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MRCP Master > Psychiatry > Flashcards

Psychiatry Flashcards

1
Q

Raised G’s and C’s raised of anorexia

A

G’s and C’s raised: GH, glucose, salivary glands, cortisol, cholesterol, carotinaemia

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2
Q

Cardiac SE of citalopram and escitalopram

A

dose-dependent QT interval prolongation

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3
Q

SSRI drug interactions

A
  1. NSAIDs: NICE dont combined but if need co-prescribe a PPI
  2. Warfarin / heparin: NICE guidelines recommend avoiding SSRIs and considering mirtazapine
  3. aspirin
  4. triptans - increased risk of serotonin syndrome

4.MAOIs- increased risk of serotonin syndrome

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4
Q

How stop SSRI?

A

stopping a SSRI the dose should be gradually reduced over a 4 week period
-this is not necessary with fluoxetine
-Paroxetine has a higher incidence of discontinuation symptoms.

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5
Q

oculogyric crisis rx

A

Procyclidine, an anticholinergic drug, is used in the management of extrapyramidal symptoms caused by antipsychotics. It works by blocking the action of acetylcholine in the central nervous system, which helps to reduce muscle stiffness and spasms.

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6
Q

Examples of atypical antipsychotics

A

clozapine
olanzapine: higher risk of dyslipidemia and obesity
risperidone
quetiapine
amisulpride
aripiprazole: generally good side-effect profile, particularly for prolactin elevation

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7
Q

Adverse effects of clozapine

A

agranulocytosis (1%), neutropaenia (3%)

reduced seizure threshold - can induce seizures in up to 3% of patients

constipation

myocarditis: a baseline ECG should be taken before starting treatment
hypersalivation

Dose adjustment of clozapine might be necessary if smoking is started or stopped during treatment.

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8
Q

Typical antipsychotics examples
MAO
SE

A

Haloperidol
Chlorpromazine

Dopamine D2 receptor antagonists, blocking dopaminergic transmission in the mesolimbic pathways

Extrapyramidal side-effects and hyperprolactinaemia common

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9
Q

ATypical antipsychotics examples
MAO
SE

A

Clozapine
Risperidone
Olanzapine

Act on a variety of receptors (D2, D3, D4, 5-HT)

Extrapyramidal side-effects and hyperprolactinaemia less common
Metabolic effects

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10
Q

Tricyclic antidepressants
More sedative

A

Amitriptyline
Clomipramine
Dosulepin
Trazodone*

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11
Q

Less sedative Tricyclic antidepressants

A

Imipramine
Lofepramine
Nortriptyline

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12
Q

Tricyclic antidepressants

A

inhibition of the reuptake of neurotransmitters
Noradrenaline (NA) & Serotonin (5-HT)

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13
Q

SSRI of choice post myocardial infarction

A

Sertraline

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14
Q

What type of drug is venlafaxine and duloxetine

A

Serotonin and noradrenaline reuptake inhibitors

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15
Q

Erotomania (De Clerambault’s syndrome)

A

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

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16
Q

Capgras syndrome

A

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

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17
Q

De Frégoli

A

This is the delusion of identifying a familiar person in various people they encounter.

18
Q

Othello syndrome

A

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

19
Q

Ekbom syndrome

A

This is delusional parasitosis and describes the delusion of infestation.

20
Q

how to withdraw a benzodiazepine

A

withdrawn in steps of about 1/8 (range 1/10 to 1/4) of the daily dose every fortnight.

Withdraw may present like alcohol withdrawel

21
Q

Other drug causes of serotonin syndrome

A

The LOSt MD Took MDMA - Tramadol,

Linezolid,
Ondansetron,
St. John’s wort,
Triptans

Meperidine, Dextromethorphan, , and
MDMA.

22
Q

serotonin syndrome rx

A

Management
supportive including IV fluids

benzodiazepines

more severe cases are managed using serotonin antagonists such as cyproheptadine and chlorpromazine

23
Q

neuroleptic malignant syndrome MAO

A

associated with dopamine receptor blockade.
More commonly occurs Typical antipsychotic medications,

24
Q

Neuroleptic malignant sx

A

More mscl rigidity

25
Q

Rx neuroleptic malignant syndrome

A
26
Q

Causes of acute dystonia

A
27
Q

Acute dystonia sx

A
28
Q

Acute dystonia sx

A
29
Q

Tyramine induced hypertension crisis is caused by

A
30
Q

Tyramine induced hypertension crisis rx

A
31
Q

Cause of DTs

A

Imbalance btwn gaba and NMDA

32
Q

Signs of opioid toxicity

A
33
Q

Opioid sx

A
34
Q

Rx of opioid withdrawal

A
35
Q

Mao Barbiturates

A
36
Q

Barbiturates intoxication sx

A
37
Q

Mao benzodiazepines

A
38
Q

Sx of benzo intoxication

A
39
Q

Sign of inhalation withdrawal

A
40
Q

Vitiligo
Associated conditions
Dx & RX

A

DM1
Addison’s disease
autoimmune thyroid disorders
pernicious anaemia
alopecia areata

Dx clinical & wood lamp; Koebner phenomenon
Rx steroids

41
Q

Acanthosis nigricans causes

A

Ass w/ insulin resistance
Causes

DM 2
GI ca
obesity
PCOS
acromegaly
Cushing’s disease
hypothyroidism
familial
Prader-Willi syndrome

drugs
COC pill
nicotinic acid

42
Q

Rx pityriasis versicolor

A

Ketoconazole shampoo is used to treat

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