Psych Questions

Question 1

What are the first rank symptoms?

Answer 1

Delusions, auditory hallucinations, thought disorder, passivity experience

Question 2

What is somatic passivity?

Answer 2

Experience of bodily sensations (including actions, thoughts, or emotions) imposed by external agency. ‘‘They’re making me feel cold all the time’

Question 3

What is passivity of affect?

Answer 3

Forced by an external agent to feel emotions

Question 4

What is passivity of impulse?

Answer 4

Forced by an external agent the desire to do things

Question 5

What is passivity of volition

Answer 5

Forced by an external agent to perform actions

Question 6

What is the strongest risk factor for future suicide completion?

Answer 6

Male gender

Question 7

What factors are associated with a increased risk of completed suicide at a future date, for patients who have previously failed?

Answer 7

Efforts to avoid discovery, planning, leaving a written note, final acts, violent method

Question 8

What is thought suppression?

Answer 8

Intentionally and temporarily withholding an idea or feeling from conscious awareness

Question 9

What is displacement of thoughts?

Answer 9

Redirection of emotions or impulses to a neutral person or object

Question 10

What are flashbacks in PTSD?

Answer 10

A form of pseudohallucination

Question 11

How does a prodromal phase in schizophrenia affect prognosis?

Answer 11

Associated with a poor prognosis

Question 12

What is a prodromal phase in schizophrenia associated with?

Answer 12

Social withdrawal and isolation

Question 13

What factors are associated with a poor prognosis in schizophrenia?

Answer 13

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

Question 14

What is malingering?

Answer 14

Falsification or profound exaggeration of illness to gain external benefits such as avoiding work or responsibility

Question 15

What is the MoA of tricyclic antidepressants?

Answer 15

Inhibition of monoamine reuptake on the presynaptic membrane, via binding to the ATPase monoamine pump within the presynaptic membrane

Question 16

What is a primary delusion vs. secondary delusion?

Answer 16

Primary delusion; those which cannot be described by any previous psychopathological state, such as a mood disorder. Most commonly seen in schizophrenia

Secondary delusions: relate to patients underlying mood. Often in mania or severe depression

Question 17

How does alcohol withdrawal affect GABA and glutamate transmission?

Answer 17

Alcohol withdrawal results from decreased inhibitory GABA and increased NMDA glutamate transmission

Question 18

What is the triad of symptoms in Korsaokoffs?

Answer 18

anteretrograde amnesia, retrograde amnesia, confabulation

Question 19

When checking lithium levels, how long after taking a dose should the levels be checked?

Answer 19

12 hours post dose

Question 20

What is a short acting bendozdiazepine?

Answer 20

Lorazepam

Question 21

What is a long acting BDZ?

Answer 21

Diazepam

Question 22

What drug class is clomipramine?

Answer 22

TCA

Question 23

What classic side effects are caused by TCAs?

Answer 23

Anticholinergic: dry mouth, blurred vision, urinary retention. Also weight gain (due to antagonism of histamine receptors)

Also can lengthen QT interval

Question 24

What is the mechanism of action of venlafaxine?

Answer 24

Serotonin and noradrenaline reuptake inhibitor

Question 25

What is the first line drug treatment for PTSD?

Answer 25

Venlafaxine or an SSRI

Question 26

What symptoms suggest depression rather than dementia?

Answer 26

Sleep disturbance, stress triggers, normal mini-mental state

Question 26

When should a patient be prescribed an PPI with an SSRI?

Answer 26

when they are taking NSAIDs. This is due to increased GI bleeding risk

Question 27

For a diagnosis of PTSD, how long should symptoms be present for?

Answer 27

1 month

Question 28

What should be done for SSRI dose when a patient is starting ECT

Answer 28

Reduce dose but not stop it

Question 29

Which antipsychotic has the most tolerable side effect profile?

Answer 29

Aripiprazole; particularly favourable for prolactin elevation

Question 30

What should be done if clozapine doses are missed for more than 48 hours?

Answer 30

Dose needs to be restarted again slowly

Question 31

What antipsychotic reduces seizure threshold?

Answer 31

Clozapine

Question 32

What drug class is mirtazapine?

Answer 32

Noradrenergic and specific serotonergic antidepressant

Question 33

What are symptoms of SSRI discontinuation syndrome?

Answer 33

Dizziness, electric shock sensations, anxiety. Also can be flu-like symptoms, hyperarousal, insomnia

Question 34

What GI s/e can clozapine cause?

Answer 34

Constipation/intestinal obstruction

Question 35

What are possible metabolic side effects of antipsychotics?

Answer 35

Dysglycaemia, dyslipidaemia, diabetes mellitus

Question 36

What is clang associations in thought disorders?

Answer 36

Ideas only related by rhyme or being similar sounding

Question 37

How long should antidepressants be continued after remission of symptoms to decrease risk of relapse?

Answer 37

At least 6 months

Question 38

When is ECT indicated?

Answer 38

Life threatening major depressive disorder, where catatonia is present

Question 39

What is echolalia?

Answer 39

The repitition of someone else's speech including the questions being asked

Question 40

What is copropraxia?

Answer 40

the involuntary performing of obscene or forbidden gestures or inappropriate touching

Question 41

What is a possible side effect of SSRI use during the third trimester?

Answer 41

Risk of persistent pulmonary HTN of the newborn

Question 42

What is a risk of SSRI use during the first trimester of pregnancy?

Answer 42

Increased risk of congenital heart defects

Question 43

What SSRI particularly has risk of congenital malformations in the first trimester?

Answer 43

Paroxetine

Question 44

Why do atypical antipsychotics increase the risk of stroke and VTE in the elderly?

Answer 44

Due to hyperprolactinaemia and weight gain, which increases the risk

Question 45

What is the SSRI choice in children?

Answer 45

Fluoxetine

Question 46

What is the difference between Knight's move and flight of ideas?

Answer 46

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

Question 47

What are drugs that should be avoided in SSRIs?

Answer 47

- NSAIDs (give PPI) - warfaring/heparin - aspirin - triptans - MAOIs

Question 48

What are the possible short term s/e of ECT?

Answer 48

Headaches, nausea, memory impairment, arrhythmias

Question 49

When should lithium levels be checked after a dose change?

Answer 49

Checked a week later, and then weekly until the levels are stable

Question 50

What test is used to differentiate organic from non organic leg paresis?

Answer 50

Hoover's sign

Question 51

What is the general treatment for acute dystonia secondary to antipsychotics?

Answer 51

Procyclidine

Question 52

What is pseudodementia?

Answer 52

Depression-related cognitive dysfunction; depressive symptoms mimic the clinical picture of dementia.

Question 53

What factors can suggest depression over dementia?

Answer 53

Short history+ rapid onset, biological symptoms, patient worried about poor memory, global memory loss (dementia characteristically causes recent memory loss)

Question 54

What are the risk factors for the development of generalised anxiety disorder?

Answer 54

Aged 35-54, being divocerved or separated, living alone, being a lone parent

Question 55

What is an alternative tx to SSRI in OCD?

Answer 55

Clomipramine (TCA)

Question 56

What PHQ-9 scores divides 'less' and 'more' severe depression?

Answer 56

Less severe: <16 More severe: >16

Question 57

What is akathisia?

Answer 57

Sense of inner restlessness and inability to keep still

Question 58

How does frontal lobe injury typically present?

Answer 58

Motor symptoms (weakness or paralysis), difficulty with speech, disinhibition

Question 59

What is 'stopping of voluntary movement or staying still in an unusual position'?

Answer 59

Catatonia

Question 60

What is the diagnostic criteria for insomnia?

Answer 60

Diagnosed after 3 months, if a person has trouble falling asleep or staying asleep at least 3 nights per week

Question 61

What is the risk of developing schizophrenia if one monozygotic twin is affected?

Answer 61

50%

Question 62

What type of urinary incontinence can tricyclic antidepressants cause?

Answer 62

Overflow incontinence

Question 63

What is the difference between Knight's move and flight of ideas?

Answer 63

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

Question 64

What is the regime for lithium monitoring?

Answer 64

Measured one week after starting, one week after dose change, then weekly until levels are stable. Once stable, they should be measured every 3 months. Always measured 12 hours post dose

Question 65

How do benzodiazepines work?

Answer 65

Enhance the effect of the inhibitory GABA