General adult

Question 1

Complications of catatonia

Answer 1

Dehydration
Deep vein thrombosis
Pulmonary embolism
Pneumonia

Question 2

Prevalence of rapid-cycling BPAD

Answer 2

10-20% of all patients with BPAD

Question 3

Lifetime prevalence of OCD

Answer 3

2-3%

Question 4

Relative contra-indications to ECT

Answer 4

acute resp infection
cardiac - MI (<3m ago), uncontrolled CHF, arrhythmia
neuro - recent stroke, raised ICP, untreated
cerebral aneurysm
untreated phaeochromocytoma
unstable major #
DVT
acute/impending retinal detachment

Question 5

Drugs that raise seizure threshhold

Answer 5

Benzodiazepines
Barbituates
Anti-convulsants

Question 6

UK700 trial

Answer 6

Failed to prove that enhanced outcomes could be

achieved under CPA by reducing case-load size.

Question 7

Diagnostic Interview Schedule

Answer 7

Designed for use by lay interviewers

Question 8

Incidence of puerperal psychosis

Answer 8

1-2/1000

Question 9

Incidence of puerperal psychosis in women with BPAD

Answer 9

50%

Question 10

Risk of recurrence of puerperal psychosis in subsequent pregnancies

Answer 10

50-80%

Question 11

Antipsychotics recommended for breastfeeding

Answer 11

Sulpride or Olanzapine

Question 12

Risk of spina bifida in valproate

Answer 12

1-2%

Question 13

Risk of spina bifida in carbamazepine

Answer 13

0.5-1%

Question 14

Risk of Ebstein’s anomaly in Lithium

Answer 14

1/1000

Question 15

Antidepressants in pregnancy

Answer 15

Fluoxetine, amitriptyline, imipramine

Question 16

Antipsychotics in pregnancy

Answer 16

Olanzapine, haloperidol, clozapine, chlorpromazine

Question 17

Hypnotic/sedative in pregancy

Answer 17

Promethazine

Question 18

Hypnotic/sedative in breastfeeding

Answer 18

Anxiety - lorazepam

Insomnia - Zolpidem

Question 19

Incidence of puerperal psychosis

Answer 19

1/500

Question 20

Serum level clozapine

Answer 20

350-500 ug/L

Question 21

Spontaneous major malformation rate in confirmed pregnancies

Answer 21

2-4%

Question 22

Prevalence of any personality disorder

Answer 22

4.4%

Question 23

M:F ratio ASD

Answer 23

5:1

Question 24

M:F ratio ADHD

Answer 24

2:1

Question 25

M:F ratio major depression

Answer 25

1:2

Question 26

M:F ratio bipolar I

Answer 26

1:1

Question 27

M:F ratio agoraphobia

Answer 27

1:3

Question 28

M:F ratio GAD, panic or phobia

Answer 28

1:2

Question 29

M:F ratio eating disorders

Answer 29

1:9

Question 30

M:F ratio BPD

Answer 30

1:3

Question 31

Disulfiram

Answer 31

Blocks the conversion of aldehyde to acetic acid by binding irreversibly to aldehyde dehydrogenase. Leads to symptoms such as abdominal colic, flushing, anxiety, dizziness, tachycardia, vomiting and headache. Symptoms start 5-15 minutes after drinking alcohol and last for several hours producing symptoms of nausea and headache.

Question 32

Acamprosate

Answer 32

A structural analogue of gamma-aminobutyric acid (GABA), leading to decreased withdrawal cravings. Chronic overdose can result in hypercalcemia. Transient diarrhoea most common side-effect

Question 33

Incidence of post-natal depression

Answer 33

10%

Question 34

Lifetime incidence of suicide in alcohol dependance

Answer 34

7%

Question 35

Buproprion

Answer 35

Norepinephrine-dopamine reuptake inhibitor (NDRI) and nicotinic acetylcholine receptor antagonist

Question 36

Buprenorphine

Answer 36

Partial mu opiod agonist Half-life over 24hrs Reduces the effect of additional street opiods Can be combined with naloxone to reduce IV use (Suboxone)

Question 37

Naltrexone

Answer 37

Opioid antagonist Half-life 96hrs Prevents relapse in drug-free patients. Also reduces both the rewarding effects of alcohol and craving for it.

Question 38

Non-compliance in schizophrenia patients following discharge from hospital

Answer 38

25% at ten days 50% at one year 75% at 2 years

Question 39

PCP intoxication

Answer 39

``` violent behavior nystagmus tachycardia hypertension anesthesia analgesia ```

Question 40

Antipsychotics in epilepsy

Answer 40

Haloperidol, sulpride, trifluperazine

Question 41

Antipsychotics in postural hypotension

Answer 41

Amisulpride | Aripiprazole

Question 42

Augmentation of clozapine

Answer 42

Lamotrigine Sulpride Amisulpride

Question 43

Risk factors for agranulocytosis in clozapine use

Answer 43

Age (increasing age increases risk) | Ethnicity (Asians are 2.4 times more likely than Caucasians)

Question 44

Risk factors for neutropenia in clozapine use

Answer 44

Race (Afro-Caribbean 77% increase in risk) Age (decrease in risk as age increases) Low baseline white cell count

Question 45

Risk factors for tardive dyskinesia

Answer 45

``` Advancing age Female African American Affective disorder Mental retardation Substance abuse ```

Question 46

Risk factors for NMS

Answer 46

``` Younger age Male Physical exhaustion Dehydration or electrolyte imbalance Previous and family history of NMS Organic mental disorders Low serum iron levels Raised creatine kinase levels Comorbid substance misuse ```

Question 47

Antidepressants in hepatic impairment

Answer 47

Imipramine Paroxetine Citalopram

Question 48

Antipsychotics in hepatic impairment

Answer 48

Haloperidol Amisulpride Sulpiride

Question 49

Antidepressant in HIV

Answer 49

citalopram

Question 50

Antipsychotic in HIV

Answer 50

risperidone

Question 51

Proportion of individuals who completed suicide who had contact with mental health services in past 12 months

Answer 51

28%

Question 52

Proportion of "patient suicides" that occurred as inpatients

Answer 52

10%

Question 53

Proportion of patient suicides that occurred within 3 months of discharge

Answer 53

18%

Question 54

Proportion of patients who present to A&E with self-harm that have seen GP in past month

Answer 54

50%

Question 55

Epilepsy and driving

Answer 55

Seizure free for 12 months | No seizures during the day for 3 years