what is level one of the diagnostic hierarchy?
a) organic disorders
b) functional psychosis
c) non-psychotic disorders
d) personality disorders
a) organic disorders
what is level two of the diagnostic hierarchy?
a) organic disorders
b) functional psychosis
c) non-psychotic disorders
d) personality disorders
b) functional psychosis
what is level three of the diagnostic hierarchy?
a) organic disorders
b) functional psychosis
c) non-psychotic disorders
d) personality disorders
c) non-psychotic disorders
what is level four of the diagnostic hierarchy?
a) organic disorders
b) functional psychosis
c) non-psychotic disorders
d) personality disorders
d) personality disorders
what is the difference between a diagnosis and a formulation?
diagnosis is a general description of a condition which prescribes treatment and predicts course
formulation explains an individual condition and its features and predicts a response to treatment
what psych drug side effect is described as:
restlessness, fidgeting legs, pacing and leg shuffling?
akathisia
how is akathisia managed?
anticholinergics propanalol cyproheptadine BZDPs clonidine
what psych drug side effect is described as: spastic contractions of certain muscles/muscle groups, often painful e.g. tongue protrusion, grimace, torticolisis
acute dystonia
what psych drug side effect is described as involuntary, repetitive, purposeless movements of tongue/lips/face/trunk/extremeties. it may be generalised or just affect one muscle group. it is mainly caused by prolonged antipsychotic use and is often irreversible
tardive dyskinesia
why should anticholinergics not be used to treat tardive dyskinesia?
exacerbate symptoms
what is neuroleptic malignant syndrome caused by?
reaction to medication (generally antipsychotic)
what psych drug side effect is caused by blockage of dopaminergic hypothalamo-spinal tracts that inhibit preganglionic sympathetic neurones?
neuroleptic malignant syndrome
what psych drug side effect is characterised by hyperthermia, muscle rigidity, autonomic instability and altered mental state?
neuroleptic malignant syndrome
in neuroleptic malignant syndrome, high creatine phosphokinase can lead to what dangerous side effect?
rhabdomyolysis
management of NMS is to stop the causative drug and supportive treatment. what drug can be given to decrease muscle rigidity?
dantrolene
lorazepam
overdose of what drug can lead to serotonin syndrome?
SSRIs
serotonin syndrome and NMS can be easily confused. how does their onset differ?
a) NMS 1-3 days, SS <12hrs
b) NMS <12hrs, SS 1-3 days
a) NMS 1-3 days, SS <12hrs
fill in the gaps in relation to NMS and SS:
hyporeflexia is present in ___, hyperreflexia and clonus are present in ___.. Pupils are normal in ___ but dilated in ___. bowel activity is decreased in ___ but increased in ___.
NMS; SS.
NMS; SS.
NMS; SS.
what is the difference between a problem drinker and a heavy drinker?
problem drinker experiences harm as a consequence of drinking
heavy drinker drinks more alcohol than is healthy/safe in the long term
how many men and women drink over the recommended daily amounts of alcohol?
a) 5% men, 2% women
b) 10% men, 5% women
c) 20% men, 10% women
d) 40% men, 20% women
c) 20% men, 10% women
what is the recommended daily units of alcohol for men and women?
a) 1 men, 0.5 women
b) 3 men, 2 women
c) 6 men, 4 women
d) 10 men, 8 women
b) 3 men, 2 women
wernicke-korsakoff syndrome is a combination of which 2 disorders?
wernicke’s encephalopathy and korsakoff’s psychosis
which of these is NOT an eye sign of wernicke-korsakoff’s?
a) nystagmus
b) bilateral LR palsy
c) dilated pupils
d) conjugate gaze palsy
c) dilated pupils
which of these is NOT an ataxic sign present in wernicke-korsakoff’s?
a) twitching
b) broad based gait
c) cerebellar signs
d) vestibular paralysis
a) twitching
are the cognitive signs of acute stupor and coma, amnestic syndrome and confabulation more characteristic of wernicke’s encephalopathy or korsakoff’s psychosis?
korsakoff’s psychosis
what does CAGE stand for in the alcohol assessment?
C - have you tried to cut down?
A - do you get angry when people criticise your drinking?
G - do you feel guilty about drinking?
E - do you ever need an eye-opener?
what happens to the pupils of someone who has taken amphetamine?
a) dilated
b) restricted
c) stay the same
a) dilated
what class drug is amphetamine?
a) A
b) B
c) C
b) B
is amphetamine addictive?
a) yes
b) no
a) yes
what class drug is cannabis?
a) A
b) B
c) C
b) B
is cannabis addictive?
a) yes
b) no
a) yes
what happens to the pupils of someone who has taken cocaine?
a) dilated
b) restricted
c) stay the same
a) dilated
what chemical does cocaine increase in the body?
a) monoamine
b) serotonin
c) dopamine
c) dopamine (35x normal)
what is the antidote for cocaine?
a) naloxone
b) paracetamol
c) BZDPs
c) BZDPs
what class drug is cocaine?
a) A
b) B
c) C
a) A
is cocaine addictive?
a) yes
b) no
a) yes
what happens to the pupils of someone who has taken BZDPs?
a) dilated
b) restricted
c) stay the same
b) restricted
what class drug are BZDPs and GHB?
a) A
b) B
c) C
c) C
are BZDPs and GHB addictive?
a) yes
b) no
a) yes
what are BZDPs and GHB agonists for in the body?
a) GABA
b) serotonin
c) dopamine
a) GABA
what happens to the pupils of someone who has taken Heroin?
a) dilated
b) restricted
c) stay the same
b) restricted
although pupils dilate in withdrawal
what class drug is heroin?
a) A
b) B
c) C
a) A
what is the antidote for heroin overdose?
a) naloxone
b) paracetamol
c) BZDPs
a) naloxone
is heroin addictive?
yes u idiot
what is heroin an agonist for in the body?
a) GABA
b) opioid
c) dopamine
b) opioid
what class drug is ketamine?
a) A
b) B
c) C
b) B
is ketamine addictive?
a) yes
b) no
a) yes
what is ketamine an antagonist for in the body?
a) GABA
b) opioid
c) NMDA
c) NMDA
what class drug is LSD?
a) A
b) B
c) C
a) A
is LSD addictive?
a) yes
b) no
b) no
what is LSD an agonist for in the body?
a) GABA
b) opioid
c) dopamine
c) dopamine
what class drug is MDMA?
a) A
b) B
c) C
a) A
is MDMA addictive?
a) yes
b) no
b) no
what happens to the pupils of someone who has taken MDMA?
a) dilated
b) restricted
c) stay the same
a) dilated
what class drug is mephedrone?
a) A
b) B
c) C
b) B
is mephadrone addictive?
a) yes
b) no
a) yes
what chemical is mephedrone an agonist for in the body?
a) monoamine
b) serotonin
c) dopamine
a) monoamine
what class drug are psilocybin mushrooms?
a) A
b) B
c) C
a) A
what chemical is mushrooms agonists for in the body?
a) monoamine
b) 5HT
c) dopamine
b) 5HT
what kind of mood disorder is this:
one that is not caused by another medical or psychiatric condition
a) primary
b) secondary
a) primary
fill in the blank:
in a _________ mood disorder, once the underlying conditions is treated, the mood disorder is treated
secondary
how can a primary mood disorder be further classified?
a) depressive vs manic
b) acute vs chronic
c) unipolar vs bipolar
c) unipolar vs bipolar
to be classified as bipolar, a patient with a primary mood disorder must have at least one episode of
a) wellness
b) psychosis
c) mania/hypomania
c) mania/hypomania
what delusional disorder does this describe?
delusions of infidelity of spouse/partner
othello
what delusional disorder does this describe?
delusion of being loved by someone who is inaccessible/have little contact with
a) cotard’s
b) fregoli
c) de clerambault’s
c) de clerambault’s
what delusional disorder does this describe?
delusional parasitosis – one’s skin is infested by parasites
a) cotard’s
b) ekbom’s
c) fregoli
b) ekbom’s
what delusional disorder does this describe?
one no longer exists, is about to die, rotting etc
a) cotard’s
b) capgras
c) fregoli
a) cotard’s
what delusional disorder does this describe?
a familiar individual has been replaced by an identical looking imposter
a) folie a deux
b) capgras
c) fregoli
b) capgras
what delusional disorder does this describe?
a familiar individual is disguising themselves as various strangers (usually persecutory)
a) folie a deux
b) multiple personality disorder
c) fregoli
c) fregoli
what delusional disorder does this describe?
delusional disorder shared by 2+ people in a close or dependant relationship. Usually chronic and persecutory/grandiose
a) folie a deux
b) multiple personality disorder
c) fregoli
a) folie a deux
what disorder does this describe? 2+ distinct identities that take control of a shared body and may have memory loss of each identity for the other. Due to childhood trauma before personality is fixed a) folie a deux b) multiple personality disorder c) fregoli
b) multiple personality disorder
loss of memory following a traumatic or stressful event is described as dissociative _______
a) amnesia
b) fugue
c) stupor
d) anaesthesia
e) convulsions
a) amnesia
An unexpected ‘journey’ lasting several months with confusion about own identity or assumption of another. Memory of the episode is lost after. This is described as a dissociative _____
a) amnesia
b) fugue
c) stupor/motor disorder
d) anaesthesia
e) convulsions
b) fugue
motionless/mute, unresponsive or partial paralysis is described as dissociative _____
a) amnesia
b) fugue
c) stupor/motor disorder
d) anaesthesia
e) convulsions
c) stupor/motor disorder
loss of sensation e.g. glove and stocking which may accompany a motor disorder is described as dissociative ______
a) amnesia
b) fugue
c) stupor/motor disorder
d) anaesthesia
e) convulsions
d) anaesthesia
pseudo-seizures with no raised serum prolactin afterwards are described as dissociative _______
a) amnesia
b) fugue
c) stupor/motor disorder
d) anaesthesia
e) convulsions
e) convulsions
which section of the MHA is this: admission for assessment, up to 28 days. non renewable. applied for by an AMPH/NR, recommended by 2 doctors (one section 12.2 approved) a) 2 b) 3 c) 4 d) 5(2) e) 5(4)
a) 2
which section of the MHA is this: admission for treatment. lasts 6 months, can be renewed for a further 6 months a) 2 b) 3 c) 4 d) 5(2) e) 5(4)
b) 3
which section of the MHA is this: emergency treatment. used if section 2 would cause delays. AMHP recommends to 1 doctor. normally converted to section 2 a) 2 b) 3 c) 4 d) 5(2) e) 5(4)
c) 4
which section of the MHA is this: detention of patient already in hospital (not A+E), lasts 72 hours. made by FY2+. mental disorder present + risk to self/others a) 2 b) 3 c) 4 d) 5(2) e) 5(4)
d) 5(2)
which section of the MHA is this: nurses holding power, lasts 6 hours a) 2 b) 3 c) 4 d) 5(2) e) 5(4)
e) 5(4)
which section of the MHA is this: AMHP can apply for patient to be removed from home for MHA assessment to be completed a) 17 b) 135 c) 136
b) 135
which section of the MHA is this: allows police to detain patients with suspected mental disorder from public a) 17 b) 135 c) 136
c) 136
which section of the MHA is this: dictates inpatients leave attended/unattended from ward a) 17 b) 135 c) 136
c) 136
does the mental capacity act apply solely to those with mental disorders?
a) yes
b) no
b) no
what are the 3 criteria used to judge if someone has capacity?
- understand information relevant to decision
- retain the info
- use/weigh it up as part of the decision making process
they must also be able to communicate their decision
when discussing a formulation, how is the chronology organised?
predisposing
precipitating
maintaining
when discussing a formulation, how is the history split into 3 elements?
biological
psychological
social
what does this mnemonic stand for?
All Brave Sane Men Think That Pizza Is Italian Really
Appearance Behaviour Speech Mood (objective, subjective, affect) Thought form Thought content Perceptions IQ (cognition) Insight Risk
