psych passmed (2)

Question 1

Differentiating between Type 1 and Type 2 bipolar disorder?

Answer 1

Type 1: Mania (elated mood AND psychotic symptoms)
Type 2: Hypomania (no psychotic symptoms) + at least one episode of major depression

Question 2

What drug is most likely (SSRI) to cause QTc prolongation on ECG and Torsades de Pointes?

Answer 2

Citalopram

Question 3

Obsessive compulsive PERSONALITY disorder: traits and management?

Answer 3

• wont actually act on the compulsions, just has perfectionist personality type
• Mx: DBT: Dialectical Behaviour Therapy(psychological therapy, is a type of talking therapy): is the main treatment for personality disorders

Question 4

PTSD Management?

Answer 4

1) CBT or EMDR (eye movement desensitisation and reprocessing) therapy
if ineffective: venlafaxine (SNRI) or SSRI: venlafaxine has proven efficacy.
- in severe cases: risperidone can be used

Question 5

Depression over dementia: difference?

Answer 5

Sleep disturbance, stress triggers and normal mini-mental test score (anything less than 24/30) with global memory loss suggests depression rather than dementia.
- Depression: also has a short history, and rapid onset.

Question 6

SSRIs should NEVER be combined with?

Answer 6

MAOIs (eg. phenelzine)= as risk of serotonin syndrome: will cause too much of an increase in serotonin: altered mental status, autonomic dysfunction, neuromuscular abnormalities.

Question 7

OCD: all patients with severe functional impairment should be? (for eg. spent majority of week in bed, loss of appetite, absent from work)

Answer 7

referred to the secondary care mental health team - treatment can be started whilst waiting for assessment

Question 8

mx. of negative symptoms of schizophrenia? (eg. on -ve symptoms? blunting affect, anhedonia, poor motivation, social withdrawal)

Answer 8

Clozapine

Question 9

Schizophrenia 1st rank symptoms? (Schneider’s 1st rank symptoms)?

Answer 9

• Auditory hallucinations: third person
• Thought disorders: thought insertion, withdrawal, broadcasting
• Passivity Phenomena
• Delusional Perceptions
  Others:
• impaired insight
• negative symptoms
• neologisms (new words)
• catatonia

Question 10

Erotomania (De Clerambault’s syndrome) ?

Answer 10

is the presence of a delusion that a famous is in love with them, with the absence of other psychotic symptoms

Question 11

Capgras syndrome?

Answer 11

This is the delusion that a person closely related to the patient has been replaced by an IMPOSTER.

Question 12

De Fregoli syndrome?

Answer 12

Delusion of identifying a familiar person in various people they encounter.

Question 13

Othello Syndrome?

Answer 13

a delusion of sexual infidelity on the part of a sexual partner.

Question 14

Ekbom syndrome?

Answer 14

delusional parasitosis and describes the delusion of infestation.

Question 15

OCD vs. Psychosis Differentiation?

Answer 15

By the LEVEL OF INSIGHT into their actions.

Question 16

SSRI use risk: in first trimester

Answer 16

• small increased chance of congenital heart defects

NB:
third trimester can result in persistent pulmonary hypertension of the newborn

Question 17

Niche psych disorders: eg. Othello syndrome?

Answer 17

Othello syndrome - seemingly unfounded jealousy
Fregoli syndrome - believing that two or more people are the same person changing their appearance to deceive you
Folie à deux - shared hallucinations/delusions between individuals
Erotomania - excessive sexual desire
Factitious disorder - consciously pretending that you have a mental illness.