Passmedicine

Question 1

what type of urinary incontinence is the most associated with amitriptyline(TCAs)?

Answer 1

overflow incontinence - anticholinergic effect

Question 2

what are the common side effects of TCAs? (6)

Answer 2

drowsiness 
dry mouth 
blurred vision 
constipation 
urinary retention 
lengthening of QT interval

Question 3

what are the more sedative TCAs? (4)

Answer 3

amitriptyline
clomipramine
dosulepin
trazodone

Question 4

what are the less sedative TCAs (3)?

Answer 4

imipramine
lofepramine
nortriptyline

Question 5

What is raised in anorexia? (G’s and C’s)

Answer 5

growth hormone, glucose, salivary glands, cortisol, cholesterol, cartinaemia

Question 6

what is the name of the condition when a person believes a famous person is in love with them?

Answer 6

Erotomania (De Clerambault’s syndrome)

Question 7

what is the cause of a suicide attempt being successful?

Answer 7

male gender
previous suicide attempts
white ethnicity, increasing age
previous mental illness such as depression

Question 8

what is not a first rank symptom of schizophrenia?

Answer 8

catatonia

Question 9

what is the duration that symptoms to be present before a diagnosis of PTSD?

Answer 9

1 month

Question 10

how can concordance with antipsychotics be improved?

Answer 10

with depot medication

Question 11

what is a common side effect of anti-psychotics?

Answer 11

parkinsonian symptoms

Question 12

which gender does antisocial personality affect more?

Answer 12

male gender

Question 13

what is stopping of voluntary movement or stay still in an unusual position?

Answer 13

catatonia

Question 14

what class of medication should be avoided in patients taking SSRIs?

Answer 14

triptans

Question 15

what happens if you prescribe NSAIDs with SSRIs?

Answer 15

prescribe PPI along with it

Question 16

If on warfarin /heparin should you avoid SSRIs?

Answer 16

yes and consider mirtazapine

Question 17

why should you avoid MAOIs and SSRIs?

Answer 17

increased risk of serotonin syndrome

Question 18

when stopping a SSRI the dose should gradually reduced over what time period?

Answer 18

4 week

Question 19

Use of SSRIs in the first trimester gives a small increased risk of?

Answer 19

congenital heart defects

Question 20

use of SSRIs in the third trimester can result in?

Answer 20

persistent pulmonary hypertension of the newborn

Question 21

which SSRI has an increased risk of congenital malformation particularly in the 1st trimester?

Answer 21

paroxetine

Question 22

what is the first line treatment for children and young people with anorexia nervosa?

Answer 22

family based therapy

Question 23

what is the second line treatment for children and young people with anorexia nervosa?

Answer 23

CBT

Question 24

what is the first line treatment for adults with anorexia nervosa?

Answer 24

ndividual eating-disorder-focused cognitive behavioural therapy (CBT-ED)

• Maudsley Anorexia Nervosa Treatment for Adults (MANTRA)
• specialist supportive clinical management (SSCM)

Question 25

what is used to treat moderate/severe tragic dyskinesia?

Answer 25

tetrabenazine

Question 26

what is used to treat acute dystonia?

Answer 26

procyclidine and benzotropine

Question 27

what is the ICD10 criteria for duration of depressive illness?

Answer 27

2 weeks

Question 28

antipsychotics in the elderly cause an increased risk of?

Answer 28

stroke and VTE

Question 29

What is the name of a syndrome where you purposefully cause symptoms?

Answer 29

munchaesen's syndrome

Question 30

what syndrome presents with loss of function which is non-physical eg. memory?

Answer 30

dissociative disorder

Question 31

which syndrome presents with loss of function with no cause?

Answer 31

conversion syndrome

Question 32

what does zopiclone increase the risk of?

Answer 32

falls in elderly patients

Question 33

what enhance the effect of BAGA, the main inhibitory neurotransmitter?

Answer 33

Benzodiazepines

Question 34

what is a short term side effect of ECT?

Answer 34

cardiac arrhythmia

Question 35

what is a sustained muscle contraction?

Answer 35

acute dystonia

Question 36

what is the 1st line management for PTSD that has lasted more than 1month?

Answer 36

trauma focused CBT or EMDR

Question 37

what is the strongest risk factor for psychotic disorders?

Answer 37

family history

Question 38

what is associated with random panic attacks on a background of no anxiety usually?

Answer 38

panic disorder

Question 39

what is associated with anxiety in situations where escape is difficult or help unavailable?

Answer 39

agoraphobia

Question 40

what is persistent free floating anxiety with associated features?

Answer 40

GAD

Question 41

what is the key difference between knight's move and flight of ideas?

Answer 41

knight's move thinking there are illogical leaps from one idea to another whereas flight of ideas there are discernible links between ideas

Question 42

what is new word formations?

Answer 42

neologisms

Question 43

when speech is completely incoherent and words are strung together into sentences that do not make sense?

Answer 43

word salad

Question 44

what is it called when ideas are related to each other only by the fact that they sound similar?

Answer 44

clang associations

Question 45

what is the syndrome when symptoms last more than three months after the initial injury. They are often non-specific neurological symptoms and the initial injury is often trivial and can be overlooked - history of contract sports?

Answer 45

post-concussion syndrome

Question 46

delirium tremens - alcohol withdrawal for?

Answer 46

72 hours

Question 47

seizures - alcohol withdrawal for?

Answer 47

36 hours

Question 48

symptoms - alcohol withdrawal for?

Answer 48

6-12 hours

Question 49

clozapine missed for more than 48 hours?

Answer 49

dose should be restarted again slowly

Question 50

what class of psychiatric drugs are associated with hyponatraemia?

Answer 50

SSRIs

Question 51

what should be considered in an elderly patient with first episode sudden onset psychosis?

Answer 51

CT head - organic cause for their presentation

Question 52

which antidepressant can be prescribe due to useful side effects of sedation and increased appetite?

Answer 52

mirtazapine

Question 53

what is the most common side effect of clozapine?

Answer 53

constipation/intestinal obstruction

Question 54

what antipsychotic is best suited for prolactin elevation?

Answer 54

aripiprazole

Question 55

what is a sense of inner restlessness and ability to keep still?

Answer 55

akathisia