8

Question 1

indications for mood stabilisers

Answer 1

bipolar
cyclothymia
schizoaffective

Question 2

receptive behaviour presentation of autism

Answer 2

• mannerisms
• obsessions
• preoccupations
• interests
• rigid, inflexible behaviour pattern
• routines, rituals, play

Question 3

monitoring of lithium

Answer 3

steady state achieved after 5 days - check 12 hours after last dose
once stable check every 3 months
aiming for 0.6-1.2

Question 4

step 2 management of depression in PC

Answer 4

• sleep hygiene
• active monitoring
• CBT
  do not use antidepressants unless:
• personal history of moderate -> severe
• present with symptoms >2 years
• don’t respond to other interventions

Question 5

describe step 3 management depression in PC

Answer 5

persistent mild-> moderate with inadequate response to original management
+ mod-> severe
- SSRI
- high intensity psychological intervention
- individual CBT
- interpersonal therapy
- couples therapy, combined treatments

Question 6

level and presentation of mild lithium toxicity

Answer 6

1.5-2
presentation:
- vomiting 
- diarrhoea 
- ataxia
- dizziness
- slurred speech
- nystagmus

Question 7

causes sub-acute, acute organic mental disorder

Answer 7

• delirium
• organic mood disorder
• organic psychotic disorder
• intoxication
• pain
• drug overdose
• infection

Question 8

what areas of the brain if damaged are most likely to cause acute amnesic syndrome

Answer 8

hypothalamic diencephalic or hippocampal

Question 9

differential diagnosis mania

Answer 9

• bipolar
• hypomania
• mixed affective state
• schizoaffective disorder
• schizophrenia
• cyclothymia
• ADHD
• drugs and alcohol
• stroke
• MS
• tumour
• epilepsy
• hyperthyroidism
• SLE

Question 10

describe mania

Answer 10

• rarely a symptom
• often associated with grandiose ideas, disinhibition, loss of judgement, similarities to mental effects of stimulant drugs
• pathological, inappropriately elevated mood

Question 11

prevalence puerperal psychosis

Answer 11

1/500 deliveries

Question 12

if someone with depression has psychotic symptoms or stupor, what is this classified as

Answer 12

severe depression

Question 13

factors involved in suicide risk assessment

Answer 13

ALWAYS ASK

• ideation/ intent/ plans
• vague/ specific/ in motion
• previous attempts
• homocidal risk
• impulsivity
• access to lethal methods
• current stressors
• hopelessness
• protective factors
• sources of support

Question 14

step 4 management anxiety in PC

Answer 14

consider referral if:

• continuing functional impairment
• risk of self harm/ suicide
• significant comorbidity
• self-neglect
• failure to respond to steps 1->3

Question 15

illusion

Answer 15

perception in presence of stimulus

Question 16

hallucination

Answer 16

perception in absence of stimulus

Question 17

effect of cocaine

Answer 17

• stimulant and euphoriant
• increased alertness and energy
• increased confidence and impaired judgement
• lessened appetite and desire for sleep

Question 18

examples of drugs that abuse the reward pathway increasing dopamine levels

Answer 18

• heroin
• cocaine
• amphetamine
• alcohol

Question 19

describe pharmacodynamic tolerance

Answer 19

• site of action is less effected by drug
• down regulation of drug receptors
• reduced signalling downstream of drug receptors
• some other compensatory mechanisms

Question 20

presentation OCD in LDs

Answer 20

• ritualistic behaviour
• obsessional themes
• compulsions more readily observed

Question 21

management alcoholism

Answer 21

thiamine and B12
support groups 
practical advice
education
CBT
inpatient treatment 
medication

Question 22

screening tool for alcoholism

Answer 22

CAGE
C - have you ever felt the need to Cut down
A - have you ever been Angered at someone questioning your drinking
G - have you ever felt Guilty about your drinking
E - have you ever felt you need an Eye-opener