Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Phase 3a Medicine > Psychiatry > Flashcards

Psychiatry Flashcards

1
Q

What is needed to diagnose dependence syndrome?

A

3 or more features present at the same time during the previous month.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Delirium Tremens

  • Peak incidence?
  • Tx? First, second?
  • What to use if psychotic features are present?
A
  • 72 hours after cessation.
  • IV Pabrinex then high dose benzo (oral Lorazepam.)
  • Haloperidol.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Describe an alcohol detox regime.

A

High dose Chlordiazepoxide 4x a day, start high and taper down.

Alongside oral Thiamine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

List the 3 drugs that can be used to prevent relapse.

A

Disulfiram.
Naltrexone.
Acamprosate.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Triad of Wernicke’s?

What is a memory feature of Wernicke’s?

A

COG:

  • Cognition change/confusion.
  • Ocular disturbances.
  • Gait is unsteady.

Antegrade amnesia - inability to form new memories.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

List the 3 categories of child psych and the disorders the contain?

A

Neurodevelopmental:
ADHD.
ASC.

Conduct disorder.

Emotional disorders
Eating disorder.
PTSD.
Mood disorders.
Anxiety and OCD.
Psychosis.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the triad of autism?

A
  • Impaired social interaction.
  • Impaired communication.
  • Restricted and stereotyped interests and behaviours.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the triad of ADHD? And 7 diagnostic criteria?

A
  • Inattention.
  • Hyperactivity.
  • Impulsivity.
  1. Core Fx at home.
  2. Core Fx at school.
  3. Core Fz directly observed.
  4. No other criteria met.
  5. Onset <7 years.
  6. Duration >/= 6 months.
  7. IQ > 50.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Define ODD

A

Oppositional defiant disorder: defiant and disruptive behaviour against authority figures, without aggressive or antisocial acts (as in conduct disorder.)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

First line Mx of ADHD? What needs to be monitored?

A

Methylphenidate (Ritalin.)

Growth and height every 6 months.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Define conduct disorder

A

Persistent, deceptive and aggressive behaviours.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

First line for any child psychiatric disorder?

A

Family therapy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Diagnostic criteria for anorexia nervosa?

A 
Deliberate weight loss.
Intense fear of fatness.
Distorted body image.
Endocrine disturbance.
BMI <17.5

Present for at least 3/12, with no bingeing or craving to eat.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the physical Sx of anorexia nervosa?

A 
Fatigue.
Hypothermia.
Bradycardia.
Peripheral oedema.
Lanugo hair.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What does persistent vomiting and laxative use show on blood gas?

A

Vomiting - metabolic alkalosis.

Laxative use - metabolic acidosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are indications for inPx admission in anorexia nervosa?

A

BMI <14, severe electrolyte abnormalities.

Suicidal ideation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the weight gain aim per week for anorexia?

A

0.5kg/week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Define refeeding syndrome.

Prevention and Tx?

A

Changes to phosphate (low), magnesium (low), potassium (low). Due to insulin surge.

Measure serum electrolytes and monitor daily. Start 122 kcal/day and increase every 5 days.

Replenish electrolyte levels oral/IV.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Diagnostic criteria for bulimia nervosa?

A

Compensatory behaviours.
Preoccupation with eating.
Fear of fatness.
Overeating (2 episodes/week for >3 months.)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Specific sign for bulimia?

A

Russell’s sign - callouses on back of hand due to abrasions from self-induced vomiting.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Tx for bulimia?

A

High dose SSRI (60mg)

CBT-BN, ITP therapy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the 4 D’s that worsen Litihum?

A

Dehydration.
Drugs (ACE-i, NSAIDs.)
Diuretics.
Depletion of sodium.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Tx for Lithium toxicity?

A

Immediate cessation of Li.
High fluid intake.
IV NaCl.
Renal dialysis if severe.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the triad of Sx for serotonin syndrome?

A

Neuromuscular excitability.
Autonomic dysfunction.
Altered mental state.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the key features of NMS?

A

Change in mental state.
Rigidity.
Fever.
Autonomic dysfunction.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the key investigation in NMS and why?

A

CK (raised secondary to muscular rigidity.)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Define bipolar affective disorder.

A

Chronic, episodic mood disorder characterised by at least one episode of mania/hypomania and a further episode of mania/hypomania or depression.

i.e. - 2 episodes in which a person’s mood and activity levels are significantly disturbed one of which must be mania or hypomania.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q 
Define:
Bipolar type 1.
Bipolar type 2.
Rapid cycling.
Cyclothymia.
A
  1. Mania and depression.
  2. Severe depression and mild hypomania.
  3. > 4 mood swings in 12 months with no asymptomatic period.
  4. Not meeting the criteria for diagnosis.
29
Q

First line Tx for:

  1. Acute mania/mixed Sx.
  2. Depressive episode.
  3. Maintenance.
A
  1. Atypical antipsychotic.
  2. Atypical antipsychotic + SSRI.
  3. Lithium (can add valproate.)
30
Q

Define mild, moderate, severe depression and their Tx.

A

Mild: 2 core, 2 other.
Moderate: 2 core, 3/4 other.
Severe: 3 core, 4+ other.

Mild: psychotherapies (CBT self-guided, group of individual.)

Recurrent or severe:
SSRI + psychotherapy.

31
Q

List the core depression Sx.

A

Anhedonia.
Anergia.
Low mood almost every day for at least 2 weeks.

32
Q

What is the pathway for depression medications?

A
  1. SSRI.
  2. Increase SSRI dose.
  3. Switch SSRI.
  4. Try an SNRI, TCA, or Mirtazapine (NaSSa).
  5. SSRI + TCA/Mirtazapine.
33
Q

Risks of SSRIs in elderly and young?

A

Elderly - hyponatraemia or GI bleed.

Young - suicidal thoughts.

34
Q

Which SSRI is used in a) children b) cardiac issues?

A

a) Fluoxetine.

b) Sertraline.

35
Q

Name:

a) an SSRI.
b) an SNRI.
c) a NaSSa
d) a TCA
e) an MAOI

A

a) Sertraline.
b) Venlafaxine, Duloxetine.
c) Mirtazapine.
d) Amitriptyline, Imipramine.
e) Phenelzine, Isocarboxazid.

36
Q

What type of SE does a TCA have and why?

A

Can’t see, can’t pee, can’t spit, can’t shit (anti-cholinergic.)

37
Q

SE of Mertazapine.

A

Sedation and weight gain.

38
Q

Define
a) conversion disorder

b) somatoform disorder

A

a) Sx that cannot be explained by a medical disorder, with a convincing association in time between the Sx and a stressful event.
b) at least 2 years of at least 6 unexplained physical Sx, continually wanting tests.

39
Q

Define hypochondrial disorder

A

Misrepresentation of normal bodily sensations leading to non-delusional preoccupation that they have a serious physical disease.

40
Q

Define malingering

A

Faking Sx for gain.

41
Q

Define factitious disorder/Munchhausen’s syndrome.

A

Faking or causing Sx to adopt a sick role.

42
Q

Define a) obsession b) compulsion

A

a) unwanted, repeated intrusive thoughts that are distressing and individual attempts to resist them. Ego-dystonic. Recognise they are not real.
b) repetitive, stereotyped acts a person feels driven to perform.

43
Q

OCD management

A
  1. CBT with ERP.
  2. Drugs: SSRI for 12 weeks (3 months.)
    then Clomipramine.
44
Q

Define panic disorder and the Tx.

A

Recurrent panic attacks with no trigger.

CBT. SSRI (try 12 weeks, switch to Clomipramine.

45
Q

Define a) social phobia b) agoraphobia

A

a) fear of social situations with the fear they will lead to humiliation or criticism.
b) fear of public spaces where immediate escape would be difficult.

46
Q

Define PTSD

A

Intense, prolonged and delayed reaction to traumatic event. Within 6 months of the event, present for at least 1/12.

47
Q

Define abnormal grief reaction

A

Delayed onset, more intense, >6/12.

48
Q

Define acute stress reaction

A

Abnormal reaction to sudden stressor. Immediate onset, diminishes with 8 hours.

49
Q

Define Adjustment disorder

A

Within 1 month of a situation, lasting less than 6. Adjusting to a new life event.

50
Q

List the key Sx of PTSD

A
  • Reliving.
  • Avoidance.
  • Emotional numbing.
  • Hyperarousal.
51
Q

Management of PTSD.

A
  • Mild and <4 weeks = watchful waiting.
  • Trauma-focussed CBT.
  • May do EMDR.
52
Q

List the 3 Cluster A, Cluster B and Cluster C PD and the overall type.

A

A = odd/eccentric

  • Paranoid.
  • Schizoid.
  • Schizotypal.

B = Dramatic

  • EUPD.
  • Histrionic.
  • Antisocial.

C = Anxious.

  • Anxious.
  • Dependent.
  • Anankastic/OCPD.
53
Q

List the 4 areas of EUPD Sx.

A
  • Impulsivity.
  • Instability of relationships.
  • Affective Sx.
  • Self-image.
54
Q

Personality disorder Tx?

A

DBT.

55
Q

Define schizoaffective disorder, and delusional disorder.

A

Schizophrenia with depression or mania.

Delusions are the only/most prominent psychotic Sx.

56
Q

List and define the Schizophrenia subtypes.

A

Paranoid.
Hebephrenic: disorganised.
Catatonic.
Residual: chronic, +ve Sx less marked.

57
Q

Define:

a) Akathisia.
b) Acute dystonia.
c) Tardive dyskinesia.

and their Tx.

A

a) restlessness. Propranolol.
b) involuntary muscle contractions of the head and face. Procyclidine.

c) More chronic involuntary facial muscle movements.
Tetrabenazine.

58
Q

What are the main SE of a) typical antipsychotics.

b) atpyical?

A

a) EPSE, raised prolactin.

b) weight gain and metabolic syndrome.

59
Q

SSRI use in pregnancy?

A

Safe except Paroxetine.

60
Q

Risks of antipsychotic in elderly?

A

Strone, VTE.

61
Q

SE/ adverse effects of Clozapine?

A
  • Constipation.

- Agranulocytosis.

62
Q

From starting Lithium, what monitoring is needed and when?

A
  • 12 hours after first dose , weekly until stable for 4 weeks, then every 3 months.
  • U&E, TFT every 6 months.
63
Q

Section 2

  • Define.
  • Who is needed?
  • Length.
  • Discharge?
A

Assessment.

AMHP, 2 doctors (1 S12.)

28 days, converted to section 3.

Responsible clinician, MHA manager, nearest relative (can be overruled.)
Tribunal.

64
Q

Section 3

  • Define.
  • Who is needed?
  • Length.
  • Discharge?
A

Treatment

AMPH, 2 Drs (1 S12.) Nearest relative must not object.

6 months.

Responsible clinician, MHA manager, nearest relative (can be overruled), Tribunal. Entitled to section 117 aftercare.

65
Q

Section 4

  • Define.
  • Who is needed?
  • Length.
  • Discharge?
A

Cases of emergency. Using another section –> undesirable delay.

AMHP, one Dr (not S12.)

72 hours, converted to section 2.

No rights of appeal, only discharged by responsible clinician.

66
Q

Section 5

  • Define.
  • Who is needed?
  • Length.
  • Discharge?
A

Already admitted to hospital (not A&E.)

5(2) Dr holding power - 72 hours.
5(4) MH or LD nurses holding power - 6 hours.

No rights of appeal.

67
Q

Define CTO.

A

Someone on a section, who can be safely Tx in community but power to recall them to hospital.

68
Q

Define sections 135 and 136.

A

135: person’s house to a place of safety.
136: public places to place of safety.

Phase 3a Medicine (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions