OSCE CA PYSCHATRIY is a collectionof different OSCE papers.ppt
- 1. 2015 OSCE CA FEED BACK ROSE NG’ANDU OCT 2015
- 3. Station 1 A 38 year-old male from George Compound presents with a history of being on antipsychotic medication for a long time. He has involuntary movements mostly pronounced over the neck and face. You actually establish that the drug is Fluphenazine deconoate which he takes four weekly. Mention the term used for this side effect. Tardive Dyskinesia
- 4. STATION 2 A 22 year-old man from Sikoswe presents to you with history of running from home seeking where to hide. His wife reports that he had been continuously drinking alcohol for the past three days none stop.On examination you elicit visual hallucinations, panic and psychomotor hyperactivity in clear consciousness What is the problem with this man? Alcoholic hallucinosis
- 5. Alcoholic hallucinosis • A rare, acute mental syndrome which is characterised by vivid auditory and visual hall ucinations that occur shortly after the cessation or reduction of alcohol consumption , and may continue for months. DiffDx: Delirium tremens (DTs), paranoid psyc hosis, borderline transient psychotic episodes, or other substance-related disorder.
- 7. STATION 3 An adult male patient was brought on detention order for admission to chainama Hills hospital with history of hyperkinesis, perseveration in activity and echolaria.The relatives state that he could not sleep for the past one week and was uncooperative. However, today he has suddenly changed, as he is maintaining postures, staring in one place with no facial movements, mute to all questions and was hypokinetic. What condition is he suffering from? • Catatonic Stupor
- 8. STATION 4 • A 18 year-old man presents to Chainama filter clinic with history of seeing visions of scary animals and dead bodies. On examination, the patient has clouded sensorium with fleeting persecutory delusions. The cousin tells you that he also appears not to be aware of his day time, is not oriented to place or person and does not look after himself. Lab investigations reveal the presence of plasmodium falciparum. What psychiatric condition is he suffering from? • Delirium
- 9. Delirium • abrupt change in the brain that causes mental confusion and emotional disruption • It makes it difficult to think, remember, sleep, pay attention • Delirium is categorized by its cause, severity, and characteristics: • Hyperactive delirium is characterized by being highly alert and uncooperative. • Hypoactive delirium is more common. With this type, you tend to sleep more and become inattentive and disorganized with daily tasks. You might miss meals or appointments.
- 10. • Some people have a combination of both hyperactive and hypoactive delirium, alternating between the two states. Causes ; inflammation, chemicals, infection, such as pneumonia, malaria can interfere with brain function • certain medications (e.g., blood pressure medicine) or abusing drugs can disrupt the chemicals in the brain. Alcohol withdrawal and eating or drinking poisonous substances can also cause delirium
- 11. STATION 5 • Yuria is 28 years old who presents at your clinic but she is hyperactive and unable to sit still. When she starts talking, she is clearly over-excited and her thoughts are hard to follow. She vaguely mentions about having special connection with God and that she is the “chosen one”. She believes that she has the power to heal all manner of human suffering from the world and even claims that she is hearing God’s voice at present. Her past history is unremarkable. • What is Yuria’s condition? • MANIA
- 12. STATION 6 • Mention the group of drugs where this drug belongs to (Mood stabilizer) • Mention one condition where you can prescribe this drug? (seizure disorders, mental/mood conditions such as manic phase of bipolar disorder and to prevent migraine headaches) • What is the dosage of the drug? 200mg BD
- 13. STATION 7 • In which condition would you use this drug? Epilepsy- generalized type • Mention one side effect of this drug • drowsiness,ataxia, hyperkinesis in children, anxiety, night meres, hallucination, megaloblastic aneamia, nausea, vomiting
- 14. STATION 8 • Njabula has been diagnosed with a psychotic condition he has been put on Risperidone and later you choose to put him on Fluphenazine Decanoate. How would you go about prescribing Fluphenazine Decanoate? • Start with test dose of 12.5mg stat the after 4-7 days follow it up with full dose of 25mg im weekly, fortnightly, monthly of six weekly
- 15. STATION 9 • Chakumba has been put on ARVs after a blood test and his CD4 count is very low. He comes home and shows you the two drugs on this table and asks you about the side effects as he was not clear when the pharmacist was explaining at ART clinic. What are the side effects you would tell him?
- 16. EFEVERANZE • Common side effects include dizziness, trouble sleeping, drowsiness, unusual dreams, and trouble concentrating. These side effects may begin 1-2 days after starting this medication and usually go away in 2-4 weeks. • hives; difficulty breathing; swelling of your face, lips, tongue, or throat. • serious psychiatric symptoms including confusion, severe depression, suicidal thoughts, aggression, extreme fear, hallucinations, or unusual behavior
- 17. EFEVIRANZE SIDE EFFECTS • mild nausea, vomiting, or stomach pain, diarrhea or constipation; • cough; • blurred vision; • headache, tired feeling, dizziness, spinning sensation; • trouble concentrating, balance or coordination; • muscle or joint pain; • sleep problems (insomnia), unusual dreams; or • changes in the shape or location of body fat (especially in your arms, legs, face, neck, breasts, and waist
- 18. EMITRICITABINE
- 19. TENOFAVIR
- 20. RETROVIR (zidovudine • Hematologic Toxicity • hematologic toxicity including neutropenia and severe anemia, particularly in patients with advanced HIV-1 disease • Myopathy • Lactic Acidosis and Severe Hepatomegaly
- 21. STATION 10 • To which group does this drug belong to? ( Amitriptyline) a tricyclic antidepressant used for depression anxiety, peripheral neuropathy, eating disorders (bulimia), migaine headaches • What are the side effects of this drug? • Dry mouth, cadiotoxity, drowsiness, dizziness, constipation, weight gain, urinary retaintion
- 22. STATION 11 • Mention THREE conditions in which you can prescribe this drug. • Carbamazepine is used in Trigeminal neuralgia (hepes zoster), Mood disorders - bipolar ,EpilepsyIt has potential as mood stabilizer & anti-epileptic (in bipolar mania, trigeminal neuralgia, restless leg syndrome) • In general medicine it is used as nerve soothing agent (Trigeminal neuralgia-Herpes zoster)
- 23. STATION 12. • Bwembya has been drinking alcohol and it has become a health problem. You choose to give him Chlordiazepoxide as detox regime. Write down how much you would give him? • used to treat anxiety and acute alcohol withdrawal. It is also used to relieve fear and anxiety before surgery. This medication belongs to a class of drugs called benzodiazepines which act on the brain and nerves (central nervous system) to produce a calming effect
- 24. • 50 to 100 mg orally, followed by repeated doses as needed until agitation is controlled Maximum dose: 300 mg orally per day Use: Relief of withdrawal symptoms of acute alcoholism
- 25. STATION 13 • When would you use this drug? • Benzexhol ( Artane) • Parkisonism and extrapyramidal disorders • What is the dose? • 2mg and 5 mg
Editor's Notes
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