Psychiatry Flashcards
(138 cards)
1
Q
What is a pseudohallucination?
A
Common after bereavement
The patient is aware that they are hallucinating
2
Q
Define perseveration
A
Repeating the same words/answers
3
Q
Define echolalia
A
Repeating exactly what someone has said
4
Q
Define neologism
A
Making up new words
5
Q
Define word salad
A
Disorganised speech, sentences that do not make sense
6
Q
Define expressive dysphagia
A
Difficulty putting together words
Often develops following a stroke
7
Q
First line treatment for children and young people with anorexia nervosa
A
Family based therapy
8
Q
Define torticollis
A
Twisting of the neck (extrapyramidal side effect)
9
Q
Which are the typical/atypical antipsychotics?
A
10
Q
How can SSRIs cause confusion?
A
Increase the risk of hyponatremia
Measure U+E
11
Q
What should be monitored at baseline and on dose titration
A
Blood pressure
12
Q
What should be monitored before starting citalopram
A
ECG in people with heart disease risk
Prolongs Q-T interval
13
Q
Define thought withdrawal
A
Belief of having the removal of a thought by an external force = thought withdrawal
14
Q
3 features of a schizoid personality disorder
A
Prefers to be alone
Doesn’t like relationships
Low libido
(negative symptoms of schizophrenia)
15
Q
Poor prognostic indicator for schizophrenia
A
Gradual onset
Low IQ
Prodromal phase of social withdrawal
16
Q
Define catatonia
A
Stopping of voluntary movement or staying still in an unusual position
17
Q
Side effect of antipsychotic medications
A
Acute dystonic reactions
18
Q
Give 2 examples of typical antipsychotics
A
HALOPERIDOL
CHLOPROMAZINE
19
Q
Give 3 examples of atypical antipsychotics
A
CLOZAPINE
RISPERIDONE
OLANZAPINE
20
Q
Define akathisia
A
Sense of inner restlessness and inability to keep still
21
Q
What happens in conversion disorder and what can it be caused by
A
Typically involves loss of motor or sensory function
Can be caused by stress
22
Q
Treatment of delirium tremens/alcohol withdrawal
A
Chlordiazepoxide or Diazepam
Pabrinex administered to prevent the development of Wernicke’s, it does not have a role in treating acute withdrawal
23
Q
Which gender is affected by antisocial personality disorder
A
Men
24
Q
Common side effect in atypical antipsychotics
A
Weight gain e.g. olanzapine
25
Unexplained physical symptoms
Somatisation = Symptoms
hypoChondria = Cancer (underlying diagnosis)
Munchausen's (intentional production of sx)
26
How long should antidepressants be continued for depression
6 months
27
A man asks for help with social anxiety. He prefers to be alone and doesn't like to share his beliefs, which other people think are odd. He has a strong interest in the paranormal and talks in an high-pitched voice when talking about his 'spirit-guide'
Schizotypal personality disorder
28
Short term side effects of ECT
```
headache
nausea
short term memory impairment
memory loss of events prior to ECT (retrograde amnesia)
cardiac arrhythmia
```
29
3 timeframes in alcohol withdrawal
symptoms: 6-12 hours
seizures: 36 hours
delirium tremens: 72 hours
30
4 first rank schizophrenia sx
auditory hallucinations
thought disorders
passivity phenomena
delusional perceptions
31
Initial management of OCD
Exposure and response prevention or CBT
32
Schizophrenia conservative management
CBT
33
What class of drug is lorazepam
Benzo
34
Side effect of benzos
Anterograde amnesia
35
What is flight of ideas a feature of?
Mania (bipolar)
36
Define flight of ideas
when a patient speaks very quickly and rapidly jumps between different topics
37
Sleep in schizophrenia
Insomnia
38
Which type of incontinence is caused by TCA
Overflow
39
Clozapine dose missed for more than 48 hours
Titrate the dose again slowly
40
To diagnose chronic insomnia
Trouble falling asleep for 3 nights a week for 3 months
41
Medication to abstain from alcohol that makes you violently vomit
Dusulfiram (Antabuse)
42
Alternative to methadone
| Tablet that goes under your tongue
Buprenorphine
43
Anti-craving medication for alcoholics that is safe to use with alcohol
Acamprosate
44
First line medication for PTSD
Venlafaxine or SSRI
45
When is ECT indicated
in life-threatening major depressive disorder, where catatonia in present
46
Strongest risk factor for psychotic disorders
FHx
47
First line drug for panic disorder and GAD
SSRI
48
What class is duloxetine
SNRI
49
Minimum time for depressive symptoms
2 weeks
50
Define torticollis
A type of acute dystonia with unilateral pain and deviation of the neck with pain on palpation and restricted range of motion
51
What is delusional parasitosis
Patient with a fixed, false belief (delusion) that they are infested by 'bugs'
52
Conservative treatment for borderline personality disorder
dialectical behaviour therapy (DBT)
53
risk of developing schizophrenia if one monozygotic twin is affected
50%
54
When should lithium levels be measured
12 hours post dose
55
poor oral compliance to antipsychotics
Once monthly IM injections
56
Side effect of clozapine
Constipation/Intestinal obstruction
Agranulocytosis/neutropenia (monitor FBC)
Reduces seizure threshold
57
SSRI decontinuation syndrome sx
GI side effects (diarrhoea), restless, mood change, insomnia, dizzy, anxiety, electric shock
58
side effects of clomipramine (TCAs)
Dry mouth (anticholinergic) and weight gain (antihistaminic)
59
What do you do with antidepressant mediation prior to starting ECT treatment
Reduce the dose
60
Risk factor for Charles Bonnet
Visual impairment
61
When does sleep paralysis most often occur
When waking from sleep
62
Difference between mania and hypomania
Mania = psychotic symptoms
63
Citalopram ECG
QT
64
3 common features of PTSD
re-experiencing e.g. flashbacks, nightmares
avoidance e.g. avoiding people or situations
hyperarousal e.g.hypervigilance, sleep problems
65
3 features of korsakoff
anterograde amnesia, retrograde amnesia, and confabulation
66
Management of hypomania
Routine referral to CMHT
67
Most tolerable antipsychotic medication with the least side effects
Aripiprazole
68
Define tardive dyskinesia
Involuntary chewing/pouting of the jaw
| SE antipsychotics
69
SSRI of choice in paeds
Fluoxetine
70
Sleep in mania/hypomania
Decreased need for sleep without feeling tired
71
Define circumstantiality
circuitous and non-direct thinking or speech that digresses from the main point of a conversation
inability to answer a question without giving excessive and unnecessary detail
in anxiety/hypomania
72
What medication interacts with SSRIs
Triptan
73
Lithium side effect
Hyperparathyroidism and hypercalcaemia (back pain, constipation, headache, low mood, reduced concentration)
Hypothyroidism
74
Timeframe of acute stress reaction to PTSD
4 weeks
75
SSRI of choice post-MI
Sertraline
76
Define othello syndrome
delusional jealously, usually believing their partner is unfaithful
77
Side effects of mirtazapine
Sedation and increased appetite
78
What factor increases the risk of suicide
Self harm
79
What condition is Cotards associated with
Severe depression
80
Side effect of zopiclone in the elderly
Increased risk of fall
81
First line conservative treatment for acute stress disorder
Trauma-focused cognitive-behavioural therapy (CBT)
82
Somatic symptoms in depression
early morning waking and changes in appetite and weight
83
Management of acute dystonia secondary to antipsychotics
Procyclidine
84
Trauma in post concussion syndrome may be trivial
85
Metabolic side effects of antipsychotics
dysglycaemia, dyslipidaemia, and diabetes mellitus
86
Scale used to assess alcohol withdrawal severity
Revised Clinical Institute Withdrawal Assessment for Alcohol (CIWA)
87
Management of moderate/severe tardive dyskinesia
Tetrabenazine
88
What endocrine abnormality can anorexia cause
Hypothyroidism
89
What class is venlafaxine
SNRI
90
Sudden onset psychosis following course of corticosteroids
Steroid induced psychosis
91
How should you stop an SSRI
Withdraw the dose gradually over 4 weeks
92
Define Erotomania (De Clerambault's syndrome)
the presence of a delusion that a famous is in love with them, with the absence of other psychotic symptoms
93
What abnormality can lithium cause on bloods
Benign leucocytosis
94
ECG shows first-degree heart block, tall P-waves and flattened T-waves
Hypokalaemia
| Bulimia
95
What is pseudodementia
Severe depression can mimic dementia but gives a pattern of global memory loss rather than short-term memory loss
96
Patient in a public place and threatening violent behaviour
Call the police
97
Why should SSRIs and MAOIs never be combined
Risk of serotonin syndrome
98
What class of drug is rasagiline
MAOIs
99
Antipsychotics in the elderly
Increased risk of stroke and VTE
100
Paroxetine in pregnancy
Risk of congenital malformations
101
Another term for hypochondriasis
Illness anxiety disorder
102
Type 1 vs 2 bipolar
Type 1: Mania
| Type 2: Hypomania
103
What side effect of antipsychotic medication is oculogyric crisis an example of
Acute dystonia
104
Define clang associations
ideas related only by rhyme or being similar sounding
105
What class is mirtazapine
oradrenergic and specific serotonergic antidepressant which increases release of neurotramsitters by blocking alpha2 adrenoreceptors
106
Paranoid personality disorder
patients who are overly sensitive and can be unforgiving if insulted, question loyalty of those around them and are reluctant to confide in others
107
Investigation in elderly patients with new sudden onset psychosis to rule out other causes
CT Head
108
Which side-effect is more common with atypical than conventional anti-psychotics
Weight gain
109
After a change in lithium dose when should levels me taken
Weekly until stable then 3 monthly
110
Common side effect in depot antipsychotics
Parkinsonian symptoms
111
What is Hoover's sign
a quick and useful clinical tool to differentiate organic from non-organic leg paresis. In non-organic paresis, pressure is felt under the paretic leg when lifting the non-paretic leg against pressure, this is due to involuntary contralateral hip extension
112
Symptoms of mania in primary care...
Urgent referral to CMHT
113
OCD vs Psychosis
Obsessive-compulsive disorder can be differentiated from psychosis by the level of insight into their actions
114
Borderline (emotionally unstable) personality disorder
associated with a history of recurrent self-harm and intense interpersonal relationships that alternate between idealization and devaluation
115
Define malingering
Lying or exaggerating for financial gain is malingering, for example someone who fakes whiplash after a road traffic accident for an insurance payment
116
How long do you continue antidepressants after remission of symptoms
Antidepressants should be continued for at least 6 months after remission of symptoms to decrease risk of relapse
117
Avoidant personality disorder
fearful of criticism, being unliked, rejection and ridicule
118
Blood results in anorexia
most things low
| G's and C's raised: growth hormone, glucose, salivary glands, cortisol, cholesterol, carotinaemia
119
Risk of SSRI use during third trimester
Persistent pulmonary hypertension of the newborn
120
Management of severe or unresponsive OCD
Sertraline
121
What class of drug is escitalopram
SSRI
122
What can cause a rise in clozapine blood levels?
Smoking cessation
123
obsessive-compulsive personality disorder
rigid with respect to morals, ethics and values and often are reluctant to surrender work to others
124
Differentiating between Knight's move and flight of ideas
Knight's move thinking there are illogical leaps from one idea to another, flight of ideas there are discernible links between ideas
125
Munchausen's syndrome
Purposefully causing symptoms, for example a diabetic taking too much insulin to cause hypos
126
What condition is important to rule out in anxiety
Thyroid disease
127
MOA of benzos
enhance the effect of GABA, the main inhibitory neurotransmitter
128
MOI - avoid which foods and why
Tyramine containing foods (e.g. cheese)
| Risk of hypertensive crisis
129
risk factor for generalised anxiety disorder
being divorced or separated
130
Severe restlesness with antipsychotics
Akathisia
131
What age do you need to be to diagnose a personality disorder?
18
| Pervasive undesirable personality traits
132
Management of mania/hypomania in patients taking antidepressants
consider stopping the antidepressant and start antipsychotic therapy
133
First line for acute stress disorders
Trauma focused CBT
134
Side effect of long-term atypical antipsychotics
glucose dysregulation and diabetes
135
Common side effects with imipramine
Blurred vision and dry mouth (TCA)
136
SSRI use in first trimester
small increased chance of congenital heart defects
137
Physical finding in anorexia
Lanugo hair
138
Which antidepressant medication would increase the GI bleeding risk and warrant a PPI
SSRI e.g. citalopram
