Pass Medicine Psychiatry

Question 1

Prefer to be alone don’t like relationships low libido

Answer 1

Schizoid personality disorder

Question 2

What is the most likely SSRI to cause QT prolongation and torsades de pointed

Answer 2

Cotalopram

Question 3

What is the recommended SSRI for patients with cardiac disease

Answer 3

Sertraline

Question 4

Which drugs are important to note the anterograde amnesia which can present as the patient worrying about dementia

Answer 4

Benzos

Question 5

Most commonly associated side effect of haemolytic anaemia

Answer 5

Nitrofurantoin

Question 6

First line in patients with schizophrenia

Answer 6

Atypical antipsychotics

Question 7

Adverse side effects of atypical antipsychotics

Answer 7

Weight gain
Agranulocytosis
Hyperprolactinaemia

Question 8

When are the atypical antipsychotics?

Answer 8

Increased risk of stroke or VTE

Question 9

Eh of atypical antipsychotics

Answer 9

Clozapine 
Olanzapone 
Risperidone 
Quetiapine 
Amisulpride 
Aripiprazole

Question 10

How long should a patient be feeling depressed before they are classed as having depression

Answer 10

2 weeks

Question 11

When is ECT used acutely

Answer 11

Catatonia
A prolonged or severe manic episode
Severe depression that is life threatening

Question 12

Upper limb weakness and inability to move with normal exam findings

Answer 12

Conversion disorder

Question 13

What is somatostatin disorder

Answer 13

Multiple physical symptoms present for at least 2 years patient refuses to accept reassurance or negative test results

Question 14

What is dissociative disorder

Answer 14

Separating off certain memories from normal consciousness involving psychiatric symptoms

Question 15

What is factitious disorder

Answer 15

Also known as munchausens syndrome where there is an intentional production of physical or psychological symptoms

Question 16

What is malingering

Answer 16

Fraudulent stimulation or exaggeration of symptoms for financial or other gain

Question 17

Treat PTSD with

Answer 17

EMDR or CBT trauma focussed

Question 18

What is akathisia

Answer 18

Severe restlessness

Question 19

What are extrapyramidal side effects

Answer 19

Parkinsonism
Acute dystonia - sustained muscle contraction
Akathisia severe restlessness
Tar dive dyskinesia - late onset of choreoathetoid movements

Question 20

Treat extrapyramidal side effects with

Answer 20

Procyclidine

Question 21

First line for panic disorder

Answer 21

SSRI

Question 22

What drug is contraindicated with the use of SSRIs

Answer 22

Triptans

Question 23

When do seizures usually occur in alcohol withdrawal

Answer 23

36 hours

Question 24

When does delirium tremendous usually occur with alcohol withdrawal

Answer 24

72 hours

Question 25

What benzo is good in alcohol withdrawal

Answer 25

Chlordiazepoxide

Question 26

What benzo is good for alcohol withdrawal in patients with her aux failure

Answer 26

Lorazepam

Question 27

New onset psychosis in elderly do a

Answer 27

CT head

Question 28

Describe tar dive dyskinesia

Answer 28

Abn involuntary movements like lip smacking

Question 29

Why is mortazapine. And alpha 2 antagonist often not tolerated

Answer 29

Increased appetite and sedation

Question 30

What causes the tyramine cheese reaction

Answer 30

MAOI such as phenelzine causes this hypertensive crisis

Question 31

What is Charles Bonnet syndrome

Answer 31

Visual hallucinations and eye disease

Question 32

Name 5 short term side effects of eCt

Answer 32

Headache nausea short term memory impairment Memory loss of events prior to ECT Cardiac arrythmia

Question 33

What is agranulocytosis

Answer 33

Low leukocytes severely low

Question 34

What is circumstantiality

Answer 34

Inability to answer a question without giving excessive unnecessary detail

Question 35

What are clang association s

Answer 35

Topics are related to each other only by sound

Question 36

What is tangentially

Answer 36

Wandering from a subject without returning to it

Question 37

How do you differentiate between knights move and flight of ideas

Answer 37

Knights move - illogical leaps from one to another | Flight of ideas - some sort of link

Question 38

What are the metabolic side effects of atypical antipsychotics

Answer 38

High lipids high cholesterol high sugar weight gain

Question 39

SSRIs cause what type of biochemical abn

Answer 39

Hyponatraemia

Question 40

Patients with poor oral compliance to antipsychotics should be considered for

Answer 40

Monthly IM antipsychotic depot injections

Question 41

SSRI used during third trimester of pregnancy

Answer 41

Can cause persistent pulmonary hypertension

Question 42

What commonly prescribed drug is associated with sudden onset psychosis

Answer 42

Prednisalone

Question 43

Paroxetine in pregnancy has been linked with

Answer 43

Congenital malformation

Question 44

What can treat tar dive dyskinesia

Answer 44

Tetrabenazine

Question 45

Treat akathisia

Answer 45

Propranolol

Question 46

Telepathy acute dystonia

Answer 46

Procylcidine and benzotropine

Question 47

What are the main side effects of tricyclics

Answer 47

Anticholinergucbside wffects and weight gain

Question 48

How should you stop an SSRI

Answer 48

Gradually reduce dose over 4 weeks

Question 49

What is torticollis

Answer 49

Wry neck - unilateral pain and deviation of the neck

Question 50

What is most commonly associated with SSRI discontinuation syndrome

Answer 50

GI side effects

Question 51

If clozapine doses are missed for more than 48 hours what should happen

Answer 51

They should be retitrated slowly

Question 52

SSRI + NSAID =

Answer 52

GI bleeding risk so give a PPI

Question 53

Which antipsychotics has the best side effect profile particularly in terms of prolactin

Answer 53

Aripiprazole

Question 54

What psychiatric disorder can be seen post concussion

Answer 54

Headache fatigue anxiety depression dizziness

Question 55

Long term lithium use can result in what biochemical abn

Answer 55

Hyperparathyroidism and resultant hypercalcaemia

Question 56

What should happen to the antidepressant before a patient is starting ECT

Answer 56

Reduce the dose

Question 57

What is more common after ECT - retrograde or anterograde amnesia?

Answer 57

Retrograde

Question 58

After changing the dose of lithium when should the lithium levels be checked

Answer 58

A week after and 12 hours atter the last dose

Question 59

For a diagnosis of PTSD symptoms must be present for at least

Answer 59

One months

Question 60

What is an oculogyric crisis

Answer 60

Acute dystonic reaction of the ocular muscles characterised by bilateral dystonic elevation of the visual gaze lasting from seconds to hours

Question 61

If you give haloperidol urgently what else do you need to have prepared

Answer 61

Procyclidine in case the patient suffers an acute dystonic reaction

Question 62

What is othello syndrome

Answer 62

Delusional jealousy usually believing their partner is unfaithful