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Question 1
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A 35-year-old patient with a history of depression visits her doctor with concerns of decreased energy, difficulty sleeping, and feelings of hopelessness.
Which self-report questionnaire would be the most suitable for the patient to fill out?Your Answer: BDI (Beck depression inventory)
Explanation:The list includes various psychiatric rating scales, with the Beck depression inventory (BDI) being the only self-report tool. It consists of 21 items that evaluate symptoms such as fatigue, irritability, and interest in others, and is designed to measure the severity of depression. On the other hand, the BAS is a clinician-administered scale that assesses medication-induced akathisia, while the BPRS evaluates depression, anxiety, and psychotic symptoms. The HAM-A is a clinician-administered questionnaire that measures the severity of anxiety, and the PANSS is a clinician-administered tool that assesses both positive (hallucinations and delusions) and negative symptoms (social and emotional withdrawal, disordered thinking) in patients with schizophrenia.
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This question is part of the following fields:
- Assessment
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Question 2
Incorrect
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A 25-year-old woman presents with significant weight loss and you suspect she may have anorexia nervosa. You decide to conduct a series of screening tests. Which of the following results would support a diagnosis of anorexia nervosa?
Your Answer: Hyperkalaemia
Correct Answer: Low white cell count
Explanation:Anorexia nervosa can lead to various biochemical and haematological abnormalities, such as hypokalaemia, hypochloraemic alkalosis (caused by vomiting and/of diuretic/laxative abuse), and hypercholesterolaemia (whose mechanism is unknown). However, the erythrocyte sedimentation rate (ESR) remains normal of decreased.
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This question is part of the following fields:
- Assessment
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Question 3
Incorrect
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A 65-year-old patient was recently diagnosed with diabetes and was prescribed medication. He now presents with weight loss and increased thirst.
Which investigation is most likely to help make the correct diagnosis of this weight loss and increased thirst?Your Answer:
Correct Answer: Fasting glucose
Explanation:The most likely diagnosis for this patient is type 2 diabetes mellitus. It is important to note that the patient is experiencing weight loss, which is more commonly associated with type 1 diabetes mellitus of new onset type 2 diabetes mellitus. A fasting glucose test can aid in making a diagnosis and provide insight into the cause of the patient’s symptoms.
While abnormalities related to dehydration may be observed in U&Es, this investigation alone would not be sufficient for a diagnosis. LFTs and FBC may be useful as routine blood tests, but they would not provide an explanation for the patient’s clinical presentation.
If the patient is taking lithium, measuring lithium levels could be helpful in identifying potential side effects such as increased thirst. However, lithium is more commonly associated with weight gain rather than weight loss, so it may not be relevant in this case.
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This question is part of the following fields:
- Assessment
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Question 4
Incorrect
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You encounter a 45-year-old man with a history of mild cognitive impairment and recurrent episodes of major depressive disorder. He was admitted to the hospital under section 3 of the Mental Health Act two months ago due to aggressive behaviour.
He reports feeling tired, sad, and lacking motivation to participate in any activities on the ward. He also reports difficulty getting out of bed in the morning. Despite being eligible for section 17 leave, he has refused to take advantage of it for the past two and a half months and spends all his time in his room.
He is currently taking fluoxetine 20 mg and PRN lorazepam for agitation. He has no known physical health issues. Your consultant has requested that you perform a blood test on him before considering adjusting his medication.
What is the most relevant blood test to request in this case?Your Answer:
Correct Answer: Vitamin D levels
Explanation:The most appropriate test to perform for this patient, who is exhibiting symptoms indicative of vitamin D deficiency due to insufficient exposure to sunlight, is a vitamin D level test. It is important to also check corrected calcium and PTH levels, as vitamin D is involved in calcium metabolism. Additionally, given the patient’s use of fluoxetine, U+Es may be checked to monitor for potential hyponatremia, while routine blood tests such as FBC, LFTS, and folic acid should also be considered.
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This question is part of the following fields:
- Assessment
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Question 5
Incorrect
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A woman in her mid-thirties who works as a full-time employee at the municipal office is experiencing symptoms of headache, dizziness, fatigue, and fever.
Your Answer:
Correct Answer: Illness
Explanation:Pilowsky introduced the term ‘abnormal illness behaviour’ to describe excessive of inadequate responses to symptoms, including hypochondriasis, somatisation, and denial of illness, which are all considered unhealthy conditions. On the other hand, healthy behaviour refers to actions taken by individuals to maintain, attain, of regain good health and prevent illness, which are influenced by their health beliefs. Illness behaviour, on the other hand, refers to how individuals perceive, evaluate, and respond to their own health status when they are sick. The sick role is a term used to describe the expectations and responsibilities society assigns to individuals who are ill, including being excused from responsibilities and seeking help to recover. However, in the scenario above, the behaviour relating to illness is not described.
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This question is part of the following fields:
- Assessment
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Question 6
Incorrect
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What is the definition of Othello syndrome?
Your Answer:
Correct Answer: Delusional belief that the one's partner is unfaithful
Explanation:Morbid jealousy of delusions of jealousy are also known as Othello syndrome, named after the Shakespearean character who murdered his wife due to false beliefs of her infidelity. This condition poses a significant risk to the partner, similar to the original story. It can affect individuals of any gender and occur in relationships of any status of gender combination.
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This question is part of the following fields:
- Assessment
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