Mental Health

Question 1

PTSD vs acute stress reaction +mx

Answer 1

PTSD >1m = Trauma focused CBT + EMDR +/- venlafaxine or sertraline

Acute stress reaction = <4 weeks, CBT

Question 2

OCD mx

Answer 2

SSRI + CBT

Question 3

GAD mx

Answer 3

> 6m
CBT +/-
(1) Sertraline
(2) SSRI/SNRI (dulox)
(3) Pregabalin
Wait until 12m after it as resolved

Question 4

Mania vs hypomania

Answer 4

Mania >7d. Impairs functioning
Psychotic symptoms (auditory hallucination)
Increased mood

Hypomania <7d (3-4)
Can be high functioning
No psychotic symptoms
Increased mood
ROutine referral

Question 5

Baby blues vs post natal depression vs postpartum psychosis

Answer 5

Baby blues 3-7d
Post-natal depression within 1m usually. Peaks 3m. Sertraline
Postpartum psychosis 2-3 weeks

Question 6

Depression 1st line medication

Answer 6

Sertraline

Question 7

Depression vs dementia

Answer 7

Depresion is shorter history, rapid onset, bio symptoms (sleep disturbance), pt is worried about poor memory, reluctant to take tests (disappointed with results), global memory loss (dementia is more recent memory loss)

Question 8

Brief psychotic disorder, timeframe

Answer 8

<1m, return to baseline

Question 9

Circumstantiality vs tangentiality

Answer 9

Circumstantiality - excessive detail, return to original point
Tangentiality - wanders from topic, without returning to original point

Question 10

strongest RF of schizophrenia

Answer 10

FH

Question 11

Atypical vs typical antipsychotics and S.E

Answer 11

1.Atypical antipsychotics for schizophrenia - EPSE + hyperprolactinaemia less common

Antipsychotics ↑ risk VTE + stroke in elderly

EPSE:
Dystonia = muscle contractions - torticollis, oculogyric crisis
Akathesia = restless
Tardive dyskinesia = chewing, pointing

Question 12

MX personality disorders

Answer 12

PS therapy, Dialectical behaviour therapy

Question 13

Schizoid personality describe

Answer 13

lack interest in sex/relationships, few interests

Question 14

Schizotypal personality describe

Answer 14

Odd beliefs

Question 15

ADHD mx (when initiate meds) and monitoring of the mx

Answer 15

Inattention, hyperactivity, impulsivity
10 week watch and wait
Methylphenidate 6 week trial - monitor weight + height

Question 16

Alcohol withdrawal - what meds can help:
Craving, sobriety, withdrawal

Answer 16

Alcohol withdrawal
Chlordiazepoxide (benzo)
Aftercare:
Disulfiram - reaction with alcohol
Acamprosate - craving
Naltrexone - sobriety

Question 17

What to use for alcohol overdose

Answer 17

activated charcoal, benzos, pabrinex

Question 18

What to give for benzo overdose

Answer 18

Flumazenil

Question 19

What to use for TCA overdose

Answer 19

Sodium bicarb

Question 20

Opioid overdose - what to use

Answer 20

Naloxone

Question 21

Paracetamol overdose mx

Answer 21

<1hr activated charcoal
<8hrs NAC IV -> methionine pO
Correct hypoglycaemia

Question 22

Wernickes triad

Answer 22

Ophthalmoplegia (nystagmus)
Ataxia
Confusion

Question 23

Korsakoffs triad + mx

Answer 23

Amnesia - anterograde + retrograde
Confabulation
Need pabrinex Vit B1

Question 24

S2

Answer 24

28d, non renewable, AMHP + 2 Drs

Question 25

S3

Answer 25

6m, renew, AMHP + 2 Drs

Question 26

S4

Answer 26

72 hrs in emergency

Question 27

S5

Answer 27

(2) vol pt in hospital detained by Dr 72hrs (4) Vol pt in hospital detained by nurses 6hrs

Question 28

s17

Answer 28

CTO, can recall back to hospital

Question 29

S 135

Answer 29

Police court order, private (136 is public)

Question 30

ad + LBD mx

Answer 30

AceE inhibitors +/- memantine

Question 31

Fronto temporal dementia symptoms

Answer 31

Personality, social conduct problems

Question 32

Parkinsons disease triad

Answer 32

Tremor, rigidity, bradykinesia

Question 33

Parkinson disease plus syndromes

Answer 33

PSP = vertical gaz palsy, falls, Hummingbird on MRI MSA = postural hypotension, ANS, hot cross bun sign Corticobasal degeneration - unilateral, alien limb

Question 34

Bulimia meds

Answer 34

FLuox

Question 35

Somatisation

Answer 35

Multiple physical symptoms >/2 year,s refuse to accept reassure

Question 36

Meds insomnia

Answer 36

Bezos or non-benzos (z drugs) 2 weeks

Question 37

Sleep paralysis meds

Answer 37

Clonazepam

Question 38

Charles bonnet syndrome

Answer 38

Complex hallucinations in clear consciousness. Usually visual impaired

Question 39

cotard syndrome

Answer 39

Believes dead/ non existant

Question 40

De Clerambaults

Answer 40

Believe someone famous in love with her

Question 41

Orthellos

Answer 41

Jealousy

Question 42

Converison disorder

Answer 42

Conversion disorder Loss motor/sensory function - Hoovers sign

Question 43

Catatonia

Answer 43

Stopping vol movement or staying still in unusual position

Question 44

Vovlulus on XR and mX