Psychiatry

Question 1

How long must sx persist for a diagnosis of depression?

Answer 1

2 weeks

Question 2

What is 1st line pharmacological mx for generalised anxiety disorder in Adults?

Answer 2

Sertraline

Question 3

How is persistent subclinical or mild-moderate depression mx?

Answer 3

1st line is CBT

Question 4

How is moderate to severe depression mx?

Answer 4

1st line is CBT + antidepressant (SSRI)

Question 5

How is severe depression +/- adverse effects such as psychosis managed?

Answer 5

ECT is 1st line

Question 6

How much longer after remission of depression should SSRIs be continued for?

Answer 6

6 Months

Question 7

Why may antipsychotics such as mirtazapine be useful in anorexia nervosa?

Answer 7

Help to settle anxiety/depression and a SE is weight gain which also helps.

Question 8

What is Russell’s sign seen in Bulimia pts? What are other signs?

Answer 8

Russell’s: Scarring of the knuckles associated with self-induced vomiting.
Others: dental erosion, parotid swelling, amenorrhoea, and Boerhaave syndrome/mallor-weiss tear are complications that they may present with.

Question 9

Schizotypal personality disorder is a class A personality disorder, what are the symptoms do you see?

Answer 9

Unusual social behaviour, bizarre/magical thinking, distorted perceptions.

Question 10

How is schizotypal personality disorder different from schizophrenia?

Answer 10

SPD pts can maintain their grasp on reality and do not hold their beliefs with such unwavering certainty.

Question 11

What do you see in pts with schizoid personality disorder?

Answer 11

Impaired relationships and attachement.

Question 12

What do you see in patient with paranoid personality disorder?

Answer 12

Enduring pattern of irrational suspicion and mistrust of others.

Question 13

What age must you be to be diagnosed with a class A personality disorder?

Answer 13

18 and over.

Question 14

What has a better prognosis for Schizophrenia, predominantly -ve sx or predominantly +ve sx?

Answer 14

Having predominantly +ve sx (hallucinations and delusions) are a sign of a good prognosis.

Question 15

What is the difference between type 1 and 2 Bipolar disorder?

Answer 15

Type 1: one or more manic episodes and one or more depressive episodes
Type 2: recurrent depressive episodes, tend to be able to continue with ADLs

Question 16

What is used to manage chronic bipolar disorder?

Answer 16

Lithium or valproate as mood stabilisers and high intensity psychological therapies.

Question 17

How long must sx persist for to diagnose PTSD?

Answer 17

1 month of sx symptoms affecting day-to-day life

Question 18

What is delusional parasitosis?

Answer 18

Unshaken belief of infection with parasite within their skin.

Question 19

What is a Capgras delusion?

Answer 19

Misidentification syndrome where the pt thinks their loved ones have been replaced by a clone.

Question 20

What is Fregoli Disorder?

Answer 20

someone who believes everyone is the same person dressed in different designs, associated with injury to the right frontal area, left tempoparietal area, and fusiform gyrus.

Question 21

What is a cotard delusion?

Answer 21

pt believes they are dead, non-existing, or rotten

Question 22

What is thought blocking?

Answer 22

Pt halts their thought process, may be seen as withdrawal from conversation/interaction and abrupt silence.
Seen in schizophrenic pts.

Question 23

What type of electrolyte disturbance is associated with purge-type bulimia?

Answer 23

Metabolic acidosis (vomiting = loss of acid) with hypokalaemia (vomiting induces RAAS).

Question 24

What blood test abnormality is commonly found in someone with Anorexia Nervosa?

Answer 24

Low WCC secondary to malnutrition.

Question 25

How long does an acute stress reaction last? How long is the onset from a significant event?

Answer 25

<4 weeks.
Onset within a couple of days of significant event.

Question 26

How long does adjustment disorder last? How long since a significant event does it onset?

Answer 26

• Lasts <6 months
• Onset < 3 months since event