Psychiatry Flashcards

Question

What is Cotard syndrome?

Answer 1

The affected patient believes that they (or in some cases just a part of their body) is either dead or non-existent. It is usually associated with severe depression and psychotic disorders.

Answer 2

a form of paranoid delusion with an amorous quality. The patient, often a single woman, believes that a famous person is in love with her.

Answer 3

A relatively rare condition where a patient has a fixed, false belief (delusion) that they are infested by 'bugs' e.g. worms, parasites, mites, bacteria, fungus. This may occur in conjunction with other psychiatric conditions or may present by itself, with patients often otherwise quite functional despite the delusion.

Answer 4

``` headache nausea short term memory impairment memory loss of events prior to ECT cardiac arrhythmia impaired memory ```

Answer 5

Raised intracranial pressure

Answer 6

Severe depression refractory to medication and with psychotic symptoms

Answer 7

excessive worry about a number of different events associated with heightened tension

Answer 8

Education and active monitoring Warn patients under 30 they are at increased risk of suicidal thinking and self-harm Psychological intervention MDT Sertraline (second line SSRI or SNRI, third line pregabalin)

Answer 9

Recognition and diagnosis CBT SSRI (second line imipramine or clomipramine) Mental health services referral

Answer 10

delayed grief: sometimes said to occur when more than 2 weeks passes before grieving begins prolonged grief: difficult to define. Normal grief reactions may take up to and beyond 12 months

Answer 11

Mania has the presence of psychotic symptoms

Answer 12

Follows on from untreated Wernicke's encephalopathy Anterograde amnesia Retrograde amnesia Confabulation

Answer 13

Interferes with cAMP formation

Answer 14

nausea/vomiting, diarrhoea fine tremor nephrotoxicity: polyuria, secondary to nephrogenic diabetes insipidus thyroid enlargement, may lead to hypothyroidism ECG: T wave flattening/inversion weight gain idiopathic intracranial hypertension leucocytosis hyperparathyroidism and resultant hypercalcaemia

Answer 15

Check levels 12 hours post-dose After starting, check levels weekly and after each dose change until levels are stable Once stable, check lithium levels every 3 months for the first year and then 6 months thereafter Check TFTs and U+Es every 6 months

Answer 16

hypertensive reactions with tyramine containing foods e.g. cheese, pickled herring, Bovril, Oxo, Marmite, broad beans anticholinergic effects

Answer 17

An obsession is defined as an unwanted intrusive thought, image or urge that repeatedly enters the person's mind.

Answer 18

Compulsions are repetitive behaviours or mental acts that the person feels driven to perform. A compulsion can either be overt and observable by others, such as checking that a door is locked, or a covert mental act that cannot be observed, such as repeating a certain phrase in one's mind.

Answer 19

Mild functional impairment: CBT, exposure and response prevention Moderate functional impairment: SSRI for at least 12 months after remission, more intense CBT/ERP Severe functional impairment: SSRI + CBT (including ERP)

Answer 20

Othello's syndrome is pathological jealousy where a person is convinced their partner is cheating on them without any real proof. This is accompanied by socially unacceptable behaviour linked to these claims.

Answer 21

Cluster A: 'Odd or Eccentric' - Paranoid - Schizoid - Schizotypal

Answer 22

Cluster B: 'Dramatic, Emotional, or Erratic' - Antisocial - Borderline (Emotionally Unstable) - Histrionic - Narcissistic

Answer 23

Cluster C: 'Anxious and Fearful' - Obsessive-Compulsive - Avoidant - Dependent

Answer 24

Hypersensitivity and an unforgiving attitude when insulted Unwarranted tendency to questions the loyalty of friends Reluctance to confide in others Preoccupation with conspirational beliefs and hidden meaning Unwarranted tendency to perceive attacks on their character

Answer 25

``` 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 ```

Answer 26

``` Ideas of reference (differ from delusions in that some insight is retained) Odd beliefs and magical thinking Unusual perceptual disturbances Paranoid ideation and suspiciousness Odd, eccentric behaviour Lack of close friends other than family members Inappropriate affect Odd speech without being incoherent ```

Answer 27

Failure to conform to social norms with respect to lawful behaviours as indicated by repeatedly performing acts that are grounds for arrest; More common in men; Deception, as indicated by repeatedly lying, use of aliases, or conning others for personal profit or pleasure; Impulsiveness or failure to plan ahead; Irritability and aggressiveness, as indicated by repeated physical fights or assaults; Reckless disregard for the safety of self or others; Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behaviour or honour financial obligations; Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another

Answer 28

Efforts to avoid real or imagined abandonment Unstable interpersonal relationships which alternate between idealization and devaluation Unstable self image Impulsivity in potentially self damaging area (e.g. Spending, sex, substance abuse) Recurrent suicidal behaviour Affective instability Chronic feelings of emptiness Difficulty controlling temper Quasi psychotic thoughts

Answer 29

Inappropriate sexual seductiveness Need to be the centre of attention Rapidly shifting and shallow expression of emotions Suggestibility Physical appearance used for attention seeking purposes Impressionistic speech lacking detail Self dramatization Relationships considered to be more intimate than they are

Answer 30

``` Grandiose sense of self importance Preoccupation with fantasies of unlimited success, power, or beauty Sense of entitlement Taking advantage of others to achieve own needs Lack of empathy Excessive need for admiration Chronic envy Arrogant and haughty attitude ```

Answer 31

Is occupied with details, rules, lists, order, organization, or agenda to the point that the key part of the activity is gone Demonstrates perfectionism that hampers with completing tasks Is extremely dedicated to work and efficiency to the elimination of spare time activities Is meticulous, scrupulous, and rigid about etiquettes of morality, ethics, or values Is not capable of disposing worn out or insignificant things even when they have no sentimental meaning Is unwilling to pass on tasks or work with others except if they surrender to exactly their way of doing things Takes on a stingy spending style towards self and others; and shows stiffness and stubbornness

Answer 32

Avoidance of occupational activities which involve significant interpersonal contact due to fears of criticism, or rejection. Unwillingness to be involved unless certain of being liked Preoccupied with ideas that they are being criticised or rejected in social situations Restraint in intimate relationships due to the fear of being ridiculed Reluctance to take personal risks due to fears of embarrassment Views self as inept and inferior to others Social isolation accompanied by a craving for social contact

Answer 33

Difficulty making everyday decisions without excessive reassurance from others Need for others to assume responsibility for major areas of their life Difficulty in expressing disagreement with others due to fears of losing support Lack of initiative Unrealistic fears of being left to care for themselves Urgent search for another relationship as a source of care and support when a close relationship ends Extensive efforts to obtain support from others Unrealistic feelings that they cannot care for themselves

Answer 34

headache fatigue anxiety/depression dizziness

Answer 35

Typically seen 3-7 days following birth and is more common in primips Mothers are characteristically anxious, tearful and irritable

Answer 36

Reassure and support

Answer 37

Most cases start within a month and typically peaks at 3 months Features are similar to depression seen in other circumstances

Answer 38

Reassure and support CBT SSRI - paroxetine, sertraline

Answer 39

Onset usually within the first 2-3 weeks following birth Features include severe swings in mood (similar to bipolar disorder) and disordered perception (e.g. auditory hallucinations)

Answer 40

Admission to hospital

Answer 41

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

Answer 42

Watchful waiting for symptoms lasting less than 4 weeks Trauma-focused CBT or eye movement desensitization and reprocessing therapy Second line: venlafaxine, SSRI (sertraline)

Answer 43

Auditory hallucinations - two or more voices discussing the patient, thought echo, voices commenting on behavior Thought disorder: insertion, withdrawal, broadcasting Passivity phenomena Delusions Impaired insight Incongruity/blunting of affect (inappropriate emotion for circumstance) Decreased speech Neologisms Catatonia Negative symptoms: incongruity/blunting of affect, anhedonia, alogia, avoliton

Answer 44

Oral atypical antipsychotics | CBT

Answer 45

``` strong family history gradual onset low IQ prodromal phase of social withdrawal lack of obvious precipitant ```

Answer 46

depression which occurs predominately around the winter months

Answer 47

CBT | SSRI

Answer 48

Citalopram or fluoxetine

Answer 49

Sertraline

Answer 50

Fluoxetine

Answer 51

``` GI Increased risk of GI bleeding Increased anxiety and agitation Prolonged QT interval (citalopram) Hyponatremia ```

Answer 52

NSAIDs (need PPI co-prescribed) Warfarin/heparin Aspirin Triptans (increased risk of serotonin syndrome) MAOIs (increased risk of serotonin syndrome)

Answer 53

``` increased mood change restlessness difficulty sleeping unsteadiness sweating gastrointestinal symptoms: pain, cramping, diarrhoea, vomiting paraesthesia ```

Answer 54

Avoid paroxetine First trimester: congenital heart defects Third trimester: persistent pulmonary hypertension of the newborn

Answer 55

Clonazepam

Answer 56

``` Male History of self-harm Alcohol or drug misuse History of mental illness History of chronic disease Advancing age Unemployment or social isolation Unmarried/divorced/widowed ```

Answer 57

``` efforts to avoid discovery planning leaving a written note final acts such as sorting out finances violent method ```

Answer 58

family support having children at home religious belief

Answer 59

``` drowsiness dry mouth blurred vision constipation urinary retention lengthening of QT interval ```

Answer 60

multiple physical SYMPTOMS present for at least 2 years | patient refuses to accept reassurance or negative test results

Answer 61

persistent belief in the presence of an underlying serious DISEASE, e.g. cancer patient again refuses to accept reassurance or negative test results

Answer 62

typically involves loss of motor or sensory function the patient doesn't consciously feign the symptoms (factitious disorder) or seek material gain (malingering) patients may be indifferent to their apparent disorder - la belle indifference - although this has not been backed up by some studies

Answer 63

dissociation is a process of 'separating off' certain memories from normal consciousness in contrast to conversion disorder involves psychiatric symptoms e.g. Amnesia, fugue, stupor dissociative identity disorder (DID) is the new term for multiple personality disorder as is the most severe form of dissociative disorder

Answer 64

also known as Munchausen's syndrome | the intentional production of physical or psychological symptoms

Answer 65

fraudulent simulation or exaggeration of symptoms with the intention of financial or other gain

Answer 66

``` Stupor or catatonia Psychotic depression Refusal of food and drink Dangerously suicidal patient Delay in effect of antidepressants will cause serious health risk ```

Answer 67

Strong desire/compulsion to drink; difficulty controlling levels of drinking Physiological withdrawal symptoms Evidence of tolerance Progressive neglect of other pleasures/interests (salience) Persistent drinking despite clear evidence of harmful effects Narrowing of the drinking repertoire Reinstatement of drinking after periods of abstinence

Answer 68

``` Approximate answers Somatic conversion Pseudohallucination Subsequent amnesia Apparent clouding of consciousness ```

Answer 69

Performance of an activity that symbolically reverses some previous behavior or thought

Answer 70

Unconscious defence mechanism by which one attempts to make up for real or imagined deficiences

Answer 71

Cyclical mood swings from mild depression to hypomania

Answer 72

Persistent (moer than 2 years) of chronic low grade depression without periods of elevated mood

Answer 73

1st line: lithium | 2nd line: sodium valproate

Answer 74

1) Numbness 2) Pining 3) Disorganization and despair 4) Reorganization and repair

Answer 75

Strongly held false belief that is not typical of the patient's cultural or religious background and will be held despite evidence to the contrary

Answer 76

50-69: mild 35-49: moderate 20-34: severe <20: profound

Answer 77

Pyrexia, tremor, hyper-reflexia anxiety, agitation, autonomic dysfunction, increased tone

Answer 78

Removing the causative drug, providing supportive care, and cyproheptadine

Answer 79

Cataplexy Hypnagogic hallucinations Daytime sleepiness Sleep paralysis

Answer 80

False perception of a real external stimulus

Answer 81

Therapist's own feelings, emotions, and attitude

Answer 82

Unconscious process in which the patient transfers feelings and emotions to the therapist

Answer 83

Words and actions of a patient that act to obstruct them from gaining access to their unconscious.

Answer 84

Expression of unconscious emotional conflicts directly into actions without the patient being consciously aware of their meaning

Answer 85

Methylphenidate

Psychiatry Flashcards

(110 cards)