Psych

Question 1

Somatization Disorder

Answer 1

multiple physical complaints. Symptoms not intentionally produced

Question 2

Conversion disorder

Answer 2

mono-symptomatic

Question 3

Factitious Disorders

Answer 3

Consciously and voluntarily produces physical symptoms of illness ie self harm
Motivation is to assume the sick role

Question 4

Malingering

Answer 4

External incentive for behaviour (eg economic gain)

Question 5

Cluster A

Answer 5

odd, eccentric, emotionally distant. Paranoid, schizoid, schizotypal

Question 6

Cluster B

Answer 6

impulsive, excessively emotional, erratic: antisocial, borderline, histrionic, narcissistic

Question 7

Cluster C

Answer 7

anxiety and fear: avoidant, dependent, obsessive-compulsive

Question 8

Generalised Anxiety Disorder

Answer 8

persistent, excessive and/or unrealistic worry with impaired concentration, autonomic arousal, insomnia… Onset usually before age 20

Question 9

Anxiety D/O - Mx

Answer 9

CBT
Antidepressants
Anxiolytics - benzos

Question 10

Schizo Symptoms + Subtypes

Answer 10

Positive symptoms: hallucinations, delusions

Negative symptoms: social withdrawal, impoverished speech, lack of motivation

Cognitive symptoms: poor executive function

Subtypes:
 Catatonic: profound changes in motor activity
 Paranoid: prominent preoccupation with a specific delusional system
 Disorganised: disorganised speech and behaviour
 Residual: residual negative symptoms without delusions, hallucinations or motor disturbance

Question 11

Comorbidities in Schizoprenia

Answer 11

T2DM
Hyperlipid
Higher rate of preventable RF - smoking, EOTH etc
Hep C, Hep B
OP
IHD, arrhymias
H pylori! OR 3.0
Sx of increased prolactin

Question 12

Depression

• sx
• sleep pattern

Answer 12

SX - SEIGECAPS

disordered REM sleep, and sometimes, reduced stage 4 delta slow wave sleep

Question 13

Depression Mx

Answer 13

CBT - effective
Meds - 40-65% will have response
SSRI, TCA, MOAi, SNRI, Lithium

Question 14

TCA - MOA, S/E

Answer 14

Amitryptiline etc
Inhibit reuptake if 5-HT
Narrow therapeutic index- toxicity can cause arrhythmia and seizures
Give sodium bicarb for cardiac toxicity
Can have anticholinergic effects
A/E - Hyponatremia, seizures, NMS

Question 15

SSRI MOA, S/E

Answer 15

Inhibits reuptake of serotonin, less sedating, better in older and diabetics

A/E - GI, tremor, headaches, restlessness, ED, SIADH

Citalopram first line

Question 16

SNRI MOA, S/E

Answer 16

Venlafaxine
Serotonin and noradrenaline reuptake inhibitor
SE - GI, sexual dysfunction, HTN, agitation
good for coexisting pain

Question 17

Lithium

Pharmaco, Tox

Answer 17

Renal excreted. risk of Tox with dehydration (causing increased Na and water resorption in kidney and thus increased Li absorption)
Tox- tremor, ataxia, nystagmus, AKI, seizures
Can cause Lithium Nephrotoxicity - Nephrogenic diabetes insidious, interstitial nephritis. Can give amiloride

Question 18

Clozapine AE

Answer 18

Agranulocytosis, neutropenia
Eosinophilia
Tachycardia
Myocarditis, cardiomyopathy
Constipation --> ileus, obs etc - common
Seizures
Weight gain -->metabolic syndrome