Clinical Procedures and Protocols Flashcards

A patient receiving ECT develops a prolonged seizure lasting over 3 minutes. What is the first-line pharmacological intervention?

Answer: IV lorazepam

IV lorazepam (or diazepam) is the first-line treatment for a prolonged ECT-induced seizure, as benzodiazepines rapidly terminate seizure activity.

A Section 117 aftercare plan is being developed for a patient being discharged. Under the Mental Health Act 1983, which patients are entitled to Section 117 aftercare?

Answer: Patients detained under Section 3, 37, 45A, 47, or 48

Section 117 aftercare applies specifically to patients who have been detained under sections 3, 37, 45A, 47, or 48 of the Mental Health Act.

Which rating scale is most appropriate for monitoring the severity of alcohol withdrawal in an inpatient setting?

Answer: CIWA-Ar

The Clinical Institute Withdrawal Assessment for Alcohol, revised (CIWA-Ar), is the standard tool for monitoring and guiding treatment of alcohol withdrawal symptoms.

A patient with a known penicillin allergy is started on a course of psychotropic medication, but the pharmacist flags a potential serious interaction. Which antidepressant has the highest risk of QTc prolongation and should be used with caution in patients on other QT-prolonging drugs?

Answer: Citalopram

Citalopram (and escitalopram) have dose-dependent QTc prolongation risk and are contraindicated with other QT-prolonging agents; maximum daily doses are restricted by the MHRA.

When conducting a risk assessment for violence, which of the following is an example of a dynamic (changeable) risk factor?

Answer: Current substance misuse

Dynamic risk factors are modifiable and include current substance misuse, medication non-adherence, and current mental state, as opposed to static factors like past history or demographics.

A patient with a personality disorder is admitted to a psychiatric ward following a serious self-harm episode. NICE guidelines (CG78) recommend which therapeutic approach as a first-line long-term intervention for borderline personality disorder?

Answer: Dialectical Behaviour Therapy (DBT)

NICE guideline CG78 recommends DBT as the preferred psychological treatment for women with borderline personality disorder, particularly when self-harm is prominent.

During the Mental State Examination, a patient uses new words with their own personal meaning that cannot be understood from the context. What is the correct term for this phenomenon?

Answer: Neologisms

Neologisms are newly coined words or existing words used with idiosyncratic meanings, commonly observed in psychotic disorders such as schizophrenia.