Exam (elaborations)
SPMM High Yield Paper B Adult Psychiatry Part 2: Q&A
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SPMM High Yield Paper B Adult Psychiatry Part 2: Q&A
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SPMM High Yield Paper B Adult Psychiatry Part 2: Q&AWhat is true concerning use of antidepressants in Anorexia? Right Ans -
Must not be used as sole treatment
Minimum washout period for switch from phenelzine to Fluoxetine? Right
Ans - 2 week's (5 weeks if fluoxetine to phenelzine)
45yo Male major depression, being treated with standard dose of Fluoxetine
for 3 months with only partial response. Severe insomnia most distressing
symptom. Which drug to add? Right Ans - Trazodone
34yo male taking SSRIs develops erectile dysfunction. What must you NOT
advise? Right Ans - Reassurance that tolerance will develop in due course
According to ICD 10, quasi psychotic episodes with prominent anxiety are
features of? Right Ans - Schizotypal disorder
Poor prognostic factor for anorexia Right Ans - Male gender
Patient grieving death of family member who died 8 months ago. Assessment
indicates moderate depressive symptoms. Next step? Right Ans - Prescribe
antidepressant and follow up
Px with BPAD on 500mg Valproate, 20mg Citalopram and 20mg Olanzapine.
Presents irritable, tearful and disinhibited. First step? Right Ans - Stop
Citalopram
Lifetime prevalence for schizophrenia? Right Ans - 1% (incidence 17-40
per 100,000)
35yo female went to GP after 1 month death of husband. Insomnia and tearful,
poor appetite and pining for husband. Hearing voices of husband at night time
and reports she feels his presence. Diagnosis? Right Ans - Stage two
bereavment
27yo pregnant lady with Hx of low mood and elated moods requiring
treatment but currently euthymic. Risk of relapse post-partum? Right Ans -
50%
, Px hospitalised for Tx of MDD, what is the chance for subsequent episodes of
hypomania/mania? Right Ans - 7-12%
Shizophrenia with best prognosis? Right Ans - F20.0 Paranoid
Schizophrenia
Best intervention for acute lithium toxicity with neurological symptoms?
Right Ans - Haemodialysis
Mr Y presents to ED with apathy and weight loss. Bloods show hyponatremia
and hyperkalenia. Likely diagnosis? Right Ans - Addison's disease
Head injury increases risk of which psychiatric condition? Right Ans -
Psychosis
Prominent risk factor for F20 Right Ans - First degree family member with
F20
Mr Y long standing F20, dishevelled, unwashed, flat affect, no interest in
activities and spends most day watching television. Which antipsychotic is
most appropriate? Right Ans - Olanzapine (fewer EPSE burden and FGAs
have less impact on negative sx)
Tom is a 13yo boy smoking cannabis over 6mo. Mum concerned re risk of
F20? Right Ans - 4 fold increase
What would you do for a px with OCD on Setraline 50mg with no
improvement after 2 months? Right Ans - Increase dose
Prognosis is better in developing countries for which disorder Right Ans -
F20
How long before an anticipated performance should Atenolol be taken?
Right Ans - 1 hour
34yo Male with insomnia being treated with hypnotics. Issues with frequent
awakenings, but able to fall asleep normally. Tx? Right Ans - Temazepam
(longer t1/2 compared to Z drugs)
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