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Year 3 > Psychiatry Quesmed > Flashcards

Psychiatry Quesmed Flashcards

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1
Q

What are the electrolyte changes in bulimia?

A

Hypokalemia
Hypochloraemic metabolic alkalosis

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2
Q

Which antipsychotics are safe for breastfeeding women?

A

SPECIFIC Second gen antipsychotics like olanzapine
Quetiapine

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3
Q

Which investigation should be performed for new onset palpitation without clear cause?

A

Referral for 48 hour Holter monitor ECG to assess for hereditary or structural cause

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4
Q

What is section 5.2 used for?

A

inpatients of psychiatric units or patients in hospitals being treated for a PHYSICAL condition. It is a holding power that gives a doctor or approved clinician up to 72 hours to detain the patient on the ward

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5
Q

What screening tool is used for postpartum depression?

A

Edinburgh Postnal depression scale

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6
Q

What is thought derailment?

A

Speech has a series of completely unrelated ideas

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7
Q

What is tangential it’s?

A

Person diverts form original train of thought

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8
Q

What is perseveration?

A

Thought disorder with inappropriate and uncontrollable repetition and responses

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9
Q

What is circumstantial Im?

A

Speech has many unnecessary details but returns to original point

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10
Q

What is a feature of lithium toxicity?

A

Coarse tremors
-> ataxia, vomiting and muscle weakness and cardiac arrythmias

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11
Q

How does lithium affect FBC?

A

Causes leukocytosis
Hypothyroidism

Raised creatinine because of renal impairment

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12
Q

How does Alzheimer’s affect the Brian?

A

Widespread cerebral atrophy

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13
Q

What causes widespread infarcts on the brain?

A

Vascular dementia

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14
Q

Which drug is most likely to cauase hypertension, tachycardia, hyperthermia and hallucinations?

A

LSD

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15
Q

Which drug likely causes tachycardia, elevated mood?

A

Ecstasy
Methamphetamine
LSD-> most commonly associated with hallucinations

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16
Q

How does heroin affect vitals?

A

Decreased respiratory and heart rate

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17
Q

What are the side effects of lithium?

A

Hypothyroidism assoicated with irregular periods, tiredness, weight gain and constipation

Nephrogenic diabetes insipidus

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18
Q

What are features on FBC for anorexia?

A

Low WBC
High cortisol
High cholesterol
Metabolic alkalosis if vomiting or using diuretics
Low sex hormone levels

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19
Q

Which antipsychotics are used for mood stabilisation?

A

Olanzapine, Risperidone, Quetiapine and haloperidol

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20
Q

Which drugs can worsen mania in bipolar?

A

Sertraline

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21
Q

What is somatoform disorder?

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A

Physical symptoms that cannot be explained by medical condition

22
Q

What is conversion disorder?

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A

Psychiatric condition causing neurological symptoms without any organic cause

23
Q

What delusion is where patient believes they are dead?

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A

Cotard
-> also includes organs have been removed

24
Q

What is fregoli delusion?

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A

Same person everywhere in different disguises

25
What does Down’s increase the risk of
Alzheimer’s disease due to greater quantity of amyloid plaques
26
Which type of dementia is haloperidol contraindicated?
Lewy-Body dementia because of their sensitivity to neuroleptics
27
What is the pharmacological treatment for patients with Alzheimer’s that have QT prolongation?
AVOID anti cholinesterase inhibitors -> use Cognitive stimulation therapy
28
What is the NICE guidance for follow up in patients under 30 starting SSRI treatment?
1 weeks
29
What is the NICE guidance for follow up in patients over 30 starting SSRI treatment?
2 weeks
30
What are the electrolyte imbalances with anorexia?
Hypercholesterolaemia High growth hormone Hypokalemia Low sex hormones Normal T4 but low T3 High cortisol levels
31
What is the first line investigation for elderly patient suspicious of dementia?
Always do bloods to rule out reversible causes like FBC, U&Es and LFTs
32
What is an early sign of opiate withdrawal?
Agitation, muscle aches and HYPERACTIVITY of heart, RUNNY nose, RUNNY eyes, SWEATING, diarrhoea
33
What is Ekbom delusion?
Patient has crawling sensation of skin -> may be related to B12 deficiency
34
35
What is transient global amnesia?
Temporary abrupt loss of short and long term memory causing disorientation even in familiar surroundings but unaffected sense of self
36
What are the side effects of sodium valproate?
VALPROATE: Vomiting Alopecia Liver toxicity Pancreatitis Retention of fats Oedema Anorexia Tremor Enzyme inhibiton
37
What is used to correct extrapyramidal symptoms?
Procyclidine, an anticholinergic for tremor, akathesia and dystonia
38
What is the management for acute stress disorder?
Trauma focused CBT
39
How to differentiate mania from hypo mania?
Mania causes severe disruption to life and disinhibition, pressured speech and grandiose delusions. Hypomania is elevated mood, decreased need for sleep and inflated self esteem.
40
What does gait disturbance, urinary inconteince and possible dementia indicate?
normal pressure hydrocephalus, where CSF builds up in the skull. CT head scan is the idea investigation and cerebrospinal shunt should be used
41
Why does metabolic alkalosis occur in anorexia?
Vomiting Use of diuretics
42
What are the features of serotonin syndrome?
MAN Mental status altered like anxiety and agitation A= autonomic hyperactivity like hyperthermia, tachycardia and hypertension Neuromuscular abnormalities like clonus and tremor
43
What is the cause of serotonin syndrome?
Interaction of SSRIs, SNRIs, tricyclic antidepressants Stimulant recreational drugs like MDMA, cocaine and amphetamines Psychiatric medications like lithium
44
How can serotonin syndrome be differentiated from neuroleptic malignant syndrome based on signs?
There is a more acute onset with serotonin syndrome, hyperreflexia and dilated pupils.
45
When should urine culture be avoided?
Over 65’s due to lower sensitivity
46
What will the electrolyte abnromalities be in serotonin syndrome?
Metabolic acidosis
47
What are the side effects of SNRIs?
Increase in blood pressure and heart rate
48
What is a marke for neuroleptic malignant syndrome?
Creatine kinase
49
50
What personality disorder is characterised by sexually inappropriate behaviour and attention seeking?
Histrionic personality disorder
51
What side effects are assoicated with tricyclic antidepressants?
Constipation Dry mouth due to antihcholnergic effect Urinary retention
52
What drug increases serum lithium levels?
ACE inhibitor

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