maria.ivanov

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About maria.ivanov

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    Bronze member

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  • Gender
    Female
  • Location
    london
  • Occupation
    Doctor
  • Status
    Not revising
  1. Hi guys! Just a short question for the people who failed the exam on the 13th (Friday): has any of you passed the cognitive exam station (the man with the frontal lobe sdr, in the linked station)? I was very confident that I will pass this station (I`ve passed it twice in the mocks with an A), but I failed it and I dont understand why.
  2. Muscle twitching is not a symptom of opioid withdrawal. It could be caused by the electrolyte imbalance due to intense sweating and vomiting, but I think I would choose piloerection. Early symptoms of withdrawal include: Agitation Anxiety Muscle aches Increased tearing Insomnia Runny nose Sweating Yawning Late symptoms of withdrawal include: Abdominal cramping Diarrhea Dilated pupils Goose bumps Nausea Vomiting
  3. Mixed state should be treated as mania, so I quite understand why Venlafaxine should be stopped. I have no clue why Mirtazapine should be stopped in a depressed patient with cognitive impairment (by the way, it seems that Mirtazapine has got an enhancing effect on cognitive functions). Maybe only because 2 antidepressants + lithium is too much?
  4. For "uncomplicated", mild to moderate cases, Clonidine should be tried first.
  5. These should be avoided, that`s what I meant to say
  6. SPMM says Risperidone and Clozapine (could cause hypotension)
  7. methylphenidate is not licensed for use in adults - NICE guidelines
  8. Hopefully we wont have to choose between them Birmingham says miosis, spmm says constipation
  9. If it`s replacement therapy then it`s Buprenorphine and it will help him become abstinent from illicit opioid use.