Psych

Question 1

how long after dose should lithium be checked

Answer 1

12 hours

Question 2

when stopping one SSRI and starting another, how long after stopping the first do you start the second

Answer 2

4-7 days (long half life)

Question 3

How long after stopping alcohol do you get withdrawal symptoms

Answer 3

12 hours

Question 4

How long after stopping alcohol do you get seizures

Answer 4

36 hours

Question 5

How long after stopping alcohol do you get delerium tremens

Answer 5

48-72 hours

Question 6

Which SSRI is used after an MI

Answer 6

sertraline

Question 7

which drug class increases the risk of stroke/VTE in elderly patients

Answer 7

atypical antipsychotics (clozapine, risperidone, olanzapine)

Question 8

When starting a patient on Electroconvulsive therapy, what should you do to the sertraline dose

Answer 8

Reduce but not stop

Question 9

Neuroleptic malignant syndrome symptoms

Answer 9

Rigidity, hyperthermia, autonomic instability (hypotension, tachycardia) and altered mental status

Question 10

Amitriptyline side effects

Answer 10

Can’t see (blurred vision)
can’t pee (urinary retention)
can’t sit (dizziness)
can’t shit (constipation)

Question 11

Coronary prone behaviour pattern

Answer 11

Highly competitive, highly stressed

Question 12

Schneider’s first rank symptoms

Answer 12

3rd person auditory hallucinations
Somatic hallucination
Delusional perception
Thought alienation

Question 13

Wernicke’s encephalopathy treatment

Answer 13

IV pabrinex - IV thiamine replacement

Question 14

Medication/drugs that cause mania

Answer 14

Antidepressant
amphetamines
cocaine

Question 15

before prescribing lithium test

Answer 15

U+E - nephrotoxic
TFT - may cause hypothyroid
ECG - long QT

Question 16

Lithium toxicity symptoms

Answer 16

Tremor
convulsions
renal failure
coma

nausea/diarrhoea/vomiting

Question 17

Which neurotransmitter primarily causes major depressive disorder

Answer 17

Serotonin

Question 18

Which receptors do opioids act on

Answer 18

Mew opioid peptide receptors

Question 19

Negative symptoms of schizophrenia

Answer 19

Blunting of affect
Poverty of speech
Anhedonia
Lack of motivation

Question 20

Clozapine monitoring

Answer 20

FBC
Blood clozapine
Lipids
Weight
Fasting glucose

Question 21

Face twitching
Rapid blinking
Repeated hand movement

Answer 21

Tardive dyskinesia

Question 22

Tardive dyskinesia symptoms

Answer 22

Extra pyramidal side effects
Face twitching
Repeated hand movements
Hand shaking
Rapid blinking

Question 23

Tardive dyskinesia treatment

Answer 23

Tetrabenazine

Question 24

Amitriptyline/tricyclic antidepressant overdose management under 1hr or 1hr +

Answer 24

under 1 hour activated charcoal
over IV sodium bicarbonate

Question 25

tricyclic antidepressant overdose first investigation + main complication

Answer 25

ECG - QRS prolongation

Question 26

Tricyclic antidepressant overdose main complication

Answer 26

QRS prolongation/cardiac issue

Question 27

which receptors does LSD act on

Answer 27

5ht2a

Question 28

Schizophrenia pathogenesis hypothesis

Answer 28

neurotransmitter - increased mesolimbic/decreased mesocortical Neurodevelopmental (HIE/autism)

Question 29

Which lobe of brain is most commonly affected in schizophrenia

Answer 29

temporal

Question 30

Which ssri can prolong qt interval

Answer 30

Citalopram

Question 31

Which ssri is preferred in young people

Answer 31

Fluoxetine

Question 32

Ssri side effects

Answer 32

Constipation/diarrhoea Sexual dysfunction Hyponatremia

Question 33

Conversion disorder/functional neurological disorder definition

Answer 33

Patient doesn't consciously feign symptoms and is not seeking material gain. Motor or sensory loss due to stress/emotional distress

Question 34

Which antipsychotic lower seizure threshold

Answer 34

Clozapine

Question 35

Clozapine side effects

Answer 35

S - seizures C - constipation A - agranulocytosis M - myocarditis

Question 36

Alcohol withdrawal treatment

Answer 36

1 - chlordiazepoxide - long acting bezodiazipine 2 - diazepam - long acting If cirrhosis - lorazepam - short acting bezodiazipine

Question 37

Alcohol withdrawal mechanism

Answer 37

Gaba causes inhibition. Alcohol enhances gaba. When alcohol is stopped brain is over stimulated

Question 38

Emotional unstable personality disorder treatment

Answer 38

Dialectical behavioural therapy

Question 39

PTSD symptoms

Answer 39

Flashbacks Hypervigilance Avoidance Emotional numbing/dissociation

Question 40

Which antipsychotic has the best side effects profile for hyperprolactinaemia

Answer 40

Aripiprazole

Question 41

What monitoring is done for Lithium

Answer 41

BMI UandE eGFR Calcium Thyroid Every 6 months

Question 42

Which antipsychotic causes worst prolactin symptoms

Answer 42

Risperidone

Question 43

Acamprostrate use and mechanism

Answer 43

Alcohol abstinence GABA Gaba agonist

Question 44

Sign of bulimia on hands

Answer 44

Russels sign

Question 45

When do you get hallucinations after alcohol

Answer 45

12-24 hours

Question 46

Ssri to which antidepressant is a direct switch

Answer 46

Venlefaxine

Question 47

ADHD medication

Answer 47

First: Methylphenidate Then: Lisdexamphetimine Then atomoxetine

Question 48

Which medication decreases pleasure while drinking alcohol

Answer 48

Disulfiram - inhibits acetaldehyde dehydrogenase causing a build of of acetaldehyde - causes flushing nausea and palpitations

Question 49

What audit score indicates harmful drinking

Answer 49

8

Question 50

What audit score indicates dependence

Answer 50

20+

Question 51

Which receptors does haloperidol act on

Answer 51

D2 antagonist

Question 52

Which SSRI is safe in breastfeeding

Answer 52

Sertraline

Question 53

What type of memory loss does electroconvulsive therapy cause

Answer 53

Retrograde amnesia

Question 54

SSRI discontinuation syndrome symptoms

Answer 54

Flu-like sx (headache, myalgia, lethargy) Imbalance (vertigo, lightheadedness) Nausea (vomiting, diarrhoea) Insomnia Sensory disturbances (electric shocks, paraesthesia, numbness) Hyperarousal (agitation, tremor).

Question 55

what is first line management for those wishing to stop abusing substances

Answer 55

motivational intervention

Question 56

Which pharmacological treatment would be the first line to manage acute disturbance in a young schizophrenia patient

Answer 56

oral lorazepam

Question 57

Which is the main hypnotic mechanism of zopiclone?

Answer 57

gaba agonist

Question 58

schizophrenia auditory hallucination features

Answer 58

3rd person running commentary thoughts spoken aloud

Question 59

psychological treatments for psychosis

Answer 59

hearing voices group, CBT, family intervention, psychoeduction

Question 60

alcohol dependence blood test

Answer 60

raised gamma glutamyl transpeptidase (GGT) raised MCV (red blood cell mean corpustular volume) raised carbohydrate deficient transferrin

Question 61

Wernicke's encephalopathy symptoms

Answer 61

Confusion Ataxia Nystagmus Ophthamoplegia PEripheral Neuropathy