Psych

Question 1

Stepwise dementia

Answer 1

vascular

Question 2

dementia- mri shows infarcts and white matter changes

Answer 2

vascular

Question 3

treatment for vascular dementia

Answer 3

no specific

Question 4

Dementia recent memories affected

Answer 4

alzheimers

Question 5

Alzheimers rx

Answer 5

mild-mod- AChEi (donepezil, rivastigmine, galantamine)

Severe/adjunct/second line- memantine

Question 6

Are antidepressants recommended in alzheimers

Answer 6

no

Question 7

Donepezil c/i and side effect (one of each)

Answer 7

not in bradycardia
Can = insomnia

Question 8

Can you give antipsychotic in alzheimers

Answer 8

yes if agitated ++

Question 9

2 types of frontotemporal dementia

Answer 9

behavioural variant (50%)

Primary progressive aphasia (has subtypes)

Question 10

dementia where behaviour change noticed before memory change

Answer 10

frontotemporal

Question 11

dementia with personality change and impulsiveness

Answer 11

frontotemporal

Question 12

frontotemporal rx

Answer 12

no drug therapy
can use SSRI/benzo/antipsychotic (as last resort for antipsych)

Question 13

EArly impairment in attention or function dementia

Answer 13

LBD

Question 14

Fluctuating cognition dementia
Visual hallucinations

Answer 14

LBD

Question 15

LBD leads to what

Answer 15

parkinsonism

Question 16

Diagnosis of LBD

Answer 16

SPECT

Question 17

Treatment of LBD

Answer 17

AChEi or memantine similar to alzheimers
AVOID neuroleptics as can cause parkinsonism

Question 18

3 treatments for parkinsons

Answer 18

Levodopa (for motor primarily)

MOAi (rasagiline, seslegiline)

Dopamine agonist

Question 19

What type of medication is not first line in parkinsons

Answer 19

Ergot derived dopamine agonists- bromocriptine, cabergoline

Question 20

3 complications of parkinsons

Answer 20

autonomic dysfunction (constipation, urinary freq, postural hypotension)
falls
cognitive impairment

Question 21

When can you define it as parkinsons dementia

Answer 21

onset after >1yr parkinsons (before 1y would be LBD)

Question 22

SSRI of choice in children/adolescent?

Answer 22

Fluoxetine

Question 23

Best antidepressant post MI

Answer 23

sertraline

Question 24

Which SSRI has QT risk

Answer 24

citalopram

Question 25

First line for GAD

Answer 25

sertraline

Question 26

how to taper off benzos when addicted

Answer 26

switch to equivalent diazepam dose then taper over 2 months

Question 27

biggest risk factor for schizophrenia

Answer 27

family history

Question 28

Dizziness, electric shock sensations and anxiety are symptoms of discontinuing what class of medication

Answer 28

SSRIs

Question 29

What PHQ-9 score is more severe depression (as opposed to 'less severe') and what is first line rx

Answer 29

PHQ-9 score of ≥ 16 CBT AND antidepressant medication

Question 30

What are the first rank symptom (categories) of schizophrenia?

Answer 30

auditory hallucinations thought disorder passivity phenomena delusional perceptions

Question 31

Cotard syndrome

Answer 31

believes they are dead

Question 32

Capgras syndrome

Answer 32

believes friend/family has been replaced by an imposter

Question 33

Erotomania

Answer 33

believe someone is in love with them, stalking

Question 34

Factors associated with poor prognosis in schizophrenia

Answer 34

strong family history gradual onset low IQ prodromal phase of social withdrawal lack of obvious precipitant

Question 35

what is an eponymous sign to see if paralysis if non-organic

Answer 35

Hoover's sign (pressure is felt under the paretic leg when lifting the non-paretic leg against pressure, this is due to involuntary contralateral hip extension)

Question 36

Conversion syndrome

Answer 36

typically involves loss of motor or sensory function

Question 37

Somatisation syndrome

Answer 37

multiple physical SYMPTOMS present for at least 2 years, refuses to accept negative tests or reassurance