MENTAL HEALTH

Which is not a criterion for substance abuse

a) Recurrent use when physically hazardousb) Tolerancec) Continued use despite

persistent/recurrent social or interpersonal problems

d) Recurrent substance-related legal problems

Match the correct drug and mechanism of action

a) Alcoholb) Barbituratesc) Benzodiazepinesd) Amphetaminese) Cocainef) Nicotineg) LSDh) Codeinei) Marijuana

1. Enhance GABA effects2. Acts on serotonin receptors3. Possibly dec Ca2+ channels4. Potentiate GABA5. Stimulate cannabinoid

receptors6. Stimulate opioid receptors7. Inhibit DA, NA and 5-HT

transporters8. Stimulates nicotine receptors9. Release of DA, NA and 5-HT

Which is generally not a recommended treatment option

for drug overdose?

a) Haemodialysisb) Administer antidotec) Emesisd) Activated charcoal

What is the MOA of paracetamol toxicity?

a) Conjugation with glucuronideb) Reaction with the scavenger glutathionec) Conjugation with sulphated) Hydroxylation and rearrangement to

NAPBQI

Which is a protective factor for suicide?

a) Intelligenceb) Male genderc) Lack of spoused) Ethanol intake

What are some considerations when communicating with patients

in a mental health setting? Ensure privacy Introduce yourself to patient (and carer) Sit down, be willing to listen and do not hurry Body language (comfortable distance, use eye contact but do

not over-do it) Generally do not touch the patient Ask open ended questions where possible to facilitate

discussion Tolerate silences Repetition Identify the patient’s emotions Allow the patient to maintain their dignity (engage them in

planning) Respect cultural/religious practices

What are the important points in a mental status examination Appearance and behaviour (eye contact and

rapport; personal hygiene; facial expressions; motor behaviour; autonomic arousal)

Speech (form, volume, content) Mood (affective expression,

appropriateness, ?suicidal ideation) Thought and perception (stream of thought,

form, thought content, perceptions, delusions, hallucinations)

Cognition (orientation, concentration, registration, memory recall)

Insight

If a patient does not open their eyes, makes incomprehensible sounds and shows decerebrate

extension to painful stimuli, what is their GCS score?

Eyes 1/4 Verbal 2/5 Motor 2/6

Total: 5/15

Which is NOT a goal of CBT?

Enhance the patient’s problem solving capacities

To relieve the role of GPs in the mental health setting

To modify patients’ perspectives about themselves

To assist in the regulation of distressing affective states

If a patient has recently been diagnosed with emphysema and is concerned that their smoking

could be contributing to the problem, which stage of

behavioural change are they at?

a) Pre-contemplationb) Contemplationc) Preparationd) Actione) Maintenancef) Relapse

Match the term and definition

1. Mood2. Affect3. Euthymia4. Anhedonia5. Alexithymia

a) Normal moodb) Inability to sense

and describe mood states

c) Superficial and immediate emotional state

d) Pervasive emotional state

e) Inability to experience pleasure

Match the disorder and description1. Major depressive

disorder2. Dysthymic

disorder3. Bipolar disorder4. Cyclothymic

disorder5. Adjustment

disorder with depressed mood

6. Mood disorder not otherwise specified

a) Depression alternating with manic/hypomanic episodes

b) Minor depression/ mixed depression and anxiety

c) Pervasively depressed mood + impaired functioning

d) Chronic low-grade dysphoriae) Feeling down in response to

a loss or setbackf) Sudden and rapid alteration

between depressive and manic/hypomanic states

Which of the following meets the criteria for a major depressive disorder

a) Insomnia + anhedonia + high self-esteem + fatigue + reduced concentration

b) Anhedonia + dysphoria + insomnia + hallucinations

c) Insomnia + weight gain + anhedonia + reduced concentration + fatigue

d) Anhedonia + diurnal mood variation + low self-esteem + suicidal thoughts

Which is a first-line antidepressant?

a) Sertraline b) Mirtazapinec) Phenelzined) Amitriptyline

Which is NOT a hypothesised pathological process leading

to schizophrenia?a) Excess dopamineb) Decreased serotoninc) Glutamate deficiencyd) Elevated acetylcholine

Match the anti-depressant and MOA

1. MAOI2. SSRI3. SNaRI4. TCA5. NaSSAs

a) Inhibit serotonin and noradrenaline reuptake

b) Inhibit monoamine oxidase

c) Inhibit presynaptic a2, 5-HT2 and 5-HT3 receptors

d) Inhibit serotonin reuptake

e) Older drugs which inhibit reuptake of NA and 5-HT

Which is not a possible treatment for bipolar disorder

a) Sodium valproateb) Risperidonec) Psychotherapyd) Increased sleepe) Electroconvulsive therapy

Which is not part of the diagnostic criteria for

schizophrenia?a) Concurrent episodes of major depressive

disorderb) Presence of psychotic symptoms for at

least a monthc) Presence of significantly impaired

psychosocial functiond) At least six months duration of

continuous signs of illness

Rehabilitation for people with schizophrenia includes

Pre-vocational programs Vocational programs Housing Social and recreational support All of the above

Which drug has the greatest extra-pyramidal side effects?

a) Chlorpromazineb) Haloperidolc) Clozapined) Risperidone

Which anti-psychotic is associated with seizures as an

adverse effect?a) Chlorpromazineb) Haloperidolc) Clozapined) Risperidone

Are doctors legally required to notify the police of

domestic violence? Yes doctors are obligated to advise police

of crimes, non-accidental injuries using weapons and application of heat or partial strangulation/asphyxiation

This includes wilful injury, property damage, intimidation, harassment and indecent behaviour

But otherwise MUST maintain confidentiality