Psych Revision Lecture Qs Flashcards
A 78 year old man is visited at home as he did not attend his diabetic clinic appointment. He scores is 14/30 on the MoCA and he is oriented to place but not time. He says he’s been feeling very well recently and hasn’t needed his medications. When he goes to the kitchen to make you a cup of tea, he returns smoking a cigarette instead.
Which option would be your initial management?
A) Minimise cardiovascular risk factors B) Initiate Donepezil C) Admit him to hospital for observation D) Offer him Olanzapine E) Initiate Sertaline
Minimise cardiovascular risk factors
In clinic, a 69 year old man states he was on the way to meet some friends but has become lost. He tries to shoo away the “dogs” he says have been following him around. He has a mild tremor at rest and his gait is slightly stiff. He denies having had any medical problems recently and says he feels “right as rain”.
Which would be the best treatment?
A) Thyroxine B) Sertraline C) Donepezil D) Olanzapine E) L-Dopa
C) Donepezil
Visual hallucinations and Parkinsonism points at dementia – particularly Lewy Body therefore start memory drug
The son of an 80 year old woman asks you to conduct a home visit as he is concerned that his mother’s memory “isn’t what it was”. She has not been dressing herself in the morning and no longer reads or does the crossword. She has put on weight, become increasingly withdrawn, lethargic; her movements are slowed. Her only significant past medical history is T2 N0 M0 carcinoma of the larynx, successfully treated with radiotherapy 4 years ago.
Which is the most appropriate treatment?
A. Fluoxetine B. Donepezil C. Levothyroxine D. Lithium E. Memantine
C. Levothyroxine
This patient is suffering from hypothyrodism
A 72 year old man he has been losing weight and no longer leaves the house. He appears dishevelled. His wife died last year. He is orientated to time but not place, and scores 72/ 95 on the ACE III , saying he “doesn’t know” and becomes frustrated with further questioning. He has been feeling very lethargic and sleeps poorly.
Which is the best treatment?
A. Cognitive behavioural therapy B. Clonazepam C. Psychodynamic therapy D. Grief counselling E. Sertaline
E. Sertaline
This patient is suffering from depression. Antidepressant should be given as they are neglecting themselves
A 56 year old woman has been hospitalised for myocardial infarction. 2 nights after admission, she screams that there is a man sitting by her bed. When the light is turned on, she is relieved that ’the man’ is actually a chair with clothes draped over it.
What misperception best describes this?
A) Delusion B) Hallucination C) Illusion D) Projection E) Formication
C) Illusion
An elderly patient recovering in a surgical ward experiences fluctuating episodes of consciousness and visual hallucinations with an altered sleep-wake cycle.
Which is the most likely diagnosis?
A) Alzheimer’s dementia B) Lewy Body disease C) Paraphrenia D) Delirium E) Acute psychotic episode
D) Delirium
A 46 year old man has been treated for paranoid schizophrenia for the last 12 years. His family have noticed that recently he has been grimacing and pulling faces. This seems to be getting worse and they are concerned that he is reacting to hallucinations again.
Which is the most likely cause of his presentation?
A) Tardive dyskinesia B) Parkinsonism C) Stereotypies D) Catatonia E) Dystonia
A) Tardive dyskinesia
A 24 year old has been taking Risperidone for 3 weeks. Nursing staff note she she “keeps pacing by the door“ and are concerned that she is trying to abscond from the ward. During the consultation she seems on edge and unable to settle. On several occasions she rises from her seat to pace up and down.
Which is the mostly likely phenomenon causing her symptoms?
A) Stereotypies B) Partially treated psychosis C) Tics D) Compulsions E) Akathisia
E) Akathisia
A) Dysarthria B. Dysphasia
C) Clang associations D. Punning
E) Pressure of speech F. Perseveration
F) Loosening of assoc. H. Poverty of speech
For each of the following, select which of the above disorders of speech is being described…
You are in A&E assessing a man with a known diagnosis of schizophrenia. He is extremely difficult to talk to and says things like… “The train rain brained me. He ate the skate, inflated yesterday’s gate toward the cheese grater”
C) Clang associations
A. Capgras syndrome B. Persecutory Delusions C. Ekbom’s syndrome D. Obsessions E. Overvalued ideas F. Passivity G. Thought alienation H. Phobia I. Delusion of reference
For each of the following statements, select the most likely psychopathological term from the list above...
- “I’m terrified, there are spiders in my kitchen – I know they’re burrowing into my skin at night”
C. Ekbom’s syndrome
Delusional parasitosis
Capgras syndrome is where someone you think someone you know has been replaced
An 18 year old man seen in A and E is asked to describe his mood. He states, ‘My mood is flextitating; I am up and down.’
The patient is exhibiting which of the following thought disorders?
A) Clang association B) No thought disorder C) Thought block D) Tangentiality E) Neologism
E) Neologism
Flexitating isn’t a word
False beliefs include all except:
A) Primary delusions B) Secondary delusions C) Tertiary delusions D) Compulsions E) Overvalued ideas
D) Compulsions
A 42 year old man complains ‘men are following me.’ He complains of voice tells him to hurt others, and that newscasters give him special messages through the TV on a daily basis.
Which best describes this last belief?
A. Grandiose delusion B. Illusion C. Loosening of associations D. Idea of reference E. Passivity
D. Idea of reference
A 23 year old man has been diagnosed with a first episode of paranoid schizophrenia. Which of the following is the most appropriate treatment option?
A) Flupentixol decanoate B) Olanzapine C) Fluoxetine D) Diazepam E) Clozapine
B) Olanzapine
First line medication for new psychosis should be an atypical anti-psychotic. Clozapine can only be tried after failure of 2 other antipsychotics.
A 35 year old man with schizophrenia attends your clinic seeking advice on lifestyle changes.
Which of the following is true of psychotic disorders?
A) Life expectancy is reduced by 20 years in comparison with the general population
B) Life expectancy is the same as for the general population
C) Any reduction in life expectancy is largely explained by an increased suicide rate
D) Cardiovascular disease does not excessively contribute to mortality
E) Death rates from cancer are lower than in the general population.
A) Life expectancy is reduced by 20 years in comparison with the general population
Death rates from cancer tend to be higher in patients with schizophrenia.
Kelly is a 30 year-old woman with bipolar affective disorder. She is currently well and treated with lithium. She presents to you in general practice as she and her husband are planning to start a family.
Which of the following is TRUE?
A) Kelly should discontinue her medication to avoid risk of harm to the foetus
B) Kelly is very likely to relapse during pregnancy if she discontinues medication
C) Bipolar affective disorder does not increase the risk of puerperal psychosis
D) Lithium is generally safe in pregnancy and breastfeeding
E) Kelly’s child is no more likely to develop a mood disorder compared to the general population
B) Kelly is very likely to relapse during pregnancy if she discontinues medication
Lithium however is not safe for use during pregnancy
A 32 year old mother attends clinic 2 months after having her first child. She presents with a 6 week history of low mood, marked anxiety, guilt, anhedonia and low energy. She is worried that she is an incapable mother. She denies any thoughts about harming herself or her child.
What is the most likely diagnosis?
A) Mild depressive episode B) Postnatal depression C) Baby blues D) Normal adjustment reaction E) Postpartum psychosis
B) Postnatal depression
No psychosis or adjustment features
Baby blues will last for a shorter period
More than a mild depressive episode and as it is following childbirth postnatal depression is the most likely feature.
