capsule psych

Question 1

what section of mental health act can you detain a pt

Answer 1

section 5 (2), doctor from treating team can use this to detain a pt for up to 72 hours

Question 2

prevalence of SPA

Answer 2

1%, always be worried about suicide risk in any psychiatric pt

Question 3

what are some adequate starting doses for 1st episode psychosis

Answer 3

olanzapine 10mg nocte
aripiprazole 10mg OD

Question 4

what anti HTN medication can cause depressio

Answer 4

beta blockers

Question 5

what us venlafaxine

Answer 5

SNRI

Question 6

what is moclobemide

Answer 6

RIMA

Question 7

waht is paroxetine

Answer 7

ssri

Question 8

what is dosulepin

Answer 8

Tricyclic

Question 9

how long should 1st episode of depression be treated for

Answer 9

6 months, if there is 2nd episode then treated for at least 2 years following remission

Question 10

section 2 of mental health act

Answer 10

if pt poses risk to others. pt could be detained against section 2 or 3, Section 2 is more likely to be appropriate if there is no recent psychiatric contact. This requires two doctors and an Approved Mental Health Professional. At least one doctor must be “approved” under s12 MHA, and ideally the other doctor would know the patient (usually a GP). Section 5(2) can only be used as a holding order for 72 hours on patients who are already admitted. This cannot be used in the ED, as being there does not count as hospital admission. It is more appropriate to use the MHA than the MCA for patients with temporary impairment of capacity due to mental illness. It has clear safeguards in place and explicitly allows psychiatric admission and treatment.

Question 11

olanzapine

Answer 11

Olanzapine can be very useful in acute mania and in disturbed patients. It can also used in long term prophylaxis for bipolar affective disorder.

Question 12

what are some problems associated with lithium

Answer 12

Renal impairment, thyroid dysfunction and parathyroid dysfunction. narrow therapuetic index

Question 13

What medication is used for mood stabilising in bipolar disorder?

Answer 13

Lithium ( can cause e Steiner anomaly where tricuspid valve is displaced. Ebsteine anamoly. and sodium valproate (can’t be used on women of child baring age)

Question 14

Antidotes for overdoses

Answer 14

Flumazenil for overdose of benzodiazepine and zopiclone.
Naloxone for treatment of opiate overdose
N-acetylchstiene used for paracetamol overdose

Question 15

Lithium toxicity

Answer 15

Coarse tremor, polydypsia and polyuria, vomiting, delirium and can lead to hypothyroidism

Question 16

Withdrawal symptoms

Answer 16

Hyperthermia temp, tachycardia, tachyoniea, dilated pupils, palpitation, tremors, dehydration

Question 17

What medications should not be used with lithium

Answer 17

Celecoxib, ibuprofen. Always check lithium function every 3 months but thyroid function every 6 months .

Question 18

How to treat acute mania

Answer 18

Anti psychotics eg olanzapi e, risperidone and quetiapine

Question 19

Mirtazepine

Answer 19

Noradrenaline and specific serotonin antidepressant

Question 20

Reboxetine

Answer 20

Selective noradrenaline reuptske inhibitor

Question 21

Lofeprsmime

Answer 21

TCA

Question 22

Trazadone

Answer 22

Tricyclic related antidepressant

Question 23

Moclobemide

Answer 23

Reversible mono amine oxidase inhibitor

Question 24

Duloxetine

Answer 24

SNRI

Question 25

Side effects of electro convulsive therapy

Answer 25

Headache, memory problems s , muscle ache. Indicated in person suffering from life threatening depresssive illness and also in Catalonia or severe manic states