psychiatry

Question 1

things that are raised with Anorexia

Answer 1

raised cortisol, carotin, glucose, cholesterol, growth hormone

Question 2

side effects of conventional anti-psychotics

Answer 2

1) acute dystonia(torticollis(neck spasms), oculogyric crisis(elevation of gaze bilaterally)
2) akathesia(restlessness)
3) tardive dyskinesia(involuntary movements of the face and jaw)

Question 3

PTSD- triad

Answer 3

1) hyperarousal
2) avoidant behaviour
3) intrusive recollections

Question 4

Section for guardianship(attend psych clinic in community and allow social worker access at home)

Answer 4

section 7

Question 5

acute schizophrenia - first rank symptoms

Answer 5

• auditory hallucinations
• somatic hallucinations
• thought disorder(broadcast , withdrawal, insertion and interruption)
• delusional perception
• somatic passivity.

Question 6

chronic schizophrenia symptoms

Answer 6

negative symptoms- poverty of thought, apathy, lack of volition, social withdrawal and loss of affect

Question 7

anorexia nervosa signs

Answer 7

-distortion of body image and weight maintained below 17.5 BMI

Question 8

somatization disorder

Answer 8

• 2 year history of multiple various physical symptoms of which no cause has been identified. Ongoing refusal to accept reassurance, regardless of negative test findings
• has a familial tendency

Question 9

Hypochondrial disorder

Answer 9

-persistent belief of one serious illness

Question 10

baby blues

Answer 10

mother becomes temporarily sad/emotional day 3-5 post-partum

Question 11

postnatal depression

Answer 11

• present anytime during the first year
• peaks at 12 weeks
• treated like depression- mother and baby groups, CBT, SSRI
• monitored using edinburgh postnatal depression scale

Question 12

echopraxia

Answer 12

automative imitation or repetition of another persons actions- involuntary

Question 13

ambitendency

Answer 13

coexistence of mixed feelings

Question 14

waxy flexibility

Answer 14

catatonic schizo-reduced response to external stimuli and tends to remain in a fixed immobile posture.

Question 15

borderline personality disorder

Answer 15

• instability and impulsivity- fear of being abandoned(feel that boyfriend is leaving)

Question 16

lithium therapeutic level and monitoring

Answer 16

0.4-1( on days 4-7 after treatment), then every week until dosage is constant for 4 weeks and every 3 months after

Question 17

drug used when not responding to lithium bipolar

Answer 17

carbamazepine

Question 18

ideal atypical depot injection

Answer 18

risperidone

Question 19

hyperthermia, fluctuating level of consciousness, muscular rigidity and autonomic dysfunction(tachycardia, labile blood pressure), rigidity

• what condition
• which is the key cause

Answer 19

neuroleptic malignant syndrome

1st generation anti-psychotics

Question 20

management of neuroleptic malignant syndrome

Answer 20

1) reduce dopamine- stop the dopamine antagonist(anti-psychotic meds), start dopamine agonists(bromocriptine)
2) cooling
3) dantrolene

Question 21

on SSRI, becomes confused- key diagnosis

Answer 21

hyponatraemia-SIADH seen in SSRIs

Question 22

dyslexia -phonemes

Answer 22

cannot process words that sound distinct in speech- p,b t and d

Question 23

Hypomania Vs Mania

Answer 23

Hypomania- nothing grandiose, no psychosis

Mania- psychotic, needs hospital admission, has grandiose delusions(god, untouchable)

Question 24

PHQ-9 minimum score for severe depression

Answer 24

severe depression -20

Question 25

dyslexia -phonemes

Answer 25

cannot process words that sound distinct

Question 26

screening phonemes for dysleksia- what test

Answer 26

GaPs - grammar and phonology screening

Question 27

already tried 2 different SSRIs- what to try next

Answer 27

SNRI class- venlafaxine 75mg MR

Question 28

what anti-depressant is safe in pregnancy

Answer 28

ssris

Question 29

fugue

Answer 29

patient forgets their whole history

Question 30

depersonalisation

Answer 30

out of body, response to stress

Question 31

Dissociative identity disorder

Answer 31

takes multiple personalities(~multiple personality disorder)

Question 32

malingering

Answer 32

purposefully fabricating /exaggerating symptoms for external gain.

Question 33

drug used to reduce the craving for alcohol

Answer 33

acamprosate, naltrexone

Question 34

paranoia and formication(feeling of ants crawling on the skin)- what withdrawal

Answer 34

cocaine

Question 35

effects of stopping anti-depressants abruptly

Answer 35

• SNRIs- GI disturbances, vivid dreams and night mares, insomnia, somatic distress(headaches, sweating, lethargy).
• SSRI-light headedness, dizzyness, numbness and electric shock like symptoms.

Question 36

bedsite tests of frontal lobe function(executive functioning)

Answer 36

1) verbal fluency(ask patients to recall as many words that start with a letter in 1 minute)- less than 10 is abnormal
2) Estimating- ask the patient to guess the height or weight of an object
3) response inhibition/motor preservation-ask patient to tap once when you tap twice and tap twice when you tap once. - tapping the same number- motor preservation/copying whatever you tap- echopraxia
4) clock drawing test
5) abstract thinking- relation between dog and cat.

Question 37

age ect is not recommended in

Answer 37

5-11

Question 38

first line medication for ADHD

Answer 38

methylphenidate(can only be started by child psych)

Question 39

section 4

Answer 39

emergency application of detention in hospital for upto 72 hours.