Passmedicine - 2

Question 1

circadian rhythm disturbance is a feature of?

Answer 1

schoziphrenia

Question 2

epilepsy is least considered a potential side effect of?

Answer 2

ECT

Question 3

what is the SSRIantidepressant of choice post myocardial infarction?

Answer 3

Sertraline

Question 4

what are the features of anorexia nervosa (4)

Answer 4

reduced BMI
bradycardia
hypotension
enlarged salivary glands

Question 5

the risk of developing schizophrenia if one monozygotic twin is affected is ~?

Answer 5

50%

Question 6

what is a relatively common finding associated with lithium?

Answer 6

benign leucocytosis

Question 7

bulimia nervosa

is associated with which ABG presentation?

Answer 7

metabolic alkalosis

Question 8

the low chloride in bulimia nervosa represents?

Answer 8

loss of hydrochloric acid from the stomach through vomiting

Question 9

a person that prefers being alone, doesn’t like relationships, low libido?

Answer 9

schizoid

Question 10

hyponatraemia is associated with which class of antidepressants?

Answer 10

SSRIs

Question 11

what is a common side-effect of aspirin?

Answer 11

dyspepsia

Question 12

what is the common side effect of beta blockers?

Answer 12

bradycardia

Question 13

what is a common side effect of ACEi?

Answer 13

hyperkalaemia

Question 14

what is the definition of OCD?

Answer 14

obsessions or compulsions or both persisting for greater than 2 weeks

Question 15

what is used in the treatment of delirium tremens?

Answer 15

chlordiazepoxide

Question 16

how can you differentiate OCD with psychosis?

Answer 16

by the level of insight into their actions

Question 17

how can you differentiate dementia and depression?

Answer 17

short history and rapid onset

Question 18

dementia characteristically causes what type of memory loss?

Answer 18

recent

Question 19

depression presents with——- memory loss

Answer 19

global

Question 20

common side effects of clomipramine?

Answer 20

dry mouth and weight gain (antihistaminic)

Question 21

what its step 1 management of panic disorder?

Answer 21

recognition and diagnosis

Question 22

what is step 2 treatment of panic disorder?

Answer 22

CBT or drug treatment - SSSRIs

Question 23

when do you consider imipramine and clomipramine in the management of panic disorder?

Answer 23

if SSRIs aree contraindicated or no response after 12 weeks

Question 24

what is step 1 management in GAD?

Answer 24

education about GAD and active monitoring

Question 25

what is step 2 management in GAD?

Answer 25

low intensity psychological interventions (individual non-facilitated self-help or individual guided self-help or psychoeducational groups)

Question 26

what is step 3 management in GAD?

Answer 26

high intensity psychological interventions (CBT or applied relaxation) or drug treatment with SSRI

Question 27

what is a life-threatening side-effect of clozapine?

Answer 27

neutropenia - decreased leukocytes or agranulocytosis

Question 28

what do you monitor in patients taking clozapine?

Answer 28

monitor FBC

Question 29

a patient losing the ability to form language?

Answer 29

aphasic speech

Question 30

a patient repeating words or phrases of the individual they are talking to/

Answer 30

echolalia

Question 31

inability to answer a question without giving excessive, unnecessary detail. However, this differs from tangentiality in that the person does eventually return the original point.

Answer 31

circumstantiality

Question 32

wandering from a topic without returning to it.

Answer 32

tangentiality

Question 33

repetition of ideas or words despite an attempt to change the topic.

Answer 33

perseveration

Question 34

symptoms of mania in primary care?

Answer 34

urgent referral to Community mental health team

Question 35

sodium valproate should be used to manage bipolar disorder in patients

Answer 35

who have been trialled antipsychotics

Question 36

section 2 applications can be made by?

Answer 36

CP and require the support of another doctor with expertise in mental health

Question 37

when are section 2 applications usually made?

Answer 37

to admit a patient who requires it but has refused admission for assessment and/or treatment of a metal disorder

Question 38

how long does section 2 applications last for?

Answer 38

28 days

Question 39

after a change in dose, lithium levels should be taken

Answer 39

a week and 12 hours after the last dose

Question 40

what co therapy should be offered to all patients with schizophrenia?

Answer 40

cognitive behavioural therapy

Question 41

what are the metabolic side-effects of antipsychotics?

Answer 41

dysglycaemia, dyslipidaemia and diabetes mellitus

Question 42

what is a poor prognostic indicator of schizophrenia/ (5)

Answer 42

``` gradual onset strong family history low iQ premorbid history of social withdrawal lack of obvious precipitant ```

Question 43

when are psedohallucinations more common?

Answer 43

after bereavement and do not imply psychosis

Question 44

what are symptoms of SSRI discontinuation syndrome?

Answer 44

``` increased mood change restlessness difficulty sleeping unsteaadinesss sweating GI symptoms: pain, cramping, diarrhea, vomiting paraesthesia ```

Question 45

SSRIs should be continued for at least how long after feeling well to reduce risk of relapse?

Answer 45

at least 6 months

Question 46

what can cause a rise in clozapine blood levels?

Answer 46

smoking cessation

Question 47

when can chronic insomnia be diagnosed?

Answer 47

after 3 months | personal has trouble falling asleep staying asleep at least 3 nights per week

Question 48

what is a common adverse effect of atypical antipsychotics such as olanzapine?

Answer 48

weight gain

Question 49

what can be used to differentiate mania from hypomania?

Answer 49

auditory hallucinations

Question 50

what type of amnesia can ECT cause?

Answer 50

retrograde amnesia

Question 51

how long can normal grief reactions last for?

Answer 51

6 months

Question 52

how often is a IM anti-psychotic depot injection administered?

Answer 52

once monthly

Question 53

risk factors for gAD include (4)

Answer 53

aged 35-54 being divorced or separated living alone being a lone parent

Question 54

what scale can be used to assess alcohol withdrawal severity?

Answer 54

clinical institute withdrawal assessment for alcohol (CIWA) scale

Question 55

sudden onset psychosis following a course of?

Answer 55

corticosteroids