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Afterlife

Solved EMIs from Autumn 2005

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EMIs from Autumn 2005

EMI 1

OPTIONS

Increased physical dependence

Being in an institution

Male patient

Male carer

Dementia

Being married to carer

Previous poor relationship with carer

QUESTIONS

1) 3 risk factors for abuse

Dementia

Previous poor relationship with carer

Being in an institution

2) 3 risk factors for depression

Male patient

Increased physical dependence

Dementia

3) 2 risk factors for carer exhaustion

Previous poor relationship with carer

Dementia

EMI 2

OPTIONS

Citalopram

Escitalopram

Quetiapine

Risperidone

Reboxetine

Fluoxetine

Lithium

Lamotrigine

Sertraline

Desipramine

QUESTIONS

1) Best treatment for a boy with OCD

Fluoxetine

2) A man with OCD and depression. Which 2 drugs would he NOT respond to

Reboxetine

Desipramine

3) Pick 2 add in treatments for a man not responsive to first line treatment

Lithium

Risperidone

EMI 3

DRUG CHOICE

A) Flupentixol depot

B) Risperidone

C) Olanzapine

D) Clozapine

E) Quetiapine

F) Haloperidol

1. Older schizophrenic women, DM, agreed to take medication but irregular compliance and psychotic. When son reminded her, end up in a quarrel.

A) Flupentixol depot

2. Psychotic elderly man, persistent psychotic symptoms, not tolerating oral flupentixol. Not responding to sulpiride and olanzapine.

D) Clozapine

3. Case of Parkinson’s disease. Not on anti-PD drug and antipsychotic naïve. Distressed by VH.

E) Quetiapine

EMI 4

OLD AGE PSYCHIATRY

A) Living in institute

B) Living with another person

C) Male carer

D) Male patient

E) Higher physical dependence in patient

F) History of poor relationship with carer

G) Carer married to patient

H) Diagnosis of dementia

1. Risk for non-accidental injury from carer (choose 2)

A) Living in institute

F) History of poor relationship with carer

2. Risk for carer distress / depress (choose 3)

H) Diagnosis of dementia

F) History of poor relationship with carer

E) Higher physical dependence in patient

3. Risk for depression of elderly (choose 3)

D) Male patient

H) Diagnosis of dementia

E) Higher physical dependence in patient

EMI 5

STATISTICS

A) Chi-square test

B) McNemar test

C) Fisher's exact test

D) Cluster analysis

E) ANCOVA

F) ANOVA

G) Multiple regression

1. Demonstrate association of height (parametric) and ASPD (choose 3)

F) ANOVA

A) Chi-square test

C) Fisher's exact test

2. Relation of conduct disorder and ASPD (choose 2)

A) Chi-square test

C) Fisher's exact test

3. ASPD vs height and IQ (height and IQ correlated) (choose 2)

B) McNemar test

F) ANOVA

EMI 6

MEDICATION / MANAGEMENT

A) Citalopram

B) Desipramine

C) Escitalopram

D) Fluoxetine

E) Reboxetine

F) Quetiapine

G) Sertraline

H) Risperidone

1. 11 year old developed OCD for 6 months and later depressed mood. (choose 1)

D) Fluoxetine

2. OCD in a teacher with sexual obsessions, unlikely to have that antidepressant drug (choose 2)

D) Fluoxetine

3. OCD child with SSRI for some time but still Obsessive compulsive behaviour with motor tics. (choose 2)

H) Risperidone

D) Fluoxetine

EMI 7

MEDICATION / MANAGEMENT

A) Cardiomyopathy

B) Diabetes mellitus

C) Lithium toxicity

D) Diabetes insipidus

E) Serotonin syndrome

F) Neuroleptic Malignant Syndrome

G) Hypothyroidism

H) Pulmonary embolism

I) Hyperthyroidism

Questions:

1. Schizophrenia on clozapine. Developed palpitation, SOB and tachycardia. (choose 1)

A) Cardiomyopathy

2. BAD on Li, developed polyuria, polydispia and lethargy. Raised sodium level and clinically dehydrated. (choose 1)

D) Diabetes insipidus

3. Started on olanzapine for few days, noticed rigidity, confusion and sweating. (choose 1)

F) Neuroleptic Malignant Syndrome

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EMI 8

DRUGS

Cytochrome P450 enzyme induction

Effect on striatal D2 receptor

Effect on meso-limbic D2 receptor

Effect on 5HT2 receptor

Effect on 5HT3 receptor

1. Started St John’s wort and later pregnant despite taking OC pill (choose 1) Cytochrome P450 enzyme induction

2. On antipsychotic and developed EPSE (choose 1) Effect on striatal D2 receptor

3. On fluoxetine, started on Li and became confused (picture of serotonin syndrome). (choose 1) Effect on 5HT2 receptor

EMI 9

BIOCHEMICAL

A) Hyperglycemia

B) Hypoglycemia

C) Hyponatremia

D) Hyperthyroidism

E) Hyperkalemia

F) Hypercalecemia

1. Alcoholism, after binge-drinking, anxious and confused in A&E (choose 1) B) Hypoglycemia

2. Depressed middle age gentleman complained of lethargy, nausea, muscle cramp. Recently started on paroxetine (choose 1) C) Hyponatremia

3. Schizophrenic patient on clozapine/olanzapine complained of abdominal pain and confusion (choose 1) A) Hyperglycemia

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