MedEd lectures

Question 1

treatment for acute mania

Answer 1

stop meds that may be causing psychosis

antipsychotic + short course lorazepam

Question 2

what antipsychotics for acute mania

Answer 2

quetiapine, olanzipine, risperidone

Question 3

when does lithium become toxic

+ sympto

Answer 3

> 1.2

GI disturbances, tremor, Renal failure etc

Question 4

lithium use in pregnancy ->

Answer 4

ebsteins anomaly

Question 5

Na Val/carbamazepine use in pregnancy ->

Answer 5

spina bifida

Question 6

risk of BPAD in pregnancy

Answer 6

v inc risk of puerperal psychosis

Question 7

treatment of acute GAD

Answer 7

benzos

Question 8

Tx for GAD that >4w

Answer 8

escitalopram, paroxetine

Question 9

Tx for panic disorder

Answer 9

CBT + SSRIs

if >12w - add clomipramine

Question 10

tx for PTSD

Answer 10

trauma focussed CBT

EMDR

Question 11

what would you monitor when giving antipsychotics

Answer 11

BMI
U&Es
FBC
lipids
glucose/HbA1c
LFTs
ECG (if change in dose)
Prolactin
BP

Question 12

ECG changes with antipsychotics

Answer 12

prolonged QT interval

Question 13

what should be considered when starting SSRIs

Answer 13

inc risk suicide in first 2 weeks (esp in kids)

Question 14

Hallucination =

Answer 14

perception in the absence of external stimuli

Question 15

Delusion =

Answer 15

fixed, false, unshakeable belief that is out of context of persons norms

Question 16

main categories of side effects with antipsychotics

Answer 16

EPSEs
metabolic syndro
hyperprolactinaemia
arrhythmias

Question 17

what are the 4 main EPSEs

Answer 17

Dystonia - sudden contraction of muscles (esp neck)
Akathisia - internal restlessness
Parkinsonism
Tardive dyskinesia - grimacing + lip smacking

Question 18

treatment for dystonia cause by antipsychotics

Answer 18

IM procyclidine

Question 19

what are the classic symptoms of neuroleptic malignant syndro

Answer 19

Hyperthermia
muscle rigidity
autonomic instability (dec BP, inc HR)
altered mental state

Question 20

timeframe for baby blues vs postpartum depression

Answer 20

BB = first 10 days, lasts < 48hrs 
PPD = last >2w

Question 21

what antidepressants is used for postpartum depression

Answer 21

sertraline

Question 22

what is the screening questionnaire for postpartum d

Answer 22

EPDS - edinburgh postpartum d scale

Question 23

treatment for postpartum psychosis

Answer 23

olanzapine + quetiapine

+ admit MBU

Question 24

what meds can be used for BPAD in pregnancy

Answer 24

olanzepine + fluoxetine

never Na VAL

Question 25

sympto of refereeing syndro

Answer 25

fatigue, weakness, confusion, hypertension, seizures

Question 26

blood findings in refeeding syndro

Answer 26

dec phos, dec mg, dec K, dec thiamine

salt + water retention

Question 27

who issues a S135

Answer 27

= court issues warrant to bring pt in for assessment

Question 28

who issues S136

Answer 28

police issue in public place

can hold for 24 hr while assessment organised

Question 29

who issues a S 5.2

Answer 29

1 dr (F2 or above) on an inpatient - can hold for 72hr for assessment

Question 30

who issues a S 5.4

Answer 30

nurse on inpatient, can hold for 6 hr

Question 31

who can issue a S2/S3

Answer 31

2 Drs + AMHP

Question 32

how long does a S2 last and what does it do

Answer 32

hold for 28days for assessment

Question 33

how long does a S3 last and what does it do

Answer 33

hold for 6 mo for assessment + Tx