Psych

Question 1

Generalised Anxiety disorder mx:

Answer 1

Sertraline

Question 2

Continuation of anti-depressants:

Answer 2

• should be continued 6 months AFTER remission(symptoms are better, not from when medication was commenced)

Question 3

side effects of clozapine:

Answer 3

• Agranulocytosis (decreased leukocytes= neutropenia)
• weight gain
  -myocarditis
  -arrhythmias

Question 4

Cotard syndrome:

Answer 4

Patient thinks they are dead and self-neglects health.

Question 5

SSRI of choice in children and teens(17 yrs included):

Answer 5

• Fluoxetine

Question 6

Managing mania/hypomania in patients ALREADY on SSRIs:

Answer 6

Consider STOPPING the medication and then starting anti-psychotic for eg. olanzapine
- stopping SSRI is important as it may worsen mania symptoms.

Question 7

EUPD Mx:

Answer 7

Dialectival BEHAVIOUR therapy

Question 8

PTSD Mx:

Answer 8

EMDR (Eye movement desensitisation therapy

Question 9

OCD: (severe)-

Answer 9

• SSRI (sertraline)
  of exposure and response therapy

Question 10

Stopping SSRI:

Answer 10

Should be stopped GRADUALLY over 4 weeks (weaned down from the original amount)

Question 11

SSRI Discontinuation symptoms:

Answer 11

• increased mood change
  -restlessness
  -difficulty sleeping
  -unsteadiness
  -sweating
  -gastrointestinal symptoms: pain, cramping, diarrhoea, vomiting
  paraesthesia

Question 12

what are SSRIs associated with? (electrolyte imbalance)

Answer 12

HYPOnatraemia (low sodium)
- other side effects: GI symptoms, increased risk of GI bleeding,

Question 13

what medication should be avoided with SSRI?

Answer 13

Triptans eg. Sumatriptan (to prevent getting serotonin syndrome as triptans are serotonin receptor agonists.

Question 14

After increasing dose of lithium, when should you next check lithium levels?

Answer 14

1 week and then weekly after than until the levels are stable.
Once established, need to be checked every 3 months.

Question 15

Schizoid personality disorder characteristics:

Answer 15

Prefers to be alone, doesn’t like relationships, low libido

Question 16

Chronic lithium toxicity causes which endocrine condition?

Answer 16

Hypothyroidism

Question 17

Pseudohallucinations?

Answer 17

Are more common after bereavement and do not portray an actual psychosis.

Question 18

how long to continue SSRIs for once remission of symptoms?

Answer 18

Continue SSRIs for 6 months after remission of symptoms

Question 19

Panic attacks Mx:

Answer 19

Sertraline (similar to Generalised Anxiety Disorder)

Question 20

TCA’s side effect:

Answer 20

for eg. Amitriptylline= can cause urinary retention, dry mouth, blurred vision, constipation, drowsiness

Question 21

how does OCD differ from Psychosis?

Answer 21

• by level of insight into their condition