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  • Question 1 - You are requested to evaluate a 35-year-old woman who is currently in isolation...

    Incorrect

    • You are requested to evaluate a 35-year-old woman who is currently in isolation in a psychiatric intensive care unit.
      She has a diagnosis of bipolar affective disorder and has been restarted on 15 mg of aripiprazole and 1000 mg of lithium carbonate since being admitted ten days ago. She has been compliant with her medication regimen.
      The nursing staff has informed you that she has been progressively deteriorating and the risks of her manic presentation are becoming challenging to manage. She has not slept for two days, is continuously restless, and has already received 1 mg of lorazepam IM without any improvement.
      What would be the next appropriate course of action?

      Your Answer: Injectable olanzapine

      Correct Answer: ECT

      Explanation:

      When a patient’s mania becomes intractable and is accompanied by severe depression and catatonia, electroconvulsive therapy (ECT) may be necessary. Despite being treated with a combination of mood stabilizers, antipsychotic medication, and a short-acting benzodiazepine, this patient has not responded to treatment and has deteriorated to the point of requiring seclusion. This suggests that the mania is treatment-resistant and requires ECT.

      Under section 58a of the Mental Health Act, there are safeguards in place to ensure that the patient’s capacity and consent are assessed before administering ECT. However, in cases where immediate action is necessary to prevent death of serious deterioration in mental health, ECT can be given without the patient’s consent under Section 62. In this case, the patient will receive ECT while awaiting a SOAD.

    • This question is part of the following fields:

      • History And Mental State
      44.3
      Seconds
  • Question 2 - Which of the following is not a typical feature of depersonalization? ...

    Correct

    • Which of the following is not a typical feature of depersonalization?

      Your Answer: The experience is pleasant

      Explanation:

      Depersonalisation is a distressing condition that is solely based on an individual’s perception. It affects one’s auditory and tactile senses, as well as causing a sense of emptiness in their thoughts. Despite this, the person’s awareness remains intact, and they may experience an increased sense of self-awareness.

    • This question is part of the following fields:

      • History And Mental State
      15.8
      Seconds
  • Question 3 - Which of the following may be considered a leading question? ...

    Correct

    • Which of the following may be considered a leading question?

      Your Answer: Do you find your mood is worse in the morning?

      Explanation:

      It may be more effective to ask open-ended questions at the beginning of an interview to gather as much information as possible. Closed questions can be used later in the interview to clarify specific points. However, it is important to avoid leading questions that may influence the patient’s response. For example, instead of asking if the patient feels worse in the morning, a more open question such as Can you describe your mood throughout the day? may be more appropriate.

    • This question is part of the following fields:

      • History And Mental State
      19.6
      Seconds
  • Question 4 - The doctor asks the patient the following question:
    Sometimes when kids feel really sad,...

    Incorrect

    • The doctor asks the patient the following question:
      Sometimes when kids feel really sad, they might have thoughts of hurting themselves. Have you ever had thoughts like that?
      What technique is he using?

      Your Answer: Facilitation

      Correct Answer: Validation

      Explanation:

      To encourage patients to express themselves freely, doctors use various techniques such as validation, confrontation, clarification, facilitation, and open-ended questions. Validation involves making patients feel more comfortable by normalizing their thoughts, feelings, of behaviors. Confrontation involves pointing out something that the patient may be missing of denying. Clarification is used to clarify something that the patient has said. Facilitation involves using verbal and non-verbal cues to encourage patients to continue sharing. Open-ended questions are used to prompt patients to respond in their own words, rather than with a simple yes or no answer.

    • This question is part of the following fields:

      • History And Mental State
      31.7
      Seconds
  • Question 5 - A 27-year-old Indian-born woman reports feeling as though others can read her thoughts...

    Correct

    • A 27-year-old Indian-born woman reports feeling as though others can read her thoughts and know her intentions. She believes this to be true because when she looks at people, they seem to send thoughts into her head. Additionally, she has experienced being targeted by individuals using powerful dark magic in the past, which has caused her to feel as though her movements and behavior are being controlled. What is the best way to describe her experiences?

      Your Answer: Passivity phenomena

      Explanation:

      Passivity Phenomena in a Patient: An Example

      The patient in question experiences the sensation of an external force attempting to interfere with his thoughts and actions. This is an example of passivity phenomena. Although he holds a belief in black magic, this may be considered a secondary delusional belief. The patient may also exhibit formal thought disorder, but the combination of thought passivity and the belief in external influence is more consistent with an overall description of passivity phenomena.

      While overvalued ideas can interfere with normal social functioning, they may be considered culturally appropriate to a lesser degree. However, the nature of the patient’s experiences precludes this possibility. There is no evidence of pseudo of other hallucinatory experiences.

    • This question is part of the following fields:

      • History And Mental State
      18.4
      Seconds
  • Question 6 - What is a characteristic physical trait of individuals with bulimia nervosa? ...

    Correct

    • What is a characteristic physical trait of individuals with bulimia nervosa?

      Your Answer: Bilateral parotid gland swelling

      Explanation:

      Bulimia nervosa is a condition characterized by recurrent episodes of binge eating followed by compensatory behaviors such as vomiting, laxative use, of excessive exercise. One of the hallmark physical symptoms of bulimia nervosa is bilateral swelling of the parotid glands, which are located on either side of the face near the ears. This swelling is caused by repeated vomiting and can be a visible sign of the disorder. Other symptoms of bulimia nervosa may include dental problems, gastrointestinal issues, and electrolyte imbalances. The International Classification of Diseases, 10th Revision (ICD-10) classifies bulimia nervosa as F50.2.

    • This question is part of the following fields:

      • History And Mental State
      14.9
      Seconds
  • Question 7 - You are requested to evaluate a young adult who has ingested a toxic...

    Correct

    • You are requested to evaluate a young adult who has ingested a toxic amount of medication. In terms of your evaluation, which of the following statements is accurate?

      Your Answer: If the patient has a family history of suicide they are more likely to die by suicide themselves

      Explanation:

      Risk Factors for Suicide

      A family history of suicide is a significant risk factor for suicide, even if there is no family history of psychiatric disorder. Asking someone about suicidal thoughts does not cause them to have those thoughts, and individuals who self-harm regularly are at a higher risk of suicide. In fact, studies have shown that 1-6% of individuals who present to the hospital after non-fatal self-poisoning of self-injury die by suicide within the first year. It is also important to note that 90% of people who die by suicide have a psychiatric disorder. These risk factors should be taken seriously and addressed in order to prevent suicide.

    • This question is part of the following fields:

      • History And Mental State
      32.3
      Seconds
  • Question 8 - What behavior is the patient displaying when she consistently answers every question during...

    Correct

    • What behavior is the patient displaying when she consistently answers every question during an MMSE with the phrase Keep calm and carry on?

      Your Answer: Verbal stereotypy

      Explanation:

      Verbal Stereotypy, Logoclonia, Neologism, Perseveration – Understanding Repetitive Language Behaviors

      Repetitive language behaviors can manifest in various forms, including verbal stereotypy, logoclonia, neologism, and perseveration. Verbal stereotypy involves the use of the same word of phrase regardless of the situation. Logoclonia is the repetition of the last syllable of a word. Neologism refers to the creation of a new word of the use of a known word with a different meaning. Perseveration is the repetition of the same response to different stimuli, which continues beyond the point of relevance. It is different from verbal stereotypy because the response is meaningful but inappropriate. Understanding these different forms of repetitive language behaviors can help in identifying and addressing them appropriately.

    • This question is part of the following fields:

      • History And Mental State
      20.5
      Seconds
  • Question 9 - What is the most prominent characteristic linked to transient global amnesia? ...

    Correct

    • What is the most prominent characteristic linked to transient global amnesia?

      Your Answer: Memory deficits are global

      Explanation:

      Transient global amnesia (TGA) is a syndrome characterized by anterograde amnesia of sudden onset lasting less than 24 h, without other accompanying neurological symptoms. Other organic amnesic syndromes, such as Korsakoff’s syndrome (whether caused by alcohol of not), may exhibit confabulation, but in transient global amnesia, there is only a temporary loss of recent memory and impaired new learning, without any other cognitive abnormalities. Patients remain alert and responsive, and their personal identity is not affected. The prevailing theory is that this amnesia is caused by a temporary dysfunction in the limbic-hippocampus circuits that are essential for memory formation.

      Although retrograde amnesia is not predominant, some patients may transiently forget relatively recent memories, as described by Ribot’s law. Most autobiographical memories however, particularly semantic ones are preserved.

    • This question is part of the following fields:

      • History And Mental State
      27.7
      Seconds
  • Question 10 - In which of the following conditions are taste hallucinations more likely to occur?...

    Correct

    • In which of the following conditions are taste hallucinations more likely to occur?

      Your Answer: Can occur in temporal lobe epilepsy

      Explanation:

      Hallucinations of taste, known as gustatory hallucinations, are characterized by unusual of unpleasant taste perceptions. The mechanism behind this disturbance in taste perception is often challenging to explain. Gustatory hallucinations can manifest in various organic conditions, including epilepsy, dementia, schizophrenia, and depression. Additionally, certain psychotropic medications, such as lithium carbonate, can also cause gustatory hallucinations.

    • This question is part of the following fields:

      • History And Mental State
      14.1
      Seconds

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History And Mental State (8/10) 80%
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