psychiatry

Question 1

how to differentiate between PTSD and acute stress reaction

Answer 1

acute stress reaction is only up to 4 weeks following the event, at which point it becomes PTSD

Question 2

name some drugs that can precipitate lithium toxicity

Answer 2

thiazide, thiazide-like diuretics, ACE, ARBs

Question 3

presentation of lithium toxicity

Answer 3

confusion, seizures, ataxia, tremor, visual disturbances and arrhythmias

Question 4

how can we manage bulimic patients who don’t respond to psychological therapy or have comorbid depression

Answer 4

fluoxetine

Question 5

first line management of bulimia in adolescents

Answer 5

bulimia nervosa focused family therapy

Question 6

what antipsychotic can we switch to if patients have hyperprolactinaemia

Answer 6

aripiprazole

Question 7

what kind of tremor is associated with lithium toxicity

Answer 7

coarse tremor

Question 8

what kind of tremor is a common side effect of lithium

Answer 8

fine

Question 9

ECG finding associated with hypokalaemia

Answer 9

U waves

Question 10

electrolyte abnormalities seen in refeeding syndrome

Answer 10

low phosphate, magnesium and potassium levels

Question 11

what vitamin is thiamine

Answer 11

B1

Question 12

most common side effect of sertraline

Answer 12

GI disturbances e.g. diarrhoea

Question 13

management of antisocial personality disorder

Answer 13

group based CBT

Question 14

management of EUPD

Answer 14

dialectal behavioural therapy

Question 15

what is circumstantiality

Answer 15

patient moves to different topics but eventually returns to answer the original question

Question 16

what is poverty of speech

Answer 16

lack of spontaneous speech

Question 17

what is perseveration

Answer 17

repetition of words or ideas when another person attempts to change the topic

Question 18

what is derailment

Answer 18

where the conversation randomly moves from one topic to another

Question 19

what is thought blocking

Answer 19

patient suddenly halts in their thought process and cannot continue

Question 20

what is la belle indifference

Answer 20

patient shows no concern over the symptoms they are experiencing

Question 21

what is conversion disorder

Answer 21

presence of neurological symptoms without any underlying neurological cause

Question 22

what is conversion disorder often linked to

Answer 22

emotional distress

Question 23

what is somatoform disorder

Answer 23

mental illness causes physical symptoms without a clear physical cause

Question 23

what is munchausens

Answer 23

patients fake illness to receive attention

Question 24

how does munchausens differ from malingering

Answer 24

munchausens is for attention, malingering is for the goal of receiving an award e.g. a payout

Question 25

first line investigation for patient presenting with palpitations

Answer 25

24-48 hour holter monitoring ECG

Question 26

capgras delusion

Answer 26

someone close to the patient has been replaced by in identical imposter

Question 27

what is a common side effect of atypical antipsychotics

Answer 27

weight gain

Question 28

which type of antipsychotics are more commonly associated with the development of tardive dyskinesia

Answer 28

long term use of typical antipsychotics

Question 29

what effect can atypical antipsychotics have on BP

Answer 29

can cause orthostatic hypotension

Question 30

what is agranulocytosis

Answer 30

major decrease in WBC count

Question 31

what is the recommended continuation of antidepressants once symptoms start to improve

Answer 31

continue for at least 6 more months

Question 32

what is the difference between rituals in OCD and obsessive compulsive personality disorder

Answer 32

OCD they are distressing and associated with anxiety in personality disorder they are enjoyable and rewarding and don't cause stress

Question 33

what is constructional apraxia and what is it commonly associated with

Answer 33

difficulty in performing tasks requiring spatial awareness and planning e.g. copying shapes or building things frontotemporal dementia

Question 34

what can commonly predispose to the development of anorexia nervosa

Answer 34

dieting

Question 35

name 3 tricyclics

Answer 35

amitriptyline, imipramine and clomipramine

Question 36

name some common side effects of tricyclics

Answer 36

urinary retention, drowsiness, blurred vision, constipation, dry mouth

Question 37

what is another name for derailment and what is it

Answer 37

loosening of associations / knights move thinking jumps from topic to topic with no link

Question 38

what is tangentiality

Answer 38

person diverts from original train of thought but never returns to original topic

Question 39

minimum duration of symptoms for a diagnosis of a major depressive disorder

Answer 39

at least 2 weeks

Question 40

which neurodegenerative disease is linked to an increased risk in patients with down syndrome

Answer 40

alzheimers - at a younger age !!

Question 41

which type of dementia is haloperidol contraindicated in and why

Answer 41

lewy body dementia - causes a deterioration in parkisonism

Question 42

what kind of drug is citalopram

Answer 42

SSRI

Question 43

minimum duration of symptoms for somatization disorder

Answer 43

>6 months of physical symptoms

Question 44

side effect of levodopa

Answer 44

risk taking behaviour

Question 45

when can adjustment disorder present

Answer 45

within 3 months of an identifiable life stressor

Question 46

first line management of depression in a patient on warfarin therapy

Answer 46

mirtazapine

Question 47

what electrolyte imbalance is linked to panic disorder and why

Answer 47

hypocalcaemia hyperventilation -> alkalosis, promotes calcium binding to albumin so reduces levels of free calcium in the blood

Question 48

how long should treatment of OCD continue once symptoms improve

Answer 48

12 months

Question 49

complication associated with long term use of antipsychotics

Answer 49

increased risk of stroke - cause weight gain and abnormal lipid profiles

Question 50

management of lithium toxicity

Answer 50

fluid resuscitation

Question 51

what do we need to test in patients who present acutely with alcohol intoxication

Answer 51

blood glucose

Question 52

biochem result often seen in patients with anorexia

Answer 52

raised serum cholesterol