Extras

Question 1

What is the definition from ICD-10 of a hallucination?

Answer 1

a false sensory perception in the absence of an external stimulus

Question 2

What is a hypnagogic hallucination?

Answer 2

Experienced vivid auditory or visual hallucinations which occur when transitioning from wakefulness to sleep, they are fleeting in duration and may occur in anyone

Question 3

what is an obsession?

Answer 3

an unwanted intrusive thought, image or urge that repeatedly enters the person’s mind

Question 4

what is a compulsion?

Answer 4

repetitive behaviours or mental acts that the person feels driven to perform

Question 5

what are risk factors for OCD?

Answer 5

-family history
-age: peak onset is between 10-20 years
-pregnancy/postnatal period
-history of abuse, bullying, neglect

Question 6

what is ERP, used in the treatment of OCD?

Answer 6

a psychological treatment which involves exposing a patient to an anxiety provoking situation and then stopping them engaging in their usual safety behaviour

Question 7

how long should you continue someone with OCD on SSRI if this has been effective?

Answer 7

continue for at least 12 months to prevent relapse and allow time for improvement

Question 8

how does the dose of SSRI compare from depression to OCD?

Answer 8

much higher doses used in OCD, and may take longer to see an initial response

Question 9

what is conversion disorder?

Answer 9

it typically involves loss of motor or sensory function
the patient doesn’t consciously feign the symptoms (factitious disorder) or seek material gain (malingering)

Question 10

what drugs increase the risk of serotonin syndrome in a patient currently on an SSRI?

Answer 10

triptans and MAOi

Question 11

what antidepressant would you give to someone on warfarin or heparin instead of an SSRI (bleed risk)?

Answer 11

mertazapine

Question 12

what other drug would need to be prescribed alongside an SSRi for someone currently taking an NSAID?

Answer 12

PPI- due to increased risk of GI bleeding

Question 13

when should patients be reviewed after starting an antidepressant?

Answer 13

after 2 weeks.
However, patients under the age of 25 or at increased risk of suicide should be reviewed after 1 week

Question 14

how should you stop taking an SSRI, why?

Answer 14

slowly reduce the dose over 4 weeks to reduce risk of discontinuation syndrome

Question 15

what is russell’s sign?

Answer 15

calluses on the knuckles and back of the hand from self-induced vomiting

Question 16

what are negative symptoms in schizophrenia?

Answer 16

incongruity/blunting of affect
anhedonia
alogia (poverty of speech)
avolition (poor motivation)
social withdrawal

Question 18

What is the mainstay treatment for personality disorders?

Answer 18

Dialectical behaviour therapy

Question 19

What does EMDR stand for and what disorder is it used to treat?

Answer 19

Eye movement desensitisation and reprocessing
PTSD

Question 20

Which SSR has the highest risk of discontinuation syndrome?

Answer 20

Paroxetine

Question 21

What is a way of differentiating avoidant and schizoid personality disorder?

Answer 21

Both are more isolated and reluctant to engage in social situations however in avoidant PD there is a strong desire to have social contact. Whereas in schizoid they aren’t interested

Question 22

What is the difference between somatisation and hypochondrial disorder?

Answer 22

With somatisation there is recurrent physical symptoms without an organic cause but in hypochondrial disorder there is a preoccupation with having or acquiring a certain serious illness

Question 23

What is Othello syndrome?

Answer 23

Patients hold the delusional belief that their partner is cheating on them

Question 24

What is cotards syndrome?

Answer 24

Patients believe that parts of their body are dead or decaying

Question 25

What is capgras syndrome?

Answer 25

When patients believe that a friend or relative has been replaced by an exact double

Question 26

How does stopping smoking affect clozapine levels in the blood?

Answer 26

Smoking cessation increases clozapine levels

Question 27

Should paroxetine be used in pregnancy?

Answer 27

Should be avoided unless benefits outweigh risks as paroxetine can lead to increased risk of congenital malformations