Psychiatry

Question 1

How long should SSRIs be tapered for?

Answer 1

4 weeks

Question 2

Which SSRI has the greatest association with congenital malformations when used in pregnancy?

Answer 2

Paroxetine

Question 3

What are the 4 features of PTSD?

Answer 3

1. Avoidance
2. Hyperarousal
3. Re-living
4. Emotional numbing

Question 4

What are the first rank symptoms of Schizophrenia?

Answer 4

1. 3rd person auditory hallucinations
2. Thought disorder
3. Delusional perception
4. Passivitiy phenomena

Question 5

How is tardive dyskinesia managed?

Answer 5

Tetrabenzine

Question 6

What is the management of OCD?

Answer 6

CBT
ERP (Exposure and response prevention)
Can add SSRI

Question 7

What are symptoms of alcohol withdrawal? What are features of delirium tremens?

Answer 7

6-12 hrs: Tremor, sweating, tachycardia, anxiety
36 hrs: Seizures
48-72 hrs: Delirium tremens

Delirium tremens:
Coarse tremor
Confusion
Delusions
Auditory/visual hallucinations
Fever
Tachycardia

Question 8

What is the treatment of delirium tremens?

Answer 8

Lorazepam

Question 9

What is the treatment of alcohol withdrawal?

Answer 9

Chlordiazepoxide or Diazepam

Question 10

What are features of opioid intoxication?

Answer 10

X

Question 11

What are features of opioid withdrawal?

Answer 11

X

Question 12

What is Cotard syndrome?

Answer 12

belief they are dead

Question 13

What is De clerambault syndrome?

Answer 13

AKA Erotomania

The patient, often a single woman, believes that a famous person is in love with her

Question 14

What is Othello syndrome?

Answer 14

pathological jealousy, belief that partner is unfaithful

Question 15

What are the risks of using SSRIs in the first trimester?

Answer 15

Small increased risk of congenital heart defects

Question 16

What are the risks of using SSRIs in the third trimester?

Answer 16

Risk of pulmonary hypertension

Question 17

Knights move thinking vs. Flight of ideas

Answer 17

Knights move thinking = Illogical leaps

Flight of ideas = Some link

Question 18

Which lab results are seen in anorexia nervosa?

Answer 18

Hypokalaemia
Low FSH and LH
Hypercholesterolaemia
Raised growth hormone
Raised cortisol

Question 19

What are the features of anorexia nervosa?

Answer 19

x

Question 20

What features are seen in bulimia?

Answer 20

x

Question 21

Management of chronic alcohol addiction

Answer 21

Two main options = Disulfram + Acamprosate

Acamprosate reduces cravings and is the preferred option

Disulfram causes a serious reaction when alcohol is drank

Question 22

Neuroleptic malignant syndrome vs. serotonin syndrome - onset?

Answer 22

Serotonin syndrome is more sudden

Neuroleptic malignant syndrome takes 1-2 weeks

Question 23

Which type of amnesia is most common following ECT?

Answer 23

Retrograde

Question 24

First Line SSRI for anxiety?

Answer 24

Sertraline

Question 25

Side effects of lithium?

Answer 25

Nausea/vomiting
Diarrhoea
Nephrotoxicity
Fine tremor
Diabetes insipidus
Hypothyroidism
Weight gain
IIH
Benign raised WCC
Hyperparathyroidism —> Hypercalcaemia.

Question 26

How is anorexia managed?

Answer 26

Treat any medical complications e.g. hypokalaemia
Controlled re-feeding to prevent refeeding syndrome
In adults - CBT-ED
In children - anorexia focused family therapy

Question 27

What are clinical features of opiate withdrawal?

Answer 27

Agitation
Anxiety
Muscle aches and cramps
Chills
Runny eyes and nose
Sweating
Insomnia
GI disturbance
Goose skin

Question 28

What patients are a risk of refeeding syndrome?

Answer 28

BMI of less than 16
weight loss of more than 15% over 3 to 6 months
Little nutritional intake for more than 10 days
Hypokalaemia hypophosphataemia or hypermagnesaemia prior to feeding