Clinical Psychiatry

Question 1

Is depression more common in males or females?

Answer 1

females (2:1)

Question 2

How long do symptoms need to last for depression be exist?

Answer 2

at least 2 weeks

Question 3

Depression must include 2 out of what 3 symptoms?

Answer 3

low mood, anhedonia, anergia

Question 4

What is speech like in depression?

Answer 4

reduced rate, lower pitch, reduced volume, reduced intonation, limited content etc

Question 5

What is dysthymia?

Answer 5

chronic low mood

Question 6

Can people with dysthymia cope with every day life?

Answer 6

yes

Question 7

Is suicidal ideation common in depression of old age?

Answer 7

no - but passive thoughts of death are

Question 8

Pregnancy increases depression risk by how many times?

Answer 8

3

Question 9

How quickly does post natal depression tend to resolve itself?

Answer 9

6 months

Question 10

How can depression of old age present itself?

Answer 10

pseudodementia

Question 11

Causes of mania?

Answer 11

infection, hyperthyroidism, SLE, stroke, water dysregulation, drugs eg amphetamines
OR
Bipolar disorder

Question 12

What happens to sleeping habits in mania?

Answer 12

There is a decreased need for sleep

Question 13

How can mania be managed acutely?

Answer 13

assessment, olanzapine, valproate semisodium

Question 14

What is the key difference between mania and hypomania?

Answer 14

there is no psychosis in hypomania (hallucinations/delusion)

Question 15

Lifetime risk of suicide in Bipolar disorder?

Answer 15

12-15%

Question 16

What is cyclothymia?

Answer 16

hypomania and mild depression

Question 17

What is bipolar 1?

Answer 17

mania or a mixed episode of mania and depression

Question 18

What is bipolar 2?

Answer 18

more common type, hypomania and depression

Question 19

Mean age of onset of bipolar disorder?

Answer 19

21 years

Question 20

What is the risk of bipolar disorder if a 1st degree relative is affected?

Answer 20

7 times greater risk

50% chance they will be affected

Question 21

What is the median length of an untreated episode of bipolar disorder?

Answer 21

3 months

Question 22

What is rapid cycling?

Answer 22

4 or more moore episodes in 1 year, may be interspersed with periods of wellness
But cycling may take place in a matter of days

Question 23

What is prophylatic treatment of mania?

Answer 23

lithium

Question 24

What should be checked before treating with lithium?

Answer 24

Us and Es, ECG and Thyroid function T4

Question 25

How often should lithium levels be checked?

Answer 25

weekly - can be nephrotoxic

Question 26

Signs of lithium toxicity?

Answer 26

decreased vision, D and V, hypokalaemia, ataxia, tremor, dysarthria, coma

Question 27

Acute cessation of lithium can precipitate what?

Answer 27

mania

Question 28

Treatment of bipolar disorder is lithium is not effective?

Answer 28

anticonvulsants (sodium valproate, carbamazepine) Antipsychotics eg olanzapine Anti depressants AND lithium (SSRI or MAOI) ECT if all else fails

Question 29

Schizoaffective disorder?

Answer 29

symptoms of both schizophrenia and bipolar affective disorder by insufficient to justify either diagnosis alone

Question 30

BMI in anorexia nervosa?

Answer 30

17.5 or less

Question 31

Investigations for anorexia nervosa?

Answer 31

FBC, u and E, ECG, DEXA bone scan

Question 32

Mortality in anorexia?

Answer 32

up to 20% (half die due to suicide)

Question 33

Effects on brain from anorexia nervosa?

Answer 33

loss of grey and white matter

Question 34

Is PTSD a normal adaptation to severe stress?

Answer 34

no

Question 35

What happens to cortisol levels in PTSD?

Answer 35

reduced

Question 36

Treatment for PTSD?

Answer 36

CBT / EMDR

Question 37

In how many women does baby blues occur?

Answer 37

50%

Question 38

Name 5 typical antipsychotics.

Answer 38

``` Chlorpromazine Thioridazine Fluphenazine Haloperidol Zuclopentixol ```

Question 39

What makes atypical antipsychotics better? 4 reasons.

Answer 39

less likely to induce extra pyramidal side effects High 5HT2a to D2 ratio Better efficacy against negative symptoms Effective in patients unresponsive to typical drugs

Question 40

Treatment for antisocial personality disorder?

Answer 40

group based therapy

Question 41

Treatment for borderline?

Answer 41

dilaectical behavioural therapy (DBT)

Question 42

Treatment of avoidant?

Answer 42

social skills training, antidepressants, MAOIs

Question 43

Borderline learning disability IQ?

Answer 43

70 +

Question 44

Mild LD IQ?

Answer 44

50-69

Question 45

Most common level of learning disability?

Answer 45

mild

Question 46

Moderate LD IQ?

Answer 46

35-49

Question 47

Severe LD?

Answer 47

20-34

Question 48

Profound LD?

Answer 48

less than 20

Question 49

What syndrome is caused by deletion of the short arm of chromosome 5?

Answer 49

Cri-du-chat

Question 50

Signs of cri-du-chat?

Answer 50

moon face, widely spaced eyes, severe learning disability, high pitched cry

Question 51

What syndrome is caused by deletion of segment of maternal chromosome 15?

Answer 51

angelman syndrome

Question 52

Signs of angelman syndrome?

Answer 52

recurrent seixures, excitable demeanor, short attention span, fascination with water

Question 53

Deletion of a segment of chromosome 15?

Answer 53

Prader Willi

Question 54

Signs of Prader Willi?

Answer 54

weak muscle tone in infancy | feeding difficulties, insatiable appetite, learning difficulties

Question 55

Deletion of segment on chromosome 22?

Answer 55

Velo cardiofacial syndrome

Question 56

What is there an increased risk of in velocardiofacial syndrome?

Answer 56

shizophrenia

Question 57

What type of delirium is harder to diagnose and has a higher mortality?

Answer 57

hypoactive

Question 58

In a patient with PD/Lewy Body dementia, what should be used to treat delirium?

Answer 58

quetiepine

Question 59

Which antipsychotic can be used in delirium?

Answer 59

haloperidol (oral, start low dose)

Question 60

How many anorexic patients develop binge eating?

Answer 60

30%