Other Psychiatric Problems

Question 1

What cardiovascular disorders can cause delirium?

Answer 1

Intracranial/Subdural bleed
MI
PE
CCF

Question 2

What GI disorders can cause delirium?

Answer 2

Liver failure

Pancreatitis

Question 3

What endocrine disorders can cause delirium?

Answer 3

Diabetic complications

Thyroid disorders

Question 4

What GU disorders can cause delirium?

Answer 4

UTI

Renal failure

Question 5

What neurlogical disorders can cause delirium?

Answer 5

Head injury
Meningitis
Encephalitis
Tumours
Epilepsy

Question 6

What is the NHS Tayside Protocol for pharmacological management of delirium?

Answer 6

Haloperidol 0.5-5mg PO then IM:

- Up to 10mg in 24 hours

Question 7

What drug, in the NHS Tayside Protocol for pharmacological management of delirium, is used in Parkinson’s, Lewy Body Dementia and Neuroleptic sensitivity?

Answer 7

Lorazepam 0.5-2mg, up to 2 times in 24 hours

Question 8

What is the mean duration of delirium?

Answer 8

1-4 weeks:

• Often longer in elderly
• Some can become chronic

Question 9

What is the most common neuropsychiatric complication of a stroke?

Answer 9

Post-Stroke depression

Question 10

How many patients have depressive symptoms following an MRI?

Answer 10

65%

Question 11

What is anterograde amnesia?

Answer 11

Difficulty in acquiring new material

Difficulty in remembering events since illness/injury onset

Question 12

What is retrograde amnesia?

Answer 12

Difficulty remembering info prior to illness/injury onset

Question 13

What is it important to assess in cognition of memory problems?

Answer 13

Memory
Attention and concentration
Executive functioning
Visuospatial functioning
Language

Question 14

In individuals with suspected cognitive impairment, what should be carried out?

Answer 14

MMSE

Question 15

What examination approves initial testing?

Answer 15

Addenbrookes Cognitive Examination

Question 16

What is MMSE scored out of?

Answer 16

30

Question 17

What is the cut off for MMSE?

Answer 17

> 27 vs <24

Question 18

What are the 4 criteria assessed in an MMSE?

Answer 18

Orientation
Memory
Visuospatial
Language

Question 19

What are the advantages of MMSE?

Answer 19

Quick

Different languages

Question 20

What are the disadvantages of MMSE?

Answer 20

Not adjusted for age
Poor for executive functioning
Poor in severe cases -> 'Floor effect'
Poor in high premorbid functioning
Not sensitive in early stages
Exclusion of non-verbal skills

Question 21

What domains are assessed in the Addenbrookes Cognitive Examination III?

Answer 21

Orientation
Attention
Memory
Executive functioning
Language
Visuospatial functioning

Question 22

How long does the Addenbrookes Cognitive Examination III take?

Answer 22

~15 minutes

Question 23

What domains are assessed in Neuropsychological Assessments?

Answer 23

Pre-morbid functioning
Orientation and attention
Memory and new learning
Visuospatial and constructional functioning
Language
Executive functioning
Emotional status

Question 24

What is the diagnostic triad in ADHD?

Answer 24

Inattention
Hyperactivity
Impulsivity

Question 25

What do the triad of features in the diagnosis if ADHD have to be to diagnose 'combined-type' ADHD (aka Hyperkinetic Disorder)?

Answer 25

Developmentally inappropriate Impairing Pervasive Longstanding

Question 26

What structured diagnostic questionnaires can be used in the diagnosis of ADHD?

Answer 26

Conners Rating Scale | ADHD Rating Scale

Question 27

What are some risk factors for ADHD?

Answer 27

Family history Male gender Socioeconomic status

Question 28

What are the first line psychological therapies for ADHD?

Answer 28

``` Parent training (New Forest parenting programme) Classroom strategies ```

Question 29

What are the second line psychological therapies for ADHD?

Answer 29

Social skills | Sleep and diet

Question 30

When might psychological therapies be useful and not sufficient?

Answer 30

Useful for secondary difficulties at home | Not sufficient in most cases

Question 31

What are the first line pharmacological treatments for ADHD?

Answer 31

Methylphenidate ('Ritalin') Dexamfetamine Lisdexamfetamine

Question 32

How do the first line pharmacological treatments for ADHD work?

Answer 32

'Stimulants' - Increase DA transmission in executive functioning networks to prefrontal cortex - Directly improve symptoms

Question 33

What are the side effects of the first line pharmacological treatments for ADHD?

Answer 33

``` Reduced appetite Reduced sleep Dysphoria Anxiety Tics ```

Question 34

What is the second line pharmacological treatment for ADHD?

Answer 34

Atomoxetine

Question 35

What are the third line pharmacological treatments for ADHD?

Answer 35

Antidepressants Antihypertensives Antipsychotics

Question 36

What weeks of the New Forest Parenting Programme are parent only?

Answer 36

Week 1 Week 2 Week 5 Week 8

Question 37

What weeks of the New Forest Parenting Programme are parent and child?

Answer 37

Week 3 Week 4 Week 6 Week 7

Question 38

What techniques do parents learn during week 2 of the New Forest Parenting Programme?

Answer 38

Routines Clear communication Limit setting Ability to avoid confrontation

Question 39

How can a parent learn to manage a child's temper during week 3 of the New Forest Parenting Programme?

Answer 39

Firm limits | Distraction strategies

Question 40

What do parents learn to use during week 4 of the New Forest Parenting Programme?

Answer 40

Time out | Quiet time

Question 41

During weeks 6 and 7, how long does the practitioner of the New Forest Parenting Programme observe the parent and child alone for?

Answer 41

15 minutes

Question 42

How common is Autism Spectrum Disorder?

Answer 42

1/68

Question 43

Is Autism Spectrum Disorder more common males or females?

Answer 43

Males

Question 44

What are the triad of impairments in Autism Spectrum Disorder?

Answer 44

1. Qualitative impairments in reciprocal social interaction 2. Language impairment 3. Thought and behaviour

Question 45

How is Autism Spectrum Disorder defined in DSM-IV-TR?

Answer 45

>=6 symptoms including: - >=2 of qualitative impairment in social interaction - >=1 of qualitative impairment in communication - >=1 symptoms of restricted/repetitive behaviour

Question 46

When is Risperidone used in Autism Spectrum Disorder?

Answer 46

Short-term for: - Aggression - Tantrums - Self-injury

Question 47

If there are ADHD symptoms in Autism Spectrum Disorder, what drug can be used?

Answer 47

Methylphenidate

Question 48

If there are sleep problems in Autism Spectrum Disorder, what drug can be used?

Answer 48

Melatonin