Psychiatric Emergencies

Question 1

T or F: Grief Reaction, Rape, Disaster, Panic Attack and Acute Excitement with Psychomotor agitation belongs to Minor Classification of Psychiatric Emergency

Answer 1

False. All except Acute Excitement with Psychomotor Agitation is considered Minor. Acute Excitement with Psychomotor Agitation and Self – Destructive or Suicidal Behavior belongs to Major Classification.

Question 2

This Psychiatric emergency is characterized by autonomic hyperactivity, fever, muscle rigidity and altered state of consciousness

Answer 2

Neuroleptic Malignant Syndrome (Antipsychotic Overdose)

Question 3

It is the willful self – inflicting of painful, destructive and injurious acts without the intention to die. Often seen in persons with Borderline Personality Disorder

Answer 3

Deliberate Self - Harm

Question 4

It is the subjective expectation and desire for Self -Destructive act to end in death

Answer 4

Suicidal Intent

Question 5

It is the thought of serving as the agent one’s own death

Answer 5

Suicidal Ideation

Question 6

Self – injurious behavior with non – fatal outcome accompanied by evidence that the person intended to die

Answer 6

Suicidal attempt

Question 7

Most important risk factor for suicide

Answer 7

Prior Suicide Attempt

Question 8

Age group in females with highest suicidal rate

Answer 8

15 -24 years old

Question 9

Most common method of suicide

Answer 9

Hanging, Shooting, Organophosphate Ingestion

Question 10

Divorce Increases Risk for Suicide by

Answer 10

2-3x

Question 11

Among Physicians who have the highest rate of suicide

Answer 11

Psychiatrists

Question 12

How much percentage of those who commit or attempt suicide have mental disorder

Answer 12

95%. 80% - depressive disorder, 10% - schizophrenia, 5% - dementia or delirium

Question 13

Risk for Suicide of Psychiatric patients

Answer 13

3-12 times

Question 14

Percentage of alcohol – dependent persons who commit suicide

Answer 14

15%

Question 15

Risk of second suicide attempt is highest within what period of time after the first attempt

Answer 15

Within 3 months

Question 16

Theory stating that suicide is caused by social problems. Integration within the society and control of society over a person’s behavior are the two factors considered.

Answer 16

Durkheim’s Theory

Question 17

T or F: The following are correctly matched:
Egoistic: Not strongly integrated into any social group
Altruistic: Excessive integration into society
Anomic: Distributed integration into the society

Answer 17

True

Question 18

When to consider that suicide is inevitable

Answer 18

When the patient received the highest treatment possible but it failed

Question 19

What are the soft signs of impending aggressive behavior

Answer 19

Crossing of elbows, restlessness, fist clenching

Question 20

Non – verbal signs of aggressive behavior

Answer 20

Proxemics, Kinesics, Paralanguage

Question 21

Best predictors of violent behaviors Excessive

Answer 21

Alcohol Intake, History of Violent acts, History of Childhood Abuse

Question 22

A study which showed the strongest evidence suggesting the presence of genetic factors in suicide. It suggest that genetic factor lowering the threshold for suicidal behavior may lead to an inability to control impulsive behavior. s

Answer 22

Danish -American Adoption Studie

Question 23

23. Two alleles identified in the polymorphism of human Tryptophan Hydroxylase (TPH) gene. TPH is involved in the synthesis of serotonin

Answer 23

U and L.

Question 24

This allele is associated with repetitive suicidal behavior

Answer 24

L allele

Question 25

Biological factor involved in suicide

Answer 25

Low concentration of serotonin metabolite 5 – hydroxyindole – acetic acid (5 – HIAA) in CSF

Question 26

It is known as the investment of energy or emotion into something

Answer 26

Cathexis

Question 27

Withdrawal of invested energy/emotion and trying to introject it inwardly into the unconsciousness

Answer 27

Decathexis

Question 28

This theory states that suicide is an inverted homicide because of patient’s anger towards another person. There is self – directed death instinct

Answer 28

Menninger’s Theory

Question 29

This theory states that suicide represents aggression turned inward against an introjected ambivalently cathected love object.

Answer 29

Freud’s Theory

Question 30

Acute onset, Recurrent Episodes, Current Medical Illness, Significant substance Abuse, Teenage are features that point to medical cause of mental disorder .

Answer 30

False. Should be first episode and Geriatric Age

Question 31

Best Predictors of Violent Behavior

Answer 31

Excessive Alcohol Intake, History of Childhood Abuse, History of violent Acts with arrests or criminal activity

Question 32

This drug is used in episodic outbursts of violence. It MOA is downregulation of postsynaptic neurons and effects are usually seen after 2 weeks.

Answer 32

Lithium