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Phase 3a > Psych > Flashcards

Psych Flashcards

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1
Q

What is the term given to someone with a fear of outdoor spaces

A

Agoraphobia

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2
Q

What sleep disturbance do you classically see in depression

A

EMW

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3
Q

Give 4 types of bipolar

A

Type 1
Type 2
Rapid cycling
Cyclothemia

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4
Q

How many cycles would someone with rapid cycling bipolar have in a year

A

4+

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5
Q

First line tx for self harm

A

DBT

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6
Q

What are the 3 key features of mania

A

IHE

Irritability
Hyperactivity
Elated out of context

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7
Q

Definition of delusion

A

A fixed unshakeable belief, out of context of religious and cultural norms, that is held in the face of evidence

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8
Q

Name the two MHA police orders and when they are applied

A

S13– need a house warrant

S136-in community/ a&e, hold for 24hrs (+12)

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9
Q

What sleep disturbances do you see in GAD

A

Insomnia, struggle to get to sleep + wake lots in the night

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10
Q

How long do you ha e to have had depressive symptoms for to get a diagnosis

A

2weeks

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11
Q

How long do you have to have had manic symptoms for to get a diagnosis of mania

A

1week

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12
Q

How long do you have to have hypomanic symptoms for to get a diagnosis of hypomania?

A

4days+

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13
Q

What are the causes of lithium toxicity

A

Dehydration- any cause for this
Excessive intake
Decline in renal function
Drug interactions

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14
Q

Complications of lithium toxicity

A

Induction of Serotonin syndrome
Nephrogenic diabetes insipidus
Coma
Death

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15
Q

Before starting lithium what tests do you need to do:

A

Preg test
Renal function test
Thyroid function test

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16
Q

What advice would you give to someone starting lithium

A

Stay hydrated
Don’t restrict salt intake
Carry lithium card

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17
Q

Lithium toxicity symptoms

A 
Tremors
hyperreflexia 
Ataxia 
Nystagmus 
Inability to concentrate urine

Sign - hypothyroidism

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18
Q

Core features of PTSD

A

Reliving experiences
Hyper vigilance
Avoidance

Due to traumatic event - occurs w/in 6 months

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19
Q

Symptoms of anxiety

A

Sweating
Palms/tachyC
HyperV

May go on to vomit/ pass out

Sign- wringing hands

(Enhanced startle response, difficulty concentrating)

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20
Q

Treatment for anxiety

A

Propanalol / benzos for tachyC
SSRIs- paroxetine/ fluoxetine
SSNRI- venlaflaxine
Mirtazapine - more sedating antiD

Psychological- 
CBT exposure techniques (graded or flooding)
In PTSD - trauma focussed CBT
Breathing techniques 
Mm relaxation techniques
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21
Q

What are the characteristics of OCD

A

Obsessional thoughts and compulsive acts

They have insight but feel compelled

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22
Q

What is meant by blunted affect

A

Reduced emotional responsiveness

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23
Q

What is meant by flat affect

A

No emotional responsiveness

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24
Q

What is psychoanalysis

A

Opening the pt up to ideas about themself

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25
What is the difference between OCD and OCPD?
OCPD- perfectionism, not aware their habits are detrimental, think others should function the same. Harsh super ego. Ego-syntonic OCD - aware their actions are irrational and are distressed by it , ego dystonic
26
Define ego
Ones self that bridges between conscious and unconscious though
27
Define dystonic (such as ego-dystonic)
Responses and behaviours are against a persons beliefs and will Inconsistent with ones self concept
28
What is meant by egosyntonic
Responses and behaviours are in keeping with the needs and goals of the ego, consistent with ones ideal self image
29
Treatment of lithium toxicity
Hydration. Stop lithium Hemodialysis
30
Symptoms of serotonin syndrome
Altered mental state - irritable, confused,manic Autonomic dysfunction- bp, tachyC, hypothermia,diarrhoea NM hyperactivity- tremor, hyperreflexia, (myo)clonus
31
What class of antidepressants give rise to anticholinergic SEs - name two
TCAs - amitriptylin, imipramide
32
What life threatening SEs does clozapine have. How are they monitored
Agranulocytosis- blood tests | Myocarditis - annual ecg
33
What is clozapine used to treat
Treatment resistant schizophrenia ( have to have tried 2APs at a reasonable dose prior)
34
SEs of olanzapine
Metabolic SEs Increase cholesterol and glucose - diabetic risk
35
What syndrome are you at risk of when you take lamotragine ?
Steven Johnson’s syndrome
36
Which APs require hepatic monitoring
Carbamazepine | Na valproate
37
MH illness+ fever + APs is a combination for what syndrome
Neuroepileptic syndrome
38
MH illness + fever + ssris are a combination for what syndrome
Serotonin syndrome
39
How to pharmacologically treat an acute depressive crisis
SSRI-citalopram AP- olanzapine Benzo- lorazepam
40
What is the classic picture of vascular dementia
Vasculopath Stepwise decline Executive function is first to go
41
What dementia is it likely to be in a younger person who has personality changes
Frontotemporal
42
How would you investigate FT dementia
SPECT - see reduce bf to frontal and temporal areas
43
Give the classic symptoms of Alzheimer’s
``` Short term memory problems Losing things Forgetting names / appts/ convos Getting lost Pacing Word finding difficulties ```
44
What area of the brain is damaged in Alzheimer’s
Hippocampus
45
Name 3 ACEi drugs used to tx mild to mod Alzheimer’s
Rivistigmine Galantamine Donepezil
46
Name a NMDA R antagonist used to tx severe Alzheimer’s
Memantine
47
SE of ACEi Alzheimer’s meds’
N&V
48
Classic symptoms of Lewy body Alzheimer’s
``` Visual hallucinations (M symps come after)- stuffing gait (don’t confuse w/ Parkinson’s dementia ```
49
Classic symptom of Parkinson’s dementia
Emotional liability (1/3 of PD pts ) (Have to have had motor symps for a year before)
50
What illness is pseudo-dementia commonly seen in
Severe depressive disorder
51
Two key features of pseudo dementia
Are aware their memory is rubbish (insight) | Respond to ADs
52
What medication must you not give in Alzheimer’s w/ Lewy bodies ?
APs - as can precipitate movement disorders
53
How many points is the ACE out of and what is the cut off?
/100 Cut off 85
54
How many points is the mini ACE out of and what’s the cut off score?
/30 Cut off 21
55
How many points is the mmse out of and what are the cut offs?
/30 Severe dementia = <12 Moderate = 13-20 Severe = 21-24
56
What is Capgras syndrome
That someone they know is being replaced by an imposter
57
Fregoli syndrome
That a stranger is someone they know in disguise
58
What is De clerabaults syndrome
That someone at a higher role in society is I love with them
59
Cotards syndrome
A person believes they are dying/ dead/ putrefying I.e. have lost all their blood
60
Charles bonnet syndrome
Complex visual hallucinations in pts with visual impairments - pt has insight
61
3 differences between EUPD and BAD
High and low moods occur within a day in EUPD. Impulsivity is in high and low moods in EUPD but only in high moods in BAD EUPD doesn’t have manic episodes Tx EUPD w/ DBT tx BAD w/ CBT
62
What are the features of EUPD
Devo quick and strong attachments/ strong sense of abandonment Self harm Impulsivity Mood swings Inner subjective space voices
63
Two types of EUPD
Boarderline Impulsive
64
What psychological interventions would be appropriate for someone with EUPD
DBT to teach coping mechanisms Mentalisation based therapy (MBT) Cognitive analytic therapy
65
What psychological therapy would be appropriate for someone with dementia
CST | Cognitive stimulation therapy
66
How does MBT work?
encourages pt to think what other people feel and think so they feel less persecuted by others
67
How does cognitive analytic therapy work in EUPD
It teaches pt about helpful and unhelpful relationships
68
What is attachment theory
It is a psychological theory regarding relationships between humans. Young children need to develop a relationship with at least one primary care giver for normal social and emotional devo
69
What are the three types of attachment someone can develop
Secure Insecure Disorganised
70
Name two chemicals in the brain that are altered during trauma
Cortisol | Adrenaline
71
How does repeated trauma cause illness
High cortisol levels lower the immune system
72
Why is memory altered in repeated trauma
Stress can inhibit neurogenasis
73
What areas of the brain are affected by repeated trauma
Hippocampus, medial prefrontal cortex, HPA axis, amygdala
74
Differentials for bipolar
Cyclothemia Schizoaffective disorder EUPD
75
What is the DSM-IV criteria for T1 bipolar
Hx of 1+ manic episodes, 4+ symps of mania lasting over 1 week giving marked functional impairment/ hospitalisation
76
What is the DSM-IV criteria for T2 bipolar
1+ depressive episode (lasts for 2w and occurs most days) 1+ hypomanic episode Symptoms are not attributed to a physical illness or induced by a drug
77
How does CBT work
Helps identify harmful thought patterns and behaviours
78
What is the term for when a person places too much importance on a normal stimulus
Delusions of reference
79
Mr X has heard his neighbours talking about him inside their house between themselves
3rd person auditory hallucinations
80
What is a delusional perception
A two stage process where you first perceive a stimulus then a delusion develops around it
81
What is passivity phenomena and what illness is it commonly seen in
Where a persons thoughts or actions are influenced or controlled by an external agent Schizophrenia
82
What are the schneiderian first rank symptoms of schizophrenia
3rd person auditory hallucinations Thought alienation - I, W, B Delusion of control-Passivity phenomena (inc somatic passivity) Thought disordered
83
Why do an ECG when someone is on APs
APs can cause long QT syndrome
84
Psychiatric Differentials for schizophrenia
Acute/transient psychotic episode BPD+ psychotic symps Delirium Dementia Mood disorders : BAD+ psychotic symps Depression + psychotic symps Schizoaffective disorder
85
How long do schizo fist rank symptoms have to be present for for ICD10 diagnosis
1month
86
Organic differentials for schizo
``` V I- Steroids, l-dopa, anticholinergics T- trauma A- SLE M-b12 deficiency, heavy metal poisoning, thyrotoxic storm I- encephalitis, HIV, neuro syphilis N- Brain tumour/ mets C ``` + drugs (cannabis) and alcohol
87
Treatment for first acute manic episode
Antipsychotic
88
Core symptoms of mania
Elated Irritability Hyperactivity
89
How long do you have to have symps of depression for a diagnosis
2w
90
How long do you have had to have had manic symptoms for for a diagnosis of mania
1w
91
What comorbidities might you have with depression
Anxiety Bipolar Addictive disorder
92
What are the most common causes of lithium toxicity
Dehydration Decline in renal function Drug interactions
93
What should you check before starting someone on lithium
Thyroid function Pregnancy Renal function
94
What is the cause of wernickes encephalopathy
Thiamine / B12 deficiency
95
What is the triad of wernickes encephalopathy
Ataxia Confusion Opthalamoplegia
96
What could be an organic cause for mania
Hyperthyroidism

Phase 3a (7 decks)

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