Paper i Misc Notes

8/10/2019 Paper i Misc Notes

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Hair loss is not reported with Acamprosate and in addition to the above rarely bullous skin reactions can

be seen; Nausea, Diarrhoea, change in libido

derealization was first used by Mapother

Paranoia: Reaction formation behaviour

The risk factors for dementia include increasing age, gender (women are more affected), oxidative stress,

education, chemical exposure, vascular risk factors including smoking. Selegeline (an antioxidant) has

been found to be protective towards dementia in some studies.

The focus in brief interpretive psychotherapy: dilemmas, traps and snags as target problems

The Clifton assessment procedures for the elderly(CAPE) consists of two components: one of which

investigates cognitive deficits by direct assessment and the second of which investigates functional

deficits by means of a behavior rating scale completed in conjunction with a relative or member of staff

who knows the patient well. The CAPE should be used when assessment of dependency needs is required,

and when management decisions have to be taken.

Fluvoxamine increases the concentration of theophyline hence concomitant administration should be

avoided but if its needed reduce theophylline dose and monitor plasma theophylline concentration

MRI scan for non-antipsychotic hyperprolactinemia

The DC LD classification system includes the severity in axis I, cause of LD in axis II and psychiatric

disorders in axis III

A relation has been found between low 5 HIAA levels and impulsive aggression.

Legrain in 1886 coined the term Bouffee delirante which was reported to have a better prognosis than

schizophrenia

PSE: Multi language; only info from patient is used

Neurasthenia: Neurotic disorder

Cognitive Dissonance: does not include attributional principles

Attribution:

Refers to the cognitive labeling theory which assigns causal explanations to observed events

ADHD risk increased with DDR2 allele

Hypertension is the big risk factor an dover 50% of patients give a positive history for this disorder.


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Acamprosate acts as GABA agonist and Glutamate antagonist ,

Clozapine: Hyperglycemia

Kohleberg

Level 5

Level 6

Othellos Syndrome:

A 52 year old man falsely believes that his wife is being unfaithful to him.

Hutchisons pupil refers to the condition where there is dilation of one pupil when the other is

contracted, resulting from compression of the third nerve due to meningeal hemorrhage at the base of the

brain

PS: MiosisS: Dilatation

MOA-B acts on DA, DOPAC, NA

Tranylcypromine structurally similar to Amphetamine

Cognitive analytic therapy (CAT) is a system of treatment in which the therapist helps the patient to

understand why things have gone wrong in the past and explores how to make sure that they dont go

wrong in the future. In simple terms what it seeks to do is to apply the step-by-step pragmatism of

cognitive therapy to some of the ideas of the more analytic approach of psychodynamic psychotherapy.

OCD Treatmetn: Thought stopping and exposure and response prevention therapy

The rapid recollection of past called "Panoramic vision" is seen in temporal lobe focus.

CBZ is a relatively stable compound when stored in the solid state at controlled room temperature . CBZ

should be stored in airtight containers and protected from

light .

Varenicline is

Alpha 4, beta 2 nicotinic partial agonist

Fundamental Attribution error is not primarily an attribution errror.

Attention is

same as consiousness for experimental psychologists

SSRI with most GI effects Sertraline(not fluvoxamine)


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Aripiprazole

Partial D2 agonist

agonist actions on 5HT1a and antagonist actions on 5HT2a

Delusions of control(FRS) not compatible with Delusional disorder

You can have grape fruit juice with MAOIs

Superior premorbid intellect and education may protect against Alzheimer's dementia

SCOFF for eating disorders

TWEAK for Alcohol

HAMD has 17 items

Clonazepam is a long acting benzodiazepine with a half-life of in excess of 20 hours.

Amisulpiride: D2 & D3 antagonism

Nicotine withdrawal: Cough, mouth ulcers and irritability

Benzo withdrawal: Vivid dreams, depression and irritability

(FBC) Leucocyctosis and elevated CPK are features of NMS.

SAH and head injury are causes of SIADH hence MRI may be useful and urine osmolality is helpful in

diagnosing this.

Carbamazepine and St Johns wort reduce efficacy of OCPs

St John's wort, rifampicin, smoking, phenytoin all induce the cytochrome p450 system.

Grape juice Inhibits Cyt system

Doppelganger is Cognitive Autoscopy is Perceptual

Autocthonous / Primary Delusions

Nasal stuffiness is a recognised side effect of sildanefil treatment.

Legitimation: During interview the doctor tells the pateint "It is quite acceptable to feel the

way you do and perhaps most people would feel the same way as you do".


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Anomic aphasia: Dominant T-P lesion

Bilateral Internuclear Ophthalmoplegia: pathognomonic of multiple sclerosis?

Risk of Alzheimer's dementia is around 3.5 fold greater in those who have a first degreerelative with AD

Borderline learning disability is a term used frequently to refer to patients with an IQ in the

range 70-85

The most abundant excitatory amino acid neurotransmitters are glutamate and aspartate

and these are the most frequently encountered excitatory Neurotransmitters in the brain.

Opportunistic infection is most commonly seen in HIV illness: Toxoplasma gondii

Reinforcement:

The examiner praises the patient for doing well despite having a difficult time

Sublimations:

A 43 year old man who got told-off by his boss in the morning goes out to play tennis with his

friend in the evening.

Isolation

A 20 year old boy who lost his father continues to carry out his work without display of emotions,

even though he is aware of the loss.

No systematised delusions in Delusional disorder

Mania: delusions (usually grandiose) or hallucinations (usually of voices speaking directly

to the patient) are present,

fMRI/ SPECT: Cerebral perfusion for Alz Dementia & FP Dementia

PET/SPECT for: Lewy Body Dementia


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Chlorpromazine increases Valproate level

Venlafaxine to Duloxetine : 1 month

Holmes and Rahe Scale

Highest LTheory of mind develops at 3 years

Depersonalisation is associated with unpleasant affect: Numbing

Anorexia nervosa: Raised Cortisol, GH others reduced

Cannabis smoking increases SCZ risk 2 fold

Enculturation: acquiring Navtive culture

Acculturation: acquiring Host Culture

Hntingtons disease Chromosome 4

Bilateral hemianopia is a loss of temporal field vision in both eyes. This may be caused by

a lesion that affects the centre of the optic chiasm and damages fibres from the nasal

halves of the retina as they decussate. Possible causes of this condition include:pituitary

tumour, craniopharyngioma & suprasellar meningioma. Clinical neurology for psychiatrists

Alcohol intake for women planning to become pregnant: None

Women who are already pregnant: one or two units of alcohol once or twice per week

Perseveration is defined persistent repetition of words, ideas, or subjects so that once a

patient begins a particular subject or uses a particular word, he continually returns to it in

the process of speaking. Echolalia is a pattern of speech in which the patient echoes the

word or phrases of the interviewer.

Smoking during pregnancy has been reported to be associated with a twofold to fourfold

increased risk of attention-deficit hyperactivity disorder (ADHD) in the offspring. Lindblad F

et al 2010. ADHD after fetal exposure to maternal smoking.

Denial, distortion and projection are considered as narcissistic defense mechanism.

Insomnia is reported in 30 % of general population,being more common in females and

elderly .Clinically significant insomnia that causes marked personal distress or interference

with social and occupational functioning is 6%

One of the definitions of Thought broadcast is - The patient hears his own thoughts being


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spoken aloud and, as a consequence, other people are able to hear his thoughts as well.

Antipsychotics that reduce the threshold for seizures should be avoided in delirium or in

delirium tremens.

Addenbrooke's cognitive examination test - revised (ACE-R).Cut-off less than 88 gives 94% sensitivity and 89% specificity for dementia: Cut-off less

than 82 gives 84% sensitivity and 100% specificity for dementia Mioshi E, Dawson K,

Mitchell J, Arnold R, Hodges JR (2006) The Addenbrookes Cognitive Examination Revised

(ACE-R): a brief cognitive test battery for dementia screening, International Journal of

Geriatric Psychiatry.

Commonest cause of stupor: SCZ, then Depression, then Mania

Posturing? catalepsy: Uncomfortable postures Resists movement

Waxy flexibility: Mouldable uncomfortable postures

Mania resolves spontaneously in 4 months

10-20% in mania have FRS

This describes an oneiroid or dream-like state. In this condition, there is narrowing of

consciousness along with vivid visual hallucinations.

This heightening of symptoms is referred to as anastrophy.

Head Injury

A GCS of 13 or above is mild, 912 is moderate, and 8 or below is severe.

100 mg Chlorpromazine orally per day is equivalent to 40 mg flupenthixol decanoate

intramuscularly (IM) every two weeks and 25 mg fluphenazine decanoate IM every two

weeks. The data sheet for Haldol decanoate states that these doses of depot

antipsychotics are equivalent to 100 mg haloperidol decanoate IM monthly.

Chlorpromazine 100mg oral/day = Flupenthixol 40mg= Fluphenazine 25mg= Haldol 100mg

The most common side effects of methylphenidate include headache,stomachache,nausea

and insomnia

Suo yang (Koro): The Genital Retraction Syndrome


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