Revision - Psych Flashcards
What term is used to describe someone with an IQ of 60?
Mild intellectual disability
normal = >70
Which one is not included in the ICD-10 criteria of anorexia nervosa?
BMI reduction of 85%
Loss of interest in food
Sexual dysfunction in men
Delayed puberty
Morbid dread of fatness
B
Which of these facts about non-epileptic attack disorder is true ?
A.Patients are normally conscious during the attack
B.NEAD can frequently be differentiated from epilepsy based on the patient’s movements during the seizure
C.NEAD is caused by a structural lesion in the brain that causes abnormal electrical activity
D.NEAD should be treated with anticonvulsants
E.NEAD is highly associated with childhood
E
What disorder is caused by Vitamin B1 aka Thiamine deficiency?
A.Pernicious anaemia
B.Wernicke’s syndrome
C.Frontotemporal dementia
D.Demyelination
E.Lewy Body dementia
A.caused by B12
B.CORRECT
An 8 year old boy has been recently diagnosed with ADHD. He constantly leaves his seat in class and finds it difficult to follow instructions. He has ran away from home impulsively on one occasion necessitating police involvement. Which is the best 1st line treatment?
A.Fluoxetine
B.Methylphenidate
C.Clomipramine
D.Atomoxetine
E.Risperidone
B.Stimulant - 1ST LINE
A.SSRI
C.tricyclic - for CATAPLEXY
D.SNRI - 2nd line for ADHD
E.anti-psychotic
Which of the following is true about OCD?
A.Specific genes have been found to predispose to early-onset OCD
B.OCD has a strong neurobiological basis so psychotherapy is not very useful in its treatment
C.You can have obsessions and compulsions but not have OCD
D.Tricyclic antidepressants are the first line pharmacological treatment for OCD
E.Most patient with OCD have no other mental illness as very specific parts of the brain are affected
C.TRUE - can have obsessive traits
D.SSRIs are first line, tricyclics next
Which statement does not belong in a mental state examination?
A.“the patient is dishevelled, wearing dirty clothes”
B.“he is thinking about his ex-wife and their recent divorce”
C.“the patient’s mother thinks he has been responding to auditory hallucinations”
D.“she agrees that she should be admitted to hospital”
E.“she is orientated in time, place and person”
C.
Which statement is true regarding psychological therapies?
A.EMDR is not a recommended treatment for PTSD
B.Cognitive behavioural therapy is suitable for anyone with mild to moderate depression
C.Psychological therapies should always be combined with pharmacological therapies as the best evidence if for a combination of the two
D.Interpersonal therapy is a recognised treatment for depression
E.Dialectical Behavioural Therapy is a recommended treatment for Antisocial disorder
B.not suitable for everyone
C.in kids usually do psychological therapies first, then meds due to the side effects
D.TRUE - working on your own
E.used for borderline personality disorder
Which of these areas in the brain is NOT implicated in mood disorders?
A.Ventromedial prefrontal cortex
B.Dorsolateral prefrontal cortex (DLPFC)
C.Hippocampus
D.Motor cortex
E.Anterior cingulate cortex
D.
What advice would you give to a woman prescribed Lithium for prophylaxis of Bipolar Affective Disorder who is planning a pregnancy?
A.The risk of developing fetal abnormalities is highest in the 3rd trimester
B.No additional monitoring is required during pregnancy when continuing Lithium
C.Lithium is associated with neural tube defects
D.Lithium should be stopped quickly when planning a pregnancy
E.Lithium can be continued if manic or depressive symptoms have not been stable
A.highest in the 1st trimester
B.must have additional monitoring - bloods
C.sodium valproate
D.stopped gradually
E.YES - need to correct mania or depression first
Which of the following is NOT a commonly used scale to measure depressive symptoms?
A.Montgomery-Asberg Rating Scale (MADRS)
B.Symptoms of Affective Disorders Scale (SAD Scale)
C.Hospital Anxiety and Depression Scale (HADS)
D.Quick Inventory of Depressive Symptomatology Self Report 16 (QIDS)
E.Inventory of Depressive Symptomatology-
Self Report 30 (IDS-30-SR)
B.made up
Which of the following is true of personality disorders?
A.The assessment of personality disorders is straightforward
B.As high as 30% of the general population meet the criteria for a personality disorder
C.Narcissistic and schizotypal personality disorders are not present in ICD10
D.Antisocial personality disorder and psychopathy are different terms for the same disorder
E.It is important to diagnose personality disorders, as there is good quality evidence for the treatment of most of them
A.NOT straightforward
B.as high as 10%, 30% of outpatient psychiatric patients
C.YES - they are present in DSM
D.Dis social
E.
Which of the following is NOT a first rank symptom of schizophrenia?
A.3rd person auditory hallucinations giving a running commentary
B.Delusional perception
C.Paranoid delusional beliefs
D.Thought broadcast
E.Passivity of actions (Made actions)
C.
Which of the following statements is NOT true of Autistic Spectrum Disorders?
A.The prevalence of ASD is around 1-2% in the general population
B.ASD is thought to have a high heritability
C.Around 65% of those with ASD will also meet the criteria for ADHD
D.Risperidone is licensed for management of severe aggression and significant self-injury in ASD
E.Symptoms must be present in the early developmental period to diagnose ASD
A.increased to 5% now, better at picking up ppl with autism
Which of the following is not a symptoms of alcohol dependence?
A.Tom finds he has to drink more than he did a year ago in order to feel the same way
B.John has a tremor and feels nauseous when he does not drink for a day
C.Gordon likes to binge drink at the weekend and sometimes has a poor memory of the events of the previous night
D.Mary has spent less time with her friends or going to the gym as she prefers to go to the pub for a drink
A.tolerance
B.physiological signs
C.YES - harmful use
D.neglect of alternative interests
E.compulsion
A 20 year old woman has been taking 60mg fluoxetine for a depressive episode for 8 weeks. Despite good compliance, she has not noticed any benefit from the medication. What is the next best treatment option?
A.Augment with risperidone
B.Switch to bupropion
C.Switch to lithium
D.Switch to sertraline
E.Switch to amitriptyline
D.SSRI (same class)
B.SNRI
In which of the following are benzos contraindicated?
A.panic disorder
B.bipolar affective disorder
C.alcohol withdrawal
D.delirium
E.schizophrenia
A.associated w poor long term outcome if benzos are used in panic disorder
C.benzos are used for this
D.used for agitation
Best treatment for patient?
Two month history of paranoid delusions about neighbour using Bluetooth device to poison the food in his fridge, auditory hallucination of his neighbour’s voice threatening to kill him
Some formal thought disorder, no mood disturbance
No past psychiatric history and no previous treatment for this episode
Well-controlled type 2 diabetes, no acute physical illness
A.Lithium carbonate
B.Risperidone
C.Olanzapine
D.Clozapine
E.Mirtazapine
A.no mood disturbance
B.YES
C.weight gain, main side effect
Which of these thoughts is an obsession?
A.”Since I had my baby I keep getting thoughts in my head about dropping her or letting go of her pram on a hill. I know it’s silly and try not to think about these things but I can’t help it.
B.”He’s obsessed with football, he loves it so much he is always talking about it”
C.”I can’t stand the house not being perfectly tidy, I spend hours on the housework”
D.”I miss my late husband so much, I just can’t stop thinking about him”
E.”My neighbours are putting thoughts into my head about horrible things happening to my children. I can’t get them out of my mind no matter how hard I try”
A.YES - unpleasant, resisted thoughts, repetitive
C.Perfectionism trait
E.thought insertion
Which important piece of info would you give a patient who is considering ECT?
A.A bite block will be used, so there is no risk of damage to your teeth
B.ECT can only be given to hospital inpatients
C.The electrodes can cause minor burns to the skin
D.You will need further treatment after your course of ECT
E.You would be given a light sedative before ECT is given
A.may have slight risk of damage
B.give to outpatient patients
C.false
D.yes, need meds to keep you well
E.anaesthetic
Best description of this woman’s current mood state?
“I felt great a few weeks ago, couldn’t have been better, I’m still very restless but now feeling ill-at-ease. I’m worried that there’s something terrible wrong with me, cancer or a stroke, something like that. I can’t get the thoughts of dying a painful death out of my mind. At first I enjoyed being able to think so quickly, I had so many great ideas, now I’m still thinking fast but it’s all horrible thoughts. I can’t sit still- the nurses keep telling to stop fidgeting and pacing about the ward, but I can’t. Of course then I get annoyed with them and shout at them, which makes things worse. “
A. Depression
B. Mania without psychotic symptoms
C. Hypomania
D. Mixed affective state
E. Cyclothymia
A.dying thoughts
B.thinking fast, fidgeting
D.restlessness, irritated, mix of depression and mania
E.a mental state characterized by marked swings of mood between depression and elation; bipolar disorder
Someone who was attacked at knifepoint three months ago makes the following statements - which would not be explained by post traumatic stress disorder?
A.”I know he’s in prison but he still controls my movements and puts thoughts into my head”
B.”Sometimes when I can’t sleep at night, I feel like I can hear his voice and smell his aftershave and I panic”
C.”I can’t bring myself to walk down the street where it happened”
D”I have bad dreams about the attack”
E”I don’t see the point in things I used to enjoy”
A.CORRECT - thought insertion
Mrs Y is an 81 year old lady who was brought to the emergency department with a few hours history of agitation, aggressive behaviour and confusion. She was diagnosed with an acute confusional state secondary to a urinary tract infection and has been admitted to the medical ward. Her bloods show that she is very dehydrated. She requires IV antibiotics, fluids and nursing care. She does not understand why she is in hospital and repeatedly attempts to leave the ward in order to go home. At interview she clearly states that she wants to go home and does not think she needs any treatment, but due to her confusion cannot understand your explanation of her illness. No psychiatrist is available.
Under what legislation would u treat this patient ?
A.Mental Health (Care and Treatment) (Scotland) Act 2003- Emergency Detention Certificate
B.Mental Health (Care and Treatment) (Scotland) Act 2003- Short Term Detention Certificate
C.Adults with Incapacity (Scotland) Act 2000- Section 47
D.Adults with Incapacity (Scotland) Act 2000- Guardianship Order
E.Common Law
Delirium
A.YES - can’t go home, 72hrs
B.28 days
C.can authorise treatment but can’t prevent them from leaving
A 22-year-old female has become very anxious; describing feelings of rising panic, a choking sensation and palpitations when in public places. It began 2-3 months ago, as she was feeling anxious when “out and about” and on public transport; and has progressively worsened. She now feels it is “crippling” her and that she cannot leave her home. It is now interfering with her ability to attend classes and complete daily activities. Which of these is the most likely diagnosis for this patient?
A.Agoraphobia
B.Generalised anxiety disorder
C.Panic disorder
D.Specific phobia
E.Social phobia
A.YES - fear of having panic attacks in public places, leaving home
B.general fear of future
C.panic attack
D.phobia of bees or heights
E.social anxiety, public speaking, eating etc
A 31-year-old female has become increasingly anxious over the past 7-8 months; describing feelings of persistent nervousness and irritability. She reports occasional episodes of palpitations and feeling “light-headed” and believes these may be related to a lack of sleep, as she has been struggling to get to sleep over the past 2-3 months. This has begun to significantly affect her ability to concentrate at work, and she has had to take time off due to these episodes. Which of these is the most appropriate management?
A.Risperidone
B.Diazepam
C.Pregabalin
D.Sertraline
E.Venlafaxine
Generalised anxiety disorder
C.used in later stages
D.SSRI is 1st line
E.activating drug, won’t help w sleep
limbic system
mesocortical
mesolimbic
nigrostriatal
connects substantia nigra with dorsal striatum
hypothalamic
atypical antipsychotics
olanzapine
typical antipsychotics
haliperidol
clozapine - main side effects
agranulocytosis / neutropenia
myocarditis
