Psych

Question 1

bad thing about z drugs

Answer 1

increase risk of falls in elderly

Question 2

— has a lower incidence of toxicity in overdose
amitriptyline and dosulepin (dothiepin) are considered the most dangerous in overdose

Answer 2

lofepramine

Question 3

there is an increased risk of gastrointestinal bleeding in patients taking SSRIs. A proton pump inhibitor should be prescribed if a patient is also taking a NSAID

Answer 3

patients should be counselled to be vigilant for increased anxiety and agitation after starting a SSRI

Question 4

warfarin / heparin: NICE guidelines recommend avoiding SSRIs and considering mirtazapine

Answer 4

Following the initiation of antidepressant therapy patients should normally be reviewed by a doctor after 2 weeks.

Question 5

For patients under the age of 30 years or at increased risk of suicide they should be reviewed after 1 week. If a patient makes a good response to antidepressant therapy they should continue on treatment for at least 6 months after remission as this reduces the risk of relapse.

Question 6

sleep paralysis cna give

Answer 6

clonazepam (benzo)

Question 7

preffered SSRIs

Answer 7

citalopram and fluoxetine

Question 8

SSRIs and pregnancy
- BNF says to weigh up benefits and risk when deciding whether to use in pregnancy.
- Use during the first trimester gives a small increased risk of congenital heart defects
- Use during the third trimester can result in persistent pulmonary hypertension of the newborn
- Paroxetine has an increased risk of congenital malformations, particularly in the first trimester

Question 9

pts under infleucen of alcohol or drugs cannot be

Answer 9

sectioned

Question 10

what can make symptoms worse in SAD

Answer 10

sleeping tablets

Question 11

bodily sensations being controlled by external influence

Answer 11

passivity phenomena

Question 12

stronest rf for developing schizophrenia

Answer 12

family history

Question 13

pseduohallucination

Answer 13

aware they are halluucinating

Question 14

PTSD symptoms less than 4 weeks

Answer 14

watch and wait

Question 15

following a traumatic event single-session interventions (often referred to as debriefing) are not recommended

Answer 15

can worsen it

Question 16

first line drug in ptsd

Answer 16

venlafaxine or ssri

Question 17

Histrionic

Answer 17

need to be centre of attention

Question 18

mx of personality disoders

Answer 18

dialectical behaviour therapy

Question 19

In OCD in comparison to depression usually SSRIusually

Answer 19

needs to be a higher dose adn for a longer duartion for an initial response

Question 20

mirtazapine usuefull

Answer 20

less interactions so useful in elderly who may be affected more or be taking other medications
taken in evening as can be sedative

Question 21

lithium has narrow therapeutic rnagle and long

Answer 21

plasma half life

Question 22

lithium levels should be taken 12hrs post dose and levels should be perfoemed weekly after change of dose or starting until concentrations are stable

Question 23

pts under 30 stareted on ssri

Answer 23

weekly follow up is recommended for the first month

Question 24

Switching from fluoxetine to another SSRI
withdraw then leave a gap of 4-7 days (as it has a long half-life) before starting a low dose of the alternative SSRI

Question 25

De Clerambault's syndrome, also known as erotomania, is a form of paranoid delusion with an amorous quality. The patient, often a single woman, believes that a famous person is in love with her.

Question 26

stoping smoking while on clozapine can cause a rise of clozapine

Answer 26

blood levels

Question 27

Two types of bipolar disorder are recognised: type I disorder: mania and depression (most common)

Question 28

antidepressant of choice in bipolar

Answer 28

fluoxetine

Question 29

benzos should onlhy be prescribed for short time

Answer 29

2-4 weeks

Question 30

important to withdrawl

Answer 30

benzos gradually

Question 31

s/e of atypical antipsychotics

Answer 31

weight gain hyperprolactinaemia in elderly - icnreased risk of stroek and VTE

Question 32

what atypical antipsychotic has the msot tolerable side effects espially for prolactin eelvation

Answer 32

aripiprazole

Question 33

what atypical antipsychotic has the highest risk of obesity

Answer 33

olanzapien

Question 34

first gen antipsychotics

Answer 34

haloperidol and chorpromazine

Question 35

what is worse with atypical

Answer 35

reducing seizure threshold

Question 36

everything low but these high in anorexia

Answer 36

raised cortisol and growth hormone hypercholesterolaemia hypercarotinaemia

Question 37

preferred benzo in liver cirrhosis associated with alcohol iwthdrawl

Answer 37

lorazepam

Question 38

benzos enhance

Answer 38

inhibitory effect of GABA

Question 39

alcohol withdrawl can cause

Answer 39

delirium tremons - coarse tremor, confusion, delusions

Question 40

alcohol withdrawl

Answer 40

first-line: long-acting benzodiazepines e.g. chlordiazepoxide or diazepam.

Question 41

PTSD diagnsoed after

Answer 41

4 weeks before this is acute stress disorder