A) Pharmacology

1) Anti-Depressants

a) A/E of Moclobemide = SNATCH

- Sleep Distrubances
- Nausea
- Agitation
- Tyramine ingestion
- Confusion
- HPT due to tyramine ingestion

b) Examples of TCA’s = DICA

- Dotheipin
- Imipramine
- Chlomipramine
- Amitriptyline

c) Side Effect of TCA’s = Anti-HAM

- Anti-Histaminic
- Anti-Adrenergic
- Anti-Muscarinic

d) Examples of SSRI’s = ESFF

- Escritalopram
- Sertraline
- Fluoxetine
- Fluvoxamine

e) Side Effect of SSRI’s = MASH N

- MSK (Rash; Cutaneous Bleeding; Tremor; Sweating)
- Abdominal Symptoms (N&V, Epigastric Pain. diarrhea) (COMMONEST!!!!!)
- Sexual Dysfunction (2ND COMMONEST)
- Hyponatremia
- Neurological (HAID) (3rd COMMONEST)

f) Neurological Side Effect of SSRI’s = HAID

- Headache
- Anxiety + Agitation
- Insomnia
- Discontinuation Symptoms

g) A/E most commonly a/e Fluoxetine = AIR

- Agitation
- Insomnia
- Rash
h) A/E of SNRI’s = HIS ND
- Headache
- Insomnia
- Somnolence
- Nausea
- Dizziness

i) A/E associated with Venlafaxine on top of the Common A/E of SNRI’s = SEA
- Sexual Dysfunction
- Elevation of BP
- Anxiety

j) Discontinuation Symptoms A/w SSRI’s = ABCDEF

- A = Agitation & Anxiety
- B = Balance Problems; Bad Dreams
- C = Concentration Problems
- D = Dizziness; Diarrhea; N&V
- E = Electric Shock-like symptoms
- F = Flu-like symptoms

k) Serotonin Syndrome = SAD MF watching HenTai

3 out of the 10 following
- S = Shivering; Sweating
- A = Ataxia; Agitation
- D = Diarrhea
- M = Myoclonus; Mental State Changes
- F = Fever
- H = Hyper-reflexia
- T = Tremors

2) Mood Stabilizers
a) A/E of Carmabezapine = GAD
- Generalised Erythematous Rash
- Ataxia
- Dizziness, Diplopia, Drowsiness

b) Toxic Features of Carbamazepine = AS

- Agranulocytosis
- Steven-Johnson Syndrome

c) A/E of Sodium Valproate = WATE

- Weight Gain
- Alopecia
- Thrombocytopenia, Tremor
- Epigastric pain
d) Toxic Features of Sodium Valproate = HEP
- Hepatotoxicity
- Encephalopathy
- Pancreatitis

e) Lithium S/E = LITHIUM

- L = Leukocytosis; Loss of Hair
- I = Increased Urination (Blocks ADH receptors >> Diabetes Insipidus)
- T = Tremors (Early = Fine , Late = Gross) ; Tiredness
- H = Hypothyroidism ; Hypokalemia
- I = Increased Thirst
- U = Underactive Memory
- M = Metallic Taste (Dysguesia) ; Mothers (Teratogenicity = Ebstein’s anomaly)

f) Mild toxicity for Lithium >1.5mmol/L = BAT

- B= Blindness
- A = Ataxia
- T = Tinnitus

g) Severe toxicity for Lithium >2.5mmol/L = 3 C’s

- Convulsion
- Circulatory Failure
- Confusion

3) Anti-Psychotics
a) Common A/E of ALL Anti-psychotics = PISA
- P = Prolactin Increase; Prolongation of QT; Pyramidal symptoms extra
- I = Increased Weight
- S = Seizures, Sedation
- A = Anti-cholinergic, Anti-adrenergic

b) AP with the higher risks for Orthostatic Hypotension = CRC

- Chlorpromazine
- Risperidone
- Clozapine

c) CF of Hyperprolactinemia = GLAD
- Gynaecomastia
- Lactation
- Amenorrhea
- Decreased Libido

d) Main differences between NM$, Serotonin $, Anti-cholinergic Toxidrome and

Malignant Hyperthermia = EMBER
- Exposure : Anti-Psychotics ; Serotinergics; Anti-cholinergics; Inhalational
anaesthethics and muscle relaxants
 - Muscle : Tensed; Tensed; Normal; Tensed
- Mucosa and Skin : Wet ; Wet; Dry; Wet
- Biochemical CHanges : Leukocytosis & Increased CK; Others normal
- Bowel Sounds : Normal ; Increased; Decreased; Decreased
- Eyes : Normal; Dilated; Dilated; Normal
- Reflexed : Bradykinesia ; Hyper-reflexia; Normal; Hyporeflexia

e) Clinical Features of Neuroleptic Malignant Syndrome (NMS) = HEAD Long

- H = Hyperthermia
- E = Extreme Lead Pipe Muscle Ridgidity ; Elevated CPK
- A = Autonomic Instability ; Alteration in Consciousness
- D = Delirium
- L = Leucocytosis

B) Psychiatric Diseases
1) Mania 3 of for >1 week = DIG FAST
D = Distractibility and easy frustration
I = Irresponsibility and erratic uninhibited behavior
G = Grandiosity

F = Flight of ideas
A = Activity increased with weight loss and increased libido
S = Sleep is decreased
T = Talkativeness

2) Hypomania
3 of for >4 days
Less functional impairment compared to mania

3) MDD. 5 of for 2 weeks = de SAGECAPS

Depressed Mood
Sleep disturbance
Anhedonia
Guilt/worthlessness
Energy loss
Concentration low
Appetite increase or decrease
Psychomotor retard/agitation
Suicidality

4) Pathological grief. 5 of 9 for 6 months

Mainly emptiness and loss
Yearning
Disbelief
Bitterness of loss
Confused of own identity
Sense of numbness
Distrust others
Meaningless life
Difficulty accept
Stunned

5) Persistent complex bereavement disorder

Death
1 of 4 for 12 months
Yearning
Intense sorrow
Thoughts of deceased
Thoughts of circumstances of deceased
Reactive distress
Identity disruption
6) Postpartum depression: mdd + 4 weeks post delivery
Assess suicide risk
Wish to be dead
Feeling of hopelessness
Regret/remorse over attempt
Expectation bout outcome of selfharming
Specific plans
Lethality
Assess current suicidal intent
If wanna suicide, assess
Duration
Method
Preparation
7) Panic attack: PANICS Dude
4 of 13
Palpitation
Abdominal distress
Numbness, nausea
Intense fear of death/going crazy
Choking, chills, chest pain
Sweating, shaking, SOB
Depersonalization/derealization

Ask: how long to resolve, duration of attack

8) GAD - BE SKIM
3 of > 6 months
Blank mood, difficult to concentrate
Easy fatigue
Sleep disturbance
Keyed up/restless
Irritability
Muscle tension
9) Stimulant use disorder
2 of 11 within 12 months
WhaT a Craving FOOL
W = Withdrawal
T = Tolerance
C = Craving despite it being physically dangerous
C = Craving to use it especially in places where substance was obtained or used before
C = Continued use of substance despite knowledge of negative effects
C = Continued use despite social and interpersonal problems
F = Failure to quit substances use
O = Obligations to home, work and school impaired
O = Obtaining, using and recovering from substance effects takes a long time
L = Large amounts or longer periods of substance use (Basically Overdosed)
L = Let go of ROS (Recreational, Occupational or Social activities) due to substance use

10) Stimulant intoxication

Psy sx: irritabilty, anger, elated mood, impaired judgement
Tachycard/bradycard
High/low bp
Perspiration
Confusion, altered gcs
Chest pain
Resp depression
Nausea/v
Seizure
11) Withdrawal:
Fatigue
Unpleasant dream
Insomnia/hypersomnia
Increased appetite
Psy retard/agitation
12) Dementia
- self care
- biological fx
- langugage fx
- behavioural
13) PTSD (trigger, re-experience, dissociation, hyperarousal, avoidance)
- Easy way to remember :Exposure , Reexperience, Avoidance, Hyperarousal
1. Exposure to threatening situation
2. 9 of following intrusion,negative mood, dissociation, avoidance, arousal for >1 month
Intrusion
- recurrent intrusive memory
- re-experience/nightmares
- flashback/dissociative rxn
- intense psychological distress/physio rxn
Negative mood
- inability to experience positive emotions
Dissociative symptoms
- sense of unreal
- dissociative amnesia
Avoidance symptoms
Arousal symptoms
- hypervigilance
- easily startled

14) Schneider’s First Rank Symptoms 1959

PP MDS
1) Perception (Thought Echo, 2nd person and 3rd person auditory hallucinations)
2) Posession (Thought insertion, Thought Withdrawal, Thought Broadcasting)
3) Made (Made Affect; Made Volition; Made Impulse)
4) Delusional Perception
5) Somatic Passivity

15) Negative Symptoms of Schizophrenia

AAAAAA
A = Alogia
A = Anhedonia
A = Asocial
A = Affective flattening
A = Avolition
A = Attention noob

16) 5 Component of High Expressed Emotion (EE)

ECHO
Excessive Warmth (Treat like useless)
Excessive Positive Remarks (Pampered Baby)
Critism (Treat like useless)
Hostility (Treat like useless)
Over-involvement (Can go both ways)

17) Features of “True Hallucinations”

SONIC
S = Sensory Organ
O = Objective Space
N = No Stimulus
I = Independent of Control
I = Insight
C = Clear & Conscious

18) Aetiology of Delirium

I WATCH DEATH
Infection
Withdrawal (Alcohol; Barbiturates; Hypnotics)
Acute Metabollic (Acidosis ; Alkalosis ; Electrolyte Imbalance; Hepatic Failure; Renal
Failure)
Trauma (Closed Head Injury; Heatstroke; Post-Op; Severe Burns)
CNS Pathology (Abscess; Hemorrhage; Stroke; Tumours; Seizures; Vasculitis)
Hypoxia (@; CNS Pathology; Hypotension; Lung or Heart Failure)
Deficiences (Vitamin B12 deficiency; Niacin Deficiency; Thiamin deficiency; Folate
deficiency)
Endocrinopathies (Hyperparathyroidism; Hypercalcemia; Hyper/Hypocortisolism;
Hyper/Hypoglycemia)
Acute Vascular (HPT Encephalopathy; Arryhtmia; Stroke; Dehydration)
Toxins or Drugs (Ilicit Drugs; Pesticides; Solvents; Medications & Chemo)
Heavy Metals (Lead; Magnanese; Mercury)

19) Clinical Features of Delirium Tremens (DT)

DT'S A HELL

Delirium = which is worse at night

Delusions = Commonly Grandiosity
Tremors
Seizures of Withdrawal ("Rum Fits") = Occurs within 12-48 hours after withdrawal
Autonomic Instability (Common Manifestations are Fever; Tachycardia; HPT; Profuse
Sweating)
Hallucinations (Commonly Tactile or Visual)
ESR Raised
Leucocytosis
LFT Impaired

20) Types of Substance-Related and Addictive Disorders according to DSM-5

ASSOC2IATE

A = Alcohol - Related Disorders

S = Sedative-, Hypnotic-, or Anxiolytic- Related Disorders
S = Stimulant-Related Disorders
O = Opioid- Related Disorder
C = Caffeine-Related Disorder
C = Cannabis-Related Disorder
I = Inhalant-Related Disorders
A = Hallucinogen-Related Disorders (Because A written with bad-handwriting looks like a
“H”)
T = Tobacco-Related Disorders
E = Etc. (Other, Unspecified , Non-substance related disorders)