Severe Mental Illness — Flashcards
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Belief of having the removal of a thought by an external force = _____
The risk of developing schizophrenia if one monozygotic twin is affected is approx _____
Schizophrenic patient seen stopping voluntary movement or staying still = _____
_____ is associate with a poorer prognosis in Schizophrenia
Hint: Onset
A long prodromal phase of _____ is associated with poor prognosis in schizophrenia
_____ can cause chest pain due to myocarditis
Hint: medication
_____ is a feature of schizophrenia
Hint: sleep
_____ should only be initiated if there is a lack of clinical improvement following sequential use of atleast 2 antipsychotics for 6-8 weeks with atleast one of these antispychotics being from the atypical class --> for schizophrenia
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What are usual precipitating events of Delirium? 7
Severe Mental Illness UK Medical PG Flashcards - Medical Study Cards
Master Severe Mental Illness with OnCourse flashcards. These spaced repetition flashcards are designed for medical students preparing for NEET PG, USMLE Step 1, USMLE Step 2, MBBS exams, and other medical licensing examinations.
Severe Mental Illness Flashcard Deck - 169 Cards
Flashcard 1: Belief of having the removal of a thought by an external force = _____
Answer: thought widthdrawal
Flashcard 2: The risk of developing schizophrenia if one monozygotic twin is affected is approx _____
Answer: 50%
Flashcard 3: Schizophrenic patient seen stopping voluntary movement or staying still = _____
Answer: catatonia
Flashcard 4: _____ is associate with a poorer prognosis in Schizophrenia
Answer: Gradual
Flashcard 5: A long prodromal phase of _____ is associated with poor prognosis in schizophrenia
Answer: social withdrawal
Flashcard 6: _____ can cause chest pain due to myocarditis
Answer: Clozapine
Flashcard 7: _____ is a feature of schizophrenia
Answer: Insomnia
Flashcard 8: _____ should only be initiated if there is a lack of clinical improvement following sequential use of atleast 2 antipsychotics for 6-8 weeks with atleast one of these antispychotics being from the atypical class --> for schizophrenia
Answer: Clozapine
Flashcard 9: bf436201fdd2467bb4524075c13428c5-ao-3
Answer:
Flashcard 10: What are usual precipitating events of Delirium? 7
Answer: • Infection: particularly UTIs • Metabolic: Hypercalcaemia, Hypoglycaemia, Hyperglycaemia, Dehydration • Change of environment • Significant cardiovascular, respiratory, neurological or endocrine condition • Severe Pain • Alcohol Withdrawal • Constipation
Flashcard 11: What is the Management for Delirium? 3
Answer: • Treatment of underlying cause • Modification of the environment • Haloperidol 0.5mg may be used first-line -> if no Parkinson's, and pharmacological therapy required
Flashcard 12: What medication is used in patients with Parkinson's disease presenting with Delirium? 2
Answer: • Lorazepam is preferred if urgent treatment is required • Or atypical antipsycotic (e.g. quetiapine, clozapine) *Careful reduction of Parkinson medication may be useful
Flashcard 13: What is prescribed in palliative care for confusion? 2
Answer: • Haloperidol (1st) • Other options: chlorpromazine, levomepromazine
Flashcard 14: What is the difference between Hyperactive and Hypoactive Delirium?
Answer: • Hyperactive delirium = typical presentation Agitation, Delusions, Hallucinations, Wandering, Aggression - Hypoactive Delirium Lethargy, Slowness with tasks, excessive sleeping, inattention
Flashcard 15: 8892364799924d4aa95741d3852db59a-ao-6
Answer:
Flashcard 16: Dopamine agonists (e.g. pramipexole, ropinirole) may _____ impulsive activities such as gambling, hypersexuality, shopping, & binge eating
Answer: ↑
Flashcard 17: In addition to late-onset dementia, _____ may present with other neuropsychiatric symptoms including depression, psychosis, and disturbed sleep
Answer: Parkinson disease
Flashcard 18: What is an important precaution before starting a patient on naltrexone? _____
Answer: They must be completely opioid free (>7-10days) to avoid precipitation of withdrawal. *see bottom for caveat
Flashcard 19: Bupropion may cause _____, especially in anorexic or bulimic patients
Answer: seizures
Flashcard 20: _____ is the process of stopping smoking
Answer: Smoking cessation
Flashcard 21: Bupropion is contraindicated in _____
Answer: epilepsy
Flashcard 22: Tobacco triggers dopamine causing _____
Answer: euphoria
Flashcard 23: Cigarette smoking is more common in _____
Answer: males
Flashcard 24: Tobacco is addictive because of _____
Answer: nicotine
Flashcard 25: Smoking cessation can cause _____ as a side effect
Answer: weight gain
Flashcard 26: Methadone is a long-acting _____ μ-opioid agonist Buprenorphine is a long-acting partial μ-opioid agonist **to attenuate opioid withdrawal symptoms
Answer: full
Flashcard 27: Healthcare professionals should screen for tobacco use and encourage them to _____
Answer: stop smoking (assuming that is their method of intake)
Flashcard 28: What is the management of smoking use? _____ and inform the patient of long-term risk
Answer: Refer for smoking cessation services
Flashcard 29: _____% of adult cigarette smokers are interested in quitting
Answer: 68
Flashcard 30: _____ is opted for in pregnant women to reduce cravings in smoking cessation
Answer: Nicotine replacement therapy (NRT)
Flashcard 31: _____ is the abrupt cessation of opioids causing autonomic, gastrointestinal, neuromuscular, & neuropsychiatric symptoms
Answer: Opioid withdrawal
Flashcard 32: What is done to investigate smoking use in pregnant women? _____
Answer: Carbon monoxide testing at first antenatal appointment and 36-week appointment
Flashcard 33: Signs of illicit opioid dependence include _____ marks & skin infections
Answer: needle track
Flashcard 34: Do NOT offer varenicline & bupropion in _____ or breast feeding women
Answer: pregnant
Flashcard 35: What investigation can be used to screen for smoking use? _____
Answer: Carbon monoxide monitor (breath)
Flashcard 36: _____ is the abrupt cessation of alcohol consumption causing tremor, insomnia, anxiety, & seizures
Answer: Alcohol withdrawal
Flashcard 37: _____ are significantly more likely to develop alcohol use disorder
Answer: Men
Flashcard 38: What is the management for alcohol withdrawal with seizures? _____
Answer: IV benzodiazepine
Flashcard 39: What is the first-line management for alcohol withdrawal/delirium tremens? _____
Answer: Chlordiazepoxide
Flashcard 40: _____ in SUD presents as using larger amounts for longer periods of time, unsuccessful attempts to cut down, excessive time commitment, & intense desires (craving)
Answer: Impaired control
Flashcard 41: Offer oral prophylactic _____ supplementation to prevent Wernicke's encephalopathy
Answer: thiamine
Flashcard 42: Alcohol can cause _____cytic anaemia
Answer: macro
Flashcard 43: What is the alcohol drinking advice for pregnancy? _____
Answer: Avoid drinking alcohol to minimise risks to baby
Flashcard 44: Substance use disorder more commonly affects _____
Answer: men **this use to be the case historically, however, the gender gap for SUD is narrowing
Flashcard 45: Spread drinks evenly over ≥ _____ days when drinking as much as 14 units/week
Answer: 3
Flashcard 46: It is safest to drink ≤ _____ units of alcohol per week for both men & women - Chief Medical Officers' guideline
Answer: 14
Flashcard 47: The _____ tool is used to classify alcohol withdrawal severity
Answer: CIWA-Ar
Flashcard 48: _____ in SUD presents as use in physically hazardous situations (e.g. DUI, unprotected sex) & recurrent use despite problems worsened by use
Answer: Risky use
Flashcard 49: Most likely diagnosis in a patient with tremors, anxiety, & confusion 2-3 days after surgery? Basic observations show tachycardia and hypertension. _____
Answer: Delirium tremens/alcohol withdrawal
Flashcard 50: Which symptoms of alcohol withdrawal occur during the 12 - 24 hour time period? _____
Answer: Alcoholic hallucinosis (visual & auditory hallucinations)
Flashcard 51: Substance intoxication, withdrawal, induced psychiatric disorders fall under the name _____
Answer: substance-induced disorders
Flashcard 52: Which symptoms of alcohol withdrawal occur during the 48 - 72 hour time period? _____
Answer: Delirium tremens (altered mental status)
Flashcard 53: _____ is a severe form of alcohol withdrawal causing altered mental status
Answer: Delirium tremens
Flashcard 54: _____ disorder is defined as ≥ 2 of the following signs in 1 year: (DSM-5) - Impaired control - Social impairment - Risky use of substance - Pharmacological effects
Answer: Substance use
Flashcard 55: _____ are more likely to complete suicide
Answer: Men
Flashcard 56: _____ is the spectrum of thoughts, behaviours, and intensions related to ending one's own life
Answer: Suicidality
Flashcard 57: Must consider assessing _____ in regards to management of patients who present with suicide / self harm
Answer: mental capacity
Flashcard 58: _____ are more likely to try suicide
Answer: Women
Flashcard 59: Sudden improvement of symptoms in agitated or depressed patients could signal an impending _____
Answer: suicide
Flashcard 60: Stereotypically, males who self harm can present with _____
Answer: hitting
Flashcard 61: Good luck studying for the UKMLA and other exams! Medical student and doctor depression/suicide is a major epidemic that isn't talked about enough. If you think someone you know is feeling down, ask how they're doing! If you're feeling down, please don't be afraid to ask for help. Be kind to yourself and others :) I wish you the best of luck for your life. With love, Spranki _____
Answer: :')
Flashcard 62: Risk factors for suicide is remembered with the mnemonic "_____"
Answer: SAD PERSONS
Flashcard 63: Which "SAD PERSONS" risk factor carries the highest risk for suicide? _____
Answer: Previous attempt
Flashcard 64: What form of self harm is the most common? _____
Answer: Cutting of the wrist, forearm, & thighs
Flashcard 65: Patients started on an SSRI are at an initial increased risk of _____
Answer: suicide
Flashcard 66: The common causes of delirium can be remembered by the PINCH ME mneumonic: _____ Infection Nutrition Constipation Hydration Medication Environment
Answer: Pain
Flashcard 67: The main difference between dementia and mild cognitive impairment is _____
Answer: functional impairment
Flashcard 68: What is the 2nd most common type of dementia? _____
Answer: Vascular
Flashcard 69: How does lewy body dementia & parkinson's dementia differ? _____
Answer: Lewybody dementia: Dementia < 1 year before parkinsonian features Parkinson's: Parkinsonism > 1 year before dementia
Flashcard 70: Early-onset dementia with Parkinsonian features suggests _____ dementia
Answer: Lewy body
Flashcard 71: A patient with diagnosed dementia should notify the _____
Answer: DVLA
Flashcard 72: Antipsychotics should not be used in patients with _____ dementia because they may exhibit neuroleptic hypersensitivity which can worsen the dementia
Answer: Lewy body
Flashcard 73: What investigation can be used for lewy body dementia? _____
Answer: DaTscan (I-FP-CT SPECT)
Flashcard 74: _____ dementia has a step-wise progression where the cognitive impairment will remain the same for months and then suddenly drop again as infarctions occur
Answer: Vascular
Flashcard 75: Patients with Lewy body dementia are especially sensitive to _____ drug class
Answer: antipsychotic
Flashcard 76: A hypertensive patient presents with sudden cognitive decline, then remains stable for 8 months and experiences another sudden drop in decline. What should you suspect? _____
Answer: Vascular dementia
Flashcard 77: Lewy body dementia diagnostic criteria for 2/3 core clinical features: _____ Parkinsonism Fluctuating cognition
Answer: Recurrent visual hallucinations
Flashcard 78: _____ dementia is a result of multiple arterial infarcts and/or chronic ischemia (e.g. hypertension, atherosclerosis, vasculitis)
Answer: Vascular
Flashcard 79: Dementia is a common feature of _____ Parkinson's disease
Answer: late
Flashcard 80: What vitamin can be used for Alzheimer's/vascular dementia to slow functional losses? _____
Answer: Vitamin E (tocopherol)
Flashcard 81: Lewy body dementia is characterized initially by dementia with _____ cognition / alertness, a(n) REM sleep behavior disorder, visual hallucinations, followed by parkinsonian features
Answer: fluctuating
Flashcard 82: A stroke can x2 ↑ the risk of suffering from _____
Answer: dementia (vascular)
Flashcard 83: What is the pharmacological management of vascular dementia? _____
Answer: None; consider AChE inhibitors or memantine in comorbid Alzheimer's, Parkinson’s disease dementia, or dementia with Lewy bodies. Main focus remains on ↓ cardiovascular risks
Flashcard 84: Familial cases of Alzheimer disease (10%) are characterized by a(n) _____ age of onset (relative to sporadic cases)
Answer: earlier
Flashcard 85: _____-onset familial Alzheimer's can be caused by PSEN1 & PSEN2 genes
Answer: Early
Flashcard 86: What is the first-line pharmacological management of Alzheimer's? _____
Answer: Acetylcholinesterase inhibitors (e.g. donepezil, galantamine, rivastigmine)
Flashcard 87: _____-onset Alzheimer's is associated with apolipoprotein ε4 allele
Answer: Late
Flashcard 88: Over 90% of Alzheimer disease cases are _____
Answer: sporadic
Flashcard 89: NICE recommend the use of cognitive testing tools for dementia, including _____ or the 6-item cognitive impairment test (6CIT)
Answer: 10-point cognitive screener (10-CS)
Flashcard 90: The ε2 allele of apolipoprotein E is associated with _____ risk for Alzheimer disease
Answer: decreased
Flashcard 91: The most common type of dementia is _____
Answer: Alzheimer's
Flashcard 92: The _____ lobe is first effected in Alzheimer's
Answer: medial temporal
Flashcard 93: The leading cause of death in Alzheimer's is _____
Answer: aspiration pneumonia (caused by poor swallow)
Flashcard 94: A mini-mental state exam (MMSE) score: _____ = normal 20-24 = mild cognitive impairment / mild Alzheimer's 10-19 = moderate Alzheimer's 0-9 = severe Alzheimer's
Answer: 25-30
Flashcard 95: Delirium is often triggered in patients with underlying risk factors when new precipitating factors are introduced such as a(n) _____, medications, or metabolic disturbances
Answer: infection
Flashcard 96: The primary types of dementia include: _____ (up to 70%) Vascular dementia (up to 15%) Dementia with Lewy bodies (up to 10%%) Frontotemporal dementia (up to 2%)
Answer: Alzheimer's disease
Flashcard 97: Delirium typically lasts ~_____ in hospital
Answer: 6 weeks
Flashcard 98: After a blood screen, what other investigation may be used for dementia? _____
Answer: CT/MRI neuroimaging to exclude other reversible conditions
Flashcard 99: The ε4 allele of apolipoprotein E is associated with _____ risk for Alzheimer disease
Answer: increased
Flashcard 100: _____ is a chronic, progressive syndrome marked by ongoing cognitive decline including memory loss, challenges in thinking and communication, & performing everyday tasks and personality alterations
Answer: Dementia
Flashcard 101: When assessing for dementia, it is vital to obtain a _____ history
Answer: collateral
Flashcard 102: A section 4 lasts for _____
Answer: 72 hours
Flashcard 103: Patients suffering from delirium will have their _____-term memory affected most
Answer: short
Flashcard 104: Delirium is a common condition which mainly affects _____ people and is also known as acute confusional state
Answer: elderly
Flashcard 105: A section 5(4) allows a _____ to detain a voluntary patient in hospital for 6 hours
Answer: nurse
Flashcard 106: Treatment cannot be given without consent for _____ conditions under the Mental Health Act but can be given under the Mental Capacity Act
Answer: physical
Flashcard 107: What is the first-line sedative for delirium? _____
Answer: Haloperidol or Olanzapine
Flashcard 108: Schizophrenia prognosis is based on "the rule of quaters". What is this? • 25% of patients _____ • 25% of patients improve substantially on treatment • 25% of patients have some improvement on treatment • 25% of patients are resistant to treatment
Answer: never have another episode
Flashcard 109: Which sections require an Approved Mental Health Professional and 2 doctors? _____ & 3
Answer: 2
Flashcard 110: Elderly patients with acute onset of memory disturbance, disorientation, mood change are most likely to be suffering from _____
Answer: delirium
Flashcard 111: For diagnosis of schizophrenia, active symptoms must be present for at least _____, with the total duration of illness lasting at least 6 months
Answer: 1 month
Flashcard 112: Under which sections can treatment be given against a patients wishes? _____ & 3
Answer: 2
Flashcard 113: A section 5(2) allows a _____ to detain a voluntary patient in hospital for 72 hours
Answer: doctor
Flashcard 114: A section 2 lasts for _____
Answer: 28 days
Flashcard 115: The main aim of delirium managment is to treat the _____
Answer: underlying cause
Flashcard 116: When sectioning a patient requires 2 doctors, both should have seen the patient within that past _____
Answer: 24 hours
Flashcard 117: Part of the management of delirium is to maintain an environment with _____ and frequent reassurance
Answer: good lighting
Flashcard 118: A section _____ can be used to recall a patient to hospital for treatment if they don't comply with conditions of the order in the community
Answer: 17a
Flashcard 119: What are the first rank symptoms of schizophrenia? _____
Answer: Auditory hallucinations, thought insertion/withdrawal/broadcasting, passivity experiences, delusional perceptions
Flashcard 120: A section 3 lasts for _____ and can be renewed
Answer: 6 months
Flashcard 121: Patients with delirium and a history of _____ should be treated with quetiapine or clozapine rather than haloperidol/olanzapine
Answer: Parkinson's Disease
Flashcard 122: What 2 common things increase the metabolism of clozapine? • _____ • Being male
Answer: Smoking
Flashcard 123: What is the first-line management of personality disorders? _____
Answer: Psychotherapy, often dialectical behaviour therapy
Flashcard 124: Are patients with schizoid personality disorder content with social isolation? _____
Answer: Yes, it is voluntary
Flashcard 125: Which personality disorder is characterised by odd beliefs, speech, behaviour, or appearance as well as magical thinking? _____
Answer: Schizotypal (cluster A)
Flashcard 126: Which personality disorder is characterised by submissive & clingy behaviour, a need to be taken care of and difficulty making decisions? _____
Answer: Dependent (cluster C)
Flashcard 127: Which personality disorder is characterised persistent distrust & suspicion that others are harming or deceiving the patient? _____
Answer: Paranoid (cluster A)
Flashcard 128: Which personality disorder is characterised by social inhibition, feelings of inadequacy, excessive shyness, & hypersensitivity to rejection? _____
Answer: Avoidant (cluster C)
Flashcard 129: Which personality disorder is characterised by disregard for & violation of the rights of others with failure to conform to social norms & lawful behaviour? _____
Answer: Antisocial (cluster B)
Flashcard 130: What cluster of personality disorder is Avoidant Personality Disorder? _____
Answer: C
Flashcard 131: What gender is antisocial personality disorder more common in? _____
Answer: Men
Flashcard 132: Which personality disorder is characterised by excessive emotionality & attention seeking with a constant need to be the centre of attention? _____
Answer: Histrionic (cluster B)
Flashcard 133: Which personality disorder is characterised by marked impulsivity, an unstable sense of self/relationships and recurrent suicidal ideation? _____
Answer: Borderline (cluster B)
Flashcard 134: Which personality disorder is characterised by persistent grandiosity about self & accomplishments, the need for excessive admiration, sense of entitlement, envy of others and a lack of empathy? _____
Answer: Narcissistic (cluster B)
Flashcard 135: What cluster of personality disorder is Dependent Personality Disorder? _____
Answer: C
Flashcard 136: Which personality disorder is characterised by voluntary social isolating & restricted emotional range? _____
Answer: Schizoid (cluster A)
Flashcard 137: _____ personality disorder can only be diagnosed if the patient is > 18 years old and has a history of conduct disorder before age 15.
Answer: Antisocial
Flashcard 138: What cluster of personality disorder is Narcissistic Personality Disorder? _____
Answer: B
Flashcard 139: What cluster of personality disorder is Histrionic Personality Disorder? _____
Answer: B
Flashcard 140: The most common psychotic disorder is _____
Answer: schizophrenia
Flashcard 141: What is the second-line/alternative management of anorexia nervosa for children? _____
Answer: CBT-ED
Flashcard 142: What cluster of personality disorder is Schizoid Personality Disorder? _____
Answer: A
Flashcard 143: Clozapine has three important complications; _____ and Myocarditis / Cardiomyopathy
Answer: agranulocytosis
Flashcard 144: Lithium is primarily excreted by the _____
Answer: kidneys
Flashcard 145: What cluster of personality disorder is Borderline Personality Disorder? _____
Answer: B
Flashcard 146: What is the first-line management of severe depression? _____
Answer: SSRI+high-intensity psychological interventions
Flashcard 147: The prognosis of anorexia nervosa is _____
Answer: poor
Flashcard 148: What is the pharmacological management of severe PTSD (e.g. disabling/resistant symptoms)? _____
Answer: Risperidone
Flashcard 149: What are the relative contraindications of electroconvulsive therapy? _____ Recent myocardial infarction (3 months) Severe hypertension
Answer: Raised ICP
Flashcard 150: Type I Bipolar Disorder = _____ Type II Bipolar Disorder = ≥ 1 hypomanic episode + major depressive episode(s) (more common)
Answer: ≥ 1 manic episode +/- depressive episode(s)
Flashcard 151: Patients on lithium should have _____ & renal function tests monitored every 6 months
Answer: thyroid
Flashcard 152: What cluster of personality disorder is Paranoid Personality Disorder? _____
Answer: A
Flashcard 153: What is the second-line long-term management for bipolar disorder? _____
Answer: Add valproate
Flashcard 154: Does severe depression require psychotic symptoms (DSM-V)? _____
Answer: Can occur with or without
Flashcard 155: What is the first-line management for a manic episode of newly diagnosed bipolar disorder? _____
Answer: Oral antipsychotic (haloperidol, olanzapine...)
Flashcard 156: _____ is a psychiatric disorder characterised by persistent restriction of energy intake leading to significantly low body weight, an intense fear of gaining weight, & a distorted perception of body shape or size
Answer: Anorexia nervosa
Flashcard 157: Describe how clozapine is monitored: _____
Answer: 0-18 weeks = weekly FBC 18-52 weeks = fortnightly FBC 1 year+ = montly FBC
Flashcard 158: _____ is the most common cause of admissions to paediatric psychiatric wards
Answer: Anorexia nervosa
Flashcard 159: What is the strongest risk factor for developing a psychotic disorder (schizophrenia)? _____
Answer: Family history
Flashcard 160: What is the management of a diagnosed psychotic disorder? _____
Answer: Oral antipsychotic with psychological intervention
Flashcard 161: A lithium blood sample should be taken _____ after the last dose
Answer: 12 hours
Flashcard 162: What is the management of anorexia nervosa for adults? _____
Answer: - CBT-ED (eating-disorder-focused) - MANTRA (Maudsley Anorexia Nervosa Treatment for Adults) - SSCM (specialist supportive clinical management)
Flashcard 163: _____ syndrome is a rare psychiatric condition characterised by nihilistic delusions, where the individuals believes they are dead, do not exist, have lost internal organs, or are decomposing
Answer: Cotard
Flashcard 164: Electroconvulsive therapy is often preferred to achieve a rapid response in depressed elderly patients who are _____.
Answer: unable to eat and drink, psychotic, or actively suicidal
Flashcard 165: What cluster of personality disorder is Antisocial Personality Disorder? _____
Answer: B
Flashcard 166: What cluster of personality disorder is Schizotypal Personality Disorder? _____
Answer: A
Flashcard 167: What is the management of mania (bipolar) if the patient is taking an antidepressant? _____
Answer: Consider stopping antidepressant & start antipsychotic
Flashcard 168: What is the first-line long-term management for bipolar disorder? _____
Answer: lithium
Flashcard 169: Before starting clozapine, what baseline tests should be done? (2) _____
Answer: FBC for leucocytes ECG for baseline cardiac function
Keywords: Severe Mental Illness flashcards, medical flashcards, NEET PG preparation, USMLE Step 1 flashcards, Anki alternative, spaced repetition medical, OnCourse flashcards
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