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psych high yield Flashcards

1
Q

De Clerambault’s syndrome

A

presence of a delusion that a famous person is in love with them, with the absence of other psychotic symptoms as is the case

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2
Q

Capgras syndrome

A

delusion that a person closely related to the patient has been replaced by an impostor

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3
Q

De Frégoli syndrome

A

delusion of identifying a familiar person in various people they encounter

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4
Q

Othello syndrome

A

delusion of sexual infidelity on the part of a sexual partner

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5
Q

Ekbom syndrome

A

delusional parasitosis - describes the delusion of infestation

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6
Q

acute stress vs ptsd?

A

ptsd diagnosed can only be diagnosed after 4 weeks

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7
Q

somatisation vs hypochondriasis?

A

somatisation = persistent belief of multiple physical symptoms lasting for at least 2 years
hypochondriasis = persistent belief in the presence of a serious underlying disease (in this case, a brain tumour)

hypochondriasis is worrying about cancer (as they both contain the letter C and it is an example of a serious underlying disease) and somatisation disorder is worrying about multiple physical symptoms (as they both contain the letter S)

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8
Q

cluster A personality disorders:

A
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9
Q

wernicke’s encephalopathy triad and what causes it:

A

confusion, ataxia, opthalmoplegia
(also nystagmus)

associated with lesions in the mamillary bodies
caused by chronic B12 (thiamine) deficiency eg chronic alcoholism / malnutrition

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10
Q

what is korsakoff syndrome

A

complication of wernicke’s encephalopathy: anterograde & retrograde amnesia + confabulation

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11
Q

complication of SSRI in first trimester pregnancy?

A

small increased risk of congenital heart defects

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12
Q

poor prognostic factors for schizophrenia:

A

low iq
gradual onset
family history
lack of obvious precipitant
prodromal phase of social withdrawal
male
poor baseline
predominant negative symptoms
younger age of diagnosis

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13
Q

first line drug treatment ptsd:

A

venlafaxine (or ssri)

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14
Q

knights move vs flight of ideas:

A

knight’s move = illogical leaps from one idea to another, flight of ideas = discernible links between ideas

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15
Q

antipsychotic choice in hyperprolactinaemia?

A

aripiprazole

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16
Q

main side effects of clozapine?

A

agranulocytosis / neutropenia, lower seizure threshold

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17
Q

demographic most likely to commit suicide

A

men age 35-49

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18
Q

when to take blood test after lithium dose?

A

12 hours

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19
Q

risk of ssri use in third trimester pregnancy?

A

persistent pulmonary hypertension

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20
Q

first line treatment for acute stress reaction

A

CBT (acute stress = within 4 weeks of trauma)

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21
Q

side effects of ssris

A

GI upset
Anxiety and agitation
QT interval prolongation (especially associated with citalopram)
Sexual dysfunction
Hyponatraemia
Gastric Ulcer

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22
Q

management of lithium toxicity?

A

IV fluid therapy and alkalisation of the urine -> enhance excretion of the drug
benzos for agitation and seizures

haemodialysis if renal function is poor

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23
Q

features of cannabis intoxication:

A

drowsiness, impaired memory, slowed reflexes and motor skills, bloodshot eyes, increased appetite, dry mouth, increased heart rate, paranoia

24
Q

features of opioid intoxication:

A

drowsiness, confusion, decreased respiratory rate, decreased heart rate, constricted pupils

25
Q

features of lsd intoxication:

A

labile mood, hallucinations, increased blood pressure, increased heart rate, increased temperature, sweating, insomnia, dry mouth

26
Q

what receptor does methamphetamine act on

A

TAAR-1

27
Q

features of stimulant intoxication:

A

euphoria, increased blood pressure, increased heart rate, increased temperature

28
Q

features of opioid withdrawal:

A

Agitation
Anxiety
Muscle aches or cramps
Chills
Runny eyes & nose
Sweating
Yawning
Insomnia
GIdisturbance such as abdominal cramps, nausea, diarrhoea and vomiting
Dilated pupils
‘Goose bump’ skin
Increased heart rate and blood pressure

29
Q

Munchausen’s syndrome

A

intentionally fake signs and symptoms (e.g. adding blood to urine and complaining of pain) in order to gain attention and play “the patient role”

30
Q

what is malingering

A

patients intentionally fake or induce illness for secondary gain; e.g. drug seeking, disability benefits, avoiding work or prison time

31
Q

what is la belle indifference

A

an inappropriate lack of concern over the symptoms they are experiencing. For example, a patient who is suddenly unable to walk proclaims that it is not of any worry to them.
- associated with conversion disorder

32
Q

what is conversion disorder

A

presentation of neurological symptoms without any underlying neurological cause (e.g. paralysis, pseudoseizures, sensory changes).
- not an intentional process, symptoms are very much “real” to the patient, linked to emotional stress

33
Q

% risks of getting schizophrenia if following family members have it: first cousin, grandparent/uncle/nephew, parent/sibling, both parents/identical twin

A

2% risk with an affected first cousin
5% risk with an affected grandparent, aunt/uncle, niece/nephew
10% risk if either a parent or sibling is affected
50% if both parents are affected or an identical twin is affected

34
Q

negative schizophrenia symptoms:

A

Alogia (poverty of speech)
Anhedonia (inability to derive pleasure)
Incongruity/blunting of affect
Avolition (poor motivation)

35
Q

prognosis of schizophrenia?

A

25% never have another episode, 25% improve substantially on treatment, 25% have some improvement and 25% are resistant to treatment

rule of quarters

36
Q

ddx for schizophrenia?

A
  • substance induced psychotic disorder (commonly drugs of abuse, but can be iatrogenic e.g. steroids)
  • organic psychosis caused by infection, brain injury and CNS diseases such as Wilson’s disease
  • metabolic disorder such as hyperthyroidism and hyperparathyroidism
  • dementia and depression can also co-occur with psychosis
37
Q

what is russell’s sign

A

scarring of knuckles from repeated induced vomiting - linked to bulimia

38
Q

physical features of bulimia?

A

parotid gland swelling, dental erosion, russells sign

39
Q

what is pica

A

eating non-food items or food items in obscene quantities

40
Q

what is mitmachen

A

motor symptom of schizophrenia where the patient’s limbs can be moved without resistance to any position but return to their original position once the limb is released

41
Q

what is muddling

A

form of speech disruption seen in schizophrenic patients where both thought blocking (speaking about two completely unrelated concepts) and fusion (the fusing of two completely different concepts into one) occur at the same time

42
Q

difference between bipolar I and bipolar II?

A

bipolar I will experience an episode of mania
bipolar II will experience a hypomanic episode

43
Q

cotard delusion

A

patient believes they are dead or have had organs removed

44
Q

charles bonnet syndrome

A

organic brain syndrome of the elderly associated with visual field defects
- cortical input from other areas (eg. memory association areas) closely involved with the occipital lobe are hypothesised to fill in for a visual deficit, producing a hallucinogenic effect

45
Q

side effect of lithium in pregnancy?

A

Ebstein’s abnormality
- leaflets of the tricuspid valve are displaced, resulting in a large right atrium and a small right ventricle

46
Q

fronto-temporal dementia (Pick’s disease):

A

cognitive impairment, personality change and disinbition

47
Q

vasular dementia:

A

sudden onset cognitive decline and stepwise deterioration as a result of multiple infarcts (background of cardiovascular disease)

48
Q

alzheimers:

A

chronic and progressive dementia

caused by a build up of amyloid protein deposits around brain cells and tau protein tangles within brain cells

49
Q

lewy-body dementia:

A

abnormal protein deposits (Lewy Bodies) cause cognitive decline associated with parkinsonism (rigidity, tremor, bradykinesia)

50
Q

side effects of sodium valproate:

A

vomiting, alopecia, liver toxicity, pancreatitis, pancytopenia, weight gain, oedema, anorexia and tremor

51
Q

side effects of carbamezapine:

A

CARBAMEAN:
Confusion
Ataxia
Rashes
Blurred vision
Aplastic anaemia
Marrow (bone marrow) suppression
Eosinophilia
ADH release
Neutropenia

52
Q

side effects of lithium:

A

hypothyroidism, nephrogenic diabetes, weight gain, diarrhoea, leukocytosis, poor concentration, drowsiness

53
Q

ecg changes on refeeding syndrome:

A

prominent u waves, prolonged QT, ST depression

54
Q

criteria for treating someone using MHA:

A

can only be used to treat mental health conditions

  • must have a mental disorder
  • must be a risk to their health/safety or the safety of others
  • must be a treatment (however this can include nursing care, not just drugs)
55
Q

what is dementia broadly speaking

A

impairment of intellect, memory and personality

56
Q

causes of delirium:

A

DELIRIUMS:

D - Drugs and Alcohol (Anti-cholinergics, opiates, anti-convulsants, recreational)
E - Eyes, ears and emotional
L - Low Output state (MI, ARDS, PE, CHF, COPD)
I - Infection
R - Retention (of urine or stool)
I - Ictal
U - Under-hydration/Under-nutrition
M - Metabolic (Electrolyte imbalance, thyroid, wernickes
(S) - Subdural, Sleep deprivation

57
Q

features of lithium toxicity:

A

GI symptoms -> neurological features of ataxia, tremor, confusion and nystagmus
often precipitated by dehydration / illness

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