Psychiatry

Question 1

Third person auditory hallucinations

Answer 1

Schizophrenia

Question 2

Mesocortical dopamine hypoactivity

Answer 2

Negative and cognitive symptoms in schizophrenia

Question 3

Subcortical dopamine hyperactivity

Answer 3

Psychosis

Question 4

Tuberoinfundibular dopamine pathway

Answer 4

Associated with prolactin release

Question 5

Nigrostriatal dopamine pathway

Answer 5

Extra-pyramidal motor movements

Question 6

Subcortical and Mesocortical dopamine pathway

= Mesolimbic system

Answer 6

Motivation and reward

Question 7

Mesolimbic dopamine blockade results in

Answer 7

Depression

Question 8

Dopamine agonism results in

Answer 8

Psychosis

Question 9

3 side effects of clozapine

Answer 9

Agranulocytosis
Cardiomyostitis
Weight gain

Question 10

Prescribing clozapine

Answer 10

Need to try 2 other anti-psychotics

Must be consultant to prescribe

Question 11

Limbic system functions

Answer 11

M2OVE
Motivation 
Memory
Olfaction 
Visceral Afferents 
Emotion

Question 12

Brain changes in schizophrenia

Answer 12

Reduced frontal lobe volume
Enlarged lateral ventricles
Reduced grey matter in the temporal cortex

Question 13

Pressure of thought

Answer 13

Varied ideas in abundance

Question 14

Poverty of thought

Answer 14

Patient reports lack/absence of thoughts

Question 15

Thought blocking

Answer 15

Abrupt and complete interruption of stream of thought

Strongly associated with schizophrenia

Question 16

Flight of ideas

Answer 16

Quickly moving from one topic to another

Seen in manic phase

Question 17

Treat EPSE with…

Answer 17

Procyclidine

Question 18

Amygdala role

Answer 18

Normal response to threat

Question 19

Pre-frontal cortex role

Answer 19

Dampens down amygdala response to threat

Question 20

Management of OCD

Answer 20

1. Try two different SSRIs
2. SSRI + TCA
3. SSRI + TCA (chlomipramine)
   Consider CBT as an adjuvant

Question 21

Learning disabilities IQ Thresholds

Answer 21

Borderline 70-80ish 
Mild 50-69 
Moderate 49-35 
Severe 20-34
Profound <20

Question 22

Beck’s Triad

Answer 22

-VE feelings about self, world and future

Question 23

NMDA antagonists produce…

Answer 23

Psychotic symptoms

Question 24

Management of alcohol withdrawal

Answer 24

Use Chlordiazepoxide

Start at 30mg QD, reduce very gradually

Question 25

When do alcohol withdrawal seizures occur?

Answer 25

48 hours

Question 26

Delirium tremens in alcohol withdrawal occurs?

Answer 26

Between 48-72 hours

Question 27

Lewy Bodies are

Answer 27

Eosinophilic inclusions

Question 28

Risk with MAO-i

Answer 28

Hypertensive crisis

Precipitated by high levels of tyramine

Question 29

Treatment of MAO-i Hypertensive Crisis

Answer 29

Phentolamine infusion

Question 30

When to avoid TCAs?

Answer 30

Cardiac problems

Patients with suicidal intent