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MRCP - Passmed > Psych > Flashcards

Psych Flashcards

1
Q

Mx of PTSD?

A

Watchful waiting

Trauma-CBT / EMDR

If not tolerated SSRI / Venlaflaxine / Risperidone (v severe)

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2
Q

How long to continue antidepressants for after resolution of sx?

A

6 months

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3
Q

Which atypical antiphsychotic has highest risk of dyslipidaemia + obesity?

A

Olanzapine

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4
Q

SSRI of choice post MI?

A

Sertraline

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5
Q

presence of a delusion that a famous is in love with them, with the absence of other psychotic symptoms

Name?

A

Erotomania (De Clerambault’s syndrome)

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6
Q

What is histrionic personality disorder characterised by?

A

inappropriate sexual seductiveness, suggestibility and intense relationships

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7
Q

What is othellos syndrome?

A

pathological jealousy where a person is convinced their partner is cheating on them without any real proof

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8
Q

Adverse effects of atypical antipsychotics?

A

weight gain
clozapine is associated with agranulocytosis (see below)
hyperprolactinaemia

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9
Q

Duloxetine MoA?

A

Serotonin-NA reuptake inhibitor

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10
Q

When do you get:
Symptoms
Seizures
DT

with alcohol withdrawal?

A

symptoms: 6-12 hours
seizures: 36 hours
delirium tremens: 72 hours

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11
Q

Mx of DT?

A

Chlordiazepoxide, lorazepam or diazepam are used in the treatment of delirium tremens/alcohol withdrawal

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12
Q

Which receptor do typical antipsychotics and atypicals act on?

A

Typical - D2 antagonist - blocking dopaminergic transmission in mesolimbic pathways

Atypical - D2, D3, D4 5HT

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13
Q

When can antidepressants be stopped after remission?

A

6 months after - reduce risk of relapse

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14
Q

Risk of developing schizophrenia
monozygotic twin has schizophrenia =
parent has schizophrenia =
sibling has schizophrenia =
no relatives with schizophrenia =

A

monozygotic twin has schizophrenia = 50%
parent has schizophrenia = 10-15%
sibling has schizophrenia = 10%
no relatives with schizophrenia = 1%

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15
Q

Which drugs can cause urinary retention particularly in those with BPH?

A

TCAs eg amitriptylline

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16
Q

What receptors does Olanzapine act on?

A

Mainlt - 5HT2A (serotonin) antagonism + D2 (dopamine) antagonism

17
Q

What are the main features of PTSD?

A

re-experiencing e.g. flashbacks, nightmares

avoidance e.g. avoiding people or situations

hyperarousal e.g.hypervigilance, sleep problems

18
Q

Examples of GABA drugs?

A

benzodiazipines increase the frequency of chloride channels

barbiturates increase the duration of chloride channel opening

19
Q

How to withdraw from benzos?

A

switch patients to the equivalent dose of diazepam

reduce dose of diazepam every 2-3 weeks in steps of 2 or 2.5 mg

time needed for withdrawal can vary from 4 weeks to a year or more

20
Q

Bulimia pharmacological mx?

A

High dose fluoxetine but limited evidence base

21
Q

Adverse effects of non-selective monoamine oxidase inhibitors

A

hypertensive reactions with tyramine containing foods e.g. cheese, pickled herring, Bovril, Oxo, Marmite, broad beans

anticholinergic effects

22
Q

Can you get alopaecia with long term lithium?

A

No

23
Q

Dosulepin MoA? anything to be aware of?

A

TCA

Dangerous in overdose

24
Q

Duloxetine MoA?

A

serotonin and noradrenaline reuptake inhibitor

25
Q

Which SSRI has highest risk of discontinuation sx?

A

Paroxetine

26
Q

What type of memory loss is seen in dementia v pseudodementia?

A

Dementia = shorter term memory + recent events

27
Q

Which TCA is safest in overdose

A

Lofepramine

28
Q

ECT side effects?

A

Short-term side-effects
>headache
>nausea
>short term memory impairment
memory loss of events prior to ECT
>cardiac arrhythmia

Long-term side-effects
>some patients report impaired memory

29
Q

Features of post concussion syndrome?

A

headache
fatigue
anxiety/depression
dizziness

30
Q

Anorexia bloods?

A

most things low

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

31
Q

What is associated with increase in mortalitiy in dementia patients?

A

antipsychotics

32
Q

Which APOE allele is highest risk of alzheimers?

A

y4 allele

33
Q

Lewy body dementia scan?

A

SPECT

MRCP - Passmed (17 decks)

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