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3rd yr clinical > Psych > Flashcards

Psych Flashcards

(46 cards)

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1
Q

What are the features of schizoid personality disorder

A

Solitary, lack of interest detached
Symptoms start in adolescence
Odd/eccentric
No desire to interact with others

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2
Q

What are the features of schizotypical personality disorder

A

Odd speech and beliefs, magical thinking, eccentric behaviour

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3
Q

What are the features of antisocial personality disorder

A

Don’t conform to social norms lie, aggressive and irresponsible

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4
Q

What are the features of histrionic personality disorder

A

Sexual seductive, dramatic, need to be centre of attention

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5
Q

What are the main poor prognostic indicators in Schizophrenia

A

Fam history
Gradual onset
Low IQ
Prodromal social withdrawal
No precipitant

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6
Q

What are some side effects of Clozapine

A

Treats schizophrenia
If you stop smoking this will increase levels of clozapine in the blood- notify Dr if you stop smoking

Risk of agranulocytosis so need FBP monitoring
Reduced seizure threshold
Constipation
Myocarditis
Hypersalivation

Atypical antipsychotics like clozapine can cause weight gain and hyperprolactinaemia

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7
Q

What is the timeline for alcohol withdrawal

A

Seizures 36 hrs after
Delirium Tremes 72 hrs after

Management
Long acting benzos- diazepam or chlordiazepoxide

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8
Q

What are the two different types of bipolar disorder and how are they managed

A

Type 1 - mania and depression
Type 2- hypomania and depression

Mania- Psychotic symptoms for 7 days or more - hallucinations/ delusions

Hypomania-Decreased or increased functioning for 4 days or more

Management of mania/ hypomania- stop antidepressant and give antipsychotic eg. Olanzapine or haloperidol

Don’t give an antidepressant without a mood stabaliser- antidepressant alone can worsen mania

Manage depression- fluoxetine

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9
Q

What are some increased risks for people with bipolar disorder

A

Increased risk diabetes, CVD and COPD

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10
Q

What is a brief psychotic disorder

A

Psychotic symptoms last less than a month

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11
Q

What is schizoaffective disorder

A

Psychotic and mood disorders present together in an episode or within 2 weeks of each other

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12
Q

What is tangentiality

A

Answers diverge from a topic - psychotic feature

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13
Q

Why are triptans and SSRI’s contraindicated

A

Risk of Serotonin syndrome

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14
Q

What are the side effects of tricyclic antidepressants

A

Drowsy, dry mouth, blurred vision, constipation, urinary retention causing frequent leaking
-Overflow incontinence due to anticholinergic effect

Amitryptylline is a TCA

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15
Q

What is illness anxiety disorder

A

Persistent belief in an underlying disease and doesn’t accept reassurance

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16
Q

What is conversion disorder

A

Loss of motor or sensory function not faking them

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17
Q

What is dissociative disorder

A

Disassociating memories - psych symptoms- amnesia
Multiple personality disorder

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18
Q

What is factitious disorder

A

Mucnhausans - physical and psychological symptoms produced

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19
Q

What is malingering

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A

Exaggerating symptoms for financial gain

20
Q

What are somatic symptoms in depression

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A

More biological depressive episode
More severe than an episode with no somatic symptoms

Loss of emotional reactivity
Diurinal mood variation
Anhedonia
Early morning waking
Psychomotor agitation/ retardation
Loss of appetite/ weight
Loss of libido

21
Q

What are the features of avoidant personality disorder

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A

Fearful/ anxious
View themselves as inferior and reluctant to engage
Still a strong desire to have interaction with others

22
Q

What is the most common treatment for panic disorder

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A

SSRI (sertraline) and CBT
If SSRI’s no response/ contra use Imipramine or clomipramine

Symptoms need to be present for at least 1 month

23
Q

What are some side effects of antipsychotics

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A

Parkinsonism
Acute dystonia (sustained muscle contraction)
Akathisia- restlessness
Tardive dyskinesia - abnormal involuntary movements eg. pouting or chewing

Increased risk of stroke and VTE

Anti-muscarinic effects- dry mouth, urinary retention, constipation
Sedation, weight gain
Raised prolactin
Neuroleptic malignant syndrome- pyrexia and muscle stiffness
Prolonged QT
Reduced seizure threshold

Apiprazole- has the best side effect profile- if patients are suffering from side effects on the other medications

24
Q

When are personality disorders diagnosed

Study These Flashcards
A

At 18
BPD is the only one that can be diagnosed before if sufficient evidence

25
What is the treatment for OCD
Use Ybocs scale- severe if they spend more than 3 hrs per day on obsession and compulsion 1. CBT 2. SSRI and CBT 3. Clomipramine if SSRI contraindicated
26
What is the difference between Formication and delusional parasitosis
Formication- feeling fo paraesthesia which feels like bugs under the skin Delusional parasitosis- fixed delusion that there are bugs under the skin
27
When are lithium levels checked
12 hrs after last dose taken 5 days after any dose changes made Want levels between0.6-0.8 Once stable on dose check every 3 months Gets toxic at around 1.2 Not recommended in pregnancy but not completely contraindicated
28
What is acute stress disorder and how is it managed
Stress reaction in the first 4 weeks after a traumatic event PTSD diagnosed after 4 weeks CBT and benzos to treat
29
What is the criteria for anorexia nervosa diagnosis
1. Restriction of energy intake - low body weight 2. intense fear of gaining weight/ becoming fat 3. Disturbance in the body weight or shape is experienced- in denial of low weight
30
What are the symptoms of anorexia nervosa
Low BMI Bradycardia Hypotension Enlarged salivary glands Hypokalaemia Low FSH, LH, oestrogen and testosterone Impaired glucose tolerance Hypercholesterolaemia Low T3
31
What is Charles Bonnet syndrome
Recurrent hallucinations in clear consciousness usually with visual impairment No other neuropsychiatric disturbance Risk factors Advanced age Peripheral visual impairment Social isolation / sensory deprivation Early cognitive impairment
32
What is the criteria for bulimia diagnosis
-Binge eating episodes -Lack of control over eating -Innappropirate compensatory behaviour to prevent weight gain - Exercise/ vomiting -Once a week for 3 months at least CBT and fluoxetine
33
What is the diagnostic criteria for depression
Less severe- PHQ of less than 16 More severe PHQ over 16 PHQ- patient health questionnaire
34
What are the rules around switching from SSRIs
First SSRI withdrawal before alternative is started
35
What are the rules around fluoxetine switching to another SSRI
Withdraw then leave a gap 4-7 days before starting a low dose alternative SSRI
36
What are the rules around switching from an SSRI to a TCA
Cross taper- current drug reduce slowly whilst dose of new drug increase
37
What are the contraindications and side effects of ETC
Useful in severe depression refractory to medication Absolute contraindication is raised ICP Side effects Headache, nausea, short term memory impairment, cardiac arrhythmia x
38
What is the stepwise management of generalised anxiety disorder
1. Recognition and pyschological interventions- self help or CBT 2. SSRI 3. Another SSRI or SNRI (duloxetine or venlafaxine)
39
What are the side effects of lithium
Mood stabiliser in bipolar Narrow therapeutic range Nausea and vomiting Fine tremor Nephrotoxicity Thyroid enlargement ECG- T wave flattening/ inversion Weight gain Idiopathic intracranial HTN Leucocytosis Hyperparathyroidism and hypercalcaemia When checking lithium levels check 12 hrs post dose
40
What are the features and management of PTSD
re-experiencing- flash backs, nightmares Avoidance- situations and people Hyperarousal- exaggerated startle, irritable Emotional numbing Trauma focussed CBT Venlafaxine or SSRI like sertraline If severe Risperidone
41
What are the features of Schizophrenia
Auditory hallucinations -2 or more voices discussing the patient in the third person -Though echo -Voices commenting on patients behaviour Body sensations being controlled by external influence Actions/impulses/feelings Delusional perceptions- perceive a normal object then be delusional- the light is green so I am the king Thought broadcasting/ withdrawal/insertion Made up words Impaired insight, negative symptoms- anhedonia, poor speech and motivation, catatonia Management Oral atypical antipsychotics CBT Check CVD risk factors
42
What drugs interact with SSRIs
NSAIDs - need to give a PPI if prescribing both together Warfarin/ heparin Aspirin Triptans Monoamine oxidase inhibitors
43
What is somatisation disorder
Multiple physical symptoms for at least 2 yrs Won't accept reassurance of negative tests
44
What is tangentiality
wandering from a topic on a tangent without returning to it
45
What medications need cautioned in lithium
ACE inhibis, diuretics- anything that increases risk of AKI
46
What are the side effects of olanzapine
A 2nd line antipsychotic High BP High BMI Diabetes Weight gain Hyperprolactinaemia

3rd yr clinical (22 decks)

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