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Fourth Yerar > PSYCH > Flashcards

PSYCH Flashcards

1
Q

What class of drug is Mirtazapine

A

Noradrenergic and specific serotonergic antidepressant

Targets certain serotonin receptors to increase levels of noradrenaline and serotonin

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2
Q

3 examples of SSRIs

A

Fluoxetine

Sertraline

Paroxetine

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3
Q

3 examples of SNRIs

A

Serotonin-noradrenaline reputable inhibitors

Inhibit reuptake of BOTH serotonin and noradrenaline so the body makes more

Venlafaxine

Duloxetine

Desvenlafaxine

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4
Q

3 examples of MAOIs

A

Monoamine Oxidase Inhibitors

Inhibit MO enzymes which break down neurotransmitters such as norepinephrine, dopamine, serotonin -> increased levels in brain

Phenelzine
Tranylcypromine
Isocarboxazid

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5
Q

What is flight of ideas and what condition is it a feature of

A

Patient speaks very quickly

Rapidly jumps between topics but there is a link between the topics

Feature of mania

If no links think Knight’s move thinking- loosening of association linked with schizophrenia

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6
Q

Give 3 examples of an atypical antipsychotic

A

Clozapine

Olanzapine

Quetiapine

COQ

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7
Q

What MH drug can you not take Triptans with

A

SSRI’s

Triptans are migraine and cluste headache relief

Serotonergic activity in both

Presents with e.g. tachycardia, hyperthermia, restless, confused

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8
Q

How do you discern between paranoid personality disorder and schizotypal personality disorder

A

Both can have suspicious and mistrust of the world

PPD is more ‘positive’ symptoms such as perceived threats to individual

SPD is more ‘negative’ e.g. lack of social integration whilst holding odd beliefs e.g. neighbors in a cult

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9
Q

Which generation of antipsychotics would you experience acute dystonic reaction with

A

First-generation

Dystonia is involuntary muscle movements

E.g. torticollis, oculogyric crisis

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10
Q

How to discern between antisocial personality disorder and borderline personality disorder

A

Both have impulsivity as key feature

Antisocial is repeated failure to conform to social norms and disregard for safety

Borderline is unstable affect with fluctuating self image and recurrent suicidal ideation

Antisocial is far more common in men, borderline is far more common in women

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11
Q

4 risk factors for GAD

A

35-54
Divorced/ separated
Living alone
Being a lone parent

Being 16-24 is protective

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12
Q

What kind of therapy is effective for borderline personality disorder

A

Dialectical behavior therapy

Focus on controlling strong emotional reactions

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13
Q

Adverse effects of clozapine

A

Agranulocytosis and neutropenia is a life threatening side effect

Reduced seizure threshold

Constipation

Myocarditis (baseline ECG taken before tx)

Hypersalivation

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14
Q

What do you give in alcohol withdrawal

A

Decreasing doses of long-acting benzodiazepines

E.g. diazepam or chlordiazepoxide

Long-term use of alcohol leads to upregulation of excitatory glutamate receptors (inhibits the excitatory effect of glutamate) and downregulation of GABA receptors (more GABA which is depressive)

If alcohol stops, then the inhibition of the glutamate stops and so the sympathetic nervous system becomes overactive presenting with restlessness, sweaty, tremors etc

Long-acting benzodiazepines potential GABA so slow down the nervous system

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15
Q

What is it called when patients intentionally create symptoms e.g. causing hypoglycemia

A

Munchaunsen’s syndrome

Aka fictitious disorder

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16
Q

How do you manage acute dystonia secdonary to antipsychotics

Vs how do you manage tardive dyskinesia when you have been taking antipsychotics for several years

A

TArdive dyskinesia- have been TAking antipsychotics for several years -> give Tetrabenezine

Acute dySTonia common when STarting antipsychotics- give Procyclidine

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17
Q

When commencing lithium treatment, when should lithium levels be monitored

A

Weekly

And always checked 12 hours post-dose

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18
Q

What drug is given to deter people from drinking and how does it work

A

Disulfiram (Antabuse)

Inhibitor of acetaldehyde dehydrogenase- build up of acetaldehyde reacts with alcohol to vomit violently

Severe Sx so prescribe carefully

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19
Q

What drug do you give to stop alcohol cravings

A

Acamprosate (Campral)

Take 3 times a day

Mechanism unclear

Minimal side-effects and can take with alcohol

OR ALSO GIVE LOMG ACTNIG BENZO

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20
Q

What is an alternative opiate replacement therapy to methadone (sublingual tablet)

A

Buprenorphine

Less sedating than methadone

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21
Q

What mechanism of action is duloxetine

A

Serotonin and noreadrenaline reuptake inhibitor

Dulo= duel

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22
Q

Which antidepressants give the following side effect:

Can’t see cant pee, cant spit cant shit

A

Tricyclic antidepressants especially ones that antagonise muscarinic receptors

E.g. imipramine

Blurred vision
Urinary retention -> incontinence
Dry mouth
Consolation

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23
Q

What do you give in PTSD if CBT or EMDR therapy is ineffective

A

SSRI or Venlafaxine (SNRI)

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24
Q

What type of memory loss can come from ElectroConvulsive Therapy

A

Retrograde amnesia (can’t remember past)

Not anterograde (cant form new memories)

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25
Q

What do u give in treatment of delirium tremens/alcohol withdrawal

A

Chlordiazepoxide or diazepam

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26
Q

symptoms of SSRI discontinuation syndrome

A

Anxiety, restlessness
Dizziness
Electric shock sensations
Difficulty sleeping
Unsteadiness
GI symptoms

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27
Q

First line tx of mild ocd

A

exposure and response prevention (ERP) therapy.

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28
Q

Common side effect of long-term lithium

A

hyperparathyroidism and resultant hypercalcaemia

stones, bones, abdominal moans, and psychic groans’.

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29
Q

How could myocarditis secondary to clozapine use present

A

general malaise over the last few days with accompanying chest pain. He looks uncomfortable and sweaty on the bed.

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30
Q

What side effects can mirtazipine cause that may be helpful

A

Sedation and increased appetite

So often used in insomniacs who have bad appetite

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31
Q

What do you give in moderate/ severe ocd when SSRIs don’t work

A

clomipramine

A tricyclic antidepressant- the only one liscenced

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32
Q

What class is mirtazapine

A

Alpha-2 receptor antagonist

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33
Q

How long do Sx need to be to diagnose chronic insomnia

A

3 months

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34
Q

Which syndrome do patients think they’re dead

A

Cotard

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35
Q

Wht is PTSD when its less than 4 weeks after the event an how do you treat

A

Acute stress disorder

Trauma-focused CBT first line

Sometimes benzos used first line in sleep disturbance etc

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36
Q

Which personality disorder only displays the negative symptoms of schizophrenia

A

Schizoid

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37
Q

What is the difference between Wernicke’s encephalopathy an Korsakoff’s syndrome and how do they each present

A

Korsakoff’s is a complication of Wernicke’s encephalopathy

Both effects of alcohol

Wernicke’s=
- Opthalmoplegia (weakened eye muscles)
- Confusion
- Ataxia

Korsakoff’s=
- anterograde amnesia (forgets previous interactions)
- confabulation (making up 2 different stories about day)

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38
Q

Timing of alcohol withdrawal:
- symptoms
- seizures
- delirium tremens

A

symptoms: 6-12 hours
seizures: 36 hours
delirium tremens: 72 hours (hallcinations, tachycardia, hypertension, hypertermia, agitation, diaphoresis)

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39
Q

Symptoms of delirium tremens (72 hours after alcohol withdrawal- 3 days)

A

hallcinations, tachycardia, hypertension, hypertermia, agitation, diaphoresis

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40
Q

How do you manage acute dystonia secondary to antipsychotics

A

Procyclidine

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41
Q

Which SSRI in kids

A

fluoxetine

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42
Q

How does serotonin syndrome present

A

Autonomic hyperactivity (hyperthermia, sweating)

Neuromuscular abnormalities (hyperreflexia and rigidity)

Often due to SSRI and MAOI combination (e.g. Sertraline and Selegiline)

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43
Q

Which SSIR is the most likely to cause ECG abnormalities such as QT prolongation and Torsades de pointes

A

Citalopram

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44
Q

Which blood test is raised in alcohol

A

Gamma GT (Gamma glutamyl transferase)

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45
Q

What class is escitalopram

A

SSRI

Second line after sertraline

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46
Q

What is Hoovers sign

A

It is performed by having the patient lie supine and then asking them to flex the hip of the affected leg against resistance. If the patient has an organic weakness, the examiner will feel pressure on the heel of the unaffected leg as the patient involuntarily extends the hip to compensate for the weakness. If the patient has a non-organic weakness, the examiner will not feel any pressure on the heel of the affected leg.

Normal people exert opposite pressure when extending one leg, psychogenic people don’t

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47
Q

Conversion vs somatisation

A

Conversion disorder, also known as Functional Neurological Symptom Disorder (FNSD), is characterised by neurological symptoms such as weakness, paralysis, sensory loss or seizures. These symptoms are often inconsistent with known neurological or medical conditions. The key feature of conversion disorder is the presence of a ‘conversion’ mechanism, where psychological distress is believed to be converted into physical symptoms.

On the other hand, Somatisation disorder (now more commonly referred to as Somatic Symptom Disorder under DSM-5) involves multiple unexplained physical complaints across different organ systems including pain, gastrointestinal symptoms like nausea, sexual symptoms and pseudoneurological complaints that persist for years. This condition usually begins before age 30 and occurs more frequently in women. It’s thought to represent a maladaptive way of expressing emotional distress through physical symptoms.

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48
Q

Knights move vs 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

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49
Q

What is the main risk factor associated with SSRI use in the first trimester

A

Small increased risk of congenital heart defects

Weigh up risks and benefits

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50
Q

What is the main risk factor associated with SSRI use in the third trimester

A

Persistent pulmonary hypertension of the newborn

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51
Q

What is the risk of using paroxetine in the first trimester

A

Congenital malformations

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52
Q

What class is Rasagiline

A

Monoamine oxidase inhibitor (MAOI)

Only really used if other meds aren’t working/ are contraindicated

Should never be combined with SSRIs

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53
Q

Meds hierarchy for GAD

A

SSRI 1 e.g. sertraline

SSRI 2 e.g. citalopram

SNRI 3 e.g. duloxetine

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54
Q

How does medical management differ for GAD and panic disorder

A

Both start with SSRIs

If they dont work then

In PD you give imipramine or clomipramine (tricyclic antidepressants)

In GAD you give duloxetine (SNRI)

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55
Q

What is more suggestive of schizophrenia: low appetite or insomnia

A

Insomnia

Circadian rhythm disturbance

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56
Q

In which atypical antipsychotic would you want to arrange a full blood count if they had an infection

A

Clozapine

Agranulocytosis/ neutropenia is a life-threatening side effect of clozapine

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57
Q

3 core Sx of depression

A

Low mood

Low motivation (anhedonia)

Low energy (anergia)

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58
Q

What is the most common endocrine side effect of chronic lithium toxicity

A

Hypothyroidism

Can lead to feeling more tired, reduced appetite and constipation

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59
Q

Do you give lithium or antipsychotics in (hypo)manic episodes

A

antipsychotics

Give lithium to prevent their reoccurrence

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60
Q

In which antipsychotic should you take care when quitting smoking

A

Clozapine

Smoking cessation can cause a rise in clozapine blood levels

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61
Q

Which finding is positive in Hoover’s sign

A

No contralateral movement is a positive finding

This suggest functional cause vs organic

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62
Q

What is the mainstay in managing personality disorders

A

Dialectical behavior therapy

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63
Q

Side effects of clomipramine (4)

A

Dry mouth
Blurred vision
Urinary retention
Weight gain

It is a tricyclic antidepressant

Can’t see cant pee can’t shit can’t spit

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64
Q

NSAID and SSRI what is the risk

A

GI bleeding

Give a PPI

It is though that SSRI may deplete platelet serotonin leading to a reduction in clot formation so increased risk of bleed

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65
Q

FIRM STOP acronym for SSRI discontinuation syndrome

A

Discontinuation Syndrome (FIRM STOP)
Flu like Sx
Insomnia
Restlessness
Mood swings
Sweating
Tummy problems (pain, cramps, D+V)
Off balance
Parasthaesia

66
Q

Which antipsychotic decreases seizure threshold

A

Clozapine

67
Q

What class of drug is Venlafaxine

A

SNRI

68
Q

What is the timeframe for lithium level checking after a change in dose

A

After a change in dose, lithium levels should be taken a week later and weekly until the levels are stable

Once levels are stable they can be checked every three months.

69
Q

Side effects of zopiclone

A

Increased fall risk

  • agitation
  • constipation
  • decreased muscle tone
  • dry mouth
  • bitter taste in mouth

Similar to benzos

70
Q

Zopiclone mechanism of action

A

Binds to GABAa-containing receptors (the α2-subunit of the GABA receptor)——- this appears to be the same as benzos but they are structurally different

Causes enhancement of the actions of GABA

So makes u sleepy

Given in insomnia

Increased fall risk

71
Q

What to do RE antidepressant meds when youre about to haveECT

A

Reduce the dose but dont stop completely

72
Q

Which MH drug can cause hyponatraemia

A

SSRIs

Especially in the elderly

73
Q

4 general side effects of SSRIs

A

General side effects

GI symptoms most common

GI bleed risk

Hyponatraemia especially in the elderly

Increased anxiety and agitation straight away after starting

74
Q

Which 2 SSRIs have a higher propensity for drug interactions

A

Fluoxetine and paroxetine

75
Q

Name 3 drugs that SSRIs interact with

A

NSAIDs- can give with a PPI (risk of GI bleed)

Triptans- avoid

Warfarin/ heparin- NICE recommends avoiding and giving mirtazipine

76
Q

When should patients be reviewed after stating an SSRI

A

If under 25 after 1 week

If over 25 after 2 weeks

77
Q

Name 5 atypical antipsychotics

A

CORQA

Clozapine
Olanzapine
Risperidone
Quetiapine
Aripiprazole

78
Q

What type of drug is chlorpromazine

A

Typical antipsychotic

High risk of extra-pyramidal symptoms

79
Q

What is the psychotherapy given in PTSD

A

Eye movement desensitization and reprocessing (EMDR)

80
Q

Which MH drug class can cause hypertension

A

SNRI

E.g. Venlafaxine

81
Q

What blood test should you run when you change sertraline dose

A

Urea and electrolytes

To check for hyponatraemia

Should check before and after dose change

82
Q

Describe the symptoms of tardive dyskinesia in long-term antipsychotic use

A

Irregular jerky movements e.g. lip smacking, jaw/ mouth movements, tapping hands or feet, excessive blinking,

Slow movements e.g. writhing/ squirming, wiggling

Muscle spasms e.g. difficulty swallowing, making grunting noises, postural changes

83
Q

What is the type of CBT used in OCD

A

Exposure and response prevention

84
Q

What is the type of CBT used in OCD

A

Exposure and response prevention

85
Q

What is the first line treatment for children and young people with anorexia nervosa

A

Anorexia focused family therapy

86
Q

6 stages of the change cycle

A

Precontemplation- not ready to change
Contemplation- aware that the problem exists but no commitment to action
Preparation-
Action-
Maintenance- sustained change, new behaviour replaces old
Relapse

87
Q

Cannabis MOA

A

THC (psychoactive component )binds to CB1 receptors (inhibitory action so is a depressant)

Indirectly increases dopamine release

88
Q

MDMA/ ecstasy MOA

A

Blocks serotonin reuptake increasing amounts of free serotonin at the synapse

Also increases dopamine and noradrenaline

89
Q

Amphetamines/ speed MOA

A

Causes neurotransmitter transporters to run in reverse

Disrupts storage of neurotransmitters in synapses leading to increased amounts of neurotransmitters

90
Q

LSD MOA

A

Binds to 5-HT (serotonin) receptors causing serotonin release

Most of any drug

Also indirectly increases dopamine and glutamate levels

91
Q

Heroin (diamorphine) MOA

A

Binds to mu-opioid receptors leading to feelings of euphoria and analgesia

Inhibits GABA- leads to increase in dopamine release

92
Q

Cocaine/ crack MOA

A

Blocks monoamine reuptake transporters

Leads to increased levels of dopamine, noradrenaline and serotonin

Can lead to serotonin syndrome if taken with SRIs

93
Q

.which drug reduces gambling cravings

A

Naltrexone

94
Q

Which med is an antidote to benzos

A

Fulmazenil

95
Q

Differences between methadone and buprenorphine in opioid replacement therapy

A

Buorenorphine is lower starting dose

Methadone is an agonist is has similar effects as heroine- no withdrawal, no high

Bupremorphine is partially agonist and partially antagonist so prevents the heroin binding if u use it alongside- even heroine wouldn’t produce the high

96
Q

How does opiate overdose present

A

Resp depression

Bradycardia

Reduced GCS

Pinpoint pupils

MEDICAL EMERGENCY

97
Q

How does opiate withdrawal present in the first day vs later

A

First day:
Lacrimation
Achy/ tired
Agitation and can’t sleep
Sweating and tachycardia and hypertension

Later:
N and v and d
Goosebumps
V v v v strong drug craving
Massive Dysphoria
Apparently feeels awful but not dangerous

98
Q

.

A
99
Q

What is naltrexone

A

Naltrexone is an opioid receptor antagonist that can be used to aid with relapse prevention in previously opioid-dependent patients.

Also used in gambling to stop cravings

100
Q

What is ondansetron

A

Ondansetron is a 5-HT3 receptor antagonist used as an anti-emetic. Ondansetron is often used to manage these symptoms during detoxification from alcohol or opiates.

101
Q

What adverse effects of antipsychotics are especially to be considered in the elderly

A

Stroke and VTE risk

102
Q

How to differentiate between OCD and OCpersonality disorder

A

In OCD the thoughts and compulsions are distressing to the patient

In OCPD they are part of their personality

103
Q

What is the max daily dose of sertraline

A

200mg

104
Q

Mesocortical pathways role in schizophrenia

A

Cognition and executive function

Low levels of dopamine here in schizophrenia cause negative symptoms

105
Q

Mesolimbic pathway role in schizophrenia

A

Mesolimbic Pathway

Motivation, emotion, reward

High levels in schizophrenia cause positive symptoms

Intended site of antipsychotics

106
Q

Nigrostriatal Pathway role in schizophrenia

A

Stimulation of movement

Normal levels in schizophrenia

Extrapyramidal side effects of antipsychotics (antagonistic effect)

Low levels of dopamine here causes increased cholinergic effect in antipsychotic medications which causes the side effects

107
Q

Tuberoinfundibular Pathway

A

Dopamime functions as prolactin inhibitory hormone (PIH)

Normal levels in schizophrenia

Elevated prolactin in antipsychotic use

108
Q

What do you give in -eclampsia and what 2 things do u need to monitor with it

A

Magnesium sulphate - monitor reflexes + respiratory rate

109
Q

What should you always ask in a depression history

A

History of mania

Lack of sleep, restless p,

110
Q

BMI CUT off for AN

A

18.5

111
Q

What is Russel’s sign

A

Knuckles knocking on teeth during bulimia

112
Q

What is the name of the abnormal hair growth in ED

A

Lanugo hair

113
Q

What is it that causes the symptoms in refeeding and what is the most common hallmark indicator

A

When glucose is given too quickly

Phosphate is the key indicator (low)
Potassium and magnesium can also be low

114
Q

2 medicines to treat refeeding syndrome

A

Thiamine= vit b 100mg TDS

Forceval OD = multivitamin

Also don’t stop giving them food

115
Q

3 core sx of adhd

A

Inattentive
Hyperactive
Impulsive

116
Q

How do stimulant adhd meds work

A

Increase dopamine and n levels in frontal cortex reducing core symptoms

Methylphenidate (ritalin) first line, Also adderral

117
Q

Which psych drug is most likely to cause weight gain

A

Atypical antipsychotics

118
Q

Which antipsychotic has the most sedative effect

A

Olanzipine

119
Q

How long do you need to wait for antipsychotics to work

A

4-8 weeks

120
Q

Which is the worst atypical antipsychotic for EPSE

A

Risperidone

121
Q

What is the unique Sid effect profile of aripiprazole

A

Agitation and nausea

Opposite to most other AtypAnti which have weight gain and sedation

Usually well tolerated

122
Q

Lithium MOA

A

Inhibits glutamate and increases GABA

123
Q

Lithium side effects common

A

Fine tremor

GI upset, dry mouth also common

Polyuriaand polydipsia

Weight gain

Hypothyroid

Renal failure

124
Q

Symptoms of lithium toxicity

A

Coarse tremor

Nystagmus

Ataxia /cerebellar syndrome (coordination, speech, balance)

125
Q

Which mood stabiliser can cause steven-Johnson syndrome

A

Lamotrigine

Rare

But safety net for any rash

126
Q

Which MH drug should not be taken in women with child bearing potential

A

Sodium valproate

Birth defects and developmental problems (1 in 10 and 3-4 in 10 respectively)

127
Q

3 very common side effects of SSRI

A

N and V-wears off after a few days

Insomnia

Sexual dysfunction (no orgasm)

128
Q

4 rare but serious side effects of SSRIs

A

Rash (allergy)

Self-harm risk

Hyponatraemia (tired, confused, headache, muscle cramp)

Serotonin syndrome

129
Q

Risperidone 3 very common side effects

A

Postural hypotension

Akathisia (restless, cant stay still)

EPSE

Also common:
-raised prolactin
-sleepy
-weight gain
-constipation

130
Q

Which 2 atypical antipsychotic is prolactin sparing

A

Quetiapien

Aripiprazole

131
Q

Airpiprazole mechanism of action

A

Balance dopamine action

Partial agonist and antagonist

132
Q

How to discern between unstable angina from NSTEMI

A

Tropomim levels

Normal in UA

133
Q

Which drug do you add in type two diabetes when they develop cardiovascular disease

A

SGLT-2 Inhibitors

E.e empagliflozin

134
Q

First line management of someone with alcohol withdrawal symptoms

A

Long-acting Benzos e.f, chlordiazepoxide or diazepam

Can also give carbemazepine

135
Q

3 risks of undescended testes

A

Cancer
Torsion
Infertility

136
Q

What do you do in baby GORD if gaviscon doesn’t work after thickening food

A

trial PPI- only do this if they are e.g. refusing food, are distressed or not growing

Nb don’t use thickening agents at the same time as alginate therapy

137
Q

Order of puberty events in girls

A

Breast development
Pubic hair
Growth spurt
Period

Boobs pubss grow flow

138
Q

Order of puberty events in boys

A

Testicle growth
Pubic hair
Growth spurt
Ejaculation

Grapes drapes grow blow

139
Q

If maternal AFP is high what might the child have

A

Omaphalocele or any other fetal abdominal wall defect e.g. gastroschisis

140
Q

What to give for medical management of PTSD

A

Either

SSRI

OR

VENLAFAXINE

141
Q

which SSRI do you not give in breastfeeding women

A

Fluoxetine

has a long plasma half-life and has been shown to accumulate in breast milk.

142
Q

2 drugs for opiate replacement and how they are different

A

methadone and buprenorphine
they both prevent withdrawls by binding to opioid receptors but dont give the high

methadone can be given liquid (or tab/ injection), bup can be given sublingual (or tab/ depot)

buprenorphine is a partial agonist and antagonist - the antagonistic effect means that you cant use heroin and still get high wheras with methadone you can use on top of it

143
Q

what do you give in opiate overdose

A

Naloxone
IM/nasal spray
ABCDE approach as medical emergency

144
Q
A
145
Q

which biochemical markers are raised in anorexia

A

G’s and C’s raised: growth hormone, glucose, salivary glands, cortisol, cholesterol, carotinaemia

146
Q
A
147
Q

Causative organism bronchiolitis

A

RSV respiratory syncytial virus

148
Q

4 pathological findings of Alzheimer’s

A

Cerebral atrophy (usually in medial temporal lobes)

Amyloid plaques

Neurofibrillary tangles

Reduced levels of Ach

149
Q

How to treat Alzheimer’s

A

acetylcholinesterase inhibitors.g. Donepezil
NMDA receptor antagonists e.g. Memantine

Cognitive rehab/ stimulation
Treat any comorbid illness with CBT e.g. anxiety

Carers
OT
Social care

150
Q

How to treat vascular dementia

A

Consider anticoagulants
Change modifiable risk factors

Psycho social as well

You can’t use Acherase inhibitors like donepezil or NMDA receptor antagonists e.g memantine

151
Q

How to treat frontotemporal dementia

A

Don’t use AChEi’s e.g. domepezil or NMDA receptor antagonists e.g. mementine

Treat symptoms e.g. depression, can use SSRI’s

152
Q

How to treat Lewy body dementia

A

Fine line between antipsychotics and anti Parkinsons drugs

Lewy bodies are deposited in the brain causing hallucinations (too much dopamine) and Parkinson’s features (not enough dopamine)

Too much antipsychotic will worsen Parkinson’s symptoms, too much rivastigmine (AChEi) can worsen psychosis

153
Q

Contraindications of Donepezil (acetylcholinesterase inhibitor) to treat Alzheimer’s

A

QT prolongation

Always check ECG before starting on AChEi

Also CI in second or third degree heart block and sinus Brady <50bpm

154
Q

Which MH drug can cause hyperparathyroidism and resultant hypercalcaemia

A

Long term lithium use

155
Q

Polymorphic waves on ECG fast rate which MH drug

A

Citalopram is the most likely SSRI to lead to QT prolongation and Torsades de pointes

156
Q

Best antidepressant for bulimia

A

Fluoxetine

157
Q

Woman says her husband has been replaced

A

Capgras

158
Q

Tricyclic antidepressant overdose presentation

A

Dilated pupils
Hypotension
Tachycardia
Dry mouth
Blurred vision

159
Q

Gram negative STI which ABX

A

Ceftriaxone

It’s gonorrhoea

160
Q

Antidote for TCA overdose

A

Sodium bicarbonate

Same for aspirin

161
Q

Which SSRI do you have to be careful when switching out

A

Fluoxetine

Stop, wait 4-7 days, then start new drug

Long Half-life

Fourth Yerar (5 decks)

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