Pathology

Question 1

describe disruptive mood dysregulation disorder

Answer 1

onset before age 10.
severe, recurrent temper outbursts out of proportion to situation
child is irritable and angry in-between outbursts

Question 2

describe intermittent explosive disorder

Answer 2

onset after age 6
recurrent verbal or physical outbursts representing a failure to control aggressive impulsives
outbursts < 30 mins, provide a sense of relief and feel remorseful afterwards

Question 3

what part of the brain is affected in korsakoffs and what type of amnesia does it predominantly cause

Answer 3

antegrade amnesia (unable to form new memories)
limbic system mainly mammillary bodies and anterior thalamus

Question 4

what is dissociative amnesia

Answer 4

unable to recall important personal information i.e. name after severe trauma or stress

Question 5

what is dissociative identity disorder

Answer 5

presence of 2 or more distinct identities or personality states, typically with distinct memories and patterns of behaviour

Question 6

diagnostic criteria for schhizophrenia

Answer 6

2 or more of the following symptoms of which 1 or more have to be from symptoms 1-3

delusions
hallucination
disorganized speech
disorganised or catatonic behaviour
negative symptoms

Question 7

changes on imaging you may find in schizophrenia

Answer 7

ventriculomegaly on brain imaging

Question 8

hormonal change in schizophrenia

Answer 8

reduced dopamine
increased serotonin

Question 9

schizoaffective disorder

Answer 9

shares symptoms with both schizophrenia and mood disorders
must have psychotic symptoms for > 2 weeks without depressive or manic episode. if psychosis coincides with mood episode then = mood disorder with psychotic features

Question 10

bipolar I vs bipolar II

Answer 10

bipolar I = 1 manic episode +/- hypomanic or depressive episode

bipolar II = a hypomanic and a depressive episode

Question 11

diagnostic criteria for manic episode

Answer 11

marked functional impairment with 3 or more of the following for 1 week or more
DIG FAST
Distractibility
Impulsivity
Grandiosity
Flight of ideas
increased goal directed Activities / psychomotor Agitation
decreased need for Sleep
Talkativeness / pressured speech

Question 12

illusion vs delucsion

Answer 12

illusion is a misperception of a real stimuli
hallucinations are perceptions in the absence of an external stimuli

Question 13

side effects and contraindications to ECT

Answer 13

side effects; headache, retrograde or antegrade amnesia, disorientation

contraindications: none (safe in pregnancy and older adults)

Question 14

what is adjustment disorder

Answer 14

emotional or behavioural symptoms that occur within 3 months of an identifiable psychosocial stressor lasting < 6 months after the stressor has been removed

Question 15

symptoms of PTSD

Answer 15

hyperarousal
re-experiencing of event
avoidance of associated stimuli
change in cognition or mood

Question 16

what is agoraphobia

Answer 16

irrational fear, anxiety and/or avoidance whilst anticipating 2 or more situations where they feels they may not be able to escape or help isnt available i.e. trains, elevators, queues, etc

Question 17

what is trichotillomania

Answer 17

compulsively pulling out ones own hair. causes significant stress but persists despite attempts to stop.

Question 18

malingering vs factitious disorder

Answer 18

malingering - consciously fakes symptoms etc to attain a specific secondary - external gain i.e. time off work

factitious- consciously creates a phsyical disorder in order to attain sick role and gain medical attention (primary - internal again)

Question 19

what is conversion disorder

Answer 19

also called functional neurological symptom disorder
unexplained loss of motor or sensory function often following an acute stressor

Question 20

biochemistry abnormalities seen in refeeding syndrome

Answer 20

low P04, Mg and K

Question 21

complications associated with refeeding syndrome

Answer 21

electrolyte disturbance
cardiac complications
rhabodmylysis
seizures

Question 22

biochemistry abnormalities seen in bulimia

Answer 22

low k, low Cl
metabolic alkalosis

Question 23

pathophysiology of nacrolepsy

Answer 23

reduced orexin (hypocretin) production in lateral hypothalamus and dysregulated sleep-wake cycles

Question 24

what are the stages in the transtheoretical model of change

Answer 24

precontemplation
contemplation
preparation/determination
action/willpower
maintenance
re-lapse

Question 25

features of serotonin syndrome

Answer 25

3 A’s
increased Activity (i.e. seizures, clonus, tremor, hyperreflexia, hypertonia)
Autonomic intability (i.e. hyperthermia, diaphoresis, diarrhoea)
Altered mental status

Question 26

1st line treatment for serotonin syndrome

Answer 26

benzodiazepines + supportive care

Question 27

treatment for hypertensive crisis associated with MAO inhibitors

Answer 27

phentolamine

Question 28

cause of hypertensive crisis

Answer 28

eating tyramine rich foods whilst taking MAO inhibitors or switching too quick to another antidepressant from MAO inhibitor without washout period

Question 29

features of neuroleptic malignant syndrome

Answer 29

Malignant FEVER
myoglobinuria
fever
encephalopathy
vitals unstable
increased enzymes (CK)
muscle rigidity

Question 30

treatment for neuroleptic malignant syndrome

Answer 30

dantrolene
dopaminergics i.e. bromocriptine, amantadine

Question 31

cause of neuroleptic malignant syndrome

Answer 31

antipsychotics (typical > atypical) and genetic predisposition

Question 32

treatment for acute dystonia

Answer 32

benztropine or diphenhydramine