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Finals HH > Psychiatry > Flashcards

Psychiatry Flashcards

(59 cards)

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1
Q

Examples of typical (1st gen) anti-psychotics? (4)

A

Chlorpromazine
Haloperidol
Fluphenazine (depot)
Clopenthixol

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2
Q

Examples of atypical (2nd gen) anti-psychotics? (7)

A

Risperidone
Clozapine
Aripiprazole
Olanzapine
Quetiapine
Zotepine
Sertindole

Wrote all, as in exam its always the one you don’t know that pops up

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3
Q

Mx of Psychosis?

A
  1. 2nd gen antipsychotic
  2. 1st or 2nd gen antipsychotic
  3. Clozapine
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4
Q

Side effect of 1st gen antipsychotics?

A

Extra-pyramidal s/e

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5
Q

Side effect of 2nd gen anti-psychotic?

A

Weight gain, sedation

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6
Q

What are the extra-pyramidal side effects? (4)

A

Dystonia (fixed muscle posture / spasms)

Akathisia (motor restlessness)

Parkinsonism

Tardive kinesia

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7
Q

What is tardive kinesia?

A

Involuntary repetitive oro-facial movements
- Lip smacking
- Blinking
- Pouting

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8
Q

Mx for extra-pyramidal side effects?

A

Change anti-psychotic

Procyclidine (lowers acetylcholine)

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9
Q

Mx of neuroleptic malignant syndrome?

A

Bromocriptine + Dantrolene

+ stop anti-psychotic

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10
Q

Mania vs hypomania?

A

Abnormally elevated or irritable mood for a week = mania

for 4 days = hypomania

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11
Q

Triad of serotonin syndrome?

A

Autonomic instability - hypertension, tachycardia, hyperthermia

Neuromuscular instability - tremor, hyperreflexia, myoclonus

Mental state changes - delirium, confusion

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12
Q

SSRI examples?

A

Citalopram
Fluoxetine
Sertraline
Paroxetine

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13
Q

Four features of PTSD?

A
  • Re-experiencing
  • Avoidance
  • Hyperarousal (enhanced startle reaction)
  • Negative alteration in mood and thinking
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14
Q

PTSD mx?

A

Options:
- Trauma-focused CBT
- EMDR
- Drugs
1. SSRI or venlafaxine
2. Anti-psychotics

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15
Q

Acute stress reaction mx?

A

Individual CBT or group-CBT within 1 month of traumatic event

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16
Q

What is the time-frame of acute stress reaction?

A

Within one month

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17
Q

GAD drug mx?

A
  1. SSRI
  2. Pregablin if can’t tolerate SSRI or SNRI
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18
Q

What are the three main phobias?

A

Social phobia - fear of socialising
Agoraphobia - fear of going outside
Specific phobia - marked and persistent fear which is excessive and irrational

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19
Q

Mx of OCD?

A
  1. CBT
  2. SSRI
  3. alternative SSRI or clomipramine
  4. Either:
    - add anti-psychotic
    - SSRI + clomipramine
    - SSRI + buspirone
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20
Q

Mx of body dysmorphic disorder?

A

Fluoxetine

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21
Q

Dx of OCD?

A

Obsessions and compulsions are time-consuming (>1h a day) or cause significant distress or significant impairment

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22
Q

What is the thought disorder - circumstantiality?

A

Inability to answer a question without giving excessive, unnecessary detail.

However, this differs from tangentiality in that the person does eventually return to the original point.

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23
Q

What is the thought disorder - Tangentiality?

A

Wandering from a topic without returning to it

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24
Q

What is a Neologism?

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A

New word formation - might include combining of two words

25
What are clang associations?
When ideas are related to each other because they sound similar or rhyme
26
What is word salad?
Completely incoherent speech where real words are strung together into nonsense sentences
27
What is Knight's move thinking?
Feature of schizophrenia Severe type of loosening of associations, where there are unexpected and illogical leaps from one idea to another
28
What is flights of idea?
Feature of mania Leaps from one topic to another but with discernible links between them
29
What is echolalia?
Repetition of someone else's speech, including the question that was asked
30
Mx of akathisia?
Either: - Propanolol - Small dose clonazepam - Cyproheptadine
31
Mx of dystonia?
Oral, IM or OV procyclidine (anti-cholinergic)
32
S/e of anti-psychotics?
SIADH Hyperprolactinaemia Postural hypotension Reduced seizure threshold Anti-cholinergic side effects - dry mouth, blurred vision, urinary retention, constipation Metabolic syndrome
33
Examples of SNRI?
Venlafaxine Duoloxetine
34
Mirtazapine drug class
Alpha2-adrenoceptor antagonist This increases NA transmission by blocking negative feedback on alpha 2 receptors.
35
What needs monitored on mirtazepine?
FBC - associated with blood dyscrasia
36
Tricyclic anti-depressant drugs?
Sedative: Amitryptiline, clomipramine, dosulepin Less sedative: Imipramine, lofepramine and nortriptyline
37
S/e of TCAs?
Antimuscarinic - dry mouth, urinary retention, blurry vision, constipation Anti-histaminic - weight gain, sedation Alpha1 adrenergic action - dizziness, orthostatic hypotension Blockage of voltage-sensitive sodium channels - coma, seizure, arrhythmias, cardiac arrest (prolonged QTc)
38
When are TCAs contra-inidcated?
Arrhythmias, recent MI, heart block Mania, hypomania Acute porphyria
39
Monoamine oxidase inhibitor examples?
Phenelzine Selegiline Tranylcypromine Isocarboxazid Reversible MOAI - moclobemide
40
S/e of MOAi?
Hypertensive reaction /crisis caused by tyramine foods - Cheese, yeast extracts - Phenylephrine Postural hypotension
41
When are MOAi contraindicated?
Delerium Pheochromocytoma Hyperthyroidism CVD and CNS disease
42
Antidepressant in young people?
Fluoxetine
43
How long to trial antidepressants for?
Patients with two prior episodes and functional impairment should be treated for at least 2 years.
44
Electrode placement in ECT?
Bilateral (bitemporal or bifrontal) and right unilateral (RUL)
45
When ECT?
Acute treatment of moderate to severe depression, mania or catatonia in patients who have failed in responding to other treatments
46
Mx of alcohol intoxication?
Supportive with airway protection Intramuscular thiamine, followed by glucose treatment
47
Mx of alcohol withdrawal?
Benzodiazepine - Chlordiazepoxide, lorazepam or diazepam Benzos contra-indicated -> Carbamazepine
48
Mx of alcohol withdrawal with liver impairment?
Lorazepam, oxazepam and temazepam - no phase 1 metabolism (CYP450)
49
Mx of alcohol dependance
Disulfarim - aldehdye dehydrogenase inhibitor, adverse s/e on drinking alcohol Acamprosate - NMDAr antagonist, reduces cravings Naltrexone - opiate antagonist, reduces cravings
50
Mx of opioid dependance?
- Methadone - Buprenorphine - Lofexidine
51
Mx of nicotine dependance?
- Nicotine replacement therapy - Varenicline - Bupropion
52
Mx of alzheimers?
Mild-moderate: Cholinesterase inhibitors - Donepezil, rivastigmine, galantamine Moderate-severe: NMDA receptor blocking - Memantine
53
Contra-indications to cholinesterase inhibitors?
Cardiac: Bradycardia (<50), LBBB. Peptic ulcer disease Medications: anticholinergic medications
54
Contra-indications to memantine?
Creatine clearance <30
55
S/e of stimulants (methylphenidate)? (7)
Decreased appetite Sleep disturbance. Stomach upset Headache Irritability Growth suppression Cardiovascular effects
56
What must be monitored for patients on stimulants?
Height and weight HR & BP Rating scaled (parent & teacher) - monitor medication response
57
ADHD mx?
1. Stimulants - methylphenidate, bisphentin, concerta, vyvanse 2. Atomoxetine (NRI)
58
S/e of carbamazepine and lamotrigine in pregnancy?
Carbamazepine - Neural tube defects Lamotrigine - oral cleft
59
S/e of benzodiazepine in pregnancy?
Cleft palate Floppy baby syndrome

Finals HH (21 decks)

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