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Psychiatry > psychiatry > Flashcards

psychiatry Flashcards

1
Q

What is the most significant side effect of clozapine?

A

agranulocytosis

  • do weekly FBCs initially
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2
Q

What regular checks should be done on patients taking antipsychotics?

A
  • blood pressure
  • glucose
  • LFTs
  • lipid profile
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3
Q

What is phenelzine?

A

irreversible monoamine oxidase inhibitor

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4
Q

What levels in the blood indicate lithium toxicity?

A

1.5-2mmol/L

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5
Q

What serious condition can lamotrigine cause (treatment of bipolar)?

A

drug-induced Stevens-Johnson syndrome

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6
Q

What form of counselling does bereavement counselling adopt?

A

person-centred

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7
Q

What is transference?

A

the theoretical process by which the patient transfers feelings/attitudes experienced in an earlier significant relationship onto the therapist

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8
Q

Do people diagnosed with dementia have to notify the DVLA?

A

yes

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9
Q

Which depressive symptoms are strongly linked with suicide

A
  • insomnia
  • psychomotor agitation
  • feelings of worthlessness
  • psychotic symptoms
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10
Q

What blood investigations should you do in patient who has overdosed on paracetamol?

A
  • paracetamol levels
  • INR
  • LFTs
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11
Q

Why do people self harm?

A

to ‘escape from a terrible state of mind’

–> also described as releasing tension

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12
Q

What is the most common method of completed suicide in England and Wales?

A

suspension hanging

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13
Q

What is the most common drug overdose in the UK?

A

paracetamol

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14
Q

What psychiatric condition can steroids precipitate?

A

depression

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15
Q

What is a nihilistic delusion?

A

the belief that part/all of ones body does not exist/has been destroyed

e.g, when someone believes their organs are rotting away

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16
Q

How many weeks must one be symptomatic for before a diagnosis of depression can be made?

A

2 or more weeks

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17
Q

What is the commonest mood state in mania?

A

irritability

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18
Q

Describe emotionally unstable personality disorder.

A

persistent pattern of maladaptive behaviour present since childhood

associated with social and occupational dysfunction

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19
Q

What is dysthymia?

A

prolonged low mood

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20
Q

What is Charles Bonnet syndrome?

A

when patients experience complex visual hallucinations associated with no other psychiatric symptoms/ impairment in consciousness

it usually occurs in older adults and is associated with loss of vision

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21
Q

What are Lilliputian hallucinations?

A

hallucinations of miniature people/animals

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22
Q

What is an over-valued idea?

A

it is a plausible belief that a patient becomes pre-occupied with to an unreasonable extent

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23
Q

What is chronic cannabis use a risk factor for?

A

schizophrenia

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24
Q

What is hebephrenic schizophrenia?

A
  • prominent thought disorder
  • incongruous affect
  • negative symptoms

it has an early onset and poor prognosis

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25
Q

What is OCD?

A

obsessions and compulsions associated with functional impairment of greater than 2 weeks duration

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26
Q

What is an obsessive-compulsive personality also known as?

A

anankastic personality

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27
Q

What symptoms are typical of normal bereavement?

A
  • wanting to be dead
  • poor concentration
  • intense guilt
  • hallucinations involving the deceased
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28
Q

Characterise adjustment disorder.

A

it is the difficulty coping with a significant change in circumstances

diagnosis warranted if disruption to occupational function

29
Q

When must the stressor occur for a diagnosis of adjustment disorder?

A

within 1 month (ICD10)

within 3 months (DSM-IV)

30
Q

What sort of disorder is IBS?

A

a somatoform dysfunction disorder

31
Q

List some characteristics of factitious disorder.

A
  • female
  • healthcare professional
  • great knowledge
  • symptoms w/o signs
  • specific demands
  • far from home
32
Q

How do you calculate alcohol units?

A

%ABV x volume of alcohol (L)

e.g. 350ml of 40% gin =
40 x 0.350 = 14 units

33
Q

What are the symptoms of cocaine intoxicity?

A
  • euphoria
  • tachycardia
  • hyperthermia
  • haptic hallucinations (sensory impression without external touch e.g. sensation insects are crawling on you)
34
Q

What personality disorder is prevalent within prisons?

A

antisocial personality disorder

35
Q

What is one of the main features that distinguishes the psychopathology of obsessive-compulsive personality disorder from obsessive-compulsive disorder?

A

obsessive thoughts are ego-syntonic (‘with the mind’) in OCPD whereas they are ego-dystonic (‘against the mind’) in OCD

36
Q

What childhood issue is associated with borderline personality disorder?

A

childhood sexual abuse

37
Q

How much body weight (%) loss is suggestive of anorexia nervosa?

A

a body weight of at least 15% below expected for height is suggestive of anorexia nervosa

38
Q

What physical causes of low weight must you rule out before considering eating disorders?

A
  • malignancy
  • endocrine abnormalities
  • infection
  • inflammatory disorders
39
Q

What blood results would you expect to see in starvation states?

A
  • hypoglycaemia
  • hypokalaemia
  • hypophophataemia
  • normocytic normochromic anaemia
  • hypercholesterolaemia
40
Q

What are the 2 types of anorexia nervosa?

A
  1. restrictive type

2. purging type

41
Q

In which psych disorder is dialectical behaviour therapy used?

A

borderline personality disorder

42
Q

In which psych disorder is graded exposure therapy used?

A

obsessive-compulsive disease and phobias

43
Q

In which psych disorder is individual CBT used?

A

moderate-severe depression

44
Q

In which psych disorder is self-help CBT used?

A

mild depression

45
Q

If one parent has schizophrenia what is the probability of their off-spring developing it?

A

13%

46
Q

If both parents have schizophrenia what is the probability their off-spring will develop it?

A

50%

47
Q

What psychological therapy does NICE recommend is offered to all patients with schizophrenia?

A

CBT

48
Q

How often should obs be checked following parenteral administration of rapid tranquillisation ?

A

every 5-10mins for 1hr

49
Q

What does IM rapid tranquillization make the pt at increased risk of?

A
  • respiratory depression
  • inability to protect own airway
  • acute arrhythmia
  • life-threatening hypotension
50
Q

Which anxiety disorders are equally common in men and women?

A
  • social phobia

- OCD

51
Q

What is the management for specific phobias?

A

CBT with desensitisation

52
Q

What is first line drug therapy for OCD?

A

SSRIs

53
Q

What is section 4 of the MHA?

A
  • detention of an individual against their own wishes for up to 72hrs
  • requires only 1 responsible medical officer
  • should only be used in the very acute situation where obtaining a section 2 would be tricky
  • section 4 can be converted to section 2
54
Q

What is a section 2?

A
  • detention of an individual against their wishes for review for up to 28days
  • requires 2 medical officers
55
Q

What is section 3?

A
  • 6month detention for treatment of a mental health illness
  • typically conversion from section 2
  • requires 2 medical recommendations to be valid
56
Q

What is your treatment of choice for acute behavioural crises?

A

haloperidol or risperidone

57
Q

What medications can cause a depressed mood in susceptible individuals?

A
  • antihypertensives
  • steroids
  • hypnotic medications
58
Q

What are the consequences of TCA overdose?

A

3 c’s:
Convulsion
Coma
Cardiac arrhythmias

59
Q

What ECG changes to you see with TCA overdose?

A
  • prolonged QT intervals
60
Q

What happens when someone on MAOi ingests food containing tyramine (cheese, red wine, some meats)?

A

hyperadrenergric state

61
Q

What is schizotypal personality disorder?

A
  • behaviour/thinking that is odd
  • excessive social anxiety
  • inability to form close, confiding relationships with other individuals
  • often paranoid ideation
62
Q

What is schizoid personality disorder?

A
  • emotionally flat affect

- lack of enjoyment for activities, close friends and relationships

63
Q

What is dependent personality disorder?

A
  • dependence on other individuals
  • an inability to be alone/not in a close relationship
  • making excessive demands on those around them for support and reassurance
64
Q

what is avoidant personality disorder?

A
  • shun social situations that bring attention to themselves
  • fear criticism
  • exhibit anxiety in social contexts
65
Q

What is sundowning and which conditions is it seen in ?

A
  • dementia and delirium

- it describes worsening of symptoms that occurs towards the end of the day

66
Q

Which condition is fluctuating levels of consciousness seen in?

A

delirium

67
Q

Which condition is eye movement desensitzation and reprocessing (EMDR) therapy used in?

A

PTSD

68
Q

List some 1st generation (typical) antipsychotics.

A
  • haloperidol

- risperidone

69
Q

List some 2nd generation (atypical) antipsychotics.

A
  • olanzepine
  • clozapine
  • quetiapine

Psychiatry (1 decks)

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