PASTest

Question 1

what is EUPD typified by?

Answer 1

explosive interpersonal relationships
lack of identity
unstable moods
impulsiveness

Question 2

splitting defence mechanism?

Answer 2

immature defence mechanism
unable to reconcile both good/bad traits in a given person

Question 3

dissociation

Answer 3

immature ego defence where one person’s identity is temporarily and drastically modified to avoid distress

Question 4

Deprivation of liberty
how long can it apply?

Answer 4

7 days
care home / hospital

Question 5

what is an AMHP and what role do they play in section 2

Answer 5

approved mental health professional

> Can decide whether a person can be detained under mental health act (section 2)

Question 6

medication for PTSD

Answer 6

paroxetine / sertraline

only if not having trauma focused psychological treatment

venlafaxine can be given

12 months > gradually withdrawn over 4 weeks

Question 7

what therapy for combat focused PTSD?

Answer 7

trauma based CBT
psychoeducation, dealing with hyperarousal and flashbacks and processing trauma related emotions

Question 8

postpartum blues

Answer 8

50% of females experience it
fatigue
tearful
depressed affect

resolves 10-14 days following birth

Question 9

postpartum depression

Answer 9

2 weeks of depressed mood
begins 4 weeks of delivery

5 symptoms:
change in sleep
guilt
loss of interest
decreased energy
diff concentrating
sluggishness
suicidal ideation

Question 10

how many women get postpartum depression?

Answer 10

10%

Question 11

how many women get postpartum psychosis?

Answer 11

0.1%
hallucinations and delusions present

Question 12

what is regression?

Answer 12

immature ego defence where you act like a child / revert to childish behaviour

in setting of stress

regressed to toddler

Question 13

flooding refers to?

Answer 13

term in behavioural therapy
exposed to worse fear aims to trigger desensitisation

Question 14

how long does a 5(2) last?

Answer 14

needs a dr to do it
72 hours

Question 15

what are scheider’s frist rank symptoms?

Answer 15

Auditory hallucinations
>3rd person commentary
>thought echo
>running commentary

Thought disorder
>Broadcast
>Withdrawal
>insertion

passivity phenomena

delusional perception
2 stage
normal object percieved then delusional insight into object

Question 16

Poor prognostic indicator for Schizophrenia?

Answer 16

strong family history
gradual onset
low IQ
prodrome of social withdrawa;
lack of obvious precipitant

Question 17

section 136 can be used to?

Answer 17

detain from a public place - shopping centre etc

by police

for mental health concern

Question 18

coping mechanism: Avoidance

Answer 18

just avoiding the problem pretending it does not exist
continue their behaviour as if the stressor is not present

Question 19

hypofunction of ___ is associated with schizophrenia

_____ cerebral ventricles are also present

Answer 19

prefrontal cortex

enlarged

Question 20

Korsakoff’s amnesia

Answer 20

severe deficiency in thiamine vitb1

= bilateral loss of mammilary bodies in the brain

Question 21

what is beri beri?

Answer 21

b1 defiency
polyneuritis
muscle waste
dilated cardiomyopathy

Question 22

Niacin Vit b3

Answer 22

can lead to pellagra

Question 23

how to report on speech? in MSE

Answer 23

rate
rhythm
volume

Question 24

how to treat folie a deux

Answer 24

shared delusional disorder
1st step is to separate patients

Question 25

acute schizophrenia how to manage?

Answer 25

commence an atypical antipsychotic olanzapine but this takes 10 days to work so sedative might be needed - short acting benzodiazepine -Lorazepam procyclidine can help with acute dystonia

Question 26

social learning?

Answer 26

modelling behaviour pattern acquired by watching other people then assimilating their actions

Question 27

diagnostic criterion for anorexia nervosa?

Answer 27

an intesne fear of gaining weight becoming fat

Question 28

violence and schizophrenia?

Answer 28

people with schizophrenia are responsible for 20th of homicides 5% compared to general popupulation 1%

Question 29

alcohol abuse what kind of therapy is best?

Answer 29

group self help

Question 30

interpersonal therapy is best for?

Answer 30

depression - prolonged grief

Question 31

when would psychoanalytic psychotherapy be best

Answer 31

deep rooted problems that did not respond to interpersonal therapy

Question 32

neuroleptic malignant syndrome

Answer 32

antipsychotic extreme side effect fever muscular rigidity delirium hypertensions

Question 33

schizophrenia stats

Answer 33

20 million people worldwide have it 1% 46% in monozygotic 14% in dizygotic

Question 34

indications for ECT

Answer 34

severe catattonic stupor high risk of suicide psychotic features food refusal refractory to antidepressants previous response to ECT

Question 35

how long is a full course of ECT?

Answer 35

12 sessions you can

Question 36

what is displacement?

Answer 36

displacing your feelings on people not involved so if you are angry with partner but shout at cyclist on your way to work

Question 37

projection is?

Answer 37

when you assume someone is in the wrong when you actually are

Question 38

motivation interview: RULE

Answer 38

resist to employ a firm course of action understand reason for change in behaviour listen to ICE empower the patient that they can change their behaviour

Question 39

Indications for Clozapine?

Answer 39

more effective than conventional antipsychotic for resistant psychosis not used first line 30% of patients improve after 6 weeks of treatment 60% respond after a year

Question 40

hypersalivation - sialorrhoea how to treat?

Answer 40

common s/e of clozapine hyoscine - anticholinergic

Question 41

procyclidine is a?

Answer 41

anticholinergic helps with acute dystonia as a s/e of antipsychotic - more with typical

Question 42

evaluating a patients suicide risk

Answer 42

assess static and dynamic factors static: age, sex, previous history of self harm dynamic: drug use, self harm, employment status

Question 43

reward system hormone

Answer 43

dopamine anhedonia is when dopamine in the brian must be affected

Question 44

IQ - normal range

Answer 44

70-130 100 is average

Question 45

severe LD?

Answer 45

20-34 IQ

Question 46

moderate LD

Answer 46

35-49

Question 47

<20 IQ

Answer 47

profound LD

Question 48

diagnosing dependence - alcohol

Answer 48

strong sense / compulsion difficult in controlling how substance behvaiour happens so like how long you take it for/ when / where/ not being able to say no if you had planned to but now someone is offering it to you evidence of tolerance neglect of other interests persisting with substance despite clear evidence of harm

Question 49

what can make lewy body dementia worse?

Answer 49

haloperidol - first gen antipsychotics

Question 50

what can be used to treat lewy body dementia?

Answer 50

clonazepam - sleep donepezil - acth inhibitor to help with hallucinations memantine - if can't take donepezil rivastigmine - increases acetylcholine in brain

Question 51

acetylcholnesterase inhibitors

Answer 51

memantine donepezil rivastigmine increase levels of acetylcholine in brain

Question 52

Cocaine-induced delusional disorder

Question 53

what are the findings in Nephrogenic DI?

Answer 53

low urine osmolality but high serum osmolality DI associated with signs of dehydration because you are not able to retain/ reabsorb water postural drop in bp sodium - hypernatraemia

Question 54

Bipolar patient presenting with mania acutely unwell

Answer 54

check lithium levels consider adding an antipsychotic

Question 55

Dementia vs delirum how to differentiate in a&e

Answer 55

fluctuating consciousness indicates delirum

Question 56

when is paroxetine > citalopram

Answer 56

paroxetine is for a major depressive disorder