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Y3 Revision Points > Psychiatry > Flashcards

Psychiatry Flashcards

1
Q

Where is serotonin produced? What are its functions? What disease is it involved in?

A

Produced in raphe nucleus
Involved in emotion, mood, appetite, arousal, appetitive and aversive behaviour
Low in depression

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2
Q

Where is noradrenaline produced? What are its functions? What disease is it involved in?

A

Produced in locus coerulus
Involved in arousal, mood, motor activity
Low in ADHD

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3
Q

Where is dopamine produced? What are its functions? What disease is it involved in?

A

Substantia nigra
Reward, cognition, attention, motor control, appetitive approach systems
Increased rceptor activation in schizophrenia, decreased in PD

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4
Q

Where is acetylcholine produced? What are its functions? What disease is it involved in?

A

Tegmental nuclei
Involved in arousal, motor function
Neurones decreased in Alzheimer’s

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5
Q

Where is histamine produced? What are its functions? What disease is it involved in?

A

Reticular formation

Involved in alertness, arousal, appetite

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6
Q

What is GABA? What are its functions? What disease is it involved in?

A

Inhibitory neurotransmitter

Decreased levels lead to seizures, anxiety

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7
Q

What is glutamate? What are its functions? What disease is it involved in?

A

Excitatory neurotransmitter

Oversupply leads to migraine, seizures

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8
Q

What do olanzapine and risperidone act on? What does this result in?

A

Histamine receptors - weight gain and sedation

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9
Q

What drugs are impacted on by smoking?

A

Olanzapine and clozapine

Smoking decreases their action - if stop smoking will need to decrease dose

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10
Q

Side effects of typical antipsychotics and how they are managed

A

Extrapyramidal side effects - anticholinergics
Acute dystonic reaction - procyclidine
Hyperprolactinaemia - gynaecomastia, galactorrhoea, loss of libido, erectile dysfunction, osteoporosis

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11
Q

Signs of lithium toxicity

A 
Vomiting
Diarrhoea
Ataxia
Coarse tremor
Drowsiness
Convulsions
Coma
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12
Q

Clozapine side effects

A 
Myocarditis
Agranulocytosis
Drooling
Weight gain
Sedation
Constipation
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13
Q

PTSD management and combat-related management

A

Normal - EMDR

Combat-related - trauma-based CBT

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14
Q

OCD management

A

CBT with re-exposure therapy

Sertraline

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15
Q

Schizoid PD presentation

A

Quiet
Enjoys being alone
No hallucinations/delusions/appetite changes

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16
Q

MHA Criteria

A 
Suspected/diagnosed mental health disorder
Implicating decision making ability
Risk to themself or others
Necessity
Available treatment
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17
Q

Aggression management

A

De-escalate situation
No Hx typical antipsychotic use - 1-2mg oral or IM lorazepam
Hx typical antipsychotic use - 5mg haloperidol

18
Q

Alcohol withdrawal management

A

Chlordiazepoxide and thiamine
Naltrexone decreases pleasure, acamprosate decreases cravings, disulfram leads to nausea and flushing
Long-term - self-help/group therapy

19
Q

Mimics of cognitive impairment

A

B12/folate deficiency
Hypothyroidism
Depression
Anxiety

20
Q

Management of Alzheimer’s

A

Anticholinesterases - donepezil, rivastigmine, galantamine

Behaviour - memantine (NDMA receptor antagonist)

21
Q

Management of FTD

A

Trazadone for behaviour

POA

22
Q

Depression management in pregnancy

A

Sertraline safest

If on fluoxetine reduce dose over 2w then wait 4-7d before starting sertraline - long half life so needs wash out period

23
Q

Overdose management of paracetamol, lithium, TCA

A

Paracetamol - n-acetylcisteine
Lithium - haemodialysis
TCA - IV sodium bicarbonate

24
Q

Delirium management

A

Environmental measures
Haloperidol if required
If PD, DLB, neuroleptic sensitivity - lorazepam

25
Q

Anorexia management

A

Mirtazapine - increases appetite

26
Q

What happens in a dexamethasone suppression test in depression? Why?

A

Cortisol will not suppress to normal levels

High ACTH and cortisol –> adrenal enlargement in depression

27
Q

What do you get hypocalcamia in a panic attack?

What symptoms does this cause?

A

Hyperventilation leads to increased CO2 blown out therefore less H ions in blood. Ca and H both bind to albumin so more Ca is therefore bound to albumin
Numbness and tingling

28
Q

What inherited condition has a high risk of schizophrenia?

A

Velocardiofacial syndrome

29
Q

Does bipolar have a high heritability?

A

Yes - 80%

30
Q

Which dopamine pathway is involved in:
Prolactin release
Reward

A

Prolactin - tuberoinfundibular

Reward - Mesolimbic

31
Q

What drug is used for anti-cholinergic side effects?

A

Procyclidine

32
Q

What is Beck’s triad? What condition is it associated with?

A

Negative feelings about - self, future, world

In emotionally unstable PD

33
Q

What MMSE score indicates mild, moderate and severe dementia

A

<10 severe
10-20 moderate
21-26 mild
27-30 normal

34
Q

What is the diagnosis of antisocial PD in someone under 18?

A

Conduct disorder

35
Q

What is oppositional defient disorder?

A

Opposition to authority

36
Q

What do you do if you miss clozapine doses for >48h?

A

Restart dose at 12.5mg

37
Q

What condition is associated with reduced function of the prefrontal cortex?

A

Schizophrenia

38
Q

List features of Korsakoff syndrome?

A

Anterograde amnesia
Apathy
Lack of insight
Confabulation

39
Q

List features of Wernicke’s encephalopathy?

A

Opthalmoplegia, ataxia, confusion

40
Q

How does TCA overdose present?

A

Hypotension

Arrhythmias - sinus tachycardia, broad complex tachycardia

41
Q

List features of opioid withdrawal

A 
Eyes watering
Nose running
Agitation
Sweating
Piloerection
Tachycardia
Vomiting
Dilated pupils

Y3 Revision Points (6 decks)

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