RANZCP MUST KNOW

Question 1

Response
Approach

Answer 1

Ax
Short term Mx
Long term Mx

Question 2

Mx Acronym

Answer 2

Setting/scale
Collateral/confidentiality and its limits
Approach
Relationship assessment
Engagement and perspective

CANMEDS
Biopsychosocial/spiritualcultural

Therapeutic alliance
Shared decision making
Confirm Dx/compliance
Involve everyone
Medicolegalethical and MDT
Family -safety planning
Peer support

Question 3

Different culture pt - buzzwords

Answer 3

Gender bias
Service access
Perception of MH

Question 3

Reg calls on the phone

Answer 3

Access their competency
See patient with reg
Debriefing
Feedback
Supervision

Question 4

Frameworks for recovery practice

Definition for recovery

Answer 4

From Australian Department of Health

“achievement of an optimal state of personal, social and emotional wellbeing, as defined by each individual, whilst living with or recovering from a mental health issue”

Question 5

GAD justification

Answer 5

Difficulty controlling the worry w
-restlessness
-fatigue
-concentration
-irritability
-muscle tension
-sleep

Question 6

What clinician factors affects the pt

Answer 6

Gender
Sexuality
Ethnicity
Affect power dynamic between dr and pt

Question 7

Care issues w prescribing stimulants

Answer 7

-second opinion when concerns about dx, hx of psychosis, SUD, or high doses
-sx before age of 12
-ritalin first line (more diversion and abuse of dex)
-risk with HTN, cardiovascular or cerebrovascular disease. Regularly monitor BP

Question 8

Types of stigma

Answer 8

Self stigma
Structural stigma - when laws and policies restrict opportunities of those with MI
Social stigma

Question 9

Therapy for BPD

Answer 9

DBT
CBT designed for BPD
Mentalisation therapy

Question 10

Comparing therapy for MDD

Answer 10

IPT focuses on external interpersonal communication patterns

CBT is more direct, focuses on internal cognitions

Both do not work as much on reflection and emotions as psychodynamic

Question 11

Obtunded pt

Answer 11

ABC
Disability - glucose, pupils, GCS (eye, verbal, motor)
Exposure -head to toe ax, imaging, urine output, injuries

Question 12

Stages of Sleep
Sleep disorders

Answer 12

Measured with polysomnogram

N1-3: Non Rem sleep
N2 (sleep spindles, K complexes), 3 - deep sleep
REM - atonic, muscle paralysis, 25% of sleep, low amplitude high frequency eeg

N1-2-3-2-REM

REM sleep disorder - Parkinsons, LBD, ADT use - acting out dreams

Narcolepsy - lapses into REM sleep during the day

Sleepwalking - occurs during N3, immature sleep cycle,also bed wetting and night terrors

Question 13

Comorbid with HIV

Answer 13

-Anxiety and depression with dx
-Stigma
-Relationship difficulties
-self esteem, anxiety during time of dx, declining CD4 count, opportunistic infection
-Meds can also cause anxiety and depression

Question 14

HIV & drug use

Answer 14

Affects compliance
Weakens immune system
Interact w HIV medicine

Question 15

HIV and depression

Answer 15

HIV causes fatigue (low cd4 counts) , weight loss, chronic pain in comorbidities or opioid dependence
Can use ssri or tca

Question 16

Methadone and adts

Answer 16

Low risk with serotonin syndrome, maois high risk
Qtc prolongation with citalopram/escitalopram
Monitor for serotonin syndrome on ssris, snris, tcas

Question 17

Sx of serotonin syndrome

Answer 17

Clonus, hyperreflexia, tremor, rigidity
Autonomic - fevers, tachycardia, diaphoresis
Altered mental state

Question 18

Dual diagnosis cause

Answer 18

They may elicit a mental illness
They may exacerbate symptoms
They can precipitate relapses

Question 19

Melancholic - ax and mx
Agitated depression

Question 20

Psychotherapy in depression

Answer 20

Behavioural activation

Question 21

Definition recovery

Answer 21

Personal
Clinical
Functional