Revision Tutorial

Question 1

is collateral history part of mental state examination?

Answer 1

no
only patient testimony and what the doctor observes belongs in mental state examination, testimony from a 3rd party (e.g family member) only later on in different part of history

Question 2

best predictor of suicide?

Answer 2

hopelessness

Question 3

examples of components of ICD-10 criteria for anorexia?

Answer 3

morbid dread of fatness
body weight <85% expected
sexual dysfunction in men
delayed puberty

Question 4

is loss of interest in food seen in anorexia?

Answer 4

no

they are pre-occupied with food

Question 5

IQ of 60 is what type of learning disability?

Answer 5

average = 100
mild = 50-70 (age 9-12)
moderate = 35-50 (age 6-9)
severe = 20-35
profound = <20 (age <3)

Question 6

learning difficulty vs disability?

Answer 6

difficulty = only one area of cognition affected (e.g dyslexia) - does not affect IQ, does make you any less intelligent
disability = global cognitive ability affected

Question 7

non-epileptic seizures are highly associated with childhood trauma, true or false?

Answer 7

true

Question 8

describe a non-epileptic seizure

Answer 8

patient generally unconscious
can last longer than epileptic
patient usually isnt incontinent like in epilepsy
usually dont cause the injuries seen in epilepsy
outwardly looks very similar to epileptic seizure

Question 9

what causes a non-epilaptic seizure?

Answer 9

type of functional disorder

no actual lesion in the brain causing abnormal electrical activity, mainly as a result of traumatic experience etc

Question 10

how are non-epileptic seizures managed?

Answer 10

anticonvulsants not used

psychological therapy

Question 11

is dissociation seen in functional disorders?

Answer 11

yes, common symptom

Question 12

what causes the problem in frontotemporal dementia?

Answer 12

same as lewy body - hyperphosphorylated tau proteins forming neurofibrilary tangles

Question 13

what is the difference between frontotemporal and lewy body dementia?

Answer 13

lewy body is a type of frontotemporal dementia but more wide spread

Question 14

how does depression affect cortisol?

Answer 14

chronically elevated cortisol seen in long term depression
negative feedback system non-functioning (dexamethasone fails to suppress cortisol production)
increased cortisol excretion in urine
increased adrenal volume due to demand for cortisol production

Question 15

how may depression affect hippocampus volume?

Answer 15

may be reduced

Question 16

why are SSRIs 1st line in depression?

Answer 16

not really more effective than tricyclics but have a better side effect profile

Question 17

mental compulsions in OCD often involve what?

Answer 17

often personal to the individual where mental compulsions are in contrast to their own beliefs/morals
(e.g someone very religious may have blasphemous mental compulsions)
can often be sexual, violent etc

Question 18

is any heritability seen in OCD?

Answer 18

yes

40% concordance in MZ twins

Question 19

treatment of OCD?

Answer 19

SSRIs = 1st line pharmacotherapy

psychotherapy very useful despite neurobiological basis of disease

Question 20

what is the most specific hallmark in schizophrenia?

Answer 20

formal though disorder (thought insertion/withdrawal/broadcasting etc)
- hallucinations/delusions etc also present but not as specific

Question 21

hazardous drinking?

Answer 21

14+ units per week in men and women

Question 22

harmful drinking?

Answer 22

35+ units in women

50+ units in men

Question 23

1st line in schizophrenia?

Answer 23

antypical antipsychotic

• resperidone
• olanzipine
• quetiapine
• clozapine (only given after 2 others have tried and failed)

Question 24

best atypical antipsychotic in diabetics?

Answer 24

risperidone

olanzipine causes metabolic syndrome, danger in diabetics

Question 25

what is an obsession?

Answer 25

type of thought that is:

• intrusive
• irrational
• difficult to get rid of
• causes distress

Question 26

examples of an absession?

Answer 26

“since i had my baby i keep geting thoughts in my head about dropping her or letting go of the pram on the hill. i know its silly and i try and stop thinking about it but i cant help it”

Question 27

obsession vs delusion?

Answer 27

similar but different in that with an obsession, the person knows that the thought is irrational and doesnt make sense

Question 28

what is an over-valued idea?

Answer 28

somewhere in between obsession and delusion

Question 29

what is a mixed affective state?

Answer 29

presentation of bipolar disorder
manic symptoms with aspects of depression and vice versa (e.g been manic, feeling amazing with lots of great ideas etc for a few days, then suddenly still restless and very busy thoughts but all thoughts are negative)
often cycle very quickly, can be in same day

Question 30

how long must symptoms be present for PTSD diagnosis?

Answer 30

6 months