RACP-mental health

Question 1

A 27 year old female was commenced on an atypical antipsychotic 2 weeks ago. She develops amenorrhoea and milky discharge from her breasts. Which investigation would help with the diagnosis?

A. Serum beta-HCG
B. Serum LH and FSH
C. Serum prolactin
D. Pituitary fossa imaging

Answer 1

C. Serum prolactin

Question 2

74. Clozapine therapy may be complicated by myocarditis. What is the predominant cellular infiltrate seen in clozapine-associated myocarditis?

A) Giant cell
B) Eosinophil
C) Lymphocyte
D) Neutrophil

Answer 2

B) Eosinophil

Question 3

2021

Q5. Which class of drugs is first line treatment for the management of obsessive compulsive disorder?
A. Benzodiazepines
B. MOAIs
C. SSRIs
D. SNRIs

Answer 3

C- first line is SSRI and CBT

Question 4

Q35. A 24yo male presents with dystonia after being administered haloperidol. What medication should be given
to reverse the dystonia?
A. Diazepam
B. Benztropine
C. Propranolol
D. Phenytoin

Answer 4

B. Benztropine

selective inhibition of dopamine transporters

Question 5

2021

Q45. A 40 year old woman presents with a long history of somatic symptoms including headache, chest pain,
lethargy, abdominal pain and paraesthesias. She is very worried about what her symptoms might mean and is
only briefly reassured after consultation. Repeated investigation has not shown any cause for her symptoms. She
continues to present, and describes herself as “sickly” and “never well”.
What is the most likely psychiatric cause of her symptoms?
A. Delusional disorder (somatic type)
B. Factitious disorder
C. Hypochondriasis (illness anxiety disorder)
D. Somatisation disorder (somatic symptom disorder)

Answer 5

D. Somatisation disorder (somatic symptom disorder)

Question 6

Q59. A 24 year old male presents with intrusive neurological symptoms and frequent nodding of his head. His
symptoms subsequently changed to right arm swinging and sensation of frequent need of swallowing. His mother
also reports symptoms suggestive of OCD.
Which of the following is the likely diagnosis?
A. Huntington disease
B. Wilson disease
C. Tourette syndrome
D. Neuroacanthocytosis

Answer 6

C. Tourette syndrome

Tourette syndrome is frequently associated with OCD

Question 7

2021

Q5. Which class of drugs is first line treatment for the management of obsessive compulsive disorder?
A. Benzodiazepines
B. MOAIs
C. SSRIs
D. SNRIs

Answer 7

C. SSRIs