Psychiatry

Question 1

Comorbid conditions

Answer 1

ADHD -> ODD, anxiety, learning difficulty, tics

ODD -> ADHD, language/learning disorder, depression

Conduct disorder -> ODD, ADHD

Tourettes -> ADHD, OCD, autism

Depression -> anxiety

Bipolar -> ADHD, anxiety, ED, PTSD

OCD -> tics, ADHD, anxiety, depression

Eating disorder -> anxiety, depression, substance abuse

Autism -> ID, ADHD, anxiety

School refusal -> depression, ODD, anxiety

Question 2

Inheritability

Answer 2

Autism most inheritable
- 60-90% MZ twins, 10% siblings

Schizophrenia second most inheritable
- 50% MZ twins, 1 parent 10%, 2 parents 45%, 4% second degree relative, 10-15% siblings

Bipolar disorder third most inheritable
- 70% MZ twins, most common inheritable if one parent

Major depressive disorder depression least inheritable
- 60-70% MZ twins, 1 parent 2x risk, 2 parents 4x risk

OCD
- 80% MZ, 5x first degree relative

ADHD
- >50% MZ, siblings 33%

Anxiety
- Twin 30-40%, parent affected 7x more likely

Question 3

ADHD

Answer 3

Stimulants (methylphenidate), atomoxitine if anxiety also, clonidine if tics

Question 4

Severe depression

Answer 4

Fluoxetine

Question 5

Anxiety

Answer 5

Fluoxetine

Question 6

Social phobia

Answer 6

Sertraline

Question 7

OCD

Answer 7

SSRI - fluoxetine/sertraline, TC (clamipramine)

Question 8

Schizophrenia

Answer 8

Risperidone, haloperidol, olanzapine

Question 9

Tourette

Answer 9

Risperidone, haloperidol

Question 10

Conduct disorder

Answer 10

Stimulants if ADHD, risperidone if aggression

Question 11

Bipolar

Answer 11

Lithium, valproate, carbamazepine, risperidone, olanzapine

Question 12

Autism

Answer 12

Risperidone/haloperidol if aggression problems

Question 13

Fluoxetine

Answer 13

SSRI

Nausea, agitation, sedation, increased suicidal ideation

Question 14

Atomoxetine

Answer 14

SNRI increases dopamine and noradrenaline
Reduced appetite, nausea
Rare: hepatotoxicity, suicide

Question 15

Methylphenidate

Answer 15

Stimulant - dopamine rey-take inhibition
Appetite suppression, weight loss, reduced height, headaches, abdominal pain
Worsens tics, don’t use in cardiac history

Question 16

Dexamphetamine

Answer 16

Stimulant - releases dopamine and noradrenaline
Appetite suppression, weight loss, reduced heigh, headaches, abdominal pain.
Worsens tics, don’t use in cardiac history

Question 17

Risperidone

Answer 17

Atypical antipsychotic. Dopamine and serotonin antagonist

Extrapyramidal side effects, weight gain, prolactin, abdominal pain, skin (weight loss least likely)

Question 18

Olanzapine

Answer 18

Atypical antipsychotic. 5HT/alpha receptor antagonist

Weight gain ***, sedation, increased prolactin

Question 19

Clozapine

Answer 19

Atypical antipsychotic

Agranulocytosis

Question 20

Quetiapine

Answer 20

Atypical antipsychotic

Weight gain, high lipids

Question 21

Clonidine

Answer 21

Drowsiness, hypotension, dry mouth

Question 22

Haloperidol

Answer 22

Typical antipsychotic

Extrapyramidal side effects, prolactin,. long QT, skin

Question 23

Lithium

Answer 23

Mood stabiliser

Nausea, diarrhoea, hypothyroidism, acne, alopecia

Question 24

Valproate

Answer 24

Mood stabiliser

Weight gain, PCOS, alopecia, LFT, teratogenic

Question 25

Carbemazapine

Answer 25

Mood stabiliser

Nausea, vomiting, blurred vision, nystagmus, ataxia, agranulocytosis

Question 26

Lamotrigine

Answer 26

Mood stabiliser

Dizziness, ataxia, blurred vision, vomiting, SJS (rare)