Psychiatry

Question 1

medications interacting with ssri and tca to cause serotonin syndrome?

Answer 1

Triptan and MAO inhibitors

Question 2

Anorexia Nervosa

Answer 2

most things low
G’s and C’s raised: growth hormone, glucose, salivary glands, cortisol, cholesterol, carotinaemia

Question 3

Side effects of typical and atypical antipsychotics

Answer 3

Typical - extra pyramidal side effects, hyperprolactinemia, qt prolongation
Atypical - less extra pyramidal side effects, causes more of weight gain, hyperprolactinemia, clozapine causes agranulocytosis

Question 4

Antipsychotics in elderly side effects?

Answer 4

Antipsychotics in the elderly - increased risk of stroke and VTE

Question 5

Unexplained symptoms diagnoses

Answer 5

Unexplained symptoms
Somatisation = Symptoms
hypoChondria = Cancer

Question 6

Lithium monitoring

Answer 6

after starting lithium levels should be performed weekly and after each dose change until concentrations are stable
once established, lithium blood level should ‘normally’ be checked every 3 months
after a change in dose, lithium levels should be taken a week later and weekly until the levels are stable.
thyroid and renal function should be checked every 6 months

Question 7

Drug of choice for benzodiazepine withdrawal

Answer 7

Diazepam reduced 1/4 to 1/10 dose every fortnight

Question 8

New Classification of personality disorder

Answer 8

New - based on severity and predominant symptoms
severity mild moderate severe
predominant patter - NDDDAB
Negative Affectivity - pattern of feeling negative emotions
Detachment
Dissoicality
Disinhibition
Anankastia - pattern of orderliness, control, perfectionism
Borderline personality disorder

Question 9

Onset of alcohol withdrawal features

Answer 9

Alcohol withdrawal
symptoms: 6-12 hours
seizures: 36 hours
delirium tremens: 72 hours

Question 10

Wernicke’s Korsakoff syndrome features

Answer 10

Wernicke’s - confusion, nystagmus, ataxia
Korsakoff - antero and retrograde amneisa, confabulation

Question 11

Feature suggestive of depression more than dementia

Answer 11

global memory loss (dementia characteristically causes recent memory loss)
reluctant to take tests, disappointed with results. short history, rapid onset
biological symptoms e.g. weight loss, sleep disturbance

Question 12

Drug of choice for PTSD

Answer 12

Venlafaxine

Question 13

TCA safest and most dangerous in overdose

Answer 13

Safest - Lofepramine
Dangerous - Dosulepin, Amitriptyline

Question 14

Highest incidence of discontinuation syndrome in SSRI

Answer 14

Paroxetine