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Psychiatry - Daniella > Psychiatry - Passtest > Flashcards

Psychiatry - Passtest Flashcards

(48 cards)

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1
Q

What is the concordance for schizophrenia for monozygotic and dizygotic twins?

A

46 and 16% respectively

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2
Q

What is the prevalence of schizophrenia worldwide?

A

up to 1% - approximately 20 million people with schizophrenia worldwide

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3
Q

What is PET scanning going to show in a patient’s brain with schizophrenia

A

Hyperactivity in prefrontal lobes, with enlarged cerebral ventricles

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4
Q

What would you do if a patient missed a dose of clozapine?

A

You would restart them at min dose which is 12.5mg daily. Note: It can be titrated up quicker than if patient was clozapine-naive.

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5
Q

Describe coagulation profile in a warfarin oD

A

Elevated PT, APTT, INR with normal platelets

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6
Q

What is the section that allows police to enter private property and remove an individual?

A

Section 135

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7
Q

What is the best type of therapy for social phobia?

A

CBT

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8
Q

Patients with BPD experience splitting - please describe this

A

Things are either good or bad no in-between - absolute thinking

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9
Q

Describe the incidence of baby blues

A

50-75% of mothers are affected following childbirth

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10
Q

In anorexia how much is body weight reduced?

A

10-15% of expected or previous weight

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11
Q

What type of therapy is indicated in combat-related trauma?

A

Trauma focused CBT rather than eye movement desensitisation and reprocessing therapy

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12
Q

List the side effects of lithium

A

Nephrogenic diabetes insipidus (low urine osmolality, high serum osmolality), confusion, coma, tremor, vomiting, diarrhoea

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13
Q

List the side effects of sodium valproate

A

Pancreatitis, liver failure, thromboyctopaenia, nausea, vomiting, diarrhoea, weight gain

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14
Q

List the investigations that need to be completed prior to starting a patient on antipsychotics

A
  • Weight
  • Waist circumference
  • Pulse and BP
  • HbA1c and fasting glucose
  • Lipid levels
  • Prolactin levels
  • Assessment of diet and exercise
  • Assessment of movement disorders
  • May do ECG
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15
Q

How does LBD present?

A

Parkinsonian symptoms, visual hallucinations, sleep behaviour disorders

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16
Q

How does Huntington’s disease present?

A

20-40yrs with psychosis, choreiform movements, depression and later on dementia. There is a strong family history in these patients.

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17
Q

How does LBD present?

A

Parkinsonian symptoms, visual hallucinations, sleep behaviour disorders. Antipsychotics are not given because they may worsen the condition.

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18
Q

What is residual schizophrenia?

A

When a patient develops prominent negative symptoms e.g. blunted affect, psychomotor retardation, lack of motivation, social withdrawal, self neglect after previous episodes of delusions and hallucinations.

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19
Q

What is residual schizophrenia?

A

When a patient develops prominent negative symptoms e.g. blunted affect, psychomotor retardation, lack of motivation, social withdrawal, self neglect after previous episodes of delusions and hallucinations.

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20
Q

What is simple schizophrenia?

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A

Insidious onset of odd behaviour and negative symptoms without previous delusions or hallucinations. It is difficult to establish this dx with confidence.

21
Q

What is catatonic schizophrenia?

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A

Characterised by prominent motor symptoms. Patients can alternate from hyperkinesis (overactivity) and under activity (stupor, posturing) or between automatic obedience (following all commands without question) and negativism (resisting movement of a body part). Waxy flexibility describes how a patient’s limbs retain in the same position that they are placed in.

22
Q

What is hebephrenic/disorganised schizophrenia?

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A

Prominent affective symptoms and disordered behaviour and speech. The patient has a shallow affect often with inappropriate laughter such that they seem immature or childish. Their speech is disorganised and incoherent. Occurs between 15-25yrs and has poor prognosis due to the rapid development of negative symptoms.

23
Q

What is paranoid schizophrenia?

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A

Characterised by predominantly positive symptoms of schizophrenia, including delusions and hallucinations.

24
Q

What is persistent delusional disorder?

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A

Delusions with no associated auditory hallucinations, control delusions or blunted affect.

25
What is the ADHD triad?
Inattention, impulsivity, hyperactivity
26
What is ADHD?
Persistent pattern of inattention, impulsivity, hyperactivity that interfere with function and development. Several symptoms present before age of 12yrs, in 2 or more settings, with symptoms lasting >6 months.
27
How many days can a person be restricted under urgent DoLS (deprivation of liberty safeguards) authorisation?
7 days
28
Where does patient have to be situated in order to issue a DoLS authorisation?
Only if in care home or currently in hospital. If at home, need to apply to court of protection to move patient as part of their best interests.
29
What is OCD?
Characterised by presence of obsessions (intrusive, frequent thoughts, ideas or impulses) and compulsions (repetitive purposeful behaviours performed with reluctance in response to an obsession). Sertraline is licensed for OCD.
30
What is the difference between personality traits and a personality disorder?
Traits: patterns of perception, processing, and/or engagement. PD: when traits become ingrained, inflexible and maladaptive. Almost an exaggeration of the personality traits which cause suffering to the individual or to others.
31
What are the three clusters of PD?
A - weird B - wild C - worried
32
What are the signs of opioid withdrawal?
Dilated pupils, vomiting yawning, epiphora (eye watering), rhinorrhoea (runny nose), piloerection, tachycardia, perspiration, agitation.
33
What are the electrolyte abnormalities seen in refeeding syndrome?
Hypophosphataemia, hypomagnesaemia, hypokalaemia, thiamine deficiency.
34
What is neuroleptic malignant syndrome?
Rare but potentially life-threatening reaction to neuroleptic medication. It is chatacterised by hyperpyrexia, autonomic dysfunction, rigidity, altered conscious state and raised creatine phosphokinase. Treatment is to stop neuroleptic medication, cool the patient down and administer meds such as bromocriptine, dantrolene and benzos.
35
What is pain disorder?
Intense, long-standing pain without a somatic explanation.
36
What are the biological treatment options fr PTSD?
SSRIs or venlafaxine (SNRI). Antipsychotics may be given later if no response.
37
Which neuroendocrine axis is involved in anxiety disorders?
HPA = hypothalamus, pituitary, adrenal axis
38
How long does a section 3 last and what are the renewal time periods?
6 months After that can renew for another 6 months After that can renew for a year
39
What is Fregoli syndrome?
Like Capgras but now a single persecutor impersonates several people known or unknown to the patient.
40
What is neurosis?
An inappropriate emotional or behavioural response to a perceived stressor e.g. anxiety states, phobic conditions.
41
What is fixation?
Lack of progression through development, whereby a person persists in a child-like state of maturity on a given topic.
42
What is sublimation?
A mature ego defence in which a person takes an unacceptable personality trait of theirs and uses it to drive respectable work that does not conflict with their value system.
43
What is dissociation?
An immature ego defence where a person's identity is temporarily and drastically modified to avoid the distress of a given situation.
44
What is reaction formation?
An immature defence mechanism whereby unacceptable emotions (unconsciously) repressed and replaced by the exact opposite.
45
What is splitting?
A common immature defence mechanism where the patient is unable to see both good and bad traits in an individual therefore sees them as all good or all bad.
46
What are some first-rank symptoms of Schizophrenia?
``` Auditory hallucination Delusional perception Thought broadcasting Thought withdrawal, insertion or interruption Somatic passivity External control of emotions ```
47
Do you ever give lithium to a patient with schizophrenia, on clozapine for instance?
Even though may not augment anti-psychotic elements, can be used in order to elevate WCC in those with previous episodes of agranulocytosis (neutropenic episodes).
48
Explain the differences between dyskinesia and dystonia?
Tardive dyskinesia causes involuntary movements most commonly in areas of the face, eyes, and mouth. Dystonia, on the other hand, leads to involuntary muscular contractions that can affect the head, face, and neck.

Psychiatry - Daniella (2 decks)

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