psych

Question 1

blood test results in anorexia

Answer 1

• Low levels of sex hormones: FSH, LH, testosterone and oestrogen
• Normal T4, low T3
• Low levels of potassium, calcium and magnesium
• Metabolic alkalosis
• High levels of cortisol

Question 2

define panic disorder

Answer 2

anxiety disorder, is characterized by the occurrence of recurrent, unexpected panic attacks, each marked by intense fear or discomfort.

Question 3

what causes neuroleptic malignant syndrome

Answer 3

• dopamine antagonist medication such as antipsychotics

Question 4

clinical signs and symptoms of NMS

Answer 4

• fever,
• muscle rigidity,
• confusion,
• rhabdomyolysis (hence the raised creatine kinase and subsequent electrolyte derangements such as hyperkalaemia and hypocalcaemia),
• metabolic acidosis,
• autonomic lability - characterized by fluctuations in blood pressure, tachycardia, and diaphoresis
• raised white cell count.

Question 5

name some cognitive assessment tests

Answer 5

• 10 point screener [10-CS]
• MOCA
• MMSE
• 6-item cognitive impairment test [6-CIT]
• mini-cog

Question 6

minimum duration for depression sx to be diagnosed as depression

Answer 6

2 weeks

Question 7

PTSD vs acute stress disorder

Answer 7

• PTSD = symptoms > 4 weeks from traumatic event.
• acute stress reaction = sx lasting <4 weeks from traumatic event

Question 8

section 5(2)

Answer 8

permits detainment for 72 hours for further assessment
by 1 doctor

Question 9

section 5(4)

Answer 9

permits detainment for 6 hours for further assessment
by 1 nurse

Question 10

section 3

Answer 10

6 month treatment order and
requires an approved mental health practitioner and 2 doctors.

Question 11

section 135

Answer 11

court order that allows police to enter a property and take a person to a Place of Safety
police order
lasts 24 hours
Followed up with an MHA Assessment

Question 12

section 136

Answer 12

court order that allows police to take a person to a Place of Safety from a public space
police order
lasts 24 hours
Followed up with an MHA Assessment

Question 13

when can you give activated charcoal for ovredose

Answer 13

if pt presents with 1 hour

Question 14

how is N-acetylcysteine dose calculated

Answer 14

The dose of N-acetylcysteine is adjusted based on the paracetamol level, nomogram and local guidelines.

Question 15

cholinergic side effects
what drugs cause this

Answer 15

• Gastrointestinal issues: Diarrhoea, N+V, abdominal cramping, gastric irritation
• Sweating and salivation: Increased sweating and salivation
• Urination: Increased urinary frequency
• Bradycardia

Question 16

anticholinergic side effects

Answer 16

can’t secant spit, can’t pee, can’t shit

Question 17

Mx of lithium toxicity

Answer 17

• mild tox = fluid resus
• severe / renal impairment = haemodialysis.
• benzes may be used to mx agitation

Question 18

what is cyclothymia

Answer 18

• Chronic mood fluctuations over 2 years with episodes of hypomania and depression
• Cyclothymia has milder symptoms than bipolar and often goes unnoticed and therefore undiagnosed

Question 19

NMS vs serotonin syndrome

Answer 19

NMS occurs over a long period of time [days-weeks] whereas serotonin syndrome occurs over a short period of time[24hrs].

Question 20

key Sx of serotonin syndrome

Answer 20

• Neuromuscular abnormalities: Tremor, Clonus
• Altered mental state
• Autonomic dysfunction

Question 21

serotonin syndrome Mx

Answer 21

supportive Mx
Benzes for agitation
Cyproheptadine 5HT antagonist for severe cases

Question 22

NMS Mx

Answer 22

• stopping the causative agent + supportive care with IV fluids + benzos for sedation.
• Some cases require dantrolene or bromocriptine.

Question 23

opiate withdrawal symptoms

Answer 23

Opiate withdrawal presents with diarrhoea, mydriasis, muscular aches, yawning, a runny nose and insomnia

Question 24

what causes korsakof syndrome

Answer 24

Korsakoff syndrome occurs due to prolonged thiamine deficiency –> degeneration of the mammillary bodies [part of the papez circuit and needed for memory formation] and other brain structures. Often irreversible

Question 25

Classic triad of Wernicke’s

T/F: all signs must be present for Dx

Answer 25

1. Confusion / change in mental status
2. Ataxia
3. Nystagmus / ophthalmoplegia / occulomotor dysfunction.

• false not all signs must be present for Dx

Question 26

what causes wernickes

Answer 26

Wernicke’s is a neurological syndrome caused by thiamine [Vit B1] deficiency, associated with alcohol excess. A medical emergency

Question 27

duration of Sx for a formal schizophrenia Dx

Answer 27

1 month