Psych General

Question 1

What are the EPSEs? Mx?

Answer 1

Acute dystonia - muscle spasm [procycladine]
Parkinsonism - tremor, rigidity [procycladine]
Akasthesia - restlessness, pacing [propanolol]
Tardive dyskinesia - jerky involuntary - lip smacking, tongue protrusion [tetrabenazine]

Question 2

Mesolimbic + meso cortical pathways? what are they? do they cause +ve/-ve symptoms?

Answer 2

Dopamine pathways

Limbic - +ve
Cortical - -ve

Question 3

Assessments for alcohol dependance?

Answer 3

CAGE - cut down, annoyed, guilty, eye-opener
AUDIT - alcohol use disorder identification test
TWEAC - Tolerance, worried, eye-opener, amnesia, cut-down

Question 4

NMS drug mx? Serotonin syndrome drug Mx?

Answer 4

Bromocriptine - NMS

Cyproheptidine - Serotonin

Question 5

Withdrawal, seizures, delirium tremens –> timings (context of alcohol)

Delusions in delirium?

Answer 5

6-12 - withdrawal
36 - seizures
72 hours - tremens

Liliputian + formication

Question 6

Wernicke’s / Korsakoffs = which is acute?

Answer 6

Wernicke’s

BOTH THIAMINE DEFICIENCY (korsakoffs chronic - remember CONFABULATION)

give pabrinex + chlordiazepoxide for both

Question 7

SCOFF criteria?

Answer 7

Sick (make yourself)
Control (lost over eating)
One stone lost in 3months 
Fat (feel it)
Food (dominates life)

> 2 = anoxeria/bulaemia
Mx:
Anorexia= ED-CBT + MANTRA
Bulemia=SSRI + ED-CBT

Question 8

What antidepressant in postnatal depression? why not others?

Answer 8

Sertralline! - all others = excreted in breast milk (inlcuding fluoextine)

Question 9

Clinical features of Dementia? (4 A’s)

Answer 9

Aphasia
Apraxia
Agnosia
Amnesia - anterograde (can’t create new memories)

Question 10

Cognitive screening tools (6 of em). Which one recommended by NICE?

Answer 10

MMSE
MoCA
AMT
GPCOG
Addenbrookes
6-CIT - RECOMMENDED

Question 11

First rank schneiderlain symptoms (schiz)

Answer 11

PETER TAKES DINNER HOME

Passivity phenoma
Thought disorder
Delusional perception
Hallucinations - 3rd person auditory

Question 12

List 3 +ve and 4 -ve symptoms in schiz (or any psych thing for that matter)

Answer 12

+VE:
Delusions, Hallucinations, Thought disorder, Passivity

-VE:
Anhedonia
Flat/Blunted affect
Poor functioning ability 
Poverty of speech

Question 13

Psychiatric assessment

Answer 13

Risk to self
Risk to others
Risk from others
Risk of criminal damage to property

Question 14

Personality disorders (name them + clusters) - think risky footy formation

Answer 14

3-4-3
Cluster A - eccentric
Paranoid, Schizoid (voluntary withdrawl), Schizotypal (magic man)

Cluster B - Flamboyant
Antisocial (criminal), Borderline (mood swings), Histrionic, Narcissistic

Cluster C - anxious
Avoidant (insecure, desires companionship), Dependant, OCPD (Okay with it - unlike OCD)

Question 15

Suicide risk assessment? Mx for each score (4 sets)?

Answer 15

SAD PERSONS
Sex (M>F)
Age (peaks in young/old)
Depression
Previous attempts
Ethanol - alcohol 
Rational thinking loss - e.g. schiz / severe depression
Support network lost
Organised? - note/ avoid detection/ planned or impulsive
No significant other 
Sickness - e.g. physical disease

Scores:
0-2 = keep watch
3-4 = check frequently
5-6 = consider hospital - involuntary/voluntary
7-10 - definite hospital - involuntary/voluntary

Question 16

How long does each section last?

Answer 16

Section 2 - 28days - assessment
Section 3 - 6months - treatment
Section 5 (iv) - 6hours - nurse (CANNOT TREAT)
Section 5 (ii) - 72hours - doc (CANNOT TREAT)

Police sections (no time)
135 - home
136 - public

Question 17

5 key principles of MHA?

Answer 17

Assume capacity
Support to make own decision 
Unwise decisions = do not mean lack of capacity 
Best interests
Least restrictive practice