Psych

Question 1

Features and timing in acute alcohol withdrawal

Answer 1

6-12 hours: tremor, sweating, tachycardia, anxiety
36 hrs - peak incidence seizures
48-72 hrs - peak delirium tremens

Question 2

Psychological abn in anorexia

Answer 2

most things low; hypokal, low FSH/LH/oestrogens/testosterone

Gs and Cs raised; growth hormone, glucose, cortisol, chol

Question 3

Typical EPSEs

Answer 3

Parkinsonism
Acute dystonia (eg oculogyric crisis) - manage with procyclidine
Akathisia
Tardive dyskinesia (chewing and pouting of jaw)

Question 4

Atypical antipsychotics - examples and adverse effects

Answer 4

Clozapine, Olanzapine

Adverse effects;
weight gain (esp with Olanzapine)
Agranulocytosis (esp cloz)
Inc risk stroke/VTE
Reduced seizure threshold (esp cloz)

Question 5

Adverse effects of lithium

Answer 5

N/V, diarrhoea
Tremor
Nephrotoxic
Weight gain
Idiopathic intracranial HTN
Hypothy
ecyg - t wave flattening/inversion

Question 6

Cluster classification of personality disorders

Answer 6

Cluster A: Odd or eccentric behaviours (e.g., Paranoid, Schizoid)
Cluster B: Dramatic, emotional, or erratic behaviours (e.g., Antisocial, Borderline)
Cluster C: Anxious and fearful behaviours (e.g., Avoidant, Dependent)

Question 7

Risk factors for developing Schizophrenia

Answer 7

+ve FHX
Black/Carribean
Migration
Urban enviroment
Cannabis use

Question 8

Section 2 MHA

Answer 8

Admission for up to 28 days
Treatment against wishes
AMHP makes application on recommendation of 2 doctors

Question 9

Section 3 MHA

Answer 9

Admission and treatment for up to 6 mo (can be renewed)
AMHP along with 2 doctors

Question 10

Section 4 MHA

Answer 10

72 hour admission/assessment order
GP and AMHP

Question 11

Section 5(2)

Answer 11

Detention of pt in hospital by Dr for 72 hrs

Question 12

Section 5(4)

Answer 12

Detention of pt in hospital by Nurse for 6 hrs

Question 13

Section 17a

Answer 13

Community treatment order
Can be used to recall pt to hospital for tx if they do not comply with Tx orders

Question 14

Section 135

Answer 14

Allows police to break into property to remove person to place of safety

Question 15

Section 136

Answer 15

Can take person from public area to place of safety

Question 16

Cautions for Citalopram prescription

Answer 16

Dose dependent prolongation of QTi

(should not be used in people with/taking drugs that cause long QT)

Question 17

SSRI interactions

Answer 17

NSAIDS/aspirin - if co-prescribed, offer PPI

+ triptans/MAOi = inc risk serotonin syndrome

Question 18

SSRIs and pregnancy

Answer 18

weigh up benefit/risk
- Use during the first trimester-> inc risk of congenital heart defects
- Use during the third trimester -> inc risk PPH of new-born

Paroxetine has an increased risk of congenital malformations

Question 19

MMSE screening and scores

Answer 19

Widely used for dementia and cog screening

Normal: 24-30.
Mild Cognitive Impairment: 18-23.
Severe Cognitive Impairment: Below 18.

Question 20

MoCA screening and scores

Answer 20

Screening for dementia - more sensitive than MMSE

Normal: 26-30.
Mild Cognitive Impairment: 18-25.
Severe Cognitive Impairment: Below 18.

Question 21

Addenbrookes Cog Exam screening and scores

Answer 21

Comprehensive, often used with memory testing. Assessed language, fluency and memory in depth - useful for differentiating Alzheimers and other types of dementia

> 88 = normal cognition
80-87 = mild cog impairment
< 80 = dementia