference between mania and hypomania?

A

Mania = symptoms <7days, elevated mood, irritability + PSYCHOSIS
Hypomania = symptoms ,4 days, no marked impairment in social functioning, no psychosis

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21
Q

How would you manage an acute episode of mania?

A
  1. therapeutic trial of oral antipsychotic
  2. if ineffective trial different antipsychotic
  3. lithium
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22
Q

What are the side effects of lithium?

Study These Flashcards
A

LITHIUM
Lethargy
Insipidus (diabetes)
Tremor
Hypothyroidism
Insides (GI)
Urine (decreased)
Metallic taste

23
Q

Give 4 drugs that should not be prescribed alongside lithium

Study These Flashcards
A

ACE-i/ARB
diuretics
NSAIDs

24
Q

Which factors might precipitate lithium toxicity?

Study These Flashcards
A

dehydration
renal failure
diuretics/ACEi/ARB/NSAIDs/metronidazole

25
Give 5 symptoms of lithium toxicity
- coarse tremor - hyperreflexia - acute confusion - seizure - polyuria
26
How do you treat lithium toxicity?
mild-moderate = volume resuscitation with normal saline severe = haemodialysis
27
Give 3 psychotic symptoms?
hallucinations delusions thought disorder
28
Give 4 examples of psychosis with negative symptoms
emotional blunting reduced speech loss of motivation self-neglect
29
what is knights move thinking?
no links between sentences
30
Which antipsychotic drugs can you NOT prescribe in pregnancy?
carbamazepine clozapine lithium
31
What is the criteria for a diagnosis of schizophrenia?
1 month history of <1 : - 3rd person auditory hallucinations - thought disorder - passivity - delusional perceptions <2 : - persistent hallucinations - catatonic behaviours - negative psychosis - social withdrawal
32
What is schizoaffective disorder?
bipolar + schizophrenia
33
Give 2 examples of typical antipsychotics
haloperidol chlorpromazine
34
Give 4 examples of atypical antipsychotics
risperidone aripiprazole clozapine olanzapine
35
Give 4 examples of extrapyramidal side-effects
1. Parkinsonism 2. Acute dystonia 3. Akathisia 4. Tardive dyskinesia
36
What is the mechanism of action of typical antipsychotics?
dopamine receptor antagonist (D2)
37
Which psych drugs can you not take whilst breast feeding?
- carbamazepine - clozapine - lithium
38
Which side effect causes involuntarily repetitive movements?
Tardive dyskinesia
39
How is tardive dyskinesia treated?
tetrabenazine
40
What is acute dystonia and how is it treated?
Sustained, painful, involuntary muscle contraction treated - procyclidine
41
What is the treatment for OCD?
1. low intensity CBT including ERP 2. SSRI 3. clomipramine
42
What are the triad of symptoms for PTSD?
1. hyperarousal 2. avoidance 3. re-experiencing
43
How is PTSD treated?
1. trauma focused CBT +/- EMDR 2. venlafaxine/SSRI
44
what clinical signs might you see in someone with anorexia?
- bradycardia - enlarged salivary glands - hypotension - proximal myopathy (squat test)
45
What blood results would you see in someone with anorexia nervosa?
- hypOkalaemia - raised cortisol, growth hormone, cholesterol - impaired glucose tolerance
46
What are the complications of anorexia nervosa?
- pancreatitis - constipation - refeeding syndrome
47
What is the management for someone with anorexia nervosa ?
1. CBT (with family) 2. monitor U&Es and ECG 3. oral supplements to correct electrolyte imbalance 4. dentist + DEXA scan
48
What is section 2 of MHA?
- used for assessment - 28 days (can't be renewed) - need 2 drs and AMHP
49
What is section 3 of MHA?
- 6 months - used for treatment (CAN be renewed) - need 2 drs and AMHP
50
What is section 4 of MHA?
- 72 hours - Used in emergency - not enough time for 2nd dr - 1 dr and 1 AMHP
51
What is section 5 (4) of MHA?
Detains pt for 6 hours - used by nurses to stop pt leaving
52
What is section 5 (2) of MHA?
72 hours holding power for Dr
53
What is section 135 of MHA?
police - used to take to or keep you at place of safety (need a warrant to enter your home)
54
What is section 136 of MHA?
police - used to enter your house without warrant

MEDICINE FINALS (19 decks)

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