Psych

Question 1

third person hallucinations

Answer 1

schiz

Question 2

mesocortiyal dopamine hypoactivity

Answer 2

negative and cognitive symptoms in schiz

Question 3

subcortical dopamine hyperactivity

Answer 3

psychosis

Question 4

dopamine pathways in the brain

Answer 4

tuberoinfundibulnar - prolactin release
nigrostriatal - extra pyramidal motor movements
subcortical and mesocortical - mesolimbic system - motivation and reward

Question 5

mesolimbic Da blockage

Da agonism

Answer 5

depression

psychosis

Question 6

clozapine SE

Answer 6

agranulocytosis

weight gain

Question 7

what atypical anti psychotic causes the most weight gain

Answer 7

olanzapine

Question 8

when should clozapine be prescribed

Answer 8

need to try 2 other anti psych
only consultant can prescribe
monster once a week for first 6m then once every 2 weeks for the next 6m then every four weeks and one month after discontinuation

Question 9

limbic system functions

Answer 9

M2OVE
motivation 
memory 
olfaction
visceral afferents 
emotion

Question 10

brain changes in schizophrenia

Answer 10

reduced frontal love volume and grey mater
enlarged lateral ventricles
reduced grey matter in the temporal cortex

Question 11

pressure of thought

Answer 11

varied ideas in abundance (characteristic of mania but can also be seen in schix)

Question 12

poverty of thought

Answer 12

px reports lack/absence of thought

Question 13

thought blocking

Answer 13

abrupt and complete interruption of stream (strongly associated with schizophrenia)

Question 14

flight of ideas

Answer 14

quickly moving from one topic to another but there is a link unlike in knight’s move thinking where there does not appear to be a link between point A and point B. - seen in bipolar during manic phase

Question 15

rx of EPSE

Answer 15

procyclidine

Question 16

amygdala

Answer 16

involved in normal response to threat

Question 17

PFC

Answer 17

dampens down amygdala response to threat (fewer connections less effective)

Question 18

management of OCD

Answer 18

1. SSRI, 2. SSRI, 3. TCA or SSRI, 4. SSRI or TCA - (TCA used is chlomipramine) so essentially an SSRI and if there is a partial response at any of those points, consider CBT as an adjunct

Question 19

LDs

Answer 19

borderline 70-80
mild 50-69
mod 35-49
severe 20-34
profound <20

Question 20

becks triad

Answer 20

neg feeling about self world and future

Question 21

NMDA antagonists

Answer 21

produce psychotic symptoms

Question 22

alcohol withdrawel

Answer 22

use chlordiazepoxide ( 30mg QDS, 25mg QDS, 20 mg QDS, 15mg QDS, 10mg QDS, 10mg TDS, 10mg BD, 10mg OD - nocte).

Question 23

alcohol withdrawel seizures

Answer 23

within 48 hours

Question 24

delirium tremens

Answer 24

between 48 and 72h

Question 25

eosinophilic inclusions

Answer 25

lewy body dementia and PD