Psych

Question 1

1s line drug for Depression

Answer 1

SSRI’s
- Citalopram/fluoxetine are preferred

Question 2

1st line drug for depresion post MI

Answer 2

Sertraline

Question 3

Monitoring on SSRI

Answer 3

Seen within 2 weeks of starting SSRI

Question 4

How long should you continue with treatment once established on SSRI for depression

Answer 4

Minimum of 6months, with a tapering of dose over 4 weeks

Question 5

Symptoms when discontinuing SSRI

Answer 5

1) GI Upset
2) Mood changes
3)Anxiety

Question 6

What drugs can increase the risk of serotonin syndrome when taken in conjunction with an SSRI

Answer 6

Triptans - Sumatriptan
Allopurinol

Question 7

Noted adverse effect of citalopram

Answer 7

Prolonged QT syndrome (Dose dependent)

Question 8

Maximal dosing of citalopram

Answer 8

40mg Max dose in adults
20mg Max dose in patients >65 or who have hepatic impairment

Question 9

What is dermatitis artefecta

Answer 9

Psychiatric condition due to self injury

Linear, geometric skin lesions which appear over ngiht

Patients may behave non-chalent about it

Question 10

4 Main features of PTSD

Answer 10

Hypervigilance - Irritability, sleep problems, difficulty concentrating
Avoidance
Re-experiencing - flashbacks, nightmares
Emotional numbing

Question 11

Issues that people may say someone with PTSD has

Answer 11

Depression
Anger
ETOH Excess

Question 12

Mx of PTSD with symptoms lasting <4 weeks

Answer 12

Watch and wait

Question 13

Mx of PTSD with symptoms lasting >1month

Answer 13

1st line - Trauma focused CBT or EMDR (Eye movement desensitisation and reprocessing)

2nd line - Venlafaxine or SSRI

3rd line/severe cases - Risperidone