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MRCPsych - paper B > General adult > Flashcards

General adult Flashcards

1
Q

Complications of catatonia

A

Dehydration
Deep vein thrombosis
Pulmonary embolism
Pneumonia

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2
Q

Prevalence of rapid-cycling BPAD

A

10-20% of all patients with BPAD

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3
Q

Lifetime prevalence of OCD

A

2-3%

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4
Q

Relative contra-indications to ECT

A 
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
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5
Q

Drugs that raise seizure threshhold

A

Benzodiazepines
Barbituates
Anti-convulsants

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6
Q

UK700 trial

A

Failed to prove that enhanced outcomes could be

achieved under CPA by reducing case-load size.

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7
Q

Diagnostic Interview Schedule

A

Designed for use by lay interviewers

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8
Q

Incidence of puerperal psychosis

A

1-2/1000

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9
Q

Incidence of puerperal psychosis in women with BPAD

A

50%

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10
Q

Risk of recurrence of puerperal psychosis in subsequent pregnancies

A

50-80%

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11
Q

Antipsychotics recommended for breastfeeding

A

Sulpride or Olanzapine

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12
Q

Risk of spina bifida in valproate

A

1-2%

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13
Q

Risk of spina bifida in carbamazepine

A

0.5-1%

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14
Q

Risk of Ebstein’s anomaly in Lithium

A

1/1000

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15
Q

Antidepressants in pregnancy

A

Fluoxetine, amitriptyline, imipramine

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16
Q

Antipsychotics in pregnancy

A

Olanzapine, haloperidol, clozapine, chlorpromazine

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17
Q

Hypnotic/sedative in pregancy

A

Promethazine

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18
Q

Hypnotic/sedative in breastfeeding

A

Anxiety - lorazepam

Insomnia - Zolpidem

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19
Q

Incidence of puerperal psychosis

A

1/500

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20
Q

Serum level clozapine

A

350-500 ug/L

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21
Q

Spontaneous major malformation rate in confirmed pregnancies

A

2-4%

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22
Q

Prevalence of any personality disorder

A

4.4%

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23
Q

M:F ratio ASD

A

5:1

24
Q

M:F ratio ADHD

A

2:1

25
Q

M:F ratio major depression

A

1:2

26
Q

M:F ratio bipolar I

A

1:1

27
Q

M:F ratio agoraphobia

A

1:3

28
Q

M:F ratio GAD, panic or phobia

A

1:2

29
Q

M:F ratio eating disorders

A

1:9

30
Q

M:F ratio BPD

A

1:3

31
Q

Disulfiram

A

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.

32
Q

Acamprosate

A

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

33
Q

Incidence of post-natal depression

A

10%

34
Q

Lifetime incidence of suicide in alcohol dependance

A

7%

35
Q

Buproprion

A

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

36
Q

Buprenorphine

A

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)

37
Q

Naltrexone

A

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

38
Q

Non-compliance in schizophrenia patients following discharge from hospital

A

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

39
Q

PCP intoxication

A 
violent behavior
nystagmus
tachycardia
hypertension
anesthesia
analgesia
40
Q

Antipsychotics in epilepsy

A

Haloperidol, sulpride, trifluperazine

41
Q

Antipsychotics in postural hypotension

A

Amisulpride

Aripiprazole

42
Q

Augmentation of clozapine

A

Lamotrigine
Sulpride
Amisulpride

43
Q

Risk factors for agranulocytosis in clozapine use

A

Age (increasing age increases risk)

Ethnicity (Asians are 2.4 times more likely than Caucasians)

44
Q

Risk factors for neutropenia in clozapine use

A

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

45
Q

Risk factors for tardive dyskinesia

A 
Advancing age
Female
African American
Affective disorder
Mental retardation 
Substance abuse
46
Q

Risk factors for NMS

A 
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
47
Q

Antidepressants in hepatic impairment

A

Imipramine
Paroxetine
Citalopram

48
Q

Antipsychotics in hepatic impairment

A

Haloperidol
Amisulpride
Sulpiride

49
Q

Antidepressant in HIV

A

citalopram

50
Q

Antipsychotic in HIV

A

risperidone

51
Q

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

A

28%

52
Q

Proportion of “patient suicides” that occurred as inpatients

A

10%

53
Q

Proportion of patient suicides that occurred within 3 months of discharge

A

18%

54
Q

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

A

50%

55
Q

Epilepsy and driving

A

Seizure free for 12 months

No seizures during the day for 3 years

MRCPsych - paper B (7 decks)

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