Psychiatric Emergencies MCQs

This is the transformation of our instinctual energy to a more socially acceptable one . So, in this case, rather than shouting back at the consultant, the trainee went to the gym and transformed his anger and frustration into exercising . This is a mature defence mechanism. Reference: Synopsis of Psychiatry, eleventh edition, chapter 4, page no. 162

Olanzapine is not associated with serotonin syndrome . Other drugs like Venlafaxine, Ecstasy and Fluoxetine have all been implicated in serotonin syndrome.(Option A, B & C) Ecstasy has been associated with serotonin syndrome in combination with venlafaxine. Reference: Synopsis of Psychiatry, Eleventh edition, Chapter 29th, Page no. 1020.

Levosulpiride is an atypical antipsychotic that blocks D2 receptors commonly prescribed in Conversion Disorder Considering the clinical presentation of the patient, all of the above medications can be provided to the patient but Levosulpiride is more prone to cause hyperprolactinemia leading to side effects like amenorrhoea, galactorrhoea, anorgasmia Escitalopram and Sertraline are SSRIs (Selective Serotonin Reuptake inhibitors) which may also lead to Hyperprolactinaemia but in much lesser propensity while Clonazepam is a Benzodiazepine lacking such effect Reference: Kaplan and Sadock’s Synopsis of Psychiatry, Eleventh edition, Chapter 29 Psychopharmacological Treatment, page no. 1014

Amongst all the antidepressants mentioned, Paroxetine is Category D drug. Selective Serotonin Reuptake Inhibitors(SSRIs) are prone to cause teratogenicity in the form of - Heart defects like ASD, VSD in the first trimester Pulmonary Hypertension in the third trimester Should be cautiously used, avoiding Paroxetine altogether. Reference : Kaplan and Sadock's Synopsis of Psychiatry, Eleventh edition, Chapter 29th, Psychopharmacological treatment, Page no. 1016.

Serotonin syndrome is a rare but serious condition characterised by excess serotonergic activity. Symptoms include confusion, muscle rigidity, hyperreflexia and GI upset . Other symptoms include hyperthermia and fluctuation of blood pressure. Linezolid is an antibiotic used in treatment of gram-positive bacteria. It is a weak monoamine oxidase inhibitor and interaction with selective serotonin reuptake inhibitor has been documented. Reference: Synopsis of Psychiatry, Eleventh edition, Chapter 29th, Page no. 1020.

OCD is ego dystonic. There is high risk of development of depression. And both should be treated simultaneously. Reference: Kaplan and Saddocks Synopsis of Psychiatry, 11th Edition, Chapter 10, Page No.: 418

Anton's syndrome (Anton-Babinski syndrome): Occurs following damage to the occipital lobe. Affected individuals are cortically blind but are unaware of this and deny they have a problem (Anosognosia). It often presents as the patient starts falling over furniture as they can't see. Affected individuals believe they can still see and describe their environments in detail but are wrong in their description (confabulation). Reference: Kaplan and Sadock’s Synopsis of Psychiatric, Chapter 1.2 Functional Neuroanatomy, Page number 6.

Explanation: Personality disorders, mood disorders, and psychotic symptoms may be more common in patients with epilepsy, particularly those with temporal lobe epilepsy. Psychotic symptoms are generally more prevalent during the interictal period rather than the ictal phase. Ictal symptoms are typically characterised by disorganised behaviour rather than psychosis (Option A) . Mood disorders, including depression and anxiety, are more common in patients with epilepsy than in the general population. This can significantly affect the patient's quality of life (Option B) . Many patients with epilepsy benefit from psychological support and counselling to address the psychosocial implications of their diagnosis, including coping with chronic illness and managing stigma (Option D) .