Psychiatric effects of medical conditions

Question 1

Percentage of patients with coronary heart disease who have comorbid depression

Answer 1

20%

Question 2

Relationship between coronary heart disease and depression

Answer 2

Higher rates of depression in patients with coronary heart disease
Depression increases risk of coronary heart disease, even if treated

Question 3

Percentage of patients with congestive heart failure who have depression

Answer 3

21.5%

Question 4

Psychiatric symptoms of hyperthyroidism

Answer 4

Generalised anxiety
Depression
Irritability
Hypomania
Cognitive dysfunction

Question 5

Most common psychiatric symptom of hyperthyroidism

Answer 5

Generalised anxiety

Question 6

Psychiatric symptoms of hypothyroidism

Answer 6

Depression
Cognitive dysfunction
Rarely psychosis

Question 7

Psychiatric symptoms of mild to moderate hypercalcaemia

Answer 7

Depression
Apathy
Irritability
Loss of initiative

Question 8

Psychiatric symptoms of severe hypercalcaemia

Answer 8

Delirium
Psychosis
Catatonia
Lethargy
Coma

Question 9

Psychiatric symptoms of Cushing’s syndrome

Answer 9

Depression
Anxiety
Mania/hypomania
Psychosis
Cognitive dysfunction

Question 10

Most common psychiatric symptom of Cushing’s syndrome

Answer 10

Depression

Question 11

Psychiatric symptoms of mild to moderate hypocalcaemia

Answer 11

Anxiety
Parasthaesia
Irritability
Emotional lability

Question 12

Psychiatric symptoms of severe hypocalcaemia

Answer 12

Psychosis
Mania
Tetany
Seizures

Question 13

Psychiatric symptoms of Addison’s disease

Answer 13

Apathy
Anhedonia
Fatigue
Depression

Question 14

Psychiatric symptoms of acromegaly

Answer 14

Mood lability
Personality change
Depression

Question 15

Psychiatric symptom caused by acromegaly treatment

Answer 15

Psychosis caused by D2 agonists given as treatment e.g. bromocriptine

Question 16

Symptoms of phaeochromocytoma

Answer 16

Tachycardia
Labile hypertension
Sweating
Palpitations
Episodic panic/anger

Question 17

Screening test for phaeochromocytoma

Answer 17

Urinary catecholamines

Question 18

Urinary catecholamines seen in high levels in phaeochromocytoma

Answer 18

Vanillyl mandelic acid
Metanephrines

Question 19

Best diagnostic test for phaeochromocytoma

Answer 19

Plasma metanephrine level

Question 20

Increase in rate of depression among patients with diabetes than the general population

Answer 20

2-3x higher in patients with diabetes

Question 21

Prevalence of major depression among people with advanced cancer

Answer 21

5-15%

Question 22

Prevalence of delirium in palliative patients shortly before death

Answer 22

62%

Question 23

Dose adjustment needed for benzodiazepines in end stage renal failure

Answer 23

50% reduction

Question 24

Antidepressants which can be given at normal dose in end stage renal failure

Answer 24

Imipramine
Amitriptyline

Question 25

Antipsychotic which does not need dose reduction in end stage renal failure

Answer 25

Haloperidol

Question 26

Features of uraemic encephalopathy

Answer 26

Cognitive dysfunction Motor dysfunction Vomiting Restlessness Myoclonus Coma

Question 27

Bacterium which causes Lyme disease

Answer 27

Borrelia burgdorferi

Question 28

Percentage of patients with a tick related target lesion who develop CNS symptoms

Answer 28

15%

Question 29

Features of early stage neurologic lyme disease

Answer 29

Facial palsy Shooting pains Fever Headache Photophobia Back pain worse at night

Question 30

Features of late stage neurologic lyme disease

Answer 30

Cognitive deficits, especially memory issues Processing impairment Psychosis Seizures Violence Irritability Anxiety Depression

Question 31

Features of insulinomas

Answer 31

Recurrent headache Lethargy Diplopia Blurred vision Depression Psychosis

Question 32

Percentage of patients with sarcoidosis who have depression

Answer 32

20%

Question 33

Ophthalmic complication of topiramate

Answer 33

Angle closure glaucoma

Question 34

Drug used to treat migraines which is contraindicated in angle closure glaucoma

Answer 34

Topiramate

Question 35

Antidepressant with the best evidence base following MI

Answer 35

Sertraline

Question 36

Antidepressants most often used for depression after MI where sedation is required

Answer 36

Mirtazapine Trazodone

Question 37

Increased risk of depression in a patient with heart failure compared to the general population

Answer 37

3x higher

Question 38

Likely diagnosis in a patient with mania, a facial rash and mouth ulcers

Answer 38

SLE

Question 39

Antidepressants considered safest for use by patients with epilepsy

Answer 39

SSRIs Moclobemide

Question 40

Thyroid condition associated with depression and rapid cycling bipolar disorder

Answer 40

Subclinical hypothyroidism

Question 41

Male:female ratio of hypothyroidism

Answer 41

1:6

Question 42

Test of effort used to help diagnose conversion disorder

Answer 42

Hoover's test

Question 43

Features of neurosyphillis

Answer 43

Meningitis Facial nerve palsy Eye problems - pupillary changes, retinitis, uveitis etc. Depression, mania, psychosis, dementia Paraesthesia High stepping gait

Question 44

Drug class of choice for depression in patients who have had a stroke

Answer 44

SSRI

Question 45

Drug class of choice for depression in patients with MS

Answer 45

SSRI

Question 46

Drug class of choice for depression in patients with Parkinson's disease

Answer 46

SSRI

Question 47

Drug class of choice for depression in patients with HIV

Answer 47

SSRI

Question 48

Drug class of choice for depression in patients with epilepsy

Answer 48

SSRI

Question 49

SSRIs with most evidence for post-stroke depression

Answer 49

Fluoxetine Citalopram

Question 50

SSRI with most evidence for depression in MS

Answer 50

Sertraline

Question 51

Suicide rate in patients with epilepsy compared to the general population

Answer 51

3x higher in patients with epilepsy

Question 52

Most common time for patients with epilepsy to complete suicide

Answer 52

Within the first 6 months of diagnosis