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Pyschiatry > Passmed wrong questions > Flashcards

Passmed wrong questions Flashcards

1
Q

What is Acute stress disorder

A

Acute (transient) stress reaction that occurs within the first 4 weeks after a traumatic event

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2
Q

TCA anticholinergic side effects

A

Anticholinergic: tachycardia, dry mouth, mydriasis and urinary retention

Remember - no cholinergic = no PSNS tf you can’t relax

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3
Q

What is not recommended in PTSD

A

Single-session interventions/debriefing

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4
Q

PTSD management (mild; severe)

A
  • Watchful waiting for mild symptoms lasting less than 4 weeks
  • CBT or eye movement desensitisation and reprocessing (EMDR) = first line
  • Venlafaxine/SSRI = 2nd line
  • Severe cases = risperidone
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5
Q

SSRI choice post MI

A

Sertraline - most evidence for safe use

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6
Q

What drug is clozapine

A

Atypical antipsychotic

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7
Q

Main risk of clozapine - how do we account for this

A

Agranulocytoisis - FBC monitoring needed

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8
Q

Clozapine side effects

A
  • Agranulocytosis
  • Reduced seizure threshold
  • Constipation
  • Myocarditis - do ECG before starting
  • Hypersalivation

C = constipation. lo = low WBC, Zap = myocarditis/seizures. Pine = saliv

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9
Q

Clozapine indication

A

If the use of 2+ antipsychotics still isn’t working in SCZ

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10
Q

Most likely SSRI to cause tornadoes de pointes

A

Citalopram - don’t use in patients with long QT

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11
Q

History of recurrent self harm and intense interpersonal relationships that alternate between idealisation and devaluation

A

Borderline personality disorder

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12
Q

Alcohol withdrawal timeframe

A

6-12 hours - symptoms
36 hours - seizures
72 hours - delirium tremens

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13
Q

ECT memory loss side effect

A

Retrograde amnensia

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14
Q

SSRI weaning period

A

4 week period of dose reduction

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15
Q

SSRI with most discontinuation symptoms

A

Paroxetine

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16
Q

SSRI discontinuation symptoms

A

PG DRUMS:
- Paraesthesia
- GIT: pain, cramping, D&V
- Difficulty sleeping
- Restlessness
- Unsteadiness
- Mood changes
- Sweating

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17
Q

What is akathisia

A

Inner restlessness and inability to keep still

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18
Q

What is acute dystonia

A

Sustained muscle contraction:
- Spasms of facial muscles
- Torticollis
- Oculogyric crisis

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19
Q

What is tardive dyskinesia

A

Late onset of abnormal involuntary movements e.g. licking lips or pouting of jaw

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20
Q

How is acute dystonia managed

A

Procyclidine

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21
Q

Common atypical antipsychotic side effects

A

Metabolic e.g. weight gain and hyperprolactinaemia

22
Q

Schizophrenia management

A

Oral atypical antipsychotics = first line
CBT offered to all patients

23
Q

SCZ comorbidities

A

Cardiovascular disease ∴ monitor patients - due to antipsychotics and smoking

24
Q

Supportive psychotherapy vs CBT

A
  • SP: Enhances self esteem, reduces anxiety and improves adaptive skills
  • CBT: Helps patients deal with the way they think and behave
25
Q

How is OCD severity measured

A

Yale brown Obsessive compulsive scale

26
Q

What is mild OCD

A

Symptoms for less than one hour per day with minimal impact on daily living

27
Q

Mild OCD management

A
  • CBT including exposure and response prevention (ERP)
  • Can then offer additional SSRI or more intense CBT including ERP
28
Q

Which disorder is associated with a history of recurrent self-harm and intense interpersonal relationships that alternate between idealization and devaluation

A

BPD/EUPD

29
Q

SSRI associated with long QT

A

Citalopram - can cause torsades du pointes - sertraline and fluoxetine may also cause to but citalopram = big boy

It sertainly floxuates but citalopram is causing it…

30
Q

PSTD first line

A
  • ?Watchful waiting if mild (<4 weeks of symptoms)
  • Trauma-focused CBT and EMDR
31
Q

PSTD second line

A

Venlafaxine or SSRI

32
Q

PSTD severe cases management

A

Risperidone

33
Q

TCA antimuscarinic effects

A

Dry mouth
Blurry vision
Constipation
Urinary retention

34
Q

GAD drug treatment

A
  • Sertraline
  • If that doesnt work - offer alternative SSRI or SNRI
  • If that doesn’t work - offer pregabilin
35
Q

Alcohol withdrawal management

A

Decreasing doses of long-acting benzos: chlordiazepoxide or diazepam
- Offer lorazepam with hepatic failure

  • Carbamazepine may also work
36
Q

SSRI of choice in children

A

Fluoxetine

37
Q

Physical findings of anorexia nervosa

A
  • Lanugo hair
  • Failure of secondary sexual characteristics
  • Bradycardia
  • Cold intolderance
  • Yellow tinge - hypercarotenemia
  • Enlarged salivary glands
38
Q

Memory loss in depression vs dementia

A

Severe depression may cause global memory loss whereas dementia causes short-term memory loss

39
Q

Why should SSRIs never be used with MAOIs

A

MAOIs prevent serotonin breakdown therefore cause serotonin syndrome

40
Q

What is illness anxiety disorder (hypochondriasis)

A

Persistent belief in the presence of an underlying serious disease

41
Q

Hypochondriasis vs somatisation disorder

A

Somatisation disorder - focus on unexplained symptoms for at least 2 years and rejection of reassurance

Hypochondriasis - they have symptoms but are convinced of a specific underlying disease e.g. cancer

Soma = Symtpoms
Chrondriasis = Cancer

42
Q

What is cluster A of personality disorders

A

Odd or eccentric:
- Paranoid
- Schizoid
- Schizotypal

43
Q

Schizotypal features

A

Ideas of reference
Odd beliefs about magical thinking
Unusual perceptual disturbances
Paranoia
Odd/eccentric behaviour
Social pariah
Inappropriate affect
Odd speech with incoherency

44
Q

Less severe depression management

A

Guided self help before offering CBT

45
Q

Patients ≤25 who have been started on an SSRI should be reviewed when?

A

After 1 week due to increased risk of suicide. Nb/ Normally review after 2 weeks for older people

46
Q

What is catatonia

A

Stopping of voluntary movement/staying in an unusual position

47
Q

Anorexia nervosa biochemistry

A

Most things are low but Gs and Cs raised:
- GH
- Glucose
- salivary Glands
- Cortisol
- Cholesterol
- Carotinaemia

48
Q

Important SSRI interactions

A
  • NSAIDs - GI bleeding risk ∴ give PPI
  • Warfarin/heparin - offer mirtazapine instead
  • Aspirin
  • Triptans - risk of serotonin syndrome
  • MAOIs
49
Q

Difference between Knight’s move and flight of ideas

A

Knight’s move thinking there are illogical leaps from one idea to another, flight of ideas there are discernible links between ideas

50
Q

What is circumstantiality

A

Inability to answer question without going into excess detail - however the question ends up being answered

Pyschiatry (6 decks)

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