Syke

Question 1

Most dangerous SEs of clozapine?

Answer 1

Agranulocytosis, neutropenia (atypical)

Question 2

SEs of olanzapine?

Answer 2

weight gain, T2DM (atypical)

Question 3

Carbamazepine SEs?

Answer 3

drowsiness, leucopaenia, diplopia, blurred vision, rash

Question 4

Sodium valproate SEs?

Answer 4

VALPROATE (A-increased appetite and weight, L- liver failure, P-pancreatitis, R- reversible hair loss which grows back curly, O-oedema, A- ataxia, T- teratogenicity, tremor, thrombocytopaenia; E-encephalopathy, due to hyperammonaemia

Question 5

MSE components

Answer 5

Appearance and Behaviour 
Speech
Mood and Affect (including suicidality)
Thoughts (form and content) 
Perception 
Cognition 
Insight 

ASEPTIC (e - emotion for mood and affect)

Question 6

Depression - min duration, 3 core symptoms

Answer 6

2 weeks min,

low mood, anhedonia, anergia

Question 7

Bipolar I diagnosis

Answer 7

Criteria for mania.

May have previous hypomania/depression

Question 8

Bipolar II diagnosis

Answer 8

Hypomaniac episode and current/past depressive episode.

Question 9

Appetitive/approach system - which substance and roughly where in brain?

Answer 9

DOPAMINE
Centre of the brain

[ascending dopamine systems – mesolimbic/cortical projection; ventral striatum; dorsal striatum (movement); amygdala (conditioning / learning); anterior cingulate (a7ention / conflict / response selection); orbitofrontal cortex (relative reward preference / rule learning)]

Question 10

Aversive/defensive systems - substance and where in the brain?

Answer 10

SEROTONIN
Peripheries of the brain
[ascending serotonin systems; NA / CRF / peptide transmitters
central nucleus of amygdala; hippocampus; ventroanterior and medial hypothalamus; periaqueductal gray matter]

Question 11

Examples of MAOI antidepressants?

Answer 11

Phenelzine, Isocarboxazid, Tranylcypromine

Question 12

Examples of RIMA antidepressants?

Reversible inhibitor of monoamine oxidase A

Answer 12

Moclebemide

Question 13

Examples of TCAs?

Answer 13

Amitriptyline Clomipramine, Imipramine, Nortriptyline, Dosulepin

Question 14

Examples of SSRIs?

Answer 14

Fluoxetine, Paroxetine, (Es)Citalopram, Sertraline, Fluvoxamine

Question 15

Examples of SNRIs?

Answer 15

Venlafaxine, Duloxetine

Question 16

Example of NARI? (Nor-Adrenaline Reuptake inhibitors)

Answer 16

Reboxetine

Question 17

SSRIs used for which conditions?

Answer 17

depression, panic disorder, 
social anxiety disorder,	
PTSD, OCD, 
chronic pain, eating disorders, 
stroke recovery, premature ejaculation

Question 18

TCAs - tricycling depressant - blocks which receptors?

Answer 18

Histamine, muscarinic ACh, adrenergic

all are post-synapse

Question 19

SEs of TCAs?

Answer 19

most anticholinergic:
Constipation, dry mouth, blurred vision, cardiac function
Postural hypotension (cholinergic and adrenergic blockade causing failure of peripheral orthostatic reflexes)

Question 20

SEs of MAOIs?

Answer 20

Tyramine inactivated in the gut by MAO so gut stuff.
Hypertensive crises with tyramine-containing foods (cheese, yoghurt, yeast, meat, alcohol, broad beans, herring)
Sympathomimetics (OTC cold remedies).
Symptoms: flushing, headache, high BP, rarely CVA. Treat: alpha blockers

Question 21

Types (3) and examles of mood stabilisers

Answer 21

• anti-convulsants (carbamazepine, valproate, lamotrigine)
• atypical antipsychotics (olanzapine, risperidone, aripiprazole, quetiapine)
• other: lithium carbonate (citrate), nimodipine (Ca channel antagonist)

Question 22

Anorexia vs bulimia

Answer 22

Anorexia - less than 17.5 BMI or 85% of expected weight (can still vomit then it’s binge-purge subtype)

Question 23

Anxiety - which brain part is responsible for emotional filter, seeing if a stimulus requires a fear/flee etc?
Which compounds increase in anxiety?

Answer 23

Amygdala

Cathecholamines and cortisol

Question 24

Panic attacks on PET scans - which region?

Answer 24

anterior pole of temporal lobe – parahippocampal gyrus

Question 25

PTSD - where in brain?

Answer 25

Limbic brain (amygdala - stores emotionally charged memories, hippocampus - locate memories) and medial prefrontal cortex (emotional and fear responses)

Question 26

Timeline for acute stress reaction, acute stress disorder and acute or chronic PTSD

Answer 26

acute stress reaction - up to 48 hrs " " disorder - up to 4 weeks PTSD - up to 3 months if acute. More - chronic

Question 27

Treatment for OCD

Answer 27

SSRI -> SSRI -> SSRI -> etc | Can add CBT and treat co-morbidities. Consider neurosurgery is still unresponsive

Question 28

Schneider's first rank of psychotic symptoms

Answer 28

Auditory hallucinations, delusions of thought interference, delusions of control, (delusional perception)

Question 29

Rape-pill: name and class

Answer 29

Rohypnol, Benzodiazepine

Question 30

3 dopaminergic pathways and what they're controlling

Answer 30

NIGROSTRATAL (extrapyramidal motor system) MESOLIMBIC/CORTICAL (motivation and reward) TUBEROINFUNDIBULAR (prolactin release)

Question 31

personality disorders - cluster A "odd and eccentric" | (2 types)

Answer 31

Paranoid (nie wierzy w wierność, bears grudges; JóCz) | Schizoid (lonely, without close friends; nowa Litw)

Question 32

Cluster B personality disorder "dramatic and emotional" | 3

Answer 32

Antisocial (kłamstwo, łamanie prawa, bójki; ja) Borderline (raz kogoś uwielbiasz, drugi raz nienawidzisz, boisz się straty, unstable image of self, impulsitivity, suicidal; stara Litw) Histrionic (teatralny, centre of attention, physical appearance; Matt)

Question 33

Cluster C personality disorder "anxious and avoidant" | 3 types

Answer 33

Avoidant (nie pójdę bo się wstydzę i nikt mnie nie polubi; Karo) Dependant (inni niech podejmą za mnie decyzje; Zain) Obsessive-Compulsive (zasady, pieniądze, praca, wysokie standardy; Franco)

Question 34

Emergency detention

Answer 34

Max 72 hrs registered medical practitioner can't treat no right to appeal

Question 35

Short term detention

Answer 35

max 28 days can treat and can appeal MHO consent needed necessary to asses the patient what to give them or give them treatment

Question 36

Compulsory treatment order

Answer 36

Two medical reports can appeal and treat up to 6 months hospital or community

Question 37

Learning disability - classification

Answer 37

Mild IQ – 50-69 Moderate 35-49 Severe 20-34 (almost always epilepsy) Profound <20 (may be bed-bound)

Question 38

How to calculate units in alcohol?

Answer 38

units = (%*volume)/10 | eg 0.4 (40% vodka) * 750 ml / 10 = 30

Question 39

Parts of brain (3) to do with memory

Answer 39

Amygdala, hippocampus (declarative learning) and striatum (habit learning). More - neurobiology of cognition (10.21)

Question 40

neuropatholody of Alzheimer's dis

Answer 40

``` Amyloid plaques (breakdown of protein, beta) Neurofibrillary tangles (TAU protein) ```

Question 41

Depletion of ACh in nucleus basalis of Meynert - which disease?

Answer 41

Alzheimer's dementia

Question 42

Autism - name for normal intelligence but bad socially (A) and for no eye contact, very severe (B)? Triad of symptoms?

Answer 42

A - Aspergers B - Kanners Sympt: socially, language, repetitive behaviour

Question 43

Side effects of main classes of antidepressants?

Answer 43

TCAs (amitriptylina) - anticholinergic SEs, eg dry mouth SSRIs (fluoxetine, paroxetine) - hyponatraemia SNRIs (venlaflaxine) - n&v, dizzy, somnolence MAOIs (phenelzine) - hypertensive crisis with amines

Question 44

Secure attachement: strangers? reaction when parent leaves? when they're back?

Answer 44

child explores freely, happy with strangers when mum there upset when leaving happy when back

Question 45

Resistant attachement: strangers? when mum leaves? when mum back?

Answer 45

explores little, wary of stranger always upset when leaving ambivalent on return

Question 46

Avoidant attachement: strangers? when mum leaves? when mum back?

Answer 46

explores freely may engage with a stranger (not dependent on parent) little distress when leaving little reaction when back