MRCPsych Clinical Procedures and Protocols 2 — Questions and Answers
Question 1: When performing a Mental State Examination, which component specifically assesses the patient's awareness of their own illness?
- Affect
- Insight (Correct answer)
- Orientation
- Cognition
Correct answer: Insight
Insight refers to the patient's awareness and understanding of their mental illness, including whether they believe they are unwell and need treatment.
Question 2: Under the Mental Health Act 1983 (amended 2007), which section allows for a patient's nearest relative to apply for compulsory admission for assessment?
- Section 2 (Correct answer)
- Section 3
- Section 4
- Section 136
Correct answer: Section 2
Section 2 allows for compulsory admission for assessment for up to 28 days, and the application can be made by an Approved Mental Health Professional or the nearest relative.
Question 3: A patient is commenced on clozapine. According to NICE guidelines, how frequently should full blood count monitoring occur during the first 18 weeks?
- Daily
- Weekly (Correct answer)
- Fortnightly
- Monthly
Correct answer: Weekly
Weekly FBC monitoring is mandatory for the first 18 weeks of clozapine treatment due to the risk of agranulocytosis.
Question 4: Which validated tool is most commonly used to assess suicide risk in clinical psychiatric practice in the UK?
- Columbia Suicide Severity Rating Scale (C-SSRS) (Correct answer)
- Hamilton Anxiety Rating Scale (HAM-A)
- Edinburgh Postnatal Depression Scale (EPDS)
- Montreal Cognitive Assessment (MoCA)
Correct answer: Columbia Suicide Severity Rating Scale (C-SSRS)
The Columbia Suicide Severity Rating Scale (C-SSRS) is widely recommended and used in the UK for structured suicide risk assessment.
Question 5: During electroconvulsive therapy (ECT), what is the minimum acceptable seizure duration for the treatment to be considered therapeutically effective?
- 5 seconds
- 15 seconds
- 25 seconds (Correct answer)
- 45 seconds
Correct answer: 25 seconds
A seizure of at least 25 seconds is generally considered the minimum duration for ECT to be therapeutically effective.
Question 6: When assessing capacity under the Mental Capacity Act 2005, which of the following is NOT one of the four functional tests a patient must fail to be deemed to lack capacity?
- Understanding the information
- Retaining the information
- Weighing up the information
- Communicating the decision verbally (Correct answer)
Correct answer: Communicating the decision verbally
Communication can be by any means (gestures, blinking, writing), so verbal communication is not specifically required; the four tests involve understanding, retaining, weighing, and communicating by any means.
Question 7: A psychiatrist is conducting a structured clinical interview using the SCID-5. What does the SCID-5 primarily assess?
- Cognitive function and dementia staging
- DSM-5 Axis I and II diagnoses (Correct answer)
- Neurological soft signs
- Personality disorder severity only
Correct answer: DSM-5 Axis I and II diagnoses
The SCID-5 (Structured Clinical Interview for DSM-5) is a semi-structured diagnostic interview designed to assess major DSM-5 diagnoses.
MRCPsych Clinical Procedures and Protocols 2
When performing a Mental State Examination, which component specifically assesses the patient's awareness of their own illness?