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MRCP > Psychiatry > Flashcards

Psychiatry Flashcards

1
Q

What is first line treatment of GAD

A

SSRI (sertraline most cost-effective)

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2
Q

What can be offered in GAD when SSRI and SNRI not tolerated

A

Pregabalin

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3
Q

What is REM sleep behaviour disorder

A

Vivid dreams associated with simple/complex motor behaviour during REM sleep - violent re-enacting of dreams

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4
Q

What condition is linked with REM sleep behaviour disorder

A

Parkinson’s disease

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5
Q

What is the DSM4 criteria for anorexia nervosa

A

BMI <17.5, intense fear of being obese, disturbance of weight perception, amenorrhoea

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6
Q

What are raised in anorexia nervosa

A

3Gs, 3Cs (growth hormone, glucose, salivary glands, cortisol, cholesterol, carotinaemia)

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7
Q

What physiological abnormalities are seen in anorexia nervosa

A

Hyponatraemia, hypokalaemia, metabolic alkalosis (vomiting), increased amylase, hypocalcaemia, low FSH/LH/oestrogen, low T3, normal albumin

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8
Q

What is lanugo hair associated with

A

Anorexia nervosa

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9
Q

What is the difference between mania and hypomania

A

Mania has psychotic symptoms (delusions of grandeur, auditory hallucinations)

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10
Q

What are Schneider’s first rank symptoms of schizophrenia

A

Auditory hallucinations, thought disorder, passivity phenomenon, delusional perceptions

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11
Q

What is the chance of a child having schizophrenia if their parent has it

A

10-15%

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12
Q

What are poor prognostic factors for schizophrenia

A

Strong FHx, gradual onset, low IQ, history of social withdrawal, lack of obvious precipitant

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13
Q

What are the 4 classes of EPSE seen with antipsychotic use

A

Parkinsonism, acute dystonia, akathisia (severe restlessness), tardive dyskinesia

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14
Q

What is the MOA of atypical antipsychotics

A

Block D2 dopamine receptors and 5-HT2 serotonin receptors

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15
Q

What is the most common side effect of olanzapine

A

Weight gain

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16
Q

What is the most common side effect of clozapine

A

Agranulocytosis

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17
Q

What is the risk of prescribing antipsychotics in elderly patients

A

Increased stroke and VTE risk

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18
Q

When is neuroleptic malignant syndrome most common

A

Within first 10 days of starting antipsychotic treatment/increasing dose

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19
Q

What percentage of mothers will have baby blues

A

60-70%

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20
Q

How long after birth does post-natal depression present

A

Within a month, peaks at 3 months

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21
Q

When does pueperal psychosis present after birth

A

2-3 weeks

22
Q

What should be prescribed alongside an SSRI in a patient on NSAIDs

A

PPI

23
Q

Which antidepressant has the highest rate of discontinuation symptoms

A

Paroxetine

24
Q

What are the side effects of TCAs

A

Drowsiness, dry mouth, blurred vision, constipation, urinary retention

25
Q

What are the ECG changes associated with TCA overdose

A

Sinus tachycardia, widening of QRS, prolongation of QT interval

26
Q

What is the management of TCA overdose

A

IV bicarbonate

27
Q

What are the organic causes of restless leg syndrome

A

IDA, uraemia, DM, pregnancy

28
Q

What is an absolute contraindication to ECT

A

Raised ICP

29
Q

What is the best way to withdraw from benzodiazepines

A

Switch to diazepam and reduce dose by 1/8 of total every fortnight

30
Q

What is the MOA of barbiturates

A

GABAa drug - increases duration of chloride channel opening

31
Q

What is the MOA of benzodiazepines

A

GABAa drug - increases frequency of chloride channel opening

32
Q

Which condition causes recurrent complex hallucinations in clear consciousness, associated with visual impairment

A

Charles-Bonnet Syndrome

33
Q

Which condition is associated with severe depression and presents with patient believing they are dead

A

Cotard syndrome

34
Q

How often should lithium levels be checked once a stable dose is achieved

A

Every 3 months

35
Q

What are the features of Korsakoff’s syndrome

A

Opthalmoplegia+confusion+ataxia + anterograde amnesia + confabulation

36
Q

How should an SSRI be stopped

A

Withdrawal gradually over 4 weeks (except fluoxetine - can be stopped without withdrawal period)

37
Q

Which receptors do atypical antipsychotics block

A

D2 dopamine receptors and 5-HT2 serotonin receptors

38
Q

Which TCA are the least sedative

A

Imipramine, lofepramine, nortriptyline

39
Q

Which TCA has the lowest incidence of toxicity in overdose

A

Lofepramine

40
Q

Which TCAs are most dangerous in overdose

A

Amitriptyline, dosulepin

41
Q

What are the discontinuation symptoms seen in stopping SSRIs abruptly

A

Increased mood change, restlessness, difficulty sleeping, unsteadiness, sweating, GI symptoms, paraesthesia

42
Q

What is the treatment of Charles Bonnet Syndrome

A

Ensure no alternative cause, then reassure

43
Q

What is Othello syndrome

A

Belief that partner is committing infidelity with no evidence of this

44
Q

What is De Clerambault syndrome

A

Patient believes that person of higher social standing than them is in love with them

45
Q

What is Ekbom syndrome

A

Delusional parasitosis - ‘bugs’ under skin

46
Q

What are the 4 symptoms associated with narcolepsy

A

Excessive daytime sleepiness
Cataplexy
Sleep paralysis
Hallucinations on going to sleep/waking

47
Q

Which screening tool is used for social anxiety disorder

A

Mini-social phobia inventory (Mini-SPIN)

48
Q

What presents with a compressible mass in the abdomen, significant malnutrition and patches of alopecia

A

Trichobezoar

49
Q

Which HLA is narcolepsy associated with

A

HLA-DR2

50
Q

When does acute stress reaction occur after trauma

A

Within one month

51
Q

What form of CBT is used to manage body dysmorphic disorder

A

Exposure and response prevention

52
Q

Atypical antipsychotics are associated with a risk of developing which condition

A

Type 2 diabetes

MRCP (16 decks)

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