1 - Psych

Question 1

Indications for use of antidepressants?

Answer 1

Depression 
Anxiety 
OCD/PTSD
Bulimia 
Neuropathic pain

Question 2

List the different classes of antidepressants?

Answer 2

SSRIs
SNRIs
TCAs
MAOIs
Atypical

Question 3

List some SSRIs and some SNRIs

Answer 3

SSRI

• Citalopram/escitalopram
• Fluoxetine/paroxetine
• Sertraline

SNRIs

• Venlafaxine/desvenlafaxine
• Duloxetine

Question 4

Name some TCAs

Answer 4

Amitriptyline
Imipramine
Lofepramine
Dosulepin

Question 5

What are the common side effects associated with TCAS?

Answer 5

Anticholinergic

• Blurred vision
• Dry mouth
• Constipation
• Urinary retention

Weight gain
Sedation

Cardio

• Post hypertension
• Tachycardia
• Arrhythmias

Question 6

What antidepressant is licensed for children?

Answer 6

Fluoxetine (SSRI)

20mg max dose

Question 7

What are some common conditions that anxiety may be secondary to?

Answer 7

Substance misuse

Medical - Hyperthyroid/pheochromocytoma

Question 8

Name some MOAIs

and their side effects

Answer 8

Irreversible = Phenelzine

Reversible = Moclobemide

Side effects:

• Insomnia
• Post hypertension
• Peripheral oedema

N.B. Decreases metabolism of barbiturates (sedatives ending “ital” e.g. Phenolbarbital

Question 9

Criteria for detention under MHA? (5)

Answer 9

1. Mental illness
2. Impaired decision making
3. Treatment required
4. Significant risk to self/others
5. Informal care refused/inappropriate

Question 10

What are the Millan principles?

Answer 10

10 principles that must be considered when treating someone under the MHA.

1. Non-discrimination
2. Equality
3. Respect for diversity
4. Reciprocity
5. Informal care
   - Does patient need to be held under MHA?
6. Participation
7. Respect for carers
8. Least restrictive alternative
   - least invasive treatment options possible
9. Benefit
10. Child welfare
    - MHA applies to all ages

Question 11

What makes up the ADHD triad?

Answer 11

Hyperactivity
Impulsivity
Inattention

Question 12

What are some predisposing/precipitating risk factors of ADHD?

Answer 12

Genetics
Smoking/drinking in pregnancy
Premature/eclampsia

Psychosocial adversity

Question 13

Treatment of mild/mod ADHD?

Answer 13

Behavioural -
Parental training 
Social skills training 
Sleep and diet 
Behavioural classroom
Specific educational interventions

Question 14

Treatment of mod-severe ADHD?

Answer 14

Behavioural Training

1st line = stimulants
2nd line = SNRI
3rd line = Alpha agonist
4th line = Antidepressants/antipsychotics

Question 15

What BMI is associated with Anorexia Nervosa?

Answer 15

<17.5

Question 16

Treatment of anorexia and bulimia nervosa?

Answer 16

CBT
Family based training (Maudsley approach)
Regular BP, height, weight, bloods and ECG to look for long QT

Question 17

What is an affect illusion in anxiety?

Answer 17

Misinterpretation of a stimuli dependant on patients worries.

I.E sees shadow thinks she’s being chased

Question 18

1st line treatment of GAD?

Answer 18

CBT & SSRI

Question 19

Which antipsychotic reduces seizure threshold?

Answer 19

Clozapine

Question 20

Example of stimulants used in ADHD

Answer 20

Amphetamine/dextroamphetamine (Adderall)
Dextroamphetamine (Dexedrine, ProCentra, Zenzedi)
Dexmethylphenidate (Focalin)
Methylphenidate (Ritalin)

Question 21

What differentiates mania and hypomania

Answer 21

To be manic you must display inflated self belief/esteem and flight of ideas

Must have symptoms for 7 days for mania vs 4 days for hypomania

Question 22

Difference between BPAD I and BPAD II?

Answer 22

BPAD 1 = mania + depression

BPAD 2 = hypomania + depression

Question 23

Can you prescribe an SSRI to someone on NSAID?

Answer 23

Yes but need PPI

Question 24

Alternative to cabergoline?

Answer 24

bromocriptione

Question 25

When is a platelet transfusion indicated?

Answer 25

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