Psych Passmed Flashcards
(32 cards)
Side effects of Clozapine
Agranulocytosis
Weight gain, etc
Increased seizures (reduces seizure threshold)
Schizoid personality disorder: signs/symptoms
Negative symptoms of schizophrenia, including
- Indifference to praise and criticism
- Preference for solitary activities
- Lack of interest in sexual interactions
- Lack of desire for companionship
- Emotional coldness
- Few interests
- Few friends or confidants other than family
Conversion disorder vs Dissociative disorder vs Somatization disorder
Conversion disorder: loss of function with no cause (e.g. loss of sensation in one arm)
Dissociative disorder: Loss of non physical function with no cause (e.g. loss of memory)
Somatization disorder: Symptoms with no cause (e.g. pain)
Side effect of steroid use (short term)
Steroid induced psychosis
Factors associated with poor prognosis in Schizophrenia
strong family history gradual onset low IQ premorbid history of social withdrawal lack of obvious precipitant
First and second line treatments for PTSD
First line: CBT and EMDR (Rapid eye movement)
Second line: Drugs: Paroxetine or Mirtazapine
first episode of sudden onset psychosis in an elderly lady, what important investigation is required to rule out other secondary causes?
CT head
potentially useful side effects or Mirtazapine
sedation and increased appetite
Hx of benzodiazepine abuse (not an addict), incontinent, drowsy, slurring words. Rx?
Observation
Hx of benzodiazepine abuse (not an addict), incontinent, drowsy, slurring words. Cardio or respiratory impairment
IV flumazenil
sense of inner restlessness and inability to keep still
Akathisia
what can cause a rise in clozapine blood levels
Smoking cessation
Risk factors for charles bonnett syndrome
Advanced age Peripheral visual impairment Social isolation Sensory deprivation Early cognitive impairment
How to differentiate pseudodementia (depression) from dementia
global memory (depression) loss rather than short-term memory loss (dementia)
How should the citalopram be stopped?
Withdraw gradually over 4 weeks
Side effects of SSRIs in pregnancy
- BNF says to weigh up benefits and risk when deciding whether to use in pregnancy.
- Use during the first trimester gives a small increased risk of congenital heart defects
- Use during the third trimester can result in persistent pulmonary hypertension of the newborn
- Paroxetine has an increased risk of congenital malformations, particularly in the first trimester
has the most tolerable side effect profile of the atypical antispsychotics, particularly for prolactin elevation
Aripiprazole
SSRI discontinuation syndrome: Symptoms
increased mood change restlessness difficulty sleeping unsteadiness sweating gastrointestinal symptoms: pain, cramping, diarrhoea, vomiting paraesthesia
Which classes of drug is most likely to interact with a selective serotonin reuptake inhibitor
Triptans - avoid SSRI
Warfarin/heparin/aspirin - Avoid SSRI, consider mirtazapine
NSAIDs: ‘do not normally offer SSRIs’, but if given co-prescribe a proton pump inhibitor
Symptoms of PTSD
re-experiencing: flashbacks, nightmares, repetitive and distressing intrusive images
avoidance: avoiding people, situations or circumstances resembling or associated with the event
hyperarousal: hypervigilance for threat, exaggerated startle response, sleep problems, irritability and difficulty concentrating
emotional numbing - lack of ability to experience feelings, feeling detached
first-line treatment for children and young people with anorexia nervosa
Family based therapy
Anorexia features
most things low
G’s and C’s raised: growth hormone, glucose, salivary glands, cortisol, cholesterol, carotinaemia
Features of alcohol withdrawal
symptoms: 6-12 hours
seizures: 36 hours
delirium tremens: 72 hours
Side effects of trycyclic antidepressants
drowsiness dry mouth blurred vision constipation urinary retention
Blurred vision and dry mouth are more common with imiprimine
