Pyschiatry

Question 1

What is the best option for people who’s symptoms of schizophrenia are well controlled on their current antipsychotic but have poor oral compliance?

Answer 1

Monthly IM depot injections

Question 2

What is the cutoff for acute stress disorder vs PTSD?

Answer 2

Acute stress reaction occurs within 4 weeks of traumatic event, PTSD is diagnosed when symptoms occur after 4 weeks

Question 3

PTSD management?

Answer 3

Trauma-focussed CBT and EMDR therapy

Question 4

What is mania defined as?

Answer 4

Persistently elevated mood state with psychotic symptoms

Question 5

What are the first rank symptoms of schizophrenia?

Answer 5

-Auditory hallucinations ( 2 or more voices discussing patient in 3rd person, thought echo, voices commenting on behaviour)
-Thought disorders ( insertion, withdrawal, broadcasting)
-Passivity phenomena (Body sensations controlled by external influences, actions and feelings can be influenced by external forces)
-Delusional perceptions ( Object is perceived and then there is delusional insight into the meaning e.g. the bus stopped for me that means i am God)
-

Question 6

What type of delusions come with Othello syndrome?

Answer 6

Jealousy - partner is being unfaithful

Question 7

Difference between somatisation disorder and Hypochondriasis?

Answer 7

Somatisation is Symptoms
hypoChondria is Cancer

Question 8

Difference between tangentiality and circumstantiality?

Answer 8

Tangentiality - always on tangents, never answers question
Circumstantiality - goes on tangents for ages before eventually getting to point of question

Question 9

What electrolyte imbalance are SSRI’s associated with?

Answer 9

Hyponatraemia

Question 10

What are the 7 S’s of SSRI side effects?

Answer 10

• Stomach upset
• Sexual dysfunction
• Serotonin syndrome - hyperthermia, muscle rigidity, flushing, diarrhea
• Sleep difficulties
• Suicidal thoughts
• Stress
• Size increase / weight gain

Question 11

Who should citalopram not be prescribed to?

Answer 11

People with congenital long QT syndrome

Question 12

Common features of PTSD?

Answer 12

Re-experiencing - flashbacks
Avoidance - people or situations
Hyperarousal e.g. hypervigilance and sleep problems

Question 13

Mechanism of typical antipsychotics?

Answer 13

Dopamine D2 receptor antagonists

Question 14

Adverse effects of typical antipsychotics

Answer 14

Extrapyramidal side effects and hyperprolactinaemia

Question 15

Examples of typical antipsychotics?

Answer 15

Haloperidol
Chlopromazine

Question 16

Examples of atypical antipsychotics?

Answer 16

Clozapine
Risperidone
Olanzapine

Question 17

What is a section 2 used for?

Answer 17

Detainment for up to 28 days for mental state assessment

Question 18

What is a section 3 used for

Answer 18

Detainment for up to 6 months for treatment of mental condition

Question 19

Risk of zopiclone use in the elderly?

Answer 19

Increased risk of falls

Question 20

Mirtazapine characteristic side effect?

Answer 20

Increase in appetite

Question 21

Flight of ideas is a feature of?

Answer 21

Mania

Question 22

Schizoid personality disorder characteristics?

Answer 22

Prefer to be alone, don’t like relationships, low libido, indifferent to praise or criticism

Question 23

What class of antidepressants can cause urinary retention?

Answer 23

Trycyclics e.g. amitriptyline

Question 24

How is depression categorised?

Answer 24

Mild - 2/3 core symptoms and at least 2 other symptoms
Moderate - at least 2/3 core symptoms and 3/4 other symptoms
Severe- All 3 core symptoms and at least 4 other symptoms .

Question 25

How to calculate alcohol units?

Answer 25

Volume in mls x ABV then divide result by 1000

Question 26

Common side effect of clozapine?

Answer 26

Constipation/intestinal obstruction

Question 27

When should levels be re-checked after commencing lithium therapy?

Answer 27

1 week - 12 hours after last dose

Question 28

Difference between type 1 and type 2 bbipolar disorder?

Answer 28

Type 1 assc with mania and type 2 assc with hypomania

Question 29

Poor prognostic indicators in schizophrenia?

Answer 29

Low IQ
Sudden onset
Prodromal social withdrawal

Question 30

Side effects of tricyclic antidepressants?

Answer 30

Dry mouth
Weight gain
Dizziness
Prolonged QT
Urinary retention

Question 31

Which atypical antipsychotic has the most tolerable side effect profile?

Answer 31

Aripiprazole - should give to those with prolactin elevation

Question 32

What is conversion disorder?

Answer 32

Typically involves loss of motor or sensory function, may be caused by stress

Question 33

Features of Anorexia?

Answer 33

Most levels are lowered
G’s and C’s are raised: Growth hormone, Glucose, salivary Glands, Cortisol, Cholesterol, Carotinaemia

Question 34

Mechanism of benzodiazipines?

Answer 34

Enhance the effect of GABA

Question 35

Which antipsychotic drug reduces seizure threshold, making seizures more likely?

Answer 35

Clozapine

Question 35

Which antipsychotic drug reduces seizure threshold, making seizures more likely?

Answer 35

Clozapine

Question 36

What medications should be avoided on SSRIs?

Answer 36

Triptans e.g. sumatriptan

Question 37

What is Akathisia and what causes it?

Answer 37

Sense of inner restlessness and inability to keep still
Usually an extra-pyramidal side effect of antipsychotic use

Question 38

SNRI’s such as venlafaxine are associated with development of?

Answer 38

HTN

Question 39

Management of oculogyric crisis?

Answer 39

Procyclidine