psych

Question 1

mx of hypomania in primary care

Answer 1

routine referral to community mental health team

Question 2

length of symptoms to be classed as depressive episode

Answer 2

2 weeks

Question 3

moa of benzodiazepines

Answer 3

enhance the effect of GABA

Question 4

conversion disorder

Answer 4

loss of motor or sensory function

may be caused by stress

Question 5

which medications can cause psychosis

Answer 5

corticosteroids

Question 6

mx of OCD with mild, moderate and severe functional impairment

Answer 6

mild - CBT including ERP (exposure and response prevention)

moderate/severe - add an SSRI to CBT + ERP

Question 7

ix to be considered in elderly patients with new onset psychosis

Answer 7

CT head to rule out organic cause

Question 8

what should be co-prescribed if a person is on an SSRI and an NSAID

Answer 8

PPI due to GI bleeding risk

Question 9

drug mx of generalised anxiety disorder

Answer 9

1. Sertraline (SSRI)
2. alternative SSRI (e.g. Citalopram) or SNRI (e.g. Duloxetine)
3. Pregabalin

Question 10

circumstantiality

Answer 10

inability to answer a questions without excessive, unnecessary detail, but the question is eventually answered

Question 11

flight of ideas

Answer 11

leaps from one topic to another with discernible links but if asked a question they do not answer
seen in mania and bipolar

Question 12

adverse effects of tricyclic antidepressants

Answer 12

urinary retention leading to overflow incontinence
dry mouth
blurred vision
constipation
drowsiness
weight gain

Question 13

paranoid personality disorder

Answer 13

patients are overly sensitive and can be unforgiving if insulted
they question the loyalty of those around them
reluctant to confide in others

Question 14

how long should SSRIs be withdrawn over

Answer 14

gradually reduce the dose over 4 weeks

Question 15

examples of tricyclic antidepressants

Answer 15

Amitriptyline
Clomipramine
Imipramine

Question 16

moa of Venlafaxine

Answer 16

serotonin and noradrenaline reuptake inhibitor (SNRI)

Question 17

adverse effects of mirtazapine

Answer 17

appetite increase (and subsequent weight gain)
drowsiness

Question 18

Knight’s move vs flight of ideas

Answer 18

Knight’s move - no links between ideas

flight of ideas - links between ideas

Question 19

what metabolic disorders can long-term lithium use cause

Answer 19

hyperparathyroidism and resultant hypercalcaemia

‘stones, bones, groans, moans’

Question 20

Munchausen’s syndrome

Answer 20

purposefully causing symptoms

Question 21

adverse effects of ECT

Answer 21

headache and nausea
short-term memory impairment + retrograde amnesia of events prior to ECT
cardiac arrhythmias

Question 22

main 3 features of PTSD

Answer 22

re-experiencing, e.g. flashbacks
avoidance
hyperarousal

Question 23

how long should patients remain on SSRIs even if their symptoms get better

Answer 23

at least 6 months following remission

Question 24

core symptoms of depression

Answer 24

low mood

anhedonia

Question 25

substance disorder mx: which medication is a 'deterrent' that cannot be taken with alcohol (causes violent vomiting)

Answer 25

Disulfiram

Question 26

substance disorder mx: which medication is an 'anti-craving' medication that is safe in combination with alcohol

Answer 26

Acamprosate

Question 27

bilateral resting tremor on antipsychotics

Answer 27

Parkinsonism

Question 28

SSRI for children and adolescents

Answer 28

Fluoxetine

Question 29

mx of tardive dyskinesia from antipsychotics

Answer 29

Tetrabenazine | both begin w T

Question 30

mx of acute dystonia from antipsychotics

Answer 30

procyclidine and benztropine

Question 31

adverse effects of SSRIs

Answer 31

``` SSSS: stomach upset sexual dysfunction sodium low serotonin syndrome ```

Question 32

mx of acute stress disorder

Answer 32

CBT | benzodiazepines can be used for acute symptoms

Question 33

what should be monitored when prescribing SNRIs?

Answer 33

BP

Question 34

what should be monitored when prescribing citalopram

Answer 34

ECG

Question 35

what should be monitored when prescribing SSRI

Answer 35

U&Es

Question 36

SSRI risks during pregnancy

Answer 36

first trimester - small increased risk of congenital heart defects third trimester - persistent pulmonary hypertension of newborn

Question 37

mx of anorexia nervosa in young people

Answer 37

1. anorexia focused family therapy | 2. CBT

Question 38

what do antipsychotics in the elderly increase risk of

Answer 38

stroke and VTE

Question 39

when do acute dystonia and tardive dyskinesia present

Answer 39

acute dystonia - in first few days/weeks of taking antipsychotics tardive dyskinesia - after many years

Question 40

mx of neuroleptic malignant syndrome

Answer 40

stop antipsychotic IV fluids Dantrolene and Bromocriptine can be used

Question 41

which antidepressants can lead to 'tyramine cheese reaction'

Answer 41

MAOI , e.g. Phenelzine

Question 42

features of anorexia

Answer 42

most things low | G's and C's high - growth hormone, glucose, glands (salivary), cortisol, cholesterol

Question 43

adverse effects of atypical antipsychotics

Answer 43

weight gain hyperprolactinaemia clozapine - agranulocytosis and reduced seizure threshold

Question 44

mx of schizophrenia

Answer 44

atypical antipsychotics | CBT

Question 45

mx of delirium tremens

Answer 45

long-acting benzodiazepines, e.g. chlordiazepoxide or diazepam