High Yield PACES Psych

Question 1

Abbreviated Mental Test Score

Answer 1

/10

1. Age
2. Time

INSET ADDRESS

3. Year
4. Location
5. Identify 2 people
6. Date of birth
7. Dates of WW1
8. Name of monarch
9. Count backwards from 20
10. Address recall

Question 2

Frontal lobe testing

Answer 2

Verbal fluency: Recall as many words beginning with F

Cognitive estimates: Educated guesses

Abstract thinking: proverb interpretation

Question 3

Causes of Delirium

I WATCH DEATH

Answer 3

Infection

Withdrawal: alcohol, drugs
Acute metabolic: hypoglycaemia, 
Trauma
CNS lesions
Hypoxia

Deficiency: B1, B6 and Dementua
Endocrine
Acute vascular insult
Toxins (drugs, antibiotics) 
Heavy metals

Question 4

AUDIT tool

Answer 4

Sensitive tool to asses alcohol dependence

Question 5

CIWA-Ar tool

Answer 5

Assessment of alcohol withdrawal and detoxification

Question 6

PHQ9

Answer 6

Depression in GP

Question 7

HADS

Answer 7

Depression in hospital

Question 8

GAD-7

Answer 8

Anxiety

Question 9

Olanzapine

Answer 9

Oral 10mg daily (5-25mg license)

Question 10

Fluoextine dose in children

Answer 10

10mg daily oral

(Max 20mg)

Question 11

Edinburgh Scale

Answer 11

Post-natal depression

> 12 = depression

Question 12

Only SSRI used in pregnancy

Answer 12

Fluoxetine

Question 13

Breastfeeding SSRI

Answer 13

Paroxetine: BNF –> present in milk but amount too small to be harmful

Sertraline has low levels excreted

Question 14

6 months of worry

Answer 14

GAD

Question 15

1 Month of worry + panic attacks

Answer 15

Episodic paroxysmal anxiety (Panic attacks)

Question 16

Differentials for Panic Attack

Answer 16

Panic attack +/- agoraphobia

Hyperthyroidism

Hyperparathyroidism (hypercalcaemia)

Phaeochromocytoma

Hypoglycaemia

Cardiac arrhythmias

Question 17

SSRI in Panic Attacks

Answer 17

Paroxetine: start 10mg each morning, increase 10mg at a time to recommended 40mg/day

OR

Citalopram

Question 18

Paroxetine dosing

Answer 18

Start 20mg (10mg in Panic attacks) and increase gradually 10 mg at a time to recommended 40mg /day

Take in morning once daily

Max dose 60mg/day

Question 19

Approved mental health professional

Answer 19

Nurses, OTs, Social workers

Makes application for sections

The Approved Mental Health Professional is authorised by the local authority and they practice for them, even though they may be employed by a Trust or another local authority.

They provide a broad range of tasks under the Mental Health Act. What is important is that they are a counter balance to the medical model that can exist in mental health and bring a social or more holistic perspective.

Their work involves nearest relatives and carers, making sure service users are properly interviewed in an appropriate manner and ensuring they know what their rights are if they are detained under the Mental Health Act 1983.

Question 20

Lithium

Answer 20

Measure 12 hours post dose
0.4-1.0mmol/L serum conc

Aim for 0.6-1.0 mmol/L when treating acute mania

Measure every week after starting until dose constant for 4 consecutive weeks

Then measure every 3 months

Question 21

Cognitive stimulation therapy

Answer 21

Lewy body dementia

Art therapy

Dance therapy

Music therapy

Aromatherapy

Structured exercise classes

Question 22

Venlafaxine

Answer 22

SSRI

Dangerous in overdose

Question 23

Drug Treatment of Alzheimers

Answer 23

Mild to Moderate
Donepezil
OR
Rivastigmine

Severe
NMDA partial agonists = Memantine

Question 24

Donepezil

Answer 24

5mg once daily at bedtime