Extras paper 2 Flashcards
What are the co-morbidities associated with bipolar disorder?
A: Increased risk of diabetes, cardiovascular disease, and COPD (2-3 times higher).
What are the management strategies for fibromyalgia?
A psychosocial and multidisciplinary approach.
Aerobic exercise (strongest evidence base), cognitive behavioural therapy (CBT), and medications such as pregabalin, duloxetine, and amitriptyline.
What is the first-line management for binge eating disorder in adults according to NICE?
NICE recommends a ‘binge-eating-disorder-focused’ guided self-help programme.
What is the first-line treatment for bulimia nervosa in adults according to NICE
NICE recommends bulimia-nervosa-focused guided self-help for adults.
What is recommended when switching from an SSRI to a tricyclic antidepressant (TCA)?
Cross-tapering is recommended, where the current drug dose is reduced slowly while the dose of the new drug is increased slowly, except for fluoxetine, which should be withdrawn, with a 4-7 day gap before starting the TCA at a low dose.
What are the common adverse effects of lithium?
Nausea/vomiting, diarrhoea, fine tremor, nephrotoxicity (polyuria secondary to nephrogenic diabetes insipidus), thyroid enlargement (leading to hypothyroidism), T wave flattening/inversion on ECG, weight gain, idiopathic intracranial hypertension, leucocytosis, hyperparathyroidism and resultant hypercalcaemia.
What factors can precipitate lithium toxicity?
Dehydration, renal failure, and drugs such as diuretics (especially thiazides), ACE inhibitors/angiotensin II receptor blockers, NSAIDs, and metronidazole.
What is the mechanism of action of nitrous oxide when inhaled?
Nitrous oxide acts as a dissociative anaesthetic by blocking NMDA receptors, impairing the perception of pain and inducing a state of euphoria and relaxation. It also causes the release of endogenous opioids and dopamine, contributing to its addictive potential.
How long should detoxification of opioids last in an inpatient/residential setting versus the community?
Detoxification should last up to 4 weeks in an inpatient/residential setting and up to 12 weeks in the community.
What are the indications for haemodialysis in salicylate overdose?
Serum concentration > 700 mg/L, metabolic acidosis resistant to treatment, acute renal failure, pulmonary oedema, seizures, and coma.
Why do salicylates cause sweating and pyrexia?
Salicylates uncouple oxidative phosphorylation, which decreases adenosine triphosphate (ATP) production, increases oxygen consumption, and leads to increased carbon dioxide and heat production, resulting in sweating and pyrexia.
when stopping fluoxetine, do you need to taper
no
where do typical antipsychotics work
dopamine D2 receptor
What are other common side effects of antipsychotics?
Other side effects include antimuscarinic effects (dry mouth, blurred vision, urinary retention, constipation), sedation, weight gain, raised prolactin (which can lead to galactorrhoea), impaired glucose tolerance, neuroleptic malignant syndrome (characterized by pyrexia and muscle stiffness), reduced seizure threshold (greater with atypicals), and prolonged QT interval (particularly with haloperidol).
What are the normal stages of grief according to a popular model?
Denial, Anger, Bargaining, Depression, Acceptance.
what xray would you do for acute epiglottitis
lateral xray - thumb sign
what xray would you do for croup
PA xray - steeple sign
go through paeds asthma management
What is the treatment for Homocystinuria?
Vitamin B6 (pyridoxine) supplements
What vaccines are given at 12-13 months of age?
Hib/Men C vaccine
MMR (Measles, Mumps, Rubella)
PCV
Men B vaccine
learn risk factors for pre eclampsia
how long do you continue iron treatment after preg
3 months
what is thelassys test used for
meniscal tear
