Psychiatry

Question 1

A breastfeeding woman requires an SSRI what is the preferred medication?

Answer 1

Setraline

Paroxetine

Question 2

What scale is used in postnatal depression?

Answer 2

Edinburgh Postnatal Depression Screen

Question 3

What monitoring is required in SSRIs?

Answer 3

BP at initiation and every time dose is titrated

Question 4

What monitoring is required for citalopram ?

Answer 4

ECG

Question 5

What should be measured before and during Antipsychotic use?

Answer 5

Hb1Ac

Question 6

What should be monitored in SSRS use?

Answer 6

U + E

Particularly Na+ as hyponatraemia is a cause of confusion in elderly.

Question 7

ADHD - managent

Answer 7

Watch and wait for 6 weeks
Refer to secondary care
Mild to moderate - Parent training and education
Severe - Medication

Question 8

Medication ADHD rules

Answer 8

Only if over 5 years old
Baseline ECG required
6 monthly weight and height measurements

Question 9

Medication in ADHD

Answer 9

Methylphenidate 1st line

Lisdexamfetamine - second line

Question 10

Which atypical antipsychotic has the best side affect profile?

Answer 10

Aripiprazole

Question 11

Management of GAD

Answer 11

Education and monitor -> Low intensity psychotherapy -.> CBT or medication

Medication - SSRI sertraline is first line

                - Venlafaxin or another SSRI
                - Pregablin

Question 12

What is first line for acute stress disorder?

Answer 12

CBT

Question 13

Management of OCD

Answer 13

Mild - CBT + exposure response and prevention ERP
Moderate - SSRI or more intensive CBT + ERP
Severe - SSRI + CBT + ERP

SSRI - fluoxetine
Use for at least 12 months to prevent relapse
If failure to respond to an SSRI trial another SSRI

Question 14

Confusion 
Hyperthermia
Hyperreflexia 
Pupil dilation 
Use of SSRIs

Answer 14

Seretonin Syndrome
Linked to ecstasy or amphetamine overdose
Tramadol can trigger it swell

Question 15

Is someone presents with mania in a primary care setting what is the management?

Answer 15

Referral to Community Mental Health Team

Question 16

What is the first line medication used in Post MI depression?

Answer 16

Setraline

Question 17

PTSD - management

Answer 17

Mild - watch and wait for 4 weeks
Severe - CBT EMDR or medication
Venlafaxine or SSRI

Question 18

Multiple physical symptoms and refusal to believe negative results or reassurance

Answer 18

Somatisation Disorder

Question 19

Persistent belief in serious underlying disorder

Answer 19

Illness anxiety disorder

Hypochondriasis ( C for Cancer)

Question 20

Loss of motor or sensory function
Involuntary
Current stressful change

Answer 20

Conversion disorder

Question 21

Internal production of physical/psychological symptoms

Answer 21

Munchausen / factitious disorder

Question 22

Creation of symptoms for financial or personal gain

Answer 22

Malingering

Question 23

Hypomania in the community

Answer 23

Routine referral to CMHT

Urgent if threat to own life or others

Question 24

How long can a normal grief reaction last?

Answer 24

<6 months

Question 25

Management of frontotemporal dementia

Answer 25

No pharmacological management

Refer to psychiatry and organise social support

Question 26

Oppositional defiant disorder.

Answer 26

Persistent defiant and hostile behaviour towards authoritative figures

Question 27

Conduct disorder

Answer 27

<18 years old

Behaviour and attitude that continually disrespects the rights of others

Question 28

What lobe is affected in early Alzheimers?

Answer 28

Temporal

Question 29

Antisocial vs conduct disorder

Answer 29

Conduct disorder occurs before 18 years old