Psychiatry

Question 1

Mneumonic for 1st rank schizophrenia symptoms

Answer 1

A - Auditory Hallucinations.
B - Broadcasting of Thought.
C - Controlled Thought (delusions of control).
D - Delusional Perception

Question 2

Effect of mesolimbic dopamine pathway?

Answer 2

DA overactivity associated with positive symptoms.

Question 3

Effect of mesocortical dopamine pathway?

Answer 3

DA underactivity associated with negative symptoms.

Question 4

Effect of nigrostriatal dopamine pathway?

Answer 4

D2 blockade by antipsychotic Px associated with Parkinsonian side-effects.

Question 5

Effect of tuberoinfundibular dopamine pathway?

Answer 5

D2 blockade by antipsychotic Px leads to increased Prolactin levels and Hyperprolactinaemia.

Question 6

Clinical features of serotonin syndrome

Answer 6

Rpid onset
Mental status change
Autonomic dysfunction- Dilated pupils, diaphoresis, tachycardia, hyperthermia, hypertension, D and V
Neuromuscular dysfunction- Tremor, hyperreflexia and myooclonus

Question 7

Pathophysiology of neuroepleptic malignant syndrome

Answer 7

Unknown

Question 8

Causes of neuroleptic malignant syndrome

Answer 8

Antipsychotic drugs
Dopaminergic drugs

Question 9

Clinical features of neuroeptic malignant syndrome

Answer 9

Gradual onset
Mental state change
Autonomic dysfunction
Neuromuscular dysfunction- severe rigitidy, tremor, hyperreflexia

Question 10

What is conversion disorder?

Answer 10

Involves loss of motor function

Question 11

What is Charles- Bonnett syndrome?

Answer 11

characterised by persistent or recurrent complex hallucinations (usually visual or auditory), occurring in clear consciousness. This is generally against a background of visual impairment (although visual impairment is not mandatory for a diagnosis). Insight is usually preserved. This must occur in the absence of any other significant neuropsychiatric disturbance.

Question 12

Most common opthalmic condition associated with Charles Bonett?

Answer 12

Age related macular degeneration

Question 13

How to treat schizophrenia if severe functional impairment

Answer 13

Refer to secondary care
Offer CBT and SSRI while waiitng

Question 14

How many months does insomnia have to last to be chronic?

Answer 14

3 months or longer

Question 15

What medication can be used to reduce alcohol cravings?

Answer 15

Acamprostate

Question 16

What medication can be used to reduce pleasurable effects of alcohol

Answer 16

Naltrexon

Question 17

What medication can be used to increase sensitivity to alcohol?

Answer 17

Disulfram

Question 18

What is the peak incidence of delerium tremens following alcohol withdrawl?

Answer 18

72 hours

Question 19

TCA side effects

Answer 19

Drowsines
Dry mouth
Blurred vision
Constipation/retention
Worsening of QT interval

Question 20

What is akasthia?

Answer 20

Inner restlessness and inability to keep still

Question 21

SSRI of choice in children and adolescents

Answer 21

Fluoxetine

Question 22

Which atypical antipsychotics has the best side effect profile, particularly for prolactin elevation?

Answer 22

Aripiprazole

Question 23

Adverse side effects of clozapine?

Answer 23

Agranulocytosis
Reduced seizure threshold
Constipation
Myocarditis
Hypersalivation

Question 24

Side effects of mirtazapine that can be helpful in older people?

Answer 24

Sedation and an increased appetite

Question 25

When checking lithium levels when should the sample be taken?

Answer 25

12 hours post last dose

Question 26

Side effects of TCAs?

Answer 26

Drowiness Dry mouth Blurred vision Constipation Urinary retention Legnthening of QT interval

Question 27

What is brief psychotic disorder?

Answer 27

Episode of psychosis lasting less than a month with a subsequent return to baseline functioning.

Question 28

What happens when triptans are used alongside SSRIs?

Answer 28

Increases risk of serotonin syndrome

Question 29

What is circumstantiality?

Answer 29

inability to answer a question without giving excessive, unnecessary detail

Question 30

What is tangentiality?

Answer 30

Wandering from a topic without returning to it

Question 31

What is an oligouric crisis?

Answer 31

Prolonged involuntary upward deviation of the eyes

Question 32

What do benzodiazepines do?

Answer 32

Inhibitory neurotransmitter gamma-aminobutyric acid (GABA) by increasing the frequency of chloride channels

Question 33

Mneumonic for atypical antipsychotics

Answer 33

CORQA Clozapine Olanzapine Risperidone Quetiapine Aripiprazole

Question 34

What should patients have monitored when starting on an SNRI?

Answer 34

BP

Question 35

Over how many weeks should an SSRI be gradually withdrawn?

Answer 35

4 weeks

Question 36

How long after onset can PTSD be diagnosed?

Answer 36

4 weeks

Question 37

What warnings are there for antipsychotic use in the eldrly?

Answer 37

Increased risk of stroke and VTE

Question 38

What is agranulocytosis?

Answer 38

Lowering of the white blood cell count, primarily neutrophils

Question 39

How long should antidepressants be continued after remission? Why?

Answer 39

For at least 6 months to decrease risk of relapse

Question 40

What should be prescribed if patient taking SSRI and NSAID?

Answer 40

PPI

Question 41

Difference between knights move and flight of ideas?

Answer 41

Knight's move thinking there are illogical leaps from one idea to another, flight of ideas there are discernible links between ideas

Question 42

Management of mania/hypomania in bipolar?

Answer 42

consider stopping antidepressant if the patient takes one; antipsychotic therapy e.g. olanzapine or haloperidol

Question 43

Mneumonic for SSRI side effects SSSSRIs

Answer 43

Stomach upset Sexual dysfunction Sodium low Serotonin syndrome

Question 44

Anorexia features

Answer 44

Most things low G and C raised: Growth hormone, glucose, salivary glands, cortisol, cholstreol, carotinaemia

Question 45

Side effects of clozapine?

Answer 45

weight gain excessive salivation agranulocytosis neutropenia myocarditis arrhythmias

Question 46

SSRI use in third trimester of pregnnacy?

Answer 46

Can cause persistent pulmonary hypertension of the newborn

Question 47

What is procyclidine?

Answer 47

anticholinergics that work by blocking acetylcholine. This helps decrease muscle stiffness, sweating, and the production of saliva, and helps improve walking ability in people with Parkinson's disease.

Question 48

Lithium side effects

Answer 48

nausea/vomiting, diarrhoea fine tremor nephrotoxicity: polyuria, secondary to nephrogenic diabetes insipidus thyroid enlargement, may lead to hypothyroidism ECG: T wave flattening/inversion weight gain idiopathic intracranial hypertension leucocytosis hyperparathyroidism and resultant hypercalcaemia

Question 49

What is Korsakoff's syndrome?

Answer 49

anterograde amnesia: inability to acquire new memories retrograde amnesia confabulation

Question 50

First line for children with ED?

Answer 50

Family based therapy

Question 51

First line for GAD?

Answer 51

Sertraline

Question 52

What antipsychotic reduced the seizure threshold?

Answer 52

Clozapine

Question 53

TCA side effects

Answer 53

drowsiness dry mouth blurred vision constipation urinary retention lengthening of QT interval

Question 54

What is delusional parasitosis?

Answer 54

Patient with a fixed, false belief (delusion) that they are infested by 'bugs

Question 55

Core depression symptoms

Answer 55

Anhedonia, anergia or low mood

Question 56

Lithium mneumonic

Answer 56

LITHIUM L- leucocytosis I - increased urine T - Tremors H - hypothyroid I - increased thirst U - underactive memory M - myoclonus

Question 57

What are Z drugs?

Answer 57

similar effects to benzodiazepines but are different structurally. They act on the α2-subunit of the GABA receptor.

Question 58

What are the 3 groups of Z drugs?

Answer 58

Imidazopyridines: e.g. zolpidem Cyclopyrrolones: e.g. zopiclone Pyrazolopyrimidines: e.g. zaleplon | q

Question 59

What are the adverse effects of Z drugs?

Answer 59

similar to benzodiazepines increase the risk of falls in the elderly

Question 60

What is de Clerambault's syndrome?

Answer 60

form of paranoid delusion with an amorous quality. The patient, often a single woman, believes that a famous person is in love with her.

Question 61

Alternative first line to SSRI in OCD?

Answer 61

clomipramine