psych

Question 1

cotard syndrome

Answer 1

patient believe they are dead

Question 2

management of PTSD

Answer 2

trauma focused CBT or eye movement desensitisation therapy
if unsuccessful: venlafaxine or SSRI
risperidone in severe cases

Question 3

what is conversion disorder

Answer 3

loss of motor or sensory function
patient is not consciously feign the symptoms

Question 4

when is the peak incidence of delirium tremens

Answer 4

48-72 hours

Question 5

management of patient in alcohol withdrawal

Answer 5

long-acting benzodiazepines (chlordiazepoxide, diazepam)
- lorazepam preferred if known liver cirrhosis

Question 6

presentation and management of acute dystonia

Answer 6

within hours of starting antipsychotic, sudden painful muscle contraction and spasms.
mx: procyclidine or benzotropine

Question 7

blood findings in neuroleptic malignant syndrome

Answer 7

raised CK
AKI- secondary to rhabdo
leukocytosis

Question 8

avoidance of social activities, fear of being criticised or rejected

Answer 8

avoidant personality disorder

Question 9

long standing delusional belief that is unlikely but not impossible

Answer 9

delusional disorder

Question 10

first line medication for depression if patient on warfarin

Answer 10

mirtazepine

Question 11

management of neuroleptic malignant syndrome

Answer 11

stop antipsychotic
IV fluids
dantrolene

Question 12

management of serotonin syndrome

Answer 12

supportive: IV fluids
benzodiazepines
severe cases: cyproheptadine or chlorpromazine