psych

Question 1

SSRI of choice in children and adolescents

Answer 1

fluoxetine

Question 2

Alcohol withdrawal results from —what chemical imbalance..?

Answer 2

decreased inhibitory GABA and increased NMDA glutamate transmission

Question 3

man with schizophrenia taking chlorpromazine develops an oculogyric crisis.

what s/e is this?

Answer 3

acute dystonia
sustained muscle contraction (e.g. torticollis, oculogyric crisis)

Question 4

symptoms may indicate mania rather than hypomania?

Answer 4

Delusions of grandeur

Question 5

section 135

Answer 5

allow them to remove a person from their property if they suspect they need a mental health assessment or treatment

Question 6

Benzodiazepines MOA

Answer 6

enhance the effect of GABA, the main inhibitory neurotransmitter

Question 7

patients with schizophrenia who have not responded adequately to at least 2 antipsychotics

WHAR drug to go for?

Answer 7

clozapine

Question 8

electolyte inbalance for Sertaline ssri

Answer 8

SSRIs are associated with hyponatraemia

Question 9

movement adverse effect of lithium?

Answer 9

fine tremor

Question 10

patient doesn’t want to take her schizophrenia meds, she does have capacity

what happens with her tx?

Answer 10

Rosie can be treated against her will under section 3, even if she has capacity

Question 11

Atypical antipsychotics commonly cause

Answer 11

weight gain

Question 12

hypochondrial vs somatisation vs conversion?

Answer 12

Conversion disorder - typically involves loss of motor or sensory function. May be caused by stress

Question 13

Imipramine for depression
s/e?

Answer 13

Question 14

useful clinical tool to differentiate organic from non-organic leg paresis

Answer 14

Hoover’s sign

Question 15

SSRI discontinuation syndrome

Answer 15

Dizziness, electric shock sensations and anxiety are symptoms of SSRI discontinuation syndrome

paroxetine

Question 16

SSRI of choice post myocardial infarction

Answer 16

sertraline

Question 17

person whose death occurs whilst under the mental health act,

mx?

Answer 17

Any person whose death occurs whilst under the mental health act, regardless of cause, must be reported to the coroner

Question 18

most often used first line for rapid tranquillization in acutely disturbed behaviour

Answer 18

Oral lorazepam

Question 19

antipsychotics in the elderly - increased risk

Answer 19

of stroke and VTE

Question 20

Tangentiality refers to …..

Answer 20

Tangentiality refers to wandering from a topic without returning to it

Question 21

what do you have to cover when prescribing a SSRI?

Answer 21

SSRI + NSAID = GI bleeding risk - give a PPI

Question 22

SECTION ACT: Allows the police to break into a property if someone appears to be mentally ill

Answer 22

section 135

Question 23

section Allows admission for 28 days

Answer 23

section 2

Question 24

Antipsychotics may cause severe restlessness

name the condition?

Answer 24

akathisia

Question 25

good response to antidepressant therapy they should continue on treatment for at least….

Answer 25

6 months

Question 26

section: Allows admission for treatment for up to 6 months

Answer 26

section 3

Question 27

Allows police to take someone who appears to be mentally ill from a public place to the Emergency Department

Answer 27

136

Question 28

section act? 72 hour assessment order for a patient who is not in hospital

Answer 28

section 4

Question 29

Under which section of the Mental Health Act (1983) could a GP detain a patient for emergency psychiatric assessment?

Answer 29

GPs may use Section 4 of the Mental Health Act (alongside an AMHP or NR) in order to transfer a patient as an emergency for psychiatric assessment

Question 30

classic somatic symptom of depression

Answer 30

Early morning waking is a classic somatic symptom of depression and often develops earlier than general insomnia.

Question 31

Acute dystonia secondary to antipsychotics is usually managed with

Answer 31

procyclidine

Question 32

first-line drug for generalised anxiety disorder

Answer 32

Sertraline

Question 33

which anti depressant….?…should be avoided in patients co-prescribed warfarin

Answer 33

citalopram

SSRI

Question 34

ECT is indicated in

Answer 34

life-threatening major depressive disorder, where catatonia in present

side note: example of catatonia : She did not co-operate with the assessment, seeming to ignore the team.