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Psych Flashcards

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1
Q

Depression

  1. 3 major sx
  2. 7 minor sx
  3. Diagnosis
A
  1. Low mood, anhedonia, fatiuge
  2. EMW, appetite change, poor conc., low self esteem, guilt, suicide, pessimistic
  3. > 1major sx most of every day for 2w
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2
Q

Mx of depression

A
  • assess risk of suicide
    Mild - low intensity psychological eg CBT
    Moderate - medication, psychosocial intervention
    Severe - medication, admit, ECT if catatonia
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3
Q

Sx of mania

A

Elated mood, increased energy, reduced sleep, disinhibition, over spending, hypersexual, pressure of speech, grandiosity
loss of insight

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4
Q

Dx of mania

A

Sx for >1w
Impact on function
Social rejection - bizarre behaviour

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5
Q
  1. When do episodes of bipolar occur?
  2. Length of manic episode?
  3. Length of depressive episode?
A
  1. following life stress
  2. 4m
  3. 6m
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6
Q
  1. Mx of mania

2. maintenance of BPD

A
  1. antipsychotic

2. Lithium

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7
Q

Personality disorders egs of each cluster?

  1. A
  2. B
  3. C
A
  1. MAD ‘odd/eccentric’ (schizoid, schizotypal, paranoid)
  2. BAD ‘dramatic, emotional, erratic’ (antisocial, emotionally-unstable, histrionic, narcissistic)
  3. SAD ‘anxious/fearful’ (anankastic, anxious, dependent)
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8
Q

Schizoid PD

  1. typical behaviours
  2. character eg
A
  1. emotionally cold, withdrawn, asexual, fantasy world

2. Sheldon from BBT

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9
Q

Schizotypal PD

  1. typical behaviours
  2. character eg
A
  1. eccentric, odd ideas, difficulty thinking, lack of emotion, ?psychotic
  2. david tennant Dr Who
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10
Q

Paranoid PD

  1. typical behaviours
  2. character eg
A
  1. suspicious, conspiracies, hold grudges

2. husband always thinks wife is cheating on him

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11
Q

Antisocial PD

  1. typical behaviours
  2. character eg
A
  1. dont care about others feelings, easily frustrate, aggressive, crimes, impulsive, no guilt
  2. millseh king of grime
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12
Q

Emotionally Unstable PD

  1. Typical behaviours
  2. character eg
A
  1. hard to control emotions, low self esteem, DSH, lose relationships, clingy
  2. jodie
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13
Q

Histrionic PD

  1. typical behaviours
  2. character eg
A
  1. over dramatic, self centred, attention seeking, strong labile emotions, seductive
  2. stu
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14
Q

Narcissistic PD

  1. typical behaviour
  2. character eg
A
  1. self-important, dreams of power, crave attention, ask for favours,
  2. hodge lol / trump
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15
Q

Anankastic (OC) PD

  1. typical behaviour
  2. character eg
A
  1. worry and doubt, perfectionist, cautious, judgemental, sensitive to criticism
  2. laurence at school
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16
Q

Avoidant PD

  1. typical behaviours
  2. character eg
A
  1. anxious, worrier, insecure, avoids

2. recluse

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17
Q

Dependant PD

  1. typical behaviours
  2. character eg
A
  1. passive, relies on others, hopeless, abandoned

2. fincheh

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18
Q

Define:

  1. hallucination

2. delusion

A
  1. perception in the absence of external stimulus

2. fixed, firm belief despite evidence to contrary

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19
Q

Parts of MMSE

A

ASEPTIC

  • Appearance +behaviour
  • Speech
  • Emotion
  • Perceptions
  • Thoughts
  • Insights
  • Cognition
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20
Q

Schizophrenia

  1. 1st rank sx
  2. other sx
  3. criteria
A
  1. 3rd person auditory hallucination, thought disorder, passivity phenomena, delusional perception
  2. incongruity, breaks in train of thought, -ve sx, neologisms, catatonia
  3. 1 clear 1st rank sx for >1m
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21
Q

Features of Paranoid schizophrenia

Study These Flashcards
A
  • Most common type
  • Delusions of persecution, reference, special mission, jealousy
  • hallucinatory voices threatening
22
Q

Features of Hebephrenic schizophrenia

Study These Flashcards
A
  • Affective changes prominent

- Behaviour irresponsible and unpredictable

23
Q

Features of catatonic schizophrenia

Study These Flashcards
A
  • Stupor/mutism
  • excitement (purposeless motor activity)
  • posturing
  • negativism
  • rigidity
  • waxy flexibility
  • automatism
24
Q

Features of residual schizophrenia

Study These Flashcards
A
  • negative symptoms (slowing, under activity, blunt affect, passivity, poverty of speech, no eye contact, poor self care)
  • positive symptoms decline in freq
25
Schizoaffective disorder 1. what is it 2. types
1. Schizophrenia and affective sx at same time 2. - manic - depressive - mixed
26
Clozapine 1. monitoring? 2. why? 3. missed dose rule?
1. Titrate dose as inpatient. Weekly for 18w, fortnightly for 1y then monthly 2. agranulocytosis 3. miss 2 days then must reinitiate treatment
27
Neuoroleptic malignant syndrome 1. what 2. who 3. dx features 4. comps 5. mx
1. imbalance of dopaminergic neurotransmitters following initiation of drugs 2. 0.5% of pts, usually young men. First 10d of treatment 3. hyperthermia, rigidity, tachycardia, delirium, autonom instab 4. rhabdomyolysis (measure CK), renal/liver failure, CV collapse 5. bromocriptine
28
RFs for suicide?
``` SAD PERSONS Sex (M) Age <19 / >45 Depression Prev attempt EtOH Rational thought loss Social support lack Organised plan No spouse Sick ```
29
pcm OD 1. ix 2. RFs for rpt 3. mx
1. U&Es, LFTs, clotting, glucose, 2. young, alcohol, life stress, prev self harm 3. NAC
30
anxiety | 1. 3 types
- GAD - Panic - Phobic
31
GAD 1. dx (GAD-7) 2. RFs 3. precipitant 4. perpetuating 5. protective
1. >6m prominent tension, worry + [palp, sweating, tremble, dry mouth, chest pain, nausea, dizzy, numbness, restlessness, on edge] 2. middle age, separated, lonely 3. stressful event 4. anxious personality, ways of thinking 5. young, married, cohabit
32
Panic disorder 1. what 2. panic attack? 3. severity
1. Recurrent spontaneous panic attacks occuring in any situation 2. Discrete episode of fear lasting a few minutes 3. Mod = 4 attacks in 4 weeks Severe = 4 attacks per week in 4 weeks
33
1. Mx of anxiety disorders | 2. when to refer
1. -Conservative (education and monitoring) - Psychological (self help, cbt, relaxation) - Pharma (SSRI, pregabalin, BB) 2. risk of suicide, self neglect
34
Bipolar disorder 1. main complication 2. other
1. suicide/DSH | 2. self neglect, exploitation, substance misuse
35
Mania vs hypomania
- Mania >7d | - Hypomania 4d and no psychotic features
36
Bipolar management
SGA lithium if manic episode --> stop antidepressants
37
1st episode of psychosis mx
SGA + psychological intervention
38
Criteria for MHA
- Patient has mental disorder - Detained for their safety / of others - Nature of disorder warrants detention in hospital
39
TCA 1. eg 2. mechanism 3. effects 4. se
1. amityptilline 2. blocks reuptake of 5HT + NA. 3. drowsy, confusion, 4. anticholinergic (dry eyes, mouth, blurred vision, retention) tachycardia, sedation, wt gain
40
SSRI 1. eg 2. mechanism 3. se
1. sertraline, citalopram, fluoxetine 2. inhibits 5HT reuptake 3. can increase suicidal ideation, nausea, diarrhoea, restless, tremor, anorgasmia
41
Serotonin syndrome 1. triad 2. mx
1. cognitive impairment (agitation, confusion); autonomic (shiver/sweat); neuromus dysfunction (akathisia) 2. STOP DRUG + ABCDE give charcoal, IV fluids + benzo 5HT block --> chlorpromzine
42
Lithium toxicity 1. sx 2. ix 3. mx
1. coarse tremor, N+V, diarrhoea, muscle twitching, renal failure, confusion 2. Li > 1.5mmol/l 3. STOP LITHIUM IV fluids, total bowel irrigation
43
Circumstantiality 1. what 2. seen in
1. trivial details when answering, eventually gets to point | 2. anxiety disorders
44
Loosening of assos 1. what 2. egs
1. breakdown in assos between topics, random chain of thoughs 2. knights move
45
OCD 1. obsession 2. compulsion 3. dx
1. stereotyped, purposeless words/phrases -OWN thoughts (intrusive + nonsensical) 2. senseless, repeated rituals done to reduce stress of obsessions 3. >2w, OWN thoughts, intrusive + unpleasant,
46
Negative sx of schizophrenia
- poverty of speech - blunt affect - social withdrawal - lack of motivation - self neglect
47
PTSD 1. what 2. sx 3. assos 4. mx
1. delayed response to severe traumatic event (>6m duration) 2. flashbacks, hypervigilance, disturbed sleep, autonom reaction 3. substance misuse, depression, aggression 4. CBT, EMDR
48
Alcohol withdrawal 1. sx of dependence 2. questionairre 3. signs of withdrawla 4. mx
1. tolerance, withdrawal, narrow rep 2. CAGE 3. delirium tremens - tremor, fits, hallucinations 4. chlordiazepoxide + pabrinex
49
Egs of thought disorders + what they are
- Echolalia --> repeating exactly what someone said - Word salad --> disorganised speech, sentences dont make sense - Perseveration --> repeating the same words/answers - Neologism--> making up new words - Expressive dysphasia --> difficulty putting together words - Tangentiality - Clang assos
50
egs of thought delusion
- insertion - withdrawal - broadcast
51
Unexplained symptoms egs (5 disorders)
- Somatisation (multiple symptoms, refuses negative results) - Hypochondrial (persistent belief of underlying serious disease) - Conversion (loss of motor/sensory function, not consciuosly feigned. often stress induced) - Dissociative - Factitious (aka Munchausen's)
52
Side effects of Lithium
``` Leukocytosis Insipidus Tremor (coarse) Hydration (dry mouth, diarrhoea, thirst) Increased GI, skin and memory problems Underactive thyroid, decreased TSH Mums beware (Ebstein's) ```

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