Psychiatry Flashcards

1
Q

Flight of ideas, rapid speech

A

Bipolar disorder

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2
Q

PTSD diagnosis time

A

1 month

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3
Q

Copropraxia

A

Involuntary obscene gestures or touching

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4
Q

Echolalia

A

Meaningless repetition of another person’s spoken words

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5
Q

Echopraxia

A

meaningless repetition of movements of others

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6
Q

Palilalia

A

repeating own words and sentences

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7
Q

Circumstantiality

A

unneccessary detail

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8
Q

Tangentiality

A

detail but comes to the point

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9
Q

Clang associations

A

similar sound and rhymes

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10
Q

Word salad

A

incoherent speech with real words but nonsense sentences

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11
Q

Knight’s move thinking

A

Severe type of loose associations; illogical leaps from one idea to another

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12
Q

Flight of ideas

A

leaps from one idea to another but wit links between them

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13
Q

Perseveration

A

repeating ideas or word despite attempts to change the topic

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14
Q

Serotonin syndrome

A

2 antidepressants such as MAOI with Citalopram; triptans

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15
Q

Neuroleptic malignant Syndrome

A

Rigidity, hyperthermia, autonomic instability and confusion.
Stopping the drug can cause

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16
Q

Treatments of delirium tremens or alcohol withdrawal

A

Chlordiazepoxide or Diazepam

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17
Q

Prevent Wernicke’s Using

A

IV pabrinex

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18
Q

Metoclopramide SE

A

Tardive dyskinesia
Parkinsonism
Extrapyramidal SE- acute dystonia
Avoid in Bowel obstruction

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19
Q

ECT can cause what type of memory impairment

A

Anterograde amnesia

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20
Q

Side effect of Mirtazapine

A

Increased appetite and sedation

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21
Q

SE of MAOI

A

Tyramine cheese reaction

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22
Q

Tardive dyskinesia is a SE of

A

Typical antipsychotic

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23
Q

Agranulocytosis is SE of

A

Clozapine

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24
Q

Treating Borderline PD

A

Dialectical Behavioral therapy

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25
Q

Capgras Syndrome

A

Delusion that person/ place replaced by exact duplicate

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26
Q

Delusional Parasitosis

A

Infested by bugs

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27
Q

Fregoli syndrome

A

One or more familiar persons, usually persecutors following the patient repeatedly change their appearance

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28
Q

Induced delusional disorder

A

Two people who share the same delusion

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29
Q

Formication

A

Crawling, biting; Stinging sensation

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30
Q

Poor prognosis for Schizophrenia

A

Strong FH, Gradual onset, Low IQ, Prodromal phase of social withdrawal and lack of obvious precipitant

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31
Q

Erotomania

A

Presence of delusion that a famous person is in love with them, No psychotic symptoms presen

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32
Q

Hypothyroidism is associated with what bipolar disorder drug

A

Lithium

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33
Q

Extrapyramidal SE of antipsychotics such as oculogyric crisis can be managed by what

A

Anticholinergic drug called procyclidine

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34
Q

Management of serotonin syndrome - Rigidity, hyper reflexes and autonomic dysfunction

A

Diazepam

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35
Q

Lead pipe muscle rigidity, pyrexia and autonomic dysfunction after antipsychotic use

A

Neuroleptic malignant syndrome

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36
Q

Involuntary and abnormal choreoathetosis (twitching) especially chewing and lip smacking and lip pouting

A

Tardive dyskinesia

Management - Tetrabenazine

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37
Q

Emotional instability, disturbed patterns of thinking or perception, impulsive behaviour and intense but unstable relationships

A

Borderline PD

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38
Q

Opthalmoplegia, Ataxia and Confusion in an alcoholic

A

Wernicke’s

Treat using thiamine (b1)

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39
Q

Flight of ideas, pressured speech, grandiosity

A

Bipolar disorder

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40
Q

Auditory hallucinations is a typical feature of

A

Schizophrenia

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41
Q

Sensitive, unforgiving if insulted, question loyalty and reluctance to confide in others

A

Paranoid personality

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42
Q

Solitary activity, lack of interests and companions

A

Schizoid personality

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43
Q

Paranoid ideations, magical beliefs, ideas of reference, odd behaviours and speech

A

Schizotypal personality

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44
Q

Munchausen’s Syndrome

A

Causing symptoms purposefully

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45
Q

Conversion disorder

A

Loss of physical function but no cause

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46
Q

Dissociative disorder

A

Loss of function but non physical such as memory

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47
Q

Important to know: 1st Rank symptom of Schizophrenia

A

3rd person auditory hallucinations, Thought echo, Delusional perception, thought insertion and withdrawal and Somatic passivity

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48
Q

2nd rank symptoms of Schizophrenia

A

Catalonia, 2nd person auditory hallucinations

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49
Q

Confusion, visual hallucination, tachycardia, and pyrexia + alcohol abuse

A

Delirium tremens

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50
Q

Hyperarousal, emotional numbing, nightmares, and avoidance are core behaviours of what disorder

A

PTSD

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51
Q

Othello syndrome

A

Delusional jealousy- unfaithful

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52
Q

Very frequent mood changes; self-destructive behaviours and unstable relationships

A

Borderline personality disorder

53
Q

Flashbacks, nightmares, dissociations, avoidance, sleep disturbances that has occured in first 4 weeks after traumatic event

A

Acute stress disorder

54
Q

Management of acute stress disorder

A

Trauma focused CBT is 1st line

Benzodiazepines for acute symptoms

55
Q

First line for Generalized Anxiety disorder

A

Sertraline (SSRI)

2nd line SNRI or other SSRI

56
Q

Type 1 Bipolar disorder and type 2 bipolar disorder

A

Type 1: mania and depression (most common)

Type 2: hypomania and depression

57
Q

Management of Bipolar disorder

A

Mood stabilizer: Lithium
Mania: Antipsychotic such as Olanzapine and Haloperidol
Depression: Fluoxetine (SSRI)

58
Q

NICE guideline on Bipolar disorder

A

Hypomania - Community mental health team

Mania or severe depression: Urgent referral to CMHT

59
Q

When should be antidepressants stop in Bipolar disorder

A

If patient is taking antidepressant at onset of acute mania

60
Q

Define cyclothymic disorder

A

Chronic mood fluctuations over at least 2 years with depression or hypomania

61
Q

Most common type of dementia

A

Alzhiemer’s dementia (55%)

62
Q

common cause of death in dementia

A

Bronchopneumonia

63
Q

characterstic of Dementia with lewy body

A

Visual hallucination

64
Q

Depression with features of psychosis is always

A

Severe depression

65
Q

Beck’s Cognitive triad of depression

A

negative thoughts about self, the world and future.

66
Q

Neurotransmitter associated with Depression

A

Noradrenaline

67
Q

Management of moderate to severe depression

A

psychological therapy + antidepressants

68
Q

Hypercortisolemia is a feature of what psychological disease

A

depression

69
Q

Management of resistant depression

A

Antidepressant + lithium + Atypical antipsychotics such as Olanzapine, risperidone, Quetiapine

70
Q

what are the types of delusions in depression

A

Nihilistic or meaningless life

*associated with Cotard syndrome

71
Q

type of hallucination in depression

A

Auditory

72
Q

Citalopram, Fluoxetine, Sertraline and Paroxetine are all

A

SSRIs

73
Q

Venlafaxine and Duloxetine

A

SNRIs

74
Q

Mirtazapine and Mianserin

A

Noradrenanergic and Selective serotonin actions

75
Q

Amitriptyline is a

A

TCA

76
Q

Side effects of TCAs

A

Cardiotoxic, fatal in overdose, cardiac arrhythmia and Seizure

77
Q

Side effects of SSRI

A

Hyponatremia, suicidal ideation

78
Q

Only antidepressant that can be used in children

A

Fluoxetine

79
Q

MAOIs SE

A

Hypertension and throbbing headache when tyramine is consumed

80
Q

Confusion, delirium, shivering, sweating, changes in BP and myoclonus, hyperreflexia, ataxia, Hyperthermia, GI upset, Mydriasis, tachycardia, hyper/hypotension

A
Serotonin syndrome (Classify Sternbach's) 
drugs: SSRI, MAOIs, TCAs, Lithium and Amfetamines
81
Q

Core Symptoms of depression

A

low mood, loss of interest and low energy

82
Q

Restrict what they eat and may compulsively overexercise to maintain a low BW

A

Anorexia nervosa

83
Q

have cravings, secretly overeat and try to prevent weight gain by vomiting

A

Bulimia nervosa

84
Q

Constricted affect and emotional expressiveness is associated with which eating disorder

A

Anorexia

85
Q

Treatment of anorexia

A

Adoloscents - Anorexia focused family therapy

2nd line is CBT

86
Q

Treatment of Bulimia

A

Self help for adults
individual eating disorder focused CBT
Family therapy for children
fluoxetine may be used

87
Q

Highest death rate for any psychiatric disorder

A

Anorexia nervosa

88
Q

unlawful behaviour, repeated lying, failure to plan, impulsive, irritability and aggressiveness, disregard safety of self and others

A

Antisocial PD

89
Q

fears critisicm or rejection, unwilling to be involved unless certain of being liked, inferior to others, social inhibitions, restricted lifestyles and cravings for social contact

A

Anxious or avoidant PD

90
Q

Unstable interpersonal relationships, idealization and devaluation, unstable self image, impulsivity in self-damaging area (Spending, sex, and substance abuse); recurrent suicidal behaviour

A

Borderline personality disorder ( linked to child hood trauma)

91
Q

difficulty in everyday decisions without excessive reassurance from others, need others to assume responsibility, difficult in expressing disagreement with others due to fears of losing support, lack initiative

A

Dependent

92
Q

Inappropriate sexual seductiveness, center of attention; shallow expression of emotions, attention seeking, impressionistic speech lacking detail and relationships considered to be more intimate than they are

A

Histrionic PD

93
Q

Grandiose, preoccupation with fantasy of unlimited success, power and beauty, sense of entitlement, takes advantages of others, lack empathy, excessive need for admiration, chronic envy and arrogant attitude

A

Narcissistic

94
Q

preoccupation with details, rules, lists and order, perfectionism hampers with completing tasks, meticulous, scrupulous and rigid about morality, ethics and values, stiff and stubborn

A

OC personality

95
Q

Hypersensitive and unforgiving when insulted, unwarranted tendancy to question the loyalty of friends
reluctant to confide in others; preoccupation with conspiracy and hidden meaning and tend to perceive attacks on their character

A

Paranoid Personality

96
Q

Indifferent to praise and critiscism, prefer solitary activities, lack interest in sexual interactions, lack desire of companionship, cold emotions, few interests and few friends or confidants other than family

A

Schizoid (no risk of psychosis)

97
Q

ideas of reference (insight is retained), odd beliefs, magical thinking, paranoid ideation and suspiciousness, odd and eccenteric behaviour, lack of close friends, inappropriate affect

A

schizotypal PD (associated to schizophrenia)

98
Q

Management of Personality disorder

A

Dialectical behaviour therapy

99
Q

Duration of symptoms in PTSD

A

more than 1 month

100
Q

Treatment of PTSD

A

trauma-focused CBT or eye movement desensitisation and reprocessing
Drug treatment: Venlafaxine or SSRI
Severe cases- Risperidone may be used

101
Q

Echolalia and echopraxia (speech and behaviours) are signs of

A

Catatonic schizophrenia

102
Q

First rank symptoms of Schizophrenia

A

3rd person auditory hallucinations, thought echo, delusional perception, thought disorder and passivity or somatic

103
Q

2nd rank symptoms of schizophrenia

A

Catatonia; 2nd person auditory hallucination

104
Q

Positive symptoms of schizophrenia

A

Hallucinations, and delusions

105
Q

Negative symptoms of Schizophrenia

A

Poverty of speech, flat affect, poor motivation, social withdrawl

106
Q

management of schizophrenia

A

oral atypical antipsychotics are 1st line

CBT

107
Q

Poor prognosis in Schizophrenia

A

strong family history, gradual onset, low IQ, prodromal phase of social withdrawl and no precipitant

108
Q

Extra-pyramidal SE, hyperprolactinemia and tardive dyskinesia are SE of

A

Typical antipsychotics

109
Q

Clozapine, risperidone, Quetiapine and Olanzapine are all

A

Atypical antipsychotics

110
Q

Chlorpromazine, haloperidol, phenothiazine are all

A

typical antipsychotics

111
Q

Agranulocytosis, Seizure risk, VTE, myocarditis, and cardiomyopathy is related to which antipsychotic

A

Clozapine

112
Q

Metabolic SE and insulin resistance as a SE

A

Atypical antipsychotics

113
Q

Extra-pyramidal SE

A

First generation or typical Antipsychotics

114
Q

Contraction of muscle group to maximal limit, typically sternocleidomastoid and tongue, eye muscle involvement (oculogyric crisis) is a SE and is called

A

acute dystonia

Treat using antimuscranics such as procyclidine)

115
Q

Tremor, rigidity, bradykinesia, >1 week after administration is called

A

Reduce dose or use antimuscranic such as procyclidine

116
Q

Restlessness usually lower limbs and a drive to move, occurs after 1 month after initiation of antipsychotic. Is called

A

Akathisia

Treat using Propranolol and benzodiazepines

117
Q

Continous slow writing movements and sudden involuntary movements, typically oral-lingual region or chorea. Irreversible symptoms

A

Tardive dyskinesia

118
Q

Fever, muscular rigidity, altered mental status, autonomic dysfunction, serious mortality, SymptomsL >38 C, muscular rigidity, confusion, agitation, altered level of consciousness, tachycardia, tachypnea, hypertension, tremor and incontinence or retention

A

Neuroleptic malignant Syndrome
Causes: antipsychotics, Anti-parkinsonian agents withdrawl and antidepressants, other drugs such as carbamazepine, metoclopramide

Treatment
BDZs for acute
stop antipsychotics or restart anti-parkinsonian drugs
reduce rigidity by dantrolene, lorazepam

may last 7-10 days after stopping oral antipsychotic and up to 21 daus after depot antipsychotics

119
Q

2 years of unexplained symptoms, no physical cause, refuse to accept

A

Somatization disorder

120
Q

Non-delusional disorder with the possibility of serious illness such as cancer, heart disease, HIV, AIDS despite medical reassurance

A

Illness anxiety disorder or hypochondriasis

121
Q

Loss of motor function or sensory function, no pathology, stress related

A

Conversion disorder

122
Q

Amnesia, memory but no pathology

A

Dissociative disorder

123
Q

inducing illness - physical or psychological

A

Factitious disorder

124
Q

Fraudulent stimulation or exaggeration of symptoms with the intention of financial or other gain

A

Malingering disorder

125
Q

Management of opiod toxicity

A

Methadone or Buprenorphine
Naltrexone for relapse
Naloxone for overdose

126
Q

Ataxia, Nystagmus, opthalmoplegia, and acute confusion
Associated with peripheral neuropathy, resting tachycardia and nutritional deficiency
CN6 palsy

A

Wernicke’s encephalopathy

Treat using IV pabrinex

127
Q

Short term memory loss, confabulation (false memories)

A

Korsakoff’s Psychosis

Treat using oral thiamine

128
Q

Delirium tremens treatment

A

Haloperidol or olanzapine

129
Q

Acute confusional state secondary to alcohol withdrawl, medical emergency, onset 1-7 days after last drink with peak at 48 hours, features: clody consciousness, amnesia, disorientation, marked psychomotor agitation, hallucinations - Lilliputian hallucintations; delusions, cardiovascular collapse

A

Delirium tremens