Psychiatry

Question 1

Third person auditory hallucinations

Answer 1

Schizophrenia

Question 2

Mesocortical dopamine hypoactivity

Answer 2

Negative and cognitive symptoms in schizophrenia

Question 3

Subcortical dopamine hyperactivity

Answer 3

Psychosis

Question 4

Dopamine pathways in the brain and functions (3)

Answer 4

Tuberoinfundibular (concerned with prolactin release)

Nigrostriatal (extra paramidal motor movements)

Subcortical and mesocortical (sometimes mesolimbic) (motivation and reward)

Question 5

Mesolimbic Da blockade

Answer 5

Depression

Question 6

Mesolimbic Da agonism

Answer 6

Psychosis

Question 7

SE of clozapine (2)

Answer 7

Weight gain (common) 
Agranulocytosis (rare but often fatal)

Question 8

Requirements for clozapine Rx (3)

Answer 8

Need to have tried 2 other antipsychotics

Consultant only prescription

Monitoring- weekly for 6/12, then fortnightly for next 6/12 and then every four weeks thereafter. Also one month after discontinuation

Question 9

Limbic system functions

Answer 9

“Self preservation and species preservation’

M20VE - motivation, memory, olfaction, visceral afferents and emotion

Question 10

Brain changes in schizophrenia

Answer 10

Reduced frontal lobe volume (and grey matter)
Enlarged lateral ventricles
Reduced grey matter in the temporal cortex

Question 11

Pressure of thought

Answer 11

Varied ideas in abundance (mania, schizophrenia)

Question 12

Poverty of thought

Answer 12

Patient reports lack/absence of thoughts

Question 13

Thought blocking

Answer 13

Abrupt and complete interruption of stream, strongly associated with schizophrenia.

Question 14

Flight of ideas

Answer 14

Quickly moving from one topic to another but there is a link (unlike knight’s move thinking)

Question 15

Treatment of extrapyramidal side effects

Answer 15

Procyclidine

Question 16

Amygdala function

Answer 16

Involved in normal response to threat; associating emotion with memory

Question 17

Prefrontal cortex

Answer 17

Dampens down amygdaloid response to threat I.e. Emotional regulation

Question 18

Management of OCD

Answer 18

1.SSRI, 2.SSRI, 3.TCA (chlomipramine) or SSRI 4. SSRI or TCA
If you’re partial response consider CBT as an adjunct

Question 19

Learning disabilities classifications

Answer 19

Borderline- 70-80
Mild- 50-69
Moderate- 35-49
Severe- 20-34 
Profound <20

Question 20

Beck’s triad

Answer 20

Negative feelings about

• self
• world
• future

Question 21

NMDA antagonists SE

Answer 21

Psychotic symptoms

Question 22

Alcohol withdrawal

Answer 22

Chlordiazepoxide 30mg QDS and reduce gradually

Long acting benzodiazepine

Question 23

When do alcohol withdrawal seizures occur

Answer 23

Within 48h

Question 24

When does delirium tremens occur

Answer 24

Between 48 and 72 hours

Question 25

Eosinophilic inclusions

Answer 25

Lewy bodies (Lewy body dementia, Parkinson’s disease)