Psychiatry

Question 0

Drugs used to prevent alcohol dependence

Answer 0

“NAD”

Naltrexone (opioid antagonist)
Acamprosate (acts on a bunch of inhibitory receptors)
- both reduces frequency of drinking
Disulfiram (acetaldehyde and histamine release, unpleasant feeling)

Question 1

Symptoms and signs of MANIA

1. Mood (x3)
2. Cognition (x3)
3. Behaviour (x5)

Answer 1

1. Irritable, euphoric, lability (“LIE”
2. Grandiosity, flight of ideas, poor concentration
3. Rapid Speech, hyperActivity, Insomnia, hyperSexuality, Extravagance. “ESSAI”

May get psychotic delusions, and hallucinations less commonly.

Question 2

Korsakoff syndrome triad

Answer 2

Anterograde amnesia
Retrograde amnesia
Confabulation

(Basically, irreversible thiamine deficiency leads to patient who forgets many things, and cannot lay down new memory. Pretty awful)

Question 3

6 typical antipsychotic drugs

Answer 3

Chlopromazine
Haloperidol
Fluophenazine
Zuclopenthixol
Fluoentixol
Trifuoperazine

Question 4

6 atypical antipsychotics

Answer 4

Respiridone
Aripiprazole
Quetiapine
Amisulpride
Clozapine
Olanzapine

Question 5

Drugs used in dementia

Answer 5

Donezepil
Rivastigmine
Galantamine
- all 3 are anti-ChE.

Memantine (NMDAR antagonist, mod-severe dementia. Stop excitatory cell death)

Question 6

Management of acutely agitated patient (ie. tranquillisation)

Answer 6

1. Reassure and calm with talking
2. Oral - If patient can be tamed with oral meds:
   - risperidone + BDZ
3. IM - haloperidol or Olanzapine, +/- lorazepam. Need many people to restrain the patient. If still feel that not safe, call police.

(IV rarely used, unless in extraordinary circumstances…)

Question 7

Symptoms of clinical depression

Answer 7

Anhedonia, low mood,

Feelings: helplessness, low self-esteem, anhedonia
Cognition: poor concentration, guilt and self-blame

Somatic symptoms: "WARS"
Weight changes
Appetite loss (or gain...)
Retardation or agitation 
Sleep disturbances

Question 8

Diagnostic criteria for manic episode

Answer 8

3/9 of following for >1 week

Appearance & behaviour: hyperSexuality, distractable, social disinhibition, spending more/wreckless
Speech: pressured
Thought form: racing thoughts
Mood: elevated, irritable, less sleep needed
Affect
Thought content: 
I
Cognition: grandiosity