end of unit test

Question 1

what drug associated with long QT syndrome
what drug specifically

how long should you continue into remission

Answer 1

SSRI - should do an ECG - citalopram

another 6 months into remission

Question 2

which SSRI should yo take a break from before starting another one

Answer 2

fluoxetine - long half life

Question 3

bipolar treatment

Answer 3

citalopram and risperidone

Question 4

acute mania with agitation what to do

Answer 4

stabilise mood with antipsychotic like Benzo

without agitation - sedation and lithium

Question 5

acute depression in bipolar

Answer 5

lithium , atypical antipsychotic , antidepressant and support

Question 6

chronic management of bipolar

Answer 6

lithium monotheapy

valproate 2nd line

Question 7

what do you need to keep lithium levels below and what symptom to high

Answer 7

1.5

tremor coarse
impaired coordination and renal failure

Question 8

what drug can you not take with lithium

Answer 8

NSAID

Question 9

cannabis use is a RF for what disease

Answer 9

schizophrenia

rubella and CMV

Question 10

1st line for schizo

Answer 10

atypical antipsychotics e.g. risperidone

referred to typical like haloperidol due to reduced risk of extea-pyramididal symptoms

hesitant - clozapine - after 2 tried
behavioural disturbance - lorazepam

Question 11

treatment fro alcohol withdrawal

Answer 11

chlordiazepoxide

if seizures IV lorazepam
pabrinex to prevent wernickes encephalopathies

naltrexone following wethdrawal to prevent relapse

acamprostate aid abstinence

Question 12

gamma gt classic for alcoholism and AST higher

Answer 12

true

Question 13

liver cirrhosis can be compensated or decompensated

caused by

Answer 13

alcohol 
heaptisi 
sarcoid 
alpha 1 antitrypsin 
budd chiarir suydnroem - blocco and vier 
methotrexate 
amiodaraone 
isoniazid 
sphillis

Question 14

liver cirrhosis can be compensated or decompensated

caused by

Answer 14

alcohol 
hepatitis
sarcoid 
alpha 1 antitrypsin 
budd chiarir syndrome - blocco and vier 
methotrexate 
amiodaraone 
isoniazid 
sphillis

Question 15

complications of liver cirrhosis

Answer 15

bacterial peritonitis 
hepatic encephalopahty 
portal hypertension 
varcieal bleeding 
hepatorenal syndrome

Question 16

what does donepezil treat

Acetylcholinesterase inhibitor

Donepezil, rivastigmine and galantamine all prevent an enzyme called acetylcholinesterase from breaking down acetylcholine. This means there is a higher concentration of acetylcholine in the brain, which leads to better communication between nerve cells

Answer 16

alzieherms dementia

Question 17

opiates vs cannabis overdose what are the features

Answer 17

opiates cause drowsiness, confusion, decreased RR and HR , constricted pupils - needle track marks

drowsiness, impaired memory, slowed reflexes and motor skills, bloodshot eyes, dry mouth, paranoia

Question 18

stimulants such as cocaine - TAAE1 cause what

Answer 18

euphoria

increased BP, HR and temp

Question 19

You are the FY1 on the gastroenterology ward. You are called to assess a 70-year-old man originally admitted for investigation of jaundice, who has started vomiting blood. On examination, he is distressed and continuing to vomit fresh red blood. There is no abdominal tenderness. Further examination is difficult.
His latest observations are as follows:

Answer 19

This patient is shocked and requires fluid resuscitation. It will also likely become necessary to transfuse red cells once cross-matched blood, or emergency O- blood is available. However, fluids should be used until these are available.

Terlipressin, a synthetic analogue of ADH, acts as a splanchnic vasoconstrictor to reduce bleeding from oesophageal varices. This should be given promptly to all patients with suspected variceal bleeds as it improves mortality rates. However fluid resuscitation takes precedence.

Question 20

A 48-year-old man is recovering on the gastroenterology ward after suffering from a large variceal haemorrhage. He is found to have grade II varices on endoscopy, which are banded. Which of the following is recommended with respect to long term prophylaxis against further bleeding?

Answer 20

Non-selective beta-blockers reduce portal blood pressure and are therefore potentially useful with respect to prophylaxis against further variceal bleeds. As such they are the long term intervention of choice.

Question 21

Atypical antipsychotics have fewer extrapyramidal side effects (eg. involuntary muscle contraction, tremors, stiff muscles, and involuntary facial movements)

Answer 21

true