Psychiatry

Question 1

what is anxiety

Answer 1

feeling of worry, nervousness or unease about something with an uncertain outcome

Question 2

what are the symptoms of anxiety

Answer 2

palpitations, dry mouth, sweating, difficultly breathing, nausea and chest pain

Question 3

what are the different types of anxiety disorder

Answer 3

social phobia, specific phobias, generalised anxiety disorder, panic disorder, OCD, PTSD

Question 4

what are the 2 theories behind the causes of anxiety

Answer 4

decreased GABA or serotonin

Question 5

what are the treatments for anxiety

Answer 5

SSRIs, benzodiazepines, CBT

Question 6

how do SSRIs help in anxiety

Answer 6

these are selective serotonin reuptake inhibitors which increase serotonin levels

Question 7

how do benzodiazepines help in anxiety

Answer 7

increase GABA transmissions by enhancing GABA binding

Question 8

why aren’t benzodiazepines used long term

Answer 8

they are addictive and very dangerous in an overdose

Question 9

how does cognitive behaviour therapy work

Answer 9

this is where you look at your current problems and change the way you think and behave about them

Question 10

what is post traumatic stress disorder

Answer 10

this is an anxiety disorder which occurs within 6 months of a traumatic even of exceptional severity resulting in repetitive, intrusion recollections of the event

Question 11

what is the theory behind the causes of PTSD

Answer 11

hyperactivity of the amygdala

low cortisol

Question 12

what is the treatment for PTSD

Answer 12

SSRIs, benzodiazepine, CBT, eye movement desensitisation

Question 13

what is OCD

Answer 13

an anxiety disorder where a person has both obsessive and compulsive traits

Question 14

how is OCD diagnosed

Answer 14

if the patient has obsessions and compulsions of a repetitive and unpleasant nature, most days for a 2 week period
the patient will acknowledge these and cant resist them

Question 15

what is the theory behind the causes of OCD

Answer 15

• re-entry circuits in the basal ganglia
• reduced serotonin
• PANDAS

Question 16

what is PANDAS

Answer 16

paediatric autoimmune neuropsychiatric disorder associated with streptococcal infection

this is where children have psychiatric problems following strep A infection

Question 17

what are the treatments for OCD

Answer 17

CBT, exposure response prevention, high/long dose of SSRIs, clomipramine, deep brain stimulation

Question 18

what is an obsession

Answer 18

a thought which persists and dominants and individuals thinking

Question 19

what is a compulsion

Answer 19

obsessional impulse which leads directly to an action

Question 20

what are the 2 types of psychosis

Answer 20

organic and functional

Question 21

what is organic psychosis

Answer 21

where the brain changes in diseases to cause physical and behavioural/mood changes e.g. parkinsons, infection, tumour, epilepsy

Question 22

what is functional psychosis

Answer 22

disorders in which there is behaviour changes with no physical brain changes e.g. anxiety and depression

Question 23

what are some of the predisposing causes of depression

Answer 23

genetics, childhood experiences, female gender

Question 24

what are some of the perpetuating causes of depression

Answer 24

stressful job, unemployment, substance misuse

Question 25

what are some of the precipitating causes of depression

Answer 25

loss of family members, divorce, loss of health

Question 26

what are the treatments for depression

Answer 26

SSRIs | CBT

Question 27

what 2 neurotransmitters are thought to be affected in depression

Answer 27

serotonin and noradrenaline

Question 28

what does the drug AMPT do

Answer 28

decreases noradrenaline production

Question 29

which areas of the brain are thought to be affected in depression

Answer 29

limbic, prefrontal cortex and basal ganglia

Question 30

what are some physical disorder which can cause depression

Answer 30

thyroid problems, vitamin B12 deficiency, chronic illness, alcohol/drug abuse

Question 31

what are some symptoms of depression

Answer 31

low mood, lack of energy, lack of interest depressive thoughts lack of eating and sleeping

Question 32

what is psychosis

Answer 32

the presence of hallucinations and delusions without insight from the patient

Question 33

what are the different types of psychosis

Answer 33

schizophrenia, drug induced, affective and postpartum

Question 34

what is drug induced psychosis

Answer 34

where psychotic symptoms develop 48 hours after substance use and last more than 48 hours

Question 35

what is affective psychosis

Answer 35

where psychotic experiences come with mood e.g. guilt delusions with depression

Question 36

what is postpartum psychosis

Answer 36

where symptoms occur days/weeks after delivery and develop quickly

Question 37

what are the presentations of schizophrenia

Answer 37

auditory hallucinations, thought withdrawal, delusional perceptions, passivity experiences and somatic hallucinations

Question 38

what is thought withdrawal

Answer 38

when patients think their thoughts are being taken out of their mind

Question 39

what are delusional perceptions

Answer 39

where patients see something which is normal but give it a different meaning

Question 40

what are passivity experiences

Answer 40

where the patient believes part of their body is being moved by an external force

Question 41

what are some organic causes of schizophrenia

Answer 41

delirium with infection, alcohol withdrawal, drugs, seizures, hyperthyroidism, lupus, Parkinson's treatment

Question 42

what are the 5 types of schizophrenia

Answer 42

paranoid, hebephrenic, simple, undifferentiated, catatonic

Question 43

what is paranoid schizophrenia

Answer 43

where hallucinations and delusions are prominent

Question 44

what is hebephrenic schizophrenia

Answer 44

where the patient acts inappropriately and in a childish manner

Question 45

what is simple schizophrenia

Answer 45

loss of social drive, social withdrawal, decline in social/work performance

Question 46

what is catatonic schizophrenia

Answer 46

where they experience mutism, posturing, negativism, rigidity, command automatism, waxy flexibility

Question 47

what is negativism

Answer 47

won't do as they are told

Question 48

what 2 dopamine pathways are affected in schizophrenia

Answer 48

mesolimbic and mesocortical `

Question 49

what is the mesolimbic pathway

Answer 49

dopamine being delivered from the ventral tegmental area to the limbic structures

Question 50

what is the mesocortical pathway

Answer 50

dopamine being delivered from the ventral tegmental area to the prefrontal cortex

Question 51

what is anti-NMDA encephalitis

Answer 51

where the body produces auto-antibodies against neurones found in teratoma tumours which then attacks the brain giving a psychotic presentation

Question 52

what are the treatments for schizophrenia

Answer 52

- typical antipsychotics = D2 blockers | - atypical antipsychotics = partial D2 blockers

Question 53

what are the side effects of typical antipsychotics

Answer 53

Parkinson symptoms | acute dystonia