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48 Cards in this Set
- Front
- Back
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Investigations before starting Lithium. (4 sets)
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Ht & Wt
FBC, U&E + creatinine, TFTs ECG Pregnancy Test |
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Lithium monitoring of serum levels
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1wk after starting then weekly till 4 stable readings
3monthly serum levels |
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Thyroid and Renal tests every...
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6 months (U&E), 12months (TFTs)
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3 Drug classes to be avoided with lithium
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ACEi, Diuretics, NSAIDs
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Valproate unusual SE
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Wt and appetite gain
Sedation Ankle swelling Hair Loss |
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Carbamazepine unusual SEs
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Skin rashes
Blurred vision Ataxia |
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SSRI SEs (3)
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WISGAS
Wt Loss Insomnia Sexual Dysfunction GI disturbance Anxiety (shrt) Sweating |
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Atypical Antipsychotic SEs
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Wt gain
Postural hypotension EP SE's (less than typical) Diabetes Neuroleptic Malignant Syndrome rare |
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Typical Antipsychotic SEs
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EP SE's tardive dyskinesia, parkinsonian, akasthesia, dystonia.
Galactorrhea Cardiovascular Antimuscarinic |
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Definition of a delusion
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Pathalogical belief
Held with absolute certainty when challenged Cannot be understood as part of cultural/religious background |
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Section 5.2
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Doctor
Inpatient 72hrs |
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Section 5.4
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Nurse
6hrs |
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Section 136
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Police
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Suicide risk factors
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SAD PERSONS
Sex, Age, Depression Previous, Ethanol, Rational, Social support, Organised plan, No hobbies |
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Catatonic rigidity
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Maintaining a fixed position and rigidly resisting attempts to be moved
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Catatonic posturing
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Adopting an unusual or bizarre position that is then maintained for some time
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Catatonic negativism
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A seemingly motiveless resistance to all instructions or attempts to be moved; patients may do the opposite to what is asked
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Catatonic waxy flexibility
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Patients can be moulded like wax
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Catatonic excitement
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Agitated, excited and seemingly purposeless motor activity, not influenced by external stimuli
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Catatonic Stupor (3)
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akinesis (lack of voluntary movement),
mutism extreme unresponsiveness in an otherwise alert patient. |
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Echopraxia
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Patients senselessly repeat or imitate the actions of those around
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Echolalia
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Repeat speech
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Mannerisms
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Apparently goal-directed movement but at inappropriate time
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Stereotypies
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Complex movement that is not goal-directed
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Cotard's Syndrome
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Hypochondriacal delusions
Nihilistic delusions As part of depressive psychosis (elderly) |
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Delusion of reference
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False belief that certain objects, people or events have intense personal significance (TV)
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Clerambault syndrome
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Woman believes a man, frequently older and of higher status, is in love with her
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Othello syndrome
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False belief that one's lover has been unfaithful
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Ekbom's syndrome
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Delusion of infestation
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Agnosia
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inability to recognise objects
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Features of Cortical dementia (4)
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Aphasia
Apraxia Agnosia Calculation |
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Features of Sub-cortical dementia (3)
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Dysarthric
Stooped posture Tremor, tics |
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Schizoid personality disorder
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L Dad
Emotional coldness Neither enjoy nor desires close sexual relationships solitary activity pleasure in few activities indifferent to praise/criticism |
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Schizotypal personality disorder
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L
Eccentric behaviour Odd beliefs or magical thinking unusual perceptual experiences ideas of reference suspicious or paranoid ideas vague circumstantial thinking social withdrawal |
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Anankastic Personality disorder
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OCD
Perfectionism and control Devoted to work at expense of leisure Pedantic rigid and stubborn Cautious |
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Borderline (emotionally unstable) personality disorder
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Unstable
Relationships Unstable self-image Inpulsivity Self-harm Avoid abandonment |
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Acamprosate
Use and MOA |
Reduce likelihood of relapse
(craving dec) Increases GABA |
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Disulfiram
Use and MOA |
Relapse prevention : Choking, Headache, Flush
Alcohol oxidation inhibitor |
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2 drugs acute treatment of alcohol withdrawl
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Benzo (chlordiazepoxide) to reduce seizure risk
Thiamine (Wernicke's) |
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2 Opiate substitution drugs
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Methadone
Buprenorphine (partial) |
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2 receptor antagonists that can precipitate severe withdrawl
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Naltrexone (opiate antag) used to block euphoria in ex-toxics
Flumazenil (benzo antag) used to differentiate loss of consciousness is due to benzo |
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Lofexidine
Use MoA |
Centrally cating alpha agonist
Reduce symptoms of Opiate withdrawl |
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Buprenorphine
Use MoA |
Partial opiate agonist
Step down reduction drug |
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Russel's sign
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Calluses on the back of hands from repeated teeth trauma in Bulimia
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Trazadone
MoA Use |
5HT2 re-uptake blocker
antidepressant Sedative property |
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Venlafaxine
MoA Use |
SNRI
like TCA but less Acetylcholine and histamine blockade. |
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Mirtazapine
MoA |
NaSSA
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Nefazodone
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SARI
potentiates 5HT but blocks 5HT-2A |
