ࡱ> ]_\ &bjbjΚΚ .>BB&&&& 2T&R.oRqRqRqRqRqRqR,&TVRRRoRoRL3RODN4[RR0RNLjWjWh3R3R(RRRjWB :   MCQ PSYCHIATRIC DISORDERS SUSAN TUCKER 1.High yield indicators of an organic illness include all of these except? disorientation rapid onset no pre morbid decline a score of 23 on Folsteins Mini Mental state Examination first presentation of mental illness 2.Delerium is characterized by all except? fluctuating or decreased level of consciousness disorientation age greater than 40 visual hallucinations and delusions movement disorders 3.Regarding Folsteins Mini Mental State examination which is incorrect? it is scored out of thirty its aim is aid in the determination of whether an illness is organic or psychiatric in origin a score of 20 or less indicates cognitive impairment it includes calculation, memory recall and comprehension orientation makes up 10% of the marks 4.Do a Mini Mental State Examination on your study buddy. 5.With regards to violent behaviour which is false? organic disorders are a more frequent cause of violent behaviour than psychiatric disorders in Australian hospitals hypoxia, head injury and dementia are frequently identified organic mental disorders causing violence a violent patient should be triaged national triage category 2 an agitated pt who is loud and pacing excessively is likely to become aggressive a violent patient cannot be legally chemically restrained if they specifically ask not to be 6.The general indications for the use of chemical and physical restraint include all except? at the patients request to prevent s significant harm to the environment of the emergency department to allow evaluation, investigation and treatment of the patient to facilitate taking of a police blood alcohol sample to prevent imminent harm to the patient or to others 7.With the use of physical restraints all are true except? they should be non-locking vital sign should be taken every fifteen minutes the pt should be supervised at all times the doctor must document the requirement for restrains there must be temporary relief of one of the four point restraints every hour to minimize neurovascular compromise 8.With regard to chemical restraint which is false? the end point of rapid tranquilization is sedation diazepam should not be given i.m. a patient should be offered oral sedation first the antipsychotic agents should not be used in seizure prone patients both the i.v amd the i.m routes are acceptable routes of administration 9.With regards to suicide which is false? the most common methods of suicide in Australia include hanging, firearms and CO poisoning suicide is the leading cause of death under 30 years of age in Australia suicide is more likely if you are male, single and unemployed there is pre-existing psychiatric illness in 90-100% of pts who suicide 20% of schizophrenic pts die by suicide, usually during an acute psychotic phase of the illness 10.With regard to suicide and deliberate self harm which is false? the peak age for suicide for men is in the early 20s the peak age for suicide for women is in the early 30s the most common cause of DSH is self poisoning a score of 10 on the sad persons scale suggests a high risk of suicide a score of 8 on the sad persons scale suggests a low risk of suicide 11.Complete this sad person scale below. ie what do the letters stand for? S A D P E R S O N S 12.With regards to schizophrenia which is false? it affects 1% of the population it usually has a gradual onset over months there is up to a 25% incidence of secondary depression the diagnosis of schizophrenia can only be made after the illness has been going for 6 weeks the earlier the onset the worse the prognosis 13.Which is false with regards to dementia? there is a disturbance of cognitive and higher cortical functioning consciousness is sometimes clouded but not always it is characterized by short term memory loss there is also some evidence of global memory impairment it is a disease of the elderly 14.Which is incorrect with regard to the DSM IV classification of psychiatric illness? Axis 1 describes the clinical syndrome of mental disorder Axis V describes the global assessment of functioning A lacerated wrist would be an Axis III disorder Borderline personality disorder would be an axis IV disorder Dementia and delerium can be an Axis I diagnosis Alcohol intoxication can be an Axis I diagnosis 15.Which is not a positive symptom of schizophrenia? hallucinations delusions disorganized behaviour disorganized speech lack of volition 16.Which is not true of major depression? it affects 10% of the population it is more common in men the symptoms must be present for at least two weeks to make the diagnosis it is more common if an individual has a family history of depression it is primarily due to a disorder of noradrenaline and serotonin in the limbic system 17.Conversion disorder, which is false? the patient consciously produces the symptom the symptom cannot be explained by a known organic aetiology the symptom expressed is a loss or change in physical function, suggesting a physical disorder the symptom is not pain the patient must have experienced a recent psychosocial stressor ANSWERS 1)D 2)E 3)E 4)30 5)E 6)D 7)E 8)A 9)E 10)E 11)D 12)D 13)B 14)D 15)E 16)B 17)A 13Which of the following patient features is LEAST associated with the risk of suicide? Male gender Divorced Excessive drug use Loss of rational thought Age between 19 and 65 years 9. In conversion disorder (psychiatry) pain is commonly a factor in presentation often have varied presentations usually has a dramatic presentation C 10. anxiety related Hyperventilation- repeat q more common in females is related to hypophasphatemia A 42. According to the Sad Persons Scale used to assess suicide risk, which of the following features scores 2 points? loss of rational thinking excessive drug use single, separated or divorced male gender severe personality disorder Cam 512 A Schizophrenia is associated with a predominant pattern of acute onset of symptoms and signs blunting of emotion and lack of volition which is responsive to anti-psychotic medication loosening of associations psychosis of less than 4 weeks duration after a stressful trigger rapid, pressurised speech Tint 1909-1910 C 57. Which ONE of the following is NOT an early characteristic or association of senile dementia: Demonstrable cortical atrophy Paranoid delusions Onset after 65 years of age Loss of long term memory Loss of short term memory All of the following characteristics are associated with an increased suicide risk EXCEPT psychosis unemployment chronic illness first attempt readily available lethal weapon 49) Regarding differentiation of dementia with depression which of the following is useful a. Early loss of short term memory loss b. Answers all questions with dont know c. Loss of autonomy at home d. e. 50) With respect to schizophrenia which is false a. An associated delusional disorder is characteristic b. Olfactory hallucinations are common c. d. e. 31) Regarding the diagnosis of schizophrenia which of the following is TRUE? a. According to DSM IV criteria all patients with the diagnosis of schizophrenia must have hallucinations b. 10% of patients have a 1st degree relative with the condition c. Drugs can cause schizophrenia d. As e. As 31) Regarding the diagnosis of schizophrenia a. According to DSM IV criteria must have hallucinations. False 2 of hallucinations, disorganized speech (due to thought disorder), delusions or bizarre behavior and negative symptoms b. 10% have 1st degree relative with the condition. ? not sure, there is some familial predisposition but its not this strong c. Drugs can cause schizophrenia. False can cause drug induced psychosis 12. Features consistent with bipolar disorder include all the following except Impulsivity Lack of remorse Unstable relationships Labile emotions Self harm behaviour +JQSjm#. %&a g k H!!&&&hQhEpB*phhEphY+hpBCJOJQJhpBCJOJQJh9hpBCJOJQJhpBhpBCJOJQJ^JhpBCJOJQJ^JhpBhpBCJOJQJ^J hpBCJhpBhhs,-x  3 c r  !    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PLP^P`LhH.AG0iXPU v(qA  h:U Sk[a;m9DFwV5qVNaPFx5AKA/>C&tg4EzO)8\hgW                                                        "                                                                                %                                  n                 pBEps@}{@UnknownG*Ax Times New Roman5Symbol3 *Cx Arial5 TahomaA$BCambria Math"qh]SV{ 'N8N8!24 3aHP(?2!xx ,MCQ PSYCHIATRIC DISORDERSRussellElspeth Richardsonh                   Oh+'0 , P \ ht|'MCQ PSYCHIATRIC DISORDERSRussell Normal.dotmElspeth Richardson17Microsoft Macintosh Word@Z7@L@?@ABCDEFGHIJKMNOPQRSUVWXYZ[^Root Entry FO`1Table WWordDocument.>SummaryInformation(LDocumentSummaryInformation8TCompObj` F Microsoft Word 97-2004 DocumentNB6WWord.Document.8