MRCPsych Clinical Procedures and Protocols 3

Question 1

A 35-year-old woman with bipolar disorder presents in labour. Her lithium level was 0.8 mmol/L last week. What is the most appropriate management of lithium during labour?

Accepted Answer

Withhold lithium during labour and restart postpartum

Answer

Lithium should be withheld during labour due to rapid fluid shifts and risk of toxicity, then restarted postpartum once the patient is stable and able to eat and drink.

Question 2

Which scale is specifically used to monitor tardive dyskinesia in patients on long-term antipsychotics?

Accepted Answer

AIMS

Answer

The Abnormal Involuntary Movement Scale (AIMS) is the standard tool for assessing and monitoring tardive dyskinesia in psychiatric practice.

Question 3

Under the UK's Deprivation of Liberty Safeguards (DoLS), which of the following settings does DoLS specifically apply to?

Accepted Answer

Hospitals and care homes

Answer

DoLS applies specifically to hospitals and care homes in England and Wales; for other settings, a Court of Protection order is required.

Question 4

A patient with treatment-resistant depression is being considered for repetitive transcranial magnetic stimulation (rTMS). Which brain region is most commonly targeted?

Accepted Answer

Left dorsolateral prefrontal cortex

Answer

High-frequency rTMS is typically applied to the left dorsolateral prefrontal cortex (DLPFC) to treat depression by increasing activity in that region.

Question 5

When using the PHQ-9 to screen for depression, what score indicates moderately severe depression?

Accepted Answer

15–19

Answer

PHQ-9 scores of 15–19 correspond to moderately severe depression; scores of 20–27 indicate severe depression.

(MRCPsych) Member of the Royal College of Psychiatrists Practice Test

(MRCPsych) Member of the Royal College of Psychiatrists Practice Test

MRCPsych Clinical Procedures and Protocols 3