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Passmed 3rd year > Psych Passmed > Flashcards

Psych Passmed Flashcards

1
Q

What acute dystonia?

A

sustained muscle contraction (e.g. torticollis, oculogyric crisis)

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2
Q

What drug is used to manage Acute dystonia secondary to antipsychotics?

A

Procyclidine - is an anticholinergic = helps decrease muscle stiffness, sweating + the production of saliva, and helps improve walking ability in people with Parkinson’s disease

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3
Q

What is tardive dyskinesia?

A

a side-effect of antipsychotics after being on the drug for several years.

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4
Q

How do you manage Tardive Dyskinesis?

A

Tetrabenazine

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5
Q

Symptoms of Tardive Dyskinesia?

A

lip-smacking, difficulty swallowing and excessive blinking

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6
Q

Which SSRI is a good choice for young adults?

A

Fluoxetine

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7
Q

When prescribing citalopram which drug should be avoided?

A

Rasagiline (MAOi)

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8
Q

What is serotonin syndrome?

A

present with fever, confusion, seizures, renal and hepatic impairment, arrhythmia, increased muscle tone, and hypersecretion of sweat

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9
Q

Typical Anti-psychotics

A

D2 Receptor Antagonist, blocking dopaminergic transmission in the mesolimbic pathways.

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10
Q

Examples of Atypical Anti-psychotic?

A

Clozapine
Risperidone
Olanzapine

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11
Q

Examples of Typical Anti-psychotic?

A

Haloperidol

Chlopromazine

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12
Q

Atypical Anti-psychotic?

A

Act on a variety of receptors (D2, D3, D4, 5-HT)

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13
Q

Mechanism of Alcohol Withdrawal?

A

decreased inhibitory GABA and increased NMDA glutamate transmission

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14
Q

When do symptoms of Alcohol start?

A

6-12 hours: tremor, sweating, tachycardia, anxiety

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15
Q

When do seizures occur after alcool withdrawal?

A

36 hrs

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16
Q

When do incidences of delirium tremens occur?

A

48-72 hours

coarse tremor, confusion, delusions, auditory and visual hallucinations, fever, tachycardia

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17
Q

What is the 1st line for Acute Mania/depression in Bipolar Disorder?

A

Atypical Anti-psychotic e.g. Olanzapine / Quetiapine

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18
Q

MoA of anticonvulsants ?

A

Block overactive pathways (reduce hyperactivity in the brain)
Possible MoA: increased GABA neurotransmission (GABA is an inhibitory neurotransmitter)

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19
Q

What are SE of Lithium ?

A 
Dry mouth 
Strange taste (metallic)
Tremor 
Polyuria 
Weight gain
Hypothyroidism 
Renal impairment = dehydration + hyponatremia
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20
Q

Adverse Effects of Atypical antipsychotics?

A

Weight gain, metabolic dysregulation (Olanzapine)
Agranulocytosis (Clozapine)
Hyperprolactinaemia (Risperidone + Amisulpride)

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21
Q

Which atypical Anti-psychotic has a good side-effect profile for prolactin elevation ?

A

Aripiprazole

22
Q

Anti-depressants that block a2 adrenergic receptors?

A

Mirtazapine

23
Q

Side Effects of Mirtazapine?

A

Increase appetite + sedation

24
Q

Mirtazapine is useful for who?

A

For elderly people: suffering from insomnia + poor appetite

25
Q

SE of TCA?

A

Anticholinergic side effects: dry mouth, blurred vision and urinary retention.
Antihistaminic side effects: weight gain

26
Q

Role of Mesolimbic?

A

Acts on nucleus accumbens (NA) to mediate pleasure /motivation.
Overactive in schizophrenia due to too much dopamine => causes +VE symptoms.

27
Q

Role of Mesocortical?

A

Underactive in schizophrenia due to reduced dopamine => causes negative symptoms.

28
Q

Role of Nigrostratal?

A

Affected by antipsychotics => extra-pyramidal side effects.

29
Q

Transient increase in suicidal ideation especially in <25yrs

A

SSRIs

30
Q

When should you stop SSRI?

A

Gradually reducing dose over 4 weeks

31
Q

SSRIs in pregnancy?

A

A small increase in congenital heart defects in 1st trimester.
Small risk of persistent pulmonary hypertension of the newborn in the 3rd trimester.
Paroxetine ++ bad for this.

32
Q

TCA examples?

A

Imipramine, Amitriptyline, Clomipramine

33
Q

SE of TCAs?

A

Anticholinergic (Drowsiness, dry mouth, blurred vision, constipation, urinary retention)
QT prolongation
Orthostatic Hypotension
Cardiotoxic in overdose

34
Q

What is Wernicke?

A

acute thiamine deficiency (ataxia, nystagmus, confusion)

35
Q

What is korsakoff?

A

chronic thiamine deficiency (dementia, confabulation)

36
Q

Opioid toxicity reversal?

A

IV Naloxone

37
Q

SE of paroxetine / SSRI?

A

gastrointestinal symptoms (Diarrhoea), restlessness, mood changes and insomnia.

38
Q

Avoidant personality disorder?

A

Fearful of criticism, being unliked, rejection and ridicule

39
Q

What is Neuroleptic malignant syndrome?

A

Presents w/ muscular rigidity, fever, altered mental status, and autonomic dysfunction (such as tachycardia and hypertension)

40
Q

Management of alcohol withdrawal?

A

First-line: long-acting benzodiazepines e.g. chlordiazepoxide or diazepam. Lorazepam may be preferable in patients with hepatic failure.

41
Q

What is a hoover sign?

A

clinical tool to differentiate organic from non-organic leg paresis.

42
Q

What is Bulimia nervosa acid-base + electrolyte imbalance?

A

Associated w/ metabolic alkalosis, hypokalemia + hypochloraemia.

43
Q

Tuberoinfundibular pathway?

A

dopaminergic pathway emanating from the hypothalamus to the median eminence.

44
Q

Nigrostraital pathway ?

A

involves in the pathophysiology of parkinson’s

45
Q

Common features of PTSD

A

Flashbacks, nightmares
Avoidance
Hyperarousal

46
Q

Believe that your movement / sensations are controlled by external force

A

Passivity

47
Q

Which anti-psychotic drug cause hperprolactinaemia?

A

Risperidone

48
Q

Which Anti-psychotic drugs is assoc. w/ seizures?

A

Clozapine reduces seizure threshold, making seizures more likely

49
Q

What is akathisia?

A

Motor restlessness + need to be in constant movement due to long-standing use of Anti-psych drugs.

50
Q

Ris factor for GAD?

A

Aged 35 - 54
Being divorced or separated
Living alone
Being a lone parent

51
Q

Comparing dementia and delirium?

A 
Delirium = sudden and Dementia = gradual decline. 
Dementia = pt are alert, orientated, normal behaviour, no halucination and deliriase pts are the opposit.
52
Q

What is the management of dilirium?

A

First line Haliperidol

Sendond line lorazepam

Passmed 3rd year (7 decks)

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