Lecture Notes In Psych Questions Flashcards
An 18 year old boy presents with auditory hallucinations and believes there is a conspiracy to have him murdered. He is, however eating and drinking sufficently and feel safe with his parents. What would your 1st line of treatment be?
A. Olanzapine B. Clozapine C. ECT D. Referral for CBT E. Lithium
A. Olanzapine
Evidence base in the treatment of psychosis. CBT is unlikely to be helpful in someone who is acutely unwell but may play a role once the patient improves with antipsychotics
A 72 year old lady has become severely depressed after the death of her husband. She believes her body is rotting away. She has stopped eating and drinking and has become very frail. What would be your preferred treatment modality
A. Olanzapine B. Clozapine C. ECT D. Referal for CBT E. SSRI
C. ECT
Psychotic depression where the patient has stopped eating and drinking is an emergency for which ECT is the preferred treatment
Drug treatments take weeks to work so are therefore unsuitable in this scenario
A 28 year old secretary finds herself becoming increasingly anxious about leaving home. She worries about fainting and making a fool of herself in crowds. She has panic attacks when she tries to leave the house. What would be the preferred treatment?
A. Benzodiazepines B. Olanzapine C. Referral for CBT D. ECT E. Clozapine
Referal for CBT
SSRI would also be appropriate
Risk of addiction if use benzodiazepines
Marion complains of a low mood and low energy which have been present for the past 6 weeks. She has lost approximately a stone in weight. She says she had a similar episode 4 years ago following the birth of her first child. What is the most likely diagnosis
A. Postnatal depression B. bipolar 2 disorder C. Dysthymia D. Depressive episode E. Recurrent depressive disorder
E - recurrent depressive disorder
Recurrent as she has had a previous depressive episode. The fact this was postnatal has no bearing on diagnosis in this instance
Brian is described by his wife as someone who is “glad half empty”. He rarely get enjoyment out of activities and expresses a generally negative outlook on life. However, up untill the last 3 week he has functioned well both at work and at home. At present he is preoccupied with the fact his bowels are rotting away and that he is undeserving of food. He says very little in the assessment and appears psychomotor retarded. What is the most likely diagnosis
A. Schizophrenia B. Psychotic depression and dysthymia C. Bipolar depression D. Drug induced psychosis E. Bowel cancer
B
history is suggestive of dysthymia whereas current presentation suggestive of psychotic depression
Which of the following is true about biploar disorder
A. Antideppressant are the main stay of treatment
B. bipolar 2 disorder is associated with the need for hospital admission when mood is elated
C. Bipolar disorder can be limmitted to episodes of mania
D. Bipolar disorder is much more common in women
E. Puerperal psychosis is less common in women who have a history of bipolar disorder
C. A diagnosis of bipolar can apply in the absence of deprressive episodes
If hospital admission is required for mania it suggest a diagnosis of type 1 as the mania is severe in nature
Charles is a 24-year-old man who presents with thoughts of shouting obscenities in a church. His psychiatrist thinks that theses are obsessional in nature. Which of the following is true about obsessional thought
A. They are egosyntonic
B. they are necessary to make a diagnosis of OCD
C. They can take the form of vivid imagery
D. They do not respond to pharmacotherapy with SSRI’s
E. They are commonly associated with antisocial PD
C - they can take the form of vivid imagery
Obssesion are egodystonic, repetitive and intrusive thoughts or images that are distressing to the patients
Only need evidence of either obsession or compulsion to make a diagnosis of OCD
SSRI and CBT are currently first line treatment for OCD
Associated with anankastic PD
A 32 year old sergeant returned from an advanced military post in a conflict zone 6 months ago and is being assessed for the development of PTSD. Which of the following would yo consider not to be a recognized feature of PTSD A. Flashbacks B. Nightmares C. Disinhibited behavior D. Exaggerated startle response E. Anxiety
C. Disinhibited behavior
Which of the following statements about anxiety disorder is true
A. Agoraphobia is more common in men
B. primary and secondary gain are associated with somatoform disorders
C. Glove and stocking anesthesia is recognized feature of dissociative disorders
D. Malingering is a psychiatric disorder
E. Somatization disorder only occurs in females
C. Primary and secondary gain are associated with dissociative disorders
Preoccupation with weight
A. Is absent in bulima nervosa
B. emerges in girls from the age of 7 onwards
C. Is never seen in males
D. Is unusal in EDNOS
B - a preoccupation with weight often precedes the emergence of an eating disorder behaviors in early puberty
Which of the following should be monitored during refeeding
A. Weight B. phosphate C. Ankle swelling D. Pottasium E. Heart rate F. All of the above
F. All of the above
A 22 yr old man present with his mother. She has noted over the last few days, he has been keeping to himself, appears perplexed and frightened, believing that a secret spy agency has conspired to murder him. He has slept with large kitchen under his pillow so as to tackle assailants. Prior to this he was attending university but his academic perforamance has been failing. Which line of management would you follow?
A. Watch and wait - advise coming back in 2 weeks to see if it resolves spontaneously
B. refer for psychological assessment to clarify and challenge beliefs
C. Admit for assessment and treatment
D. Prescribe an antipsychotic and suggest taking time of uni
E. Prescribe a benzodiazepine and refer as outpatient to the early intervention service
C. Given the risk of running away, fearing for saftey and use of wepon it would be safest to admit him
An 82 year old with no previous psychiatric contact has been increasingly agitated last few days. She is brought to hospital where she describes seeing ghost at the end of the bed and is frightened by them. She remains awake at night during the day. The nursing team on the medical assessment unit feel that she psychiatrically Unwell in light of her reports and ask for psychiatric opinion. What do you do next.
A. Suggest commencing a benzodiazepine to reduce agitation and help sleep
B. suggest commencing an antipsychotic drug to help hallucinations
C. Ask for an opthalmogy opinion
D. Ask for urine dip, blood test and TPR Chart ( temp, pulse, RR)
E. Suggest urgent transfer to in-patient psych unit
D - this lady could be presenting with a delirium
Which of the following facts about schizophrenia is incorrect
A majority of individuals with schizophrenia are dangerous
B. people with schizophrenia are more likely to get in trouble with the law
C. People with schizophrenia are more likely to use illicit drugs
D. Some people with schizophrenia may need support for many years
E. People with schizophrenia can make up to contributions to socitey
A
What is the most common type of dementia A. Alzheimer disease B . Vascular dementia C. Dementia with lewy bodies D. Frontotemporal dementia E. Metabolic disorder
Alzhiemer account for 50-60% of dementia
