MRCPsych Mentor Flashcards
Which antidepressants are available as IV?
Citalopram
Mirtazapine
Amitriptyline
Clomipramine
Which antidepressants are available PR?
Amitriptyline Clomipramine Imipramine Doxepin Trazadone
How can one take Amitriptyline?
PO
IV
IM
Which antidepressant is available transdermally?
Selegiline
Medications indicated for phobic & obsessional states
Clomipramine
Adjunctive treatment of cataplexy associated with narcolepsy
Clomipramine
Medications indicated for panic disorder and agoraphobia
Citalopram Escitalopram Sertraline Paroxetine Venlafaxine
Medications indicated for soxial anxiety & phobias
Escitalopram Paroxetine Sertraline Moclobemide Venlafaxine
Medications indicated for GAD
Escitalopram
Paroxetine
Duloxetine
Venlafaxine
Medications indicated for OCD
Escitalopram Fluoxetine Fluvoxamine Paroxetine Sertraline
Medications indicated for Bulimia
Fuloxetine
Medications indicated for PTSD
Paroxetine
Sertraline
How long should people >65 continue antidepressant medication for following remission?
2 years
Which medication has is supported by evidence for use to treat hypersalivation secondary to clozapine?
Amisulpride
Cut-off score indicating an ED in SCOFF?
2
What was the first fully structured diagnostic interview for use by lay interviewers?
Diagnostic Interview Schedule
Who created the Diagnostic Interview Schedule?
Robins et al. 1981
Who launched the Epidemiological Catchment Programme?
National Institute of Mental Health
What is the Composite International Diagnostic Interview?
Version of the DIS that uses ICD criteria
Who created the Composite International Diagnostic Interview?
WHO
What was the first large scale use of CIDI?
National Comorbidity Survery
When did NCS take place?
1990s
Was NCS an international survey?
No - national
What did data from NCS and ECA suggest?
Number of people with MH problems outnumbered resources
What led to the development of the Word Mental Health CIDI?
The fact that ECA and NCS did not comment on severity of MH
What does WMH-CIDI take into account?
Severity of MH
Risk factors
Socio-demographics
Treatments
First line treatment of Tourettes?
Clonidine
Which antipsychotics show evidence for treating Tourettes?
Haloperidol
Pimozide
Risperidone
Olanzapine
When should valproate be considered with clozapine use?
Using high doses
Plasma levels >0.5mg/L
Patient has seizures
How many people develop fatal agranulocytosis form clozapine?
1 in 10,000
How many patients on clozapine develop neutropenia?
2.7%
Risk factors for neutropenia?
Race - 77% increase in risk for Afro-Caribbeans
Age (reduces)
Low baseline WCC
Is risk of neutropenia from clozapine related to dose?
No
Risk factors for clozapine induced agranulocytosis?
Age (increases)
Ethnicity - 2.4x more likely in Asians than Caucasians
What does mutation of HPRT1 gene cause?
Lesch-Nyan syndrome
What refers to the true meaning behind a dream?
Latent content
Which factors are associated with poor prognosis of Anorexia?
Long duration of hospital care Psychiatric co-morbidity Adopted One-parent household Young mother
What is the primary metabolite of Paracetamol?
Benzoquinoneimine
How many databases are in the Cochrane Library?
6
What databases are in the Cochrane Library?
Cochrane Database of Systematic Reviews
Cochrane Central Register of Controlled Trials
Cochrane Methodology Register
Database of Abstracts of Reviews of Effects
Health Technology Assessment
NHS Economic Evaluation Database
Lifetime prevalence of use of cannabis
24%
Lifetime prevalence of use of amphetamines
7%
Lifetime prevalence of use of magic mushrooms
5%
Lifetime prevalence of use of ecstacy, cocaine or LSD
4%
Lifetime prevalence of use of transquilisers
3%
Lifetime prevalence of use of glue
1%
Lifetime prevalence of use of crack, heroin, anabolic steroids
<1%
Which antidepressants have a lower incidence os sexual dysfunction?
Bupropion Mirtazapine Moclobemide Nefazadone Reboxetine
What is transference based psychotherapy based on?
Otto Kernberg’s theory of BPD
Which herbal remedy has evidence to support its effectiveness for depression?
Hypericum Perforatum
M:F ratio of reading disorder
3-4:1
M:F ratio of autism
4-5:1
M:F ratio of Aspergers
5:1
M:F ratio of Tourette’s
2-5:1
M:F ratio of ADHD in children?
2:1
M:F ratio of ADHD in adults?
1.6:1
M:F ratio of depression
1:2
M:F ratio of Type 1 Bipolar
1:1
M:F ratio of Panic with agoraphobia
1:3
M:F ratio of Panic without agoraphobia
1:2
M:F ratio of GAD
1:2
M:F ratio of OCD
1:1
M:F ratio of specific phobia
1:2
M:F ratio of conversion disorder
1:2-10
M:F ratio of anorexia
1:9
M:F ratio of bulimia
1:9
M:F ratio of BPD
1:3
What does Suboxone contain?
Naloxone and Buprenorphine
In the AESOP study, the incidence of schizophrenia in Black-African groups was increased by what factor?
9
Drugs recommended for PTSD by NICE?
Paroxetine
Mirtazapine
Amitriptyline
Phenelzine
What did Bleuler divide schizophrenia into?
Type A
Type B
What is indicative of Type A schizophrenia as per Bleuler?
Organic cause
Which type of schizophrenia is associated with the 4 A’s?
Type A
What are the 4 A’s of Bleuler’s schizophrenia?
Autism
Ambivalence
Affect
Associations
Which sx does opiate misuse not lead to tolerance of?
Miosis
Constipation
Maximum dose of clozapine
900mg/day
Maximum dose of haloperidol
20mg/day
Maximum dose of olanzapine
20mg/day
Maximum dose of quetiapine for schizophrenia
750mg/day
Maximum dose of quetiapine for bipolar
800mg/day
Maximum dose of risperidone
16mg/day
Maximum dose of amisulpride
1200mg/day
Maximum dose of aripiprazole
20mg/day
Maximum dose of flupentixol
400mg/week
Maximum dose of zuclopenthixol depot
600mg/week
Maximum dose of haloperidol depot
300mg every 4 weeks
Which psychiatric problem is maternal smoking most associated with?
ADHD
Conduct Disorder
How many people with LD do not have an identifiable cause?
60%
Who divided schizophrenia into Type I and Type II?
Crow
Type I of schizophrenia
+ve sx
Type II of schizophrenia
-ve sx
What was suggested to cause Type I schizophrenia
Excess D2 receptors S
What was suggested to cause Type II schizophrenia?
Structural abnormality
Half-life (hours) of Diazepam
20-100
Half-life (hours) of clonazepam
18-50
Half-life (hours) of chlordiazepoxide
5-30
Half-life (hours) of nitrazepam
15-38
Half-life (hours) of temazepam
8-22
Half-life (hours) of lorazepam
10-20
Half-life (hours) of alprazolam
10-15
Half-life (hours) of oxzazepa
6-10
Half-life (hours) of zopiclone
5-6
Half-life (hours) of zolpidem
2
Half-life (hours) of zaleplon
2
Street names of Nephedrone
Meow Meow
M-Cat
White magic
Class of Mephedrone
Class B
What is Mephedrone structurally similar to?
Cathinone
Street names of Piperazines
BZP
Silver Bullet
Class of Piperazine
Class B
Street names of GBL
Liquid ecstacy
GBH
Class of GBL
Class C
What is GBL similar to?
Benzos
Baclofen
Alcohol
Street names of cannibinoids
Spice
Black Mamba
Class of synthetic cannibinoids
B
Street name of Benzofuran compounds
Benzo fury
Class of Benzofuran compounds
B
Most common anxiety disorder in ECA?
Phobia
How does Heroin bind to opiate receptors?
G-coupled
What is mania a potu?
Pathological intoxication
At what age can a child copy a triangle?
5
At what age can a child hop on one foot?
4
At what age can a child copy a cross?
4
At what age can a child feed themself?
3
At what age can a child speak 2-3 word sentences
2
At what age can a child run
2
At what age can a child climb up and down the stairs alone
2
At what age can a child speak 10-20 words
18 months
At what age can a child walk without assistance
18 months
Which TCA is most associated with discontinuation sx?
Imipramine
Which Class C drug can one possess for personal use?
Anabolic steroids
Withdrawal features of opioids
Piloerection Insomnia Dilated Pupils Yawning/sweating Abdominal cramps
Withdrawal features of amphetamines and cocaine
Hypersomnia
Hyperphagia
Depression/irritability/agitation
Vivid Dreams
Withdrawal features of ecstasy
Depression/insomnia
Depersonalisation/derealisation
Withdrawal features of cannabis
Insomnia
Reduced appetite
Irritability
Withdrawal features of hallucinogens
None
Withdrawal features of ketamine
None
Effects of opioids
Euphoria
Drowsiness
Pupil constriction
Respiratory depression
Effects of amphetamine and cocaine
Increased energy Insomnia Euphoria Paranoia Reduced appetite
Effects of MDMA/ecstasy
Increased energy & sweating
Jay Clenching
Euphoria
Increased response to touch
Effects of cannabis
Relaxation
Intensified sensory experience
Paranoia/anxiety
Injected conjunctivae
Effects of Hallucinogens
Perceptual changes Pupil dilatation Tachy/sweating Palpitations Tremors Incoordination
Effects of ketamine
Euphoria Dissociation Ataxia Hallucinations Muscle rigidity
Street names of Ketamine
Vitamin K Super K Special K K Green Donkey dust
Street names of hallucinogens
Trips Tripper Tab Stars Similies Rainbows Paper
Street names of cannabis
Grass
Mull
Cone
Chronic
Street names of ecstasy
XTC E Eccies Pills Adam Many
Street names of amphetamine
Ice
Uppers
Street names of Cocaine
Snow
Rock
Street names of opioids
Smack Horse Junk Skag Brown Harry H
What does Gudjonsson scale assess?
Suggestibility
Which gender develop conduct disorder at a younger age?
Males
What is each item of PANSS scored out of?
7
How many patients with Dementia are <65?
2%
What are the SCOFF questions?
Do you ever make yourself Sick because you feel uncomfortably full?
Do you ever worry that you have lost Control over how much you eat?
Have you recently lost more than One stone in a three month period?
Do you believe yourself to be Fat when others say you are too thin?
Would you say Food dominates you life?
What SCOFF score indicates likely ED?
2 or more
What are the cortical dementias?
Alzheimers
Picks
CJD
What does ADI-R stand for?
Autism Diagnostic Interview-Revised
What is ADI-R?
Semi-structured interview of caregivers of individuals with autism
What does ADOS-G stand for?
Autism Diagnostic Observation Schedule-Generic
What is ADOS-G?
Semistructured use of observational schedules
What does AAA stand for?
Adult Asperger Assessment
What does AAA consist of>
2 screening instruments; Autism-Spectrum Quotient & Empathy Quotient
1 clinician-conducted diagnostic questionnare; Adult Asperger Assessment
What does ASDI stand for
Asperger Syndrome Diagnostic INterview
What is ASDI
Investigator-based interview developed for assessment of Aspergers in adults and children.
What does ASDI consist of
Structured interview, 20 items divided into 6 behaviour areas
What does RAADS-R stand for
Ritvo Autism Asperger Diagnostic Scale Revised
What does RAADS-R consist of?
80-item self-rating scale for adults with averege/above average IQ
Best antipsychotics if hyperprolactinaema
Aripiprazole
Quetiapine
Olanzapine
After what age is enuresis diagnosed
5
Which model of the mind includes the id, ego and superego?
Structural
Prevalence of early onset schizophrenia
1 in 1000
What proportion of completed suicide occur in people >65?
20%
Risk of suicide following episode of DSH?
0.5-1.5%
What do the Maudsley guidelines advice re augmentation with clozapine?
Amisulpride Aripiprazole Haloperidol Lamotrigine Omega-3-triglycerides Risperidone Sulpiride Topiramate Ziprasidone
What drugs are specifically advised not to be augmented with clozapine?
Pimozide
Olanzapine
Options if clozapine ineffective
Allopurinol + antipsychotic Max dose amisulpride Max dose aripiprazole D-Alanine and D-Serine ECT High dose olanzapine
What stage of sleep do night terrors occur?
4
Duration of sx for diagnosis of schizophrenia?
1 months
Prevalence of OCD per 1000
19
Prevalence of avoidant PD per 1000
8
Prevalence of schizoid PD per 1000
8
Prevalence of paranoid PD per 1000
7
Prevalence of BPD per 1000
7
Prevalence of antisocial PD per 1000
6
Prevalence of dependent PD per 1000
1
Prevalence of schizotypal PD per 1000
1
% neutropenia risk for clozapine
3%
% agranulocytosis risk for clozapine
1%
Treatment for refractory depression
Add lithium ECT Add T3 (tri-iodothyronine) Combined use of olanzapine and fluoxetine Add quetiapine to an SSRI or SNRI Add risperidone Add aripiprazole Bupropion and SSRI SSRI and venlafaxine, mirtazapine, or mianserin
Prevalence of conduct disorder in 5-15 year olds
5%
Prevalence of anxiety and depression in 5-15 year olds
4%
Prevalence of hyperactive disorder in 5-15 year olds
1%
Prevalence of autism in 5-15 year olds
0.5%
Prevalence of tic disorder in 5-15 year olds
0.5%
Prevalence of ED in 5-15 year olds
0.5%
Is hypersalivation from clozapine dose related?
No
Which LD has cluttered speech?
Fragile X
Most common anxiety disorder in National Comorbidity survey
Specific phobia
Which medication is licensed for self-mutilating behaviour?
Lithium
What is asthenic PD?
Dependent PD
Which depot antipsychotic can be used as prophylaxis for mania?
Haloperidol
According to the ECA, which disorder was found to be most prevalent?
Substance misuse
Which SSRIs are licensed for treatment of OCD in young people
Sertraline
Fluvoxamine
What is needed for diagnosis of HIV?
p24 antigen
First line investigation to help differentiate type of dementia
HMPAO SPECT
2nd line investigation for differentiating type of dementia
FDG PET
Who created IPT?
Sullivan
Which antipsychotics are recommended when avoiding TD?
Clozapine
Quetiapine
Antipsychotics not associated with high prolactin?
Clozapine Aripiprazole Quetiapine Olanzapine Ziprasidone
Which family therapy concentrates on communication?
Strategic
