Most IMP. Psychiatry Topics for Entrance Exams

1) "SCHIZOPHRENIA(SP).----
Fes.--Thought Alienation, Thought Insertion & Broadcasting, Suspiciousness, Conspire against him, Hallucination of VOICES, Paranoid Delusion, Passivity, Delusions in CLEAR CONSCIOUSNESS, Loss of insight occurs,-ve Symp.-Auditory H.,Visual H.,Delusions of persecution, Increased Psychomotor activity,AMBIVALENCE-seen,Personality deterioration seen, Delusion of Presentation, Delusions of Reference, Delusion of Control,waxy flexibility,Fes. of Affect seen, NIHILISTIC IDEAS seen,' FIRST RANK SYMP.--Thought Insertion, Delusion of Perception,Hallucination,Thought Alienation phenomenon, ass. with ASTHENIC personalities, SP.is a side-effect of Amphetamine, Incidence in India 5-10 per1000, Most common /Pathognomonic Hallucination--AUDITORY H., auditory H.-commanding the pt., Autism,Ass.Defect,Ambivalence,Cortisone,&ACTH-causes SP., Prognosis of SP.is improved by/Good prognosis is due to->ATYPICAL SYMP., Neurotransmittors involved are =PGE1,NorEpinephrine,5-HT, DOPAMINE is also found in increased quantity, Early SP.-resembles Anxiety neurosis, SP.is more common in low socioeconomic group/class, good prognosis is indicated by Early Onset, alsp good prognosis--is seen in Affective disorder, BLEULER'S Emphasis--is on Flattened affect, Loose associations, Ambivalence,
Rx of SP. ---DOC--FLUPHENAZINE,Rx of Auditory H.-CLOZAPINE,Rx of Chronic Resistant SP.-CLOZAPINE,
CATATONIC SP. --- Grimacing , Defect in Conation, First symp. to disappear after Rx/Symp. with Best prognosis--Auditory H., C.SP.-mostly occurs in Adolescents, Fes.--Mannerism, Increased Psychomotor activity ,Rigidity, Negativism, Waxy flexibility,Echolalia is also seen,
HEBEPHRENIC SP. --- has got BAD/WORST Prognosis, Grossly disorganised with severe deterioration,.. PARANOID SP. --- Caused by Amphetamine, GOOD PROGNOSIS & LATE ONSET, Psychosis due to chronic amphetamine intake-resembles->SP."-----------((47))

2) "DEPRESSION---most common D.-post partum psychosis, pseudodementia seen in D.,drugs causing--Methyldopa,Reserpine,O.C.pills,Propranolol,Rx of acute D.->ECT., Neurotransmittor Involved is =GABA & DOPAMINE,due to DEFICIENCY OF 5HT.,
MAJOR D.-- death of loved person,UNIPOLAR MAJOR D.--more common in females, Lithium carbonate -least likely to cause serious D.,
NEUROTIC D.-- commonest psychiatric illness in India, Ravenous appetite , INCREASED libido , common risk is-Fatigablity ,NIHILISTIC DELUSIONS & early morning Insomnia,
ENDOGENOUS D.---middle age 40-60 yrs.,sucidal tendecy most common,
Rx.of D.--Cognitive Theraphy ,DOC.-imipramine,DOC.for Rapid cyclers in Bipolar illness--valproic acid / Carbamazepine , DOC.for D.+CAD(coronary artery disease)--is-MIANSERIN."-------------((20))

3) "MOOD DISORDERS---seen in Schizoid state , MANIA---is a mood disorder, fes.--Mood Congruent delution, Delution of Grandeur, Neologism characteristic, Euphoria, Suicidal tendencies, pressure of Speech, Insomnia, Basic disturbance--ELATION, ass. With Good Humour, Physical Overactivity,
Rx of acute mania--is Lithium, drugs used--Haloperidol, Lithium,Carbamazepine,Chlorpromazine,"-------((13))

4) "OBSESSIVE COMPULSIVE DISORDER/ NEUROSIS---characterised by Eleborate, checking, Repeated hand washing, Execessive Slowness, Irresistant Irrational behavior , Fixed at ANAL Stage, Persistance Irrational thought resisting the Data ,Mostcommon complication--is Depression,
DOC.-Clomipramine, Rx-Dugs+Behavior therapy, Rx of severe intractable OCN--is Cingulotomy, DOC.-Fluoxetine, DOC(OCN)--Imipramine" -------------((13))

5) "DELUSIONAL DISORDERS---/DELUSIONS---DEF.-firm false /unshakeable belief ,seen in schizophrenia, mania, delirium, psychosis,psychotic depression ,it is comprehensible, It is a Disorder of THINKING, MOOD CONGUENT DELUSIONS--MANIA & DEPRESSION ,DELUSION-OF-PERSECUTION---seen in schizophrenia.,"------------((12))

6) "HALLUCINATIONS---disorder of false perception, Visual hallucinations--seen in Alcoholism & Organic brain synd./lesion, Auditory H.--seen in Schizophrenia, Mania, Amphetamine toxicity, Hypnagogic H.--arises when a pt. is falling a sleep"------------((12))

7) "ALCOHOL---morbid jealously seen,ALCOHOL WITHDRAWAL SYND.---DOC.-chordiazepoxide,early morning drinking ,delirium,secretiveness about the amount taken,obessions,delusions,tremulousness,hallucination,hyperactive state,amnestic disorder,delirium tremens,epileptic seizures,ALCOHOL ADDICTION---direct evidence-withdrawal symptoms, ALCOHOLIC BLACK-OUTS---characterised by amnesia for events during drinking,ALCOHOLIC HALLUCINATIONS---occurs within 24hrs.of alcohol intake,ALCOHOLISM---auditory hallucinations,visual hallucinations,delirium ,&amnestic reaction."--------------((11))

8) "ECT / ELECTROCONVULSIVE THERAPY---CI--in Brain Tumour ,Pergnancy ,Absolutely CI-in-increased ICT.commonest side-effect--Amnesia,it is used in the Rx--of depression with sucidal tendencies, Req.>80Mvolts, memory disturbance-recovers in few days to few wks.,antegrade amnesia of short duration occurs after ECT.,ECT is not useful in Rx of acute & chronic Schizophrenia, Unilateral ECT--less memory disturbance , "--------------((11))

9) "LITHIUM---Prophylactic Rx-MDP(manic depressive psychosis),used for Rx of Mood disorders,used in prophylaxis-Bipolar MDP,commonest symp.of lithium toxicity --is POLYURIA,chronic use of lithium--> HYPOTHYROIDISM, side-effects--hypothyroidism,Leucocytosis,Polyuria, Organs affected in Lithium toxicity--are Brain,Heart,Kidney(but not liver), Serum Li2+ levels=0.7-1.2meq/l , Lithium induced tremors--Rx Propranolol , "--------------((11))

10) "DEMENTIA---head injury, alzheimer's,huntington's chorea, multiple infarctions,deficiency of Niacin, Fes.--impaired memory, loss of judgment, loss of learned function,, Reversible cause--post encephalitis,Common in old age >60yrs. SUBCORTICAL DEMENTIA---Tactile agnosia,causes-parkinsonism,wilson's disease ,huntington's chorea,"-------------((10))

11) "PHOBIAS---is a type of neurosis, AGORAPHOBIA--Fear of OPEN Places, Animal Phobia--occurs at 8yrs. Of age, SOCIAL Phobia--Fear of public/seniors, IRRATIONAL Fear of Normal Instances,
Mx--Systemic Desensitization, Rx--Behavioural Therapy & Flooding , "-------------((10))

12) "PSYCHOSIS---Acute<2wks., auditory Hallucination seen, Major Psychosis--Endogeneous depression, Acceptance of other persons delusion-is the characteristis fes., ORGANIC Psychosis--Disorientation in time ,place,&person, Clouding of consciousness, Hallucination, Itellectual Impairment, Loss of insight, Rx-drugs used--Chlorpromazine,PUERPERAL Psychosis---, PSYCHOTIC DISORDERS---Schizophrenia, Mania, Psychotic depression"---------------((10))

13) "DISSOCIATIVE DISORDER---loss of Memory of all modalities , DISSOCIATION---seen in Fugue,Multiple personalities , Hysterical conversion, Somnabulism, dissociation hysteria leads to Amnesia , "----------((7))

14) "HYSTERIA---commonest symp.--motor or sensory phenomenon, Fixation of Hysteria--occurs at Phallic stage, uncommon symp.-Palpitation, Hysterical Somatization--Hemiplegia, Blindness, Fugue, Normal Intelligence, Rx--Psychoanalysis ,HYSTERICAL FITS---diff.fromm that of Epileptic Fits --Hyst.Fits occurs when people are Wachting , Incontinence of urine occurs,"--------------((7))

15) "TCA---ANTIDEPRESSANTS---TCA overdose-Rx-amitryptilline,safest TCA in HTN-Fluoxetine, TCA are CI. in angle closure glaucoma, Indications-gastric ulcer,depression,anxiety,…TCA adversly interact with Trnaylcypromine , TCA-causing Tardive dyskinesia-is-AMOXAPINE, side effects of TCA--metallic taste,dry mouth,epigastric discomfort,"-------------((6))