DHA DHA Mental Health & Psychiatry 4 — Questions and Answers
Question 1: A patient with bipolar I disorder is stable on lithium but presents with a serum lithium level of 1.8 mEq/L and coarse tremor. What is the most appropriate next step?
- Increase the lithium dose to achieve better mood stabilization
- Hold lithium and assess for toxicity symptoms (Correct answer)
- Add valproate and continue current lithium dose
- Switch immediately to quetiapine
Correct answer: Hold lithium and assess for toxicity symptoms
A lithium level above 1.5 mEq/L with symptoms like coarse tremor indicates early toxicity and requires holding the dose and clinical reassessment.
Question 2: Which defense mechanism is a patient using when they attribute their own unacceptable feelings of anger onto another person?
- Reaction formation
- Displacement
- Projection (Correct answer)
- Sublimation
Correct answer: Projection
Projection involves attributing one's own unacceptable thoughts or feelings to another person.
Question 3: A 28-year-old female presents with recurrent episodes of binge eating followed by excessive exercise but no purging. Her BMI is 22. Which diagnosis best fits?
- Anorexia nervosa, binge-purge subtype
- Bulimia nervosa, purging subtype
- Binge eating disorder
- Bulimia nervosa, non-purging subtype (Correct answer)
Correct answer: Bulimia nervosa, non-purging subtype
Bulimia nervosa non-purging subtype involves compensatory behaviors like excessive exercise rather than vomiting or laxative use.
Question 4: Which medication is FDA-approved for the treatment of irritability associated with autism spectrum disorder in children?
- Methylphenidate
- Aripiprazole (Correct answer)
- Clonidine
- Sertraline
Correct answer: Aripiprazole
Aripiprazole (and risperidone) are FDA-approved for treating irritability associated with autism spectrum disorder in pediatric patients.
Question 5: A patient describes hearing a voice that comments on their actions throughout the day. This is best described as:
- Second-person auditory hallucination
- Third-person auditory hallucination (Correct answer)
- Thought broadcasting
- Ideas of reference
Correct answer: Third-person auditory hallucination
A voice that comments on the patient's actions is a third-person auditory hallucination, characteristic of schizophrenia.
Question 6: In the UAE Mental Health Law, what is the maximum duration of emergency involuntary psychiatric admission before formal review is required?
- 24 hours
- 48 hours
- 72 hours (Correct answer)
- 7 days
Correct answer: 72 hours
Under UAE Mental Health Law, emergency involuntary admissions must undergo formal review within 72 hours.
Question 7: Which of the following best describes the concept of 'expressed emotion' (EE) in the context of schizophrenia relapse?
- Patient's ability to express hallucinations verbally
- Family communication patterns involving criticism and over-involvement (Correct answer)
- The patient's insight into their own emotional states
- Therapeutic expression of trauma in group therapy
Correct answer: Family communication patterns involving criticism and over-involvement
High expressed emotion—characterized by criticism, hostility, and emotional over-involvement from family—is a major predictor of relapse in schizophrenia.
DHA DHA Mental Health & Psychiatry 4
A patient with bipolar I disorder is stable on lithium but presents with a serum lithium level of 1.8 mEq/L and coarse tremor.
What is the most appropriate next step?