PSYCHIATRY Flashcards
Features of PTSD?
1 month of…
Re-experiencing - flashbacks, nightmares, repetitive/distressing intrusive images
Avoidance - avoiding people, situations or circumstances associated with the event
Hyperarousal - hypervigilance for threat, exaggerated startle response, sleep problems, irritability, difficulty concentrating
Emotional numbing - lack of ability to experience feelings, feeling detached
When does acute stress disorder occur?
Within the first 4 weeks after a person has been espoused to a traumatic event
Which foods should be avoided when on MAOI? why?
Tyramine containing foods e.g. cheese, marmite, broad beans, oxo, bovril, pickled herring
Can cause hypertensive reactions!
Factors suggesting pseudodementia?
Short history & rapid onset
Biological symptoms e.g. weight loss, sleep disturbance
Pt worrying about their bad memory
Reluctant to take tests and disappointed with the results
Global memory loss rather than recent memory loss
Features of borderline personality disorder?
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 and self-harm
Affective instability
Chronic feelings of emptiness
Difficulty controlling temper
Quasi psychotic thoughts - non-bizarre short-lived hallucinations/delusions
Features of antisocial personality disorder?
Failure to conform to social norms e.g. laws
Deception: repeated lying, using aliases, conning others
Impulsiveness
Irritability and aggressiveness -> repeated physical fights
Reckless disregard for safety of self or others
Consistent irresponsibility -> failure to sustain work/finance obligations
Lack of remorse
Features of paranoid personality disorder?
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
Features of schizoid personality disorder?
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
Features of schizotypal personality disorder?
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
Features of histrionic personality disorder?
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
Features of narcissistic personality disorder?
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
Features of obsessive-compulsive personality disorder?
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
Features of avoidant personality disorder?
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
Features of dependant personality disorder
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
The age group for highest rates of suicide in the UK?
Highest among people aged 45-54
What severity rating scale can be used for OCD?
Yale-Brown Obsessive-Compulsive Scale (Y-BOCS)
Symptoms of serotonin syndrome?
Neuromuscular excitation - hyperreflexia, myoclonus, rigidity
ANS excitation - hyperthermia, sweating
Altered mental state - confusion
What is Hoover’s sign?
A test to differentiate between the organic and functional weakness of pyramidal origin - for functional neurological disorder
It is based on the principle of crossed extensor reflex - when one hip is flexed, the contralateral hip is extended eg. if a person in supine is asked to lift the right leg with knee extended, the left heel will be observed to dig into the bed/onto your hand if its underneath their foot
Schneider’s first rank symptoms
Auditory hallucinations - voices discussing the pt in third person, thought echo or voices commenting on pt behavior
Thought disorders - insertion, withdrawal, broadcasting
Passivity phenomena - being controlled by an external source
Delusional perceptions
Negative symptoms of schizophrenia?
5As:
Affected blunted
Anhedonia
Alogia (Poverty of speech)
Avolition (Poor motivation)
Avoiding society (Social withdrawal)
What is catatonia
Abnormal movements - waxy flexibility, posturing, stereotypy etc
Immobility & mutism
Abnormal behaviours
Withdrawal
What is conversion disorder also known as?
Functional neurological disorder
What questionnaire can be used to assess the nature and severity of alcohol misuse
AUDIT
Alcohol Use Disorders Identification Test\
(AUDIT-C is a shorter version!)
What questionnaire can be used to screen for excessive alcohol drinking and alcoholism
CAGE
Cut down
Annoyed when people critique
Guilty about drinking
Eye-opener
What questionnaire can be used to assess risk of alcohol harm quickly?
FAST - Fast Alcohol use Screening Test
Outline features of alcohol withdrawal and their timings?
6-12 hrs - tremor, sweats, tachycardia, anxiety
36 hrs - seizures
48-72 hrs - coarse tremor, confusion, delusions, auditory and visual hallucinations, fever, tachycardia (this is DT)
Interpret PHQ9
<15 = less severe
>15 = more severe
Peak times for symptoms, seizures and DT after alcohol withdrawal?
6-18 hours - Sx
36 hours - seizures
72 hours - DT
(Half hours: 72 -> 36 -> 18 (6+12))
Causes of pseudohallucinations
Normal grieving process
Trauma
BPD
What type of hallucinations are pseudohallucinations typically?
Auditory or visual
