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SPMM Liaison Psychiatry: Questions With A+ Solutions
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SPMM Liaison Psychiatry: Questions With A+ Solutions
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SPMM Liaison Psychiatry: Questions With A+ SolutionsSub clinical hypopituitarism (or hypothyroidism?) is a risk factor for? Right
Ans - Depression and Rapid Cycling in Bipolar Disorder
Clinical feature most suggestive of herpes simplex encephalitis? Right Ans -
Abrupt onset of confusion (70%)
memory impairment, seizures, depression, psychosis
Male to female ratio of hypothyroidism Right Ans - 1:6
A woman who has had herpes encephalitis develops severe carbohydrate
craving, weight gain and inappropriate sexuality. Likely diagnosis? Right
Ans - Kluver-Bucy Syndrome (HSE most common cause)
Emotional blunting, hyperphagia, visual agnosia, hyper sexuality
bilateral temporal lobe damage.
Carbamezapine
Oral facial dystonia characterised by repetitive blinking and chin thrusting?
Right Ans - Meige's Disease
Middle aged females
Rest and active but disappears with sleep
Can reduce if chew gum, whistle or touch face
Meeeiggann has uncontrollable blinking.
Causes of secondary Meige's Disease? (3) Right Ans - Antipsychotics,
Levodopa and DLB
Think dopamine abnormalities
,Likely patient group in Meige's Disease? Right Ans - More likely to be
middle aged women
SSRI which is weakest inhibitor of CYP450 system? Right Ans - Citalopram
Intentional falsification of symptoms and fabrication of signs of physical or
mental disorders with the primary aim of obtaining medical condition and
treatment? Right Ans - Münchausen syndrome
Risk factors for depression in Parkinson's (5) Right Ans - Female (more
depressed generally),
Younger onset,
Prominent right-sided signs (think more disabling as most people right
handed),
Bradykinesia/gait disturbance
Rapid disease progression
Which patient group do not respond always to neuroleptic use in delirium?
Right Ans - Palliative care group
Mr Y suffering from depressive symptoms and vomiting. On examination
unexplained dark skin pigmentation. Right Ans - Addison's disease
Description of patients who are at high risk of HIV which are seronegatibe but
remain anxious about contracting HIV? Right Ans - Worried well
(harbouring fear she has the disease or may contract an infection imminently)
Best evidence for use in HIV dementia complex? Right Ans - Zidovudine
Which is a primary organic disorder due to HIV diagnosis? Right Ans - HIV
Dementia
Most frequent cause of psychiatric admission in those with HIV seropositivity?
Why? What is also co-morbid? What might it suggest? Right Ans - Mania
Can be substance induced but also due to HIV meds include didanosine,
ganciclovir, procarbazine, estavudine, steroids and zidovudine.
Often associated with cognitive impairment.
,If someone with HIV develops new onset mania, may be predictive of reduced
survival.
Minimum duration of symptoms for HIV Dementia diagnosis? Right Ans - 1
month i.e. much shorter time period than normal dementia
Most common neuropsychiatric symptom associated with Parkinson's
disease? Right Ans - Depression (50%)
Anxiety (50-65%)
In post stroke depression the antidepressant treatment should be continued
for at least? Right Ans - 4-6 months post improvement
Mean duration of MD episode following a stroke? Right Ans - 34 weeks i.e.
people who have a stroke are often depressed for 8 months
Which cognitive faculty remains intact in amnestic disorders? Right Ans -
Immediate memory
Cognitive impairment seen in MS has similar features to? Right Ans -
Subcortical Dementia
Hypomania is a side effect of which AntiParkinsonian medication? Right
Ans - Levodopa
Frequency of depressive symptoms in epilepsy? Especially in which region?
Right Ans - 30-50%
i.e. a 1/3-1/2 of patients with epilepsy are depressed.
Temporal lobe epilepsy
Video recording of ictal and peri-ictal behaviour can help in diagnosis of what?
Right Ans - Pseudoseizures (non-epileptic seizures)
Prevalence of psychosis in epilepsy. What is a RF? Right Ans - 3-7%
Often visual hallucinations
, RF:
- partial epilepsy (mesial temporal/extratemporal)
- Post-ictal
- Vigabitran
antipsychotic most epileptogenic Right Ans - Clozapine
Post traumatic epilepsy is seen in what proportion of patients with open head
injury? Right Ans - 30%
Seen on MRI in patients with MS showing mania with psychotic symptoms?
Right Ans - Plaques distributed predominantly in the bilateral temporal horns
45y Male with hx of stroke and recent deteriorating mental state. MRI scan
showed lesions proxminal to the left frontal lobe? Psychiatric condition most
likely to occur? Right Ans - Depression
Mild to moderate degrees of mania seen in what proportion of MS patients
given steroids? Right Ans - 1/3
Time limit within which the measurements of prolactin concentrations after
seizure to determine true seizure activity? Right Ans - 15minutes
Lifetime prevalence of depressive symptoms in px with MS Right Ans - 40-
50%
i.e. almost half of patients with MS are depressed during their lifetime.
65y Male with Parkinson's presents with psychotic symptoms of paranoia and
visual hallucinations. Which antipsychotic can improve his symptoms without
worsening Parkinsonism? Right Ans - Clozapine <100mg/day
i.e. if someone with parkinson's develops psychosis, best to give clozapine
Gene for HD is located on which chromosome? Right Ans - Short arm of
Ch4
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