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))

IMP.Psychiatric Topics.

1) "ANXIETY---anxiety is usually viewed as repressed or forgotten -fear ,features--hyperventilation,cold extremities,palpitations,pupillary dilatation,…..ANXIETY NEUROSIS---acute restlessness & fear of impending doom , anti -anxiety effect--chlorpromazine,TCA,BZD.,"------------((5))

2) "COCAINE---coined by FREUD.,jet black pigmentation of tongue with tactile hallucination ,creeping sensation,COCAINE-BUGS---sensation of bugs crawling all over the body"-----------((5))

3) "DELIRIUM---illusions with loss of consciousness,acute delerium-impaired consciousness, visual hallucination, hyperactivity& Fragmentary Delusions,"-------------((5))

4) "FREUD---introduced ---Cocaine , Psychoanalysis , concept of ""SUPER-EGO"" , free association , "" OEDIPUS COMPLEX""--by sigmund freund"----------((5))

5) "ANOREXIA NERVOSA---amenorroea-100%,phobic avoidance of normal wt.,wt.loss seen,over perception of body image,self induced vomiting ,excessive exercise,evident psychosis,least characteristic--decreased physical activity,false-decreased appetite,"-----------((4))

6) "CANNABIS---medical purposes/uses-in-Epilepsy ,glaucoma,nausea,Flash black phenomenon,.CANNABIS ADDICTION---symptomatic,Rx not req.,JHAGNAN phenomenon seen,"-------------((4))

7) "DEFENSE MECHANISIMS---MATURE defense mech.-->Projection & Altruism,IMP.defense mech.-->Repression,RATIONALIZATION-->drinks due to quarrel with wife ,"------------((4))

8) "DELIRIUM TREMENS---altered cons. ,tremors & visual hallucinations ,DOC.-diazepam."---------((4))

9) "EGO---works on realitiy principle , EGO DEFENSE MECHANISMS---""undoing""-seen in--OCN, Picasso synd.--Sublimation, Projection , Conversion,Reaction formation, "-----------((4))

10) "FUGUE---& DISOCIATIVE FUGUE--- seen in Schizophrenia , hysteria,epilepsy,wandering purposefully with some amnesia, "-----------((4))

11) "KORSAKOFF'S PSYCHOSIS---long term memory loss ,fes.--loss of Intellectual function but preservation of memory, lack of insight, unable to understand the disability, it is a REVERSIBLE state, CONFABULATION seen,Rx--VIT.B1(THIAMINE)"-------------((4))

12) "MENTAL RETARDATION---commonest cause--Birth Asphyxia ( Intellectual deficiency ),MENTALLY ILL---commonest mental illness in Chlidren --Neuroses,"------------((4))

13) "NEUROSIS---defective childhood experiences & adjustments & mild mental disorder , NEUROTIC DISORDERS---Anxiety, Hysteria, Phobia, OCN, "-------------((4))

14) "BULIMIA NERVOSA---episodes of excessive&uncontrolled eating , carries teeth , inducing vomiting,"----------((3))

15) "CATATONIA---FES.-automatic obedience,cataplexy,negativism,is seen in Schizophrenia,CATATONIA STUPOROUS---waxy flexibility is characteristic."---------((3))

16) "CONFABULATION---making stories to fill up gaps in memory loss , seen in alcoholism ,korsakoff psychosis"--------((3))

17) "FLASH BACK PHENOMENON---seen in Cannabis , Psilocybin , LSD.,"---------((3))

18) "HYPERKINETIC DISORDER---LOW I.Q., low Attention SPAN, poor impulse control, increase in Anger outburst, DOC-AMPHETAMINE.,"------------((3))

19) "LSD--Flash Blacks & Bad Trips , LSD Intoxication--> panic,confusion,Hyperreflexia, "------------((3))

20) "NOCTURNAL ENURESIS---DOC.-Imipramine, occurs in Stage IV sleep , "------------((3))

21) "OPIOID WITHDRAWAL---Rx nonaddicting drug -->Clonidine is used, OPIUM WTHDRAWAL---fes.-Lacrimation"---------((3))

22) "ORGANIC BRAIN SYND.---Visual Hallucination, Disorientation seen , bender gestalt test"---------((3))

23) "PANIC DISORDERS---DOC.--Diazepam, sudden attacks of anxiety with fear"-----------((3))

24) "PSYCHOANALYSIS---coined by Freud , this Tech. Used in Hypnosis,"-------------((3))

25) "SUICIDAL TENDENCIES---least in married person, Due to Withdrawal from Cocaine,Amphetamine,Alcohol, SUICIDE---most prone among -Adolecscent Girls,"------------((3))

Psychiatry-Topics Asked more than Twice

1) "AKATHISIA---restlessness/irresitible urge to move about & increased motor activity,Rx-amantadine,benzhexol,propranolol,"----------((2))

2) "ALZHEMER'S DISORDER---Ach.-biochemical cause ,predisposing factors--down's synd.,head trauma,low edu.group,"---------((2))

3) "ANTIPSYCHOTICS---longacting -Fluphenazin,"----------((2))

4) "BEHAVIOUR---TYPE A---time urgency ,impatiency,hard driving ,career orientation,ambitiousness, COINED BY friedman & rosenman ,"---------((2))

5) "BEHAVIOR THERAPY---indicated for Phobia,cardinal elements--Systemic desensitization & Flooding,"----------((2))

6) "BUSPIRONE---anti-anxiolytic,newer NONSEDATIVE ,non hypnotic axiolytic,"---------(2)

7) "CLOZAPINE---assosiated with agranulocytosis , causes sialorrhyroea,"-----------(( 2))

8) "EEG---alpha waves--> awake & eyes closed ( stage I sleep) ( ATKD'S-MNEMONIC-B,,,,A1,T1K2,D34(NREM),,,B-REMS)"-----------((2))

9) "FEAR---due to abnormal experiences of childhood , over consciousness & excess perception of danger , least common in depressive psychosis ,"-----------((2))

10) "FLUOXETINE---mech. of action--inhibition of serotonin uptake , side-effect--Anxiety,loose stools,Nause is troublesome"-----------((2))

11) "GPI(GENERAL PARESIS OF INSANE) ---fes. Confabulation, Grandiose, Delusions, Mental deterioration, "-----------((2))

12) "HALLUCINOGENS---Cocaine, Mescaline, LSD, Phencyclidine, "----------((2))

13) "HALOPERIDOL----acute drug dystonia after> 1day, causes Akathesia , used in BALLISMUS aswell,"---------((2))

14) "HYPOCHONDRIASIS---Preoccupation with body diseases, Over conscious about some illness, "----------((2))

15) "IMPOTENCE---it is also seen in D.M., diff. Between psy.Impotence & Organic I.--is diagnosed by monitoring of Penile TUMESCENCE during sleep ,"-----------((2))

16) "INTELLIGENCE QUOTIENT---I.Q.= (mental age X 100)/ chronological age (%), I.Q. Test = Binet Stanfort Test"------------((2))

17) "NEUROLEPTICS---blood levels checked for toxicity , commonest side-effect--Sedation , "---------((2))

18) "OEDIPUS COMPLEX---coined by sigmund Freud, seen in boys 3-5yrs of age,"------------((2))

19) "PHENOTHIAZINEs---involuntary perioral movement , used in Rx of depression , tardive dyskinesia is the side-effect,"------------((2))

20) POST-TRAUMATIC STRESS DISORDER---most common after major life threatening event/ e.g. any CAR accident,rape,earthquake,.. etc.-----------((2))

21) "PREMATURE EJACULATION --- Rx-SQUEEZE Technique, "------------((2))

22) "PSYCHONEUROSIS---diagnosis by VERBAL ACCOUNTS.,"------------((2))

23) "PSYCHOSOMATIC DISORDERS---e.g.--HTN,Peptic Ulcer disease, Bronchial Asthama, Hyperventilation"------------((2))

24) "THOUGHT---DISORDERS--loosening of Association, THOUGHT INSERTION---this is SCHEIDNER'S FIRST RANK SYMP."--------------((2))

25) "WITHDRAWAL SYMP.---PHYSICAL--absent-in Cannabis, Present in Pethidine,Opium,Haloperidol,Alcohol, Rx required in for withdrawal symp.--Cannabis, Cocaine,Alcohol,"------------((2))