Mental Health Flashcards
The following is included in the test for cognition: A. Mood B. Hallucinations C. Delusions D. Memory
D. Memory
An illusion is:
A. A sense perception in the absence of a stimulus
B. A false sense perception of a real stimulus
C. A false belief held in the absence of proof
D. A false perception in the auditory modality
B. A false sense perception of a real stimulus
The following statement is true about delusion:
A. It is always accompanied by hallucination
B. It is classified as bizarre if it cannot be probable in the realm of possibility
C. It is something that can never happen in the realm of possibility
D. It means to hold an odd belief
B. It is classified as bizarre if it cannot be probable in the realm of possibility
Life stresses play a role in psychiatric illness because they:
A. Must always be severe to lead to an acute illness
B. Can be a trigger for a breakdown leading to a need for hospitalisation
C. Cause the underlying illness
D. Must always be present with every illness
B. Can be a trigger for a breakdown leading to a need for hospitalisation
The following statement is true for DSM IV – R:
A. It uses 4 axes to record diagnosis
B. It divides mental illness into 16 categories
C. It is a system that categorises both mental and physical illnesses
D. It is available in all the languages of the world
B. It divides mental illness into 16 categories
The following statement is true for hallucination:
A. It can only occur in the visual or auditory modality
B. It is always present in depression
C. It can occur in any sensory modality
D. It can be classified as bizarre or non-bizarre
C. It can occur in any sensory modality
I.Q. testing can demonstrate if someone has ........ A. Mental retardation B. a disorder of affect C. Long and short term memory D. Concrete thinking
A. Mental retardation
Attention and concentration is tested by ………
A. giving a patient 3 objects to remember and testing recall
B. Asking a patient to explain a proverb
C. Asking a patient to link similarities
D. Doing the ‘Serial seven’s and serial three’s’ test
D. Doing the ‘Serial seven’s and serial three’s’ test
People with cognitive deficit display possible …… A. Disturbances in affect B. Symptoms of de-realisation C. Deficits in short term memory D. Complex delusions
C. Deficits in short term memory
In suspected dementia this test is essential ……… A. Serial seven's and serial three's B. Test for abstract thinking C. I Q testing D. Test for long and short term memory
D. Test for long and short term memory
Match the listed examples with the DSM IV – R diagnostic axes below:
Axis I A. Physical illness B. Psychiatric diagnosis C. Personality disorder D. Global assessment of functioning
B. Psychiatric diagnosis
Match the listed examples with the DSM IV – R diagnostic axes below:
Axis II A. Physical illness B. Psychiatric diagnosis C. Personality disorder D. Global assessment of functioning
C. Personality disorder
Match the listed examples with the DSM IV – R diagnostic axes below:
Axis III A. Physical illness B. Psychiatric diagnosis C. Personality disorder D. Global assessment of functioning
A. Physical illness
Axis V A. Physical illness B. Psychiatric diagnosis C. Personality disorder D. Global assessment of functioning
D. Global assessment of functioning
Mental retardation is
A. Defined by having an IQ less than 70
B. Always accompanied by autism
C. Defined as being of moderate intensity if the IQ is less than 30
D. Defined by having an IQ less than 90
A. Defined by having an IQ less than 70
Sexual Identity is defined as
A. A person’s biological sex
B. A person’s erotic response in real life or in their fantasies
C. A subjective feeling of being a man or a woman
D. A social display of their gender identity
A. A person’s biological sex
A phobia can be
A. Treated with in depth psychoanalysis
B. Treated with antipsychotic medication
C. Treated with the therapy of flooding and electroconvulsive therapy
D. Treated with the therapy of flooding or systematic desensitization
D. Treated with the therapy of flooding or systematic desensitization
A 78 year old lady complains that for some time she has had to rush to the toilet when she feels the urge to urinate as she wets herself if she delays. In the past week it has been much worse and she has had several episodes of wetting herself before she gets to the toilet.
The most likely reversible cause of urinary incontinence for which you should investigate this patient is; A. spinal chord lesion B. autonomic neuropathy C. urinary tract infection D. uterine prolapse
D. uterine prolapse
A 70 year old diabetic man complains that for the past year he has had a poor urinary stream and must press to pass urine and more recently he dribbles small amounts of urine all the time.
The most likely kind of urinary incontinence in this case is: A. stress incontinence B. overflow incontinence C. urge incontinence D. functional incontinence
B. overflow incontinence
Which of the following does an ADL (activity of daily living) scale such as the Barthel test: A. the ability to cook food B. the ability to work with money C. both B and C correct D. the ability to walk and transfer
D. the ability to walk and transfer
IADL’s (instrumental activities of daily living) scales such as the Frenchay are most useful in assessing a patient’s;
A. Ability to take care of their basic grooming needs
B. ability to walk and climb stairs
C. ability to live independently in the community
D. need for full time frail care
C. ability to live independently in the community
In a patient who is having recurrent falls which you think are due to a peripheral neuropathy the best functional assessment of this problem is
A. The reach test ( patient stands with feet together and distance they can reach with arm outstretched is measured)
B. The sternal nudge (push on sternum while patient stands with feet together)
C. The Rhomberg’s test (stand with feet together and eyes closed)
D. A thorough neurological examination
D. A thorough neurological examination
You see an 80 year old woman who has fallen once and is now terrified of falling again. You assess her fully and find no cause for the fall.
Which of the following would be the most appropriate management of her fear of falling:
A. prescribe a mild benzodiazepine for anxiety
B. reassure her that there is nothing wrong with her
C. suggest that she uses a walking stick
D. refer her for physiotherapy for balance exercises
C. suggest that she uses a walking stick
An 85 year old woman with moderate Alzheimer’s disease, on no medications, who was still able to bath and dress herself and walk to church nearby on her own deteriorates over 2 weeks to the point that she is disorientated in her own house, confused, restless at night, drowsy during the day, having falls and episodes of incontinence.
Which of the following would be the most likely cause for her deterioration?
A. rapidly progressive form of Alzheimer’s disease
B. delirium due to an underlying infection
C. delirium on its own
D. the multiple falls
A. rapidly progressive form of Alzheimer’s disease
Which of the following cognitive problems would be most likely to fulfil the DSM IV criteria for dementia?
A. poor executive function
B. Progressive impairment of language and memory
C. memory impairment alone with preserved function
D. stable memory impairment and apraxia
B. Progressive impairment of language and memory
Which of the following best describes a delirium?
A. slow onset of disorientation for time and place
B. agitation and restlessness plus cognitive impairment
C. sudden onset of poor concentration, disorientation and perceptual disturbances
D. sudden onset of memory impairment
C. sudden onset of poor concentration, disorientation and perceptual disturbances
Which of the following patient characteristics would make the MMSE (Minimental-state-examination) score unreliable or difficult to interpret in terms of dementia? A. mild Alzheimer’s disease B. severe Alzheimer’s disease C. previous severe stroke D. no formal schooling
D. no formal schooling
A patient in an acute psychiatric ward complains that there are voices talking to him/her. — Choose match
Hyperacousis Hallucination Expansive mood Dissociation Disorientation Delusion Dereailization
Hallucination
A patient was brought in for an assessment as she was causing a disruption in a supermarket. On evaluation you find that she expresses her feelings without restraint and overestimate her own importance. — Choose
Hyperacousis Hallucination Expansive mood Dissociation Disorientation Delusion Dereailization
Expansive mood
Individuals with an expansive mood may behave brashly or lavishly, assume a superior or grandiose attitude, or dress and act flamboyantly. They exhibit larger-than-life behaviors that can often be accompanied by (or result in) extreme bursts of irritability.
An elderly patient cannot tell you the date , time of the day, or month of the year. — Choose
Hyperacousis Hallucination Expansive mood Dissociation Disorientation Delusion Dereailization
Disorientation
A patient tells you that aliens have implanted a sensor in his head and are tracking all his movements. — Choose m
Hyperacousis Hallucination Expansive mood Dissociation Disorientation Delusion Dereailization
Delusion
A patient in an acute psychiatric ward tells you that he is seeing pink insects flying around in his room. — Choose
Hyperacousis Hallucination Expansive mood Dissociation Disorientation Delusion Dereailization
Hallucination
A male patient believes he is pregnant. — Choose
Hyperacousis Hallucination Expansive mood Dissociation Disorientation Delusion Dereailization
Delusion
A patient cannot tell you in which country he lives — Choose
Hyperacousis Hallucination Expansive mood Dissociation Disorientation Delusion Dereailization
Disorientation
The patient is restless and paces up and down — Choose match
hallucination appearance pressure of speech psychomotor agitation cognitive impairment mood suicidal sublimation
psychomotor agitation
The patient wants to end her own life. — Choose
hallucination appearance pressure of speech psychomotor agitation cognitive impairment mood suicidal sublimation
suicidal
The patient is unkempt and dirty. — Choose hallucination appearance pressure of speech psychomotor agitation cognitive impairment mood suicidal sublimation
appearance
The patient feels sad /depressed most of the time. — Choose hallucination appearance pressure of speech psychomotor agitation cognitive impairment mood suicidal sublimation
mood
The patient’s memory is impaired. — Choose hallucination appearance pressure of speech psychomotor agitation cognitive impairment mood suicidal sublimation
cognitive impairment
The patient is elated and feeling very happy. — Choose
hallucination appearance pressure of speech psychomotor agitation cognitive impairment mood suicidal sublimation
mood
The patient is hearing voices — Choose
hallucination appearance pressure of speech psychomotor agitation cognitive impairment mood suicidal sublimation
hallucination
A 75 year old woman is brought to see you by her daughter who complains that the patient has been becoming very forgetful over the past year. She also confuses the days, gets lost in shopping malls and can no longer do her own shopping or cook for herself. There is no past history of any medical condition. The most likely diagnosis is:
a. delirium
b. Alzheimer’s dementia.
c. An underling medical illness
d. A frontal lobe tumour
b. Alzheimer’s dementia.
An 80 year old man has a history of long standing confusion and memory problems. He does not speak English and has no formal education. You suspect that he has a dementia. What is the most reliable way of making the diagnosis?
a. The Mini Mental State Examination (MMSE)
b. An MRI scan of his brain
c. A thorough neurological examination
d. A careful history documenting functional decline.
d. A careful history documenting functional decline.
When caring for patients with dementia which aspect of follow-up is the most important?
a. Regularly checking the Mini Mental State Examination (MMSE).
b. Finding out if the care giver is coping and receiving adequate support.
c. Performing a neurological examination regularly.
d. Checking the thyroid function regularly.
a. Regularly checking the Mini Mental State
A 68 year old woman is admitted to hospital for severe pneumonia. She has a history of moderate dementia, hypertension and diabetes. On admission she is agitated, trying to climb out of bed, disorientated, hallucinating and will not co-operate with the nurses. The most likely reason for her mental state is;
a. A new intracerebral medical problem.
b. The dementia itself.
c. A superimposed delirium due to the pneumonia.
d. Pneumonia complicated by a psychotic illness
c. A superimposed delirium due to the pneumonia.
A 90 old woman is brought in from the old age home. The nurse informs you that she recently had a urinary tract infection after which she was restless and wandering around confused at night. She was then put on a benzodiazepine to sleep. She has normal vital signs, no focal signs on CNS examination and no obvious injury but is drowsy and uncooperative. The most likely cause for her mental state is;
a. A rapidly progressive dementia aggravated by benzodiazepine use.
b. A delirium due to the infection and benzodiazepine use.
c. A subdural haematoma.
d. A stroke.
b. A delirium due to the infection and benzodiazepine use.
Doing formal cognitive testing in a patient with delirium is difficult and not informative. Which of the following is a diagnostic feature of delirium and makes cognitive testing (e.g. A MMSE) difficult.
a. Disordered language.
b. Poor short term memory.
c. Hallucinations
d. A deficit in attention (distractible/ poor concentration)
d. A deficit in attention (distractible/ poor concentration)
