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MSRA > psychiatry > Flashcards

psychiatry Flashcards

1
Q

SSRI of choice:

  1. post MI
  2. in paeds
A
  1. sertraline
  2. fluoxetine
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2
Q

SSRIs

  1. most common SE
  2. which 2 have higher SE profile?
  3. which one causes long QT
A
  1. GI - add omeprazole if also on NSAID
  2. fluoxtetine
    paroxetine
  3. citalopram
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3
Q

SSRIs interactions:

(4)

A

NSAIDS (add on omeprazole)

warfarin/ heparin –> consider mirtazapine

triptans –> increased risk of serotonin syndrome

MAOIS (monoamine oxidase inhibitors) - increase risk of seratonin syndrome

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4
Q

SSRIs

  • how long after starting do you r/v?
A

2 weeks
1 week if <25 or high suicide risk

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5
Q

SSRIs discontinuation sx:

A

increased mood change
restlessness
difficulty sleeping
unsteadiness
sweating
gastrointestinal symptoms: pain, cramping, diarrhoea, vomiting
paraesthesia

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6
Q

SSRIs in pregnancy

  1. risk in 1st trimester
  2. risk in 3rd trimester
  3. which causes increased risk of congenital malformation
A
  1. congenital heart defects
  2. peristant pulmonary HTN
  3. paroxetine
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7
Q

mechanism of action for benzodiazepines

A

enhance effect of GABA (the main inhibitory neurotransmitter)

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8
Q

poor prognostic indicator for schizophrenia: (5)

A

FH
gradual onset
low IQ
prodromal phases of social withdrawal
lack of obvious precipitant

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9
Q

section 2

A
  • admission for up to 28 days (not renewable)
  • rx can be given agains pt’s wishes
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10
Q

section 3

A
  • admission for up to 6 months, can be renewed
  • rx can be given against pt’s wishes
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11
Q

section 4

A
  • 72 hr assessment order
    (used in emergency when section 2 would cause unacceptable delay)
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12
Q

section 5 (2)

section 5 (4)

A

a patient who is a voluntary patient in hospital can be legally detained by a doctor for 72 hours

similar to section 5(2), allows a nurse to detain a patient who is voluntarily in hospital for 6 hours

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13
Q

section 17a

A

Supervised Community Treatment (Community Treatment Order)

can be used to recall a pt to hospital for rx if they do not comply with conditions of the order in the community, such as complying with medication

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14
Q

section 135

A

a court order can be obtained to allow the police to break into a property to remove a person to a Place of Safety

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15
Q

section 136

A

someone found in a public place who appears to have a mental disorder can be taken by the police to a Place of Safety
can only be used for up to 24 hours, whilst a Mental Health Act assessment is arranged

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16
Q

Hoover’s sign

  • what does it differentiate between
A

organic/ non-organic leg paresis

non-organic paresis, pressure is felt under the paretic leg when lifting the non-paretic leg against pressure, this is due to involuntary contralateral hip extension

17
Q

anti-muscarinic SE (4)

what group of drugs cause them?

A

dry mouth
blurred vision
constipation
urinary retention

TCAs

18
Q

TCA SE: (4)

A

anti-cholinergic (dry mouth, blurred vision, constipation, urinary retention)
drowsiness
postural hypotension
long QT

19
Q

which antipsychotic has best SE profile (especially re: prolactin elevation)

A

apriprazole

20
Q

medication for mgt of acute dystonia

A

procyclidine

21
Q

clozapine SE: (5)

A

agranulocytosis
neutropenia
constipation
myocarditis (need baseline ECG before starting)
hypersalivation

22
Q

what can cause serum clozapine levels to increase unexpectedly?

A

smoking cessation

23
Q

atypical antipsychotics SE:

A

weight gain
hyperprolactinaemia
agranulocytosis (clozapine)

24
Q

what do atypical antipsychotics increase risk of in elderly? (2)

A

VTE
stroke

25
Q

tardive dyskinesia definition

A

involuntary repetitive movements

most commonly face & tongue

usually onset with LT anti-psychotic use

26
Q

acute dystonia definition

A

sustained muscle contractions leading to abnormal postures

typically onset within DAYS of starting anti-psychotic

27
Q

akathisia definition

A

= restlessness (does not involve involuntary movements)

MSRA (7 decks)

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