Psychiatry, Obstetrics, and General Medicine Comprehensive Review

Practice flashcards covering psychiatry, obstetrics, and general medicine based on the lecture transcript notes.

Opioid withdrawal syndrome

A 'flu-like syndrome' appearing 6-12 hours after short-acting opioid use, consisting of agitation, diaphoresis, tachycardia, dilated pupils, rhinorrhoea, lacrimation, and yawning.

Delirium Tremens (DTs)

A severe alcohol withdrawal condition occurring 48–72 hours after cessation, characterized by confusion, fever, extreme agitation, and hallucinations.

Wernicke Encephalopathy

A condition caused by thiamine deficiency presenting with the triad of confusion, ataxia, and ophthalmoplegia (nystagmus).

Korsakoff syndrome

A progression of untreated Wernicke encephalopathy characterized by severe anterograde amnesia and confabulation.

Alcohol Intoxication Mechanism

Acts primarily as a positive allosteric modulator of $GABA_A$ receptors and inhibits glutamate action at NMDA receptors, causing CNS depression.

Egodystonic thoughts

Thoughts recognized by the patient as excessive and irrational, yet they feel unable to control them; commonly seen in OCD.

Dysthymia

A persistent depressive disorder characterized by a chronic, mild depressed mood lasting for at least two years.

Major Depressive Disorder Diagnosis

At least 5 of 9 symptoms (including sad mood or decreased interest) for $\ge 2$ weeks.

Clozapine Agranulocytosis

A severe side effect defined as an absolute neutrophil count (ANC) below $0.5 \times 10^9/L$.

Neuroleptic Malignant Syndrome (NMS)

A life-threatening reaction to antipsychotics characterized by slow-onset fever, 'lead-pipe' muscle rigidity, altered mental status, and autonomic dysfunction.

Serotonin Syndrome

A rapid-onset condition characterized by extreme fever, autonomic instability, and hyperreflexia with clonus resulting from neuromuscular excitation.

Lithium Therapeutic Level

Maintenance level typically monitored between $0.6\text{ and }1.0\,mmol/L$.

Refeeding Syndrome

A life-threatening metabolic shift after restarting nutrition in malnourished patients, primarily characterized by hypophosphataemia.

Postpartum Psychosis

An acute onset condition occurring within two weeks of delivery, involving confusion, disorganization, and mixed affective and psychotic features.

AUB-O (Adolescents)

Abnormal Uterine Bleeding related to Ovulatory dysfunction, common in adolescents presenting with heavy or irregular periods.

PCOS (Rotterdam Criteria)

Requires 2 of: oligomenorrhoea/amenorrhoea, biochemical/clinical hyperandrogenism, or polycystic ovarian morphology (PCOM).

Bishop Score

A tool assessing cervical readiness for induction; a score of $\ge 6$ indicates a favourable cervix.

Preeclampsia Prophylaxis

Low-dose aspirin ($100\text{ to }150\,mg$) started before 16 weeks gestation in high-risk women.

Combined First Trimester Screening (CFTS)

A risk stratification tool for T13, T18, and T21 using maternal serology (PAPP-A, b-hCG) and nuchal translucency on ultrasound.

Postpartum Haemorrhage (PPH) Causes

The '4 Ts': Tone (atony), Tissue (retained products), Trauma (genital injury), and Thrombin (coagulopathy).

Sheehan Syndrome

Pituitary gland necrosis following hypovolaemic shock during birth, leading to failed lactation and amenorrhoea.

Amniotic Fluid Index (Oligohydramnios)

Defined as an AFI of $< 5\,cm$ or a deepest vertical pocket of $< 2\,cm$.

Lynch Syndrome

An autosomal dominant condition causing DNA mismatch repair defects, leading to increased risk of colorectal and endometrial cancers.

Osteomyelitis (Sequestrum)

A radiological feature showing a separated lucent bony fragment representing devitalised bone.

Aortic Dissection (Type A vs B)

Type A involves the ascending aorta (surgical emergency); Type B is distal to the left subclavian origin (medical management).

Beck's Triad

The signs of cardiac tamponade: hypotension, muffled heart sounds, and elevated jugular venous pressure (JVP).

Intussusception (Target Sign)

A sausage-shaped mass appearance on ultrasound in infants, often presenting with 'red-currant jelly' stools.

TURP Syndrome

A condition caused by irrigation fluid absorption during prostate surgery, resulting in hyponatraemia and confusion.

SAAG (Serum-Ascites Albumin Gradient)

A gradient $> 11\,g/L$ indicates portal hypertension as the cause of ascites.

Spontaneous Bacterial Peritonitis (SBP)

An infection of ascitic fluid diagnosed by a neutrophil count of $\ge 250\,cells/mm^3$.

Glasgow Outcome Scale (Pancreatitis)

A severity score for acute pancreatitis incorporating parameters like glucose, $\text{PaO}_2$, calcium, urea, and albumin.

Myasthenia Gravis Pathophysiology

Autoimmune antibodies against postsynaptic $ACh$ receptors leading to fluctuating fatigable muscle weakness.

Parkland Formula for Fluids

Fluid resuscitation for burns calculated as $4\,mL \times weight\,(kg) \times \%TBSA$, with half given in the first 8 hours.

Gestation Diabetes (Diagnosis)

One abnormal value on OGTT at 24-28 weeks: Fasting $> 5.1$, 1h $> 10.0$, or 2h $> 8.5\,mmol/L$.

Parkinson’s Disease Triad

Resting tremor, bradykinesia, and rigidity.

Number Needed to Treat (NNT) Formula

Defined as $1 / \text{Absolute Risk Reduction (ARR)}$ of a treatment.