MRCPsych Clinical Procedures and Protocols 4

Question 1

A patient on long-term lithium therapy develops polyuria and polydipsia. Which investigation should be prioritised?

Accepted Answer

Urine osmolality after water deprivation

Answer

Lithium can cause nephrogenic diabetes insipidus, and a water deprivation test with measurement of urine osmolality confirms the diagnosis.

Question 2

Which of the following is a contraindication to the use of ECT?

Accepted Answer

Raised intracranial pressure

Answer

Raised intracranial pressure is a major contraindication to ECT because the procedure increases cerebral blood flow and intracranial pressure transiently.

Question 3

A 28-year-old with schizophrenia is prescribed depot antipsychotic medication. What is the primary clinical advantage of depot over oral medication in this context?

Accepted Answer

Improved adherence

Answer

Depot antipsychotics bypass first-pass metabolism and covert non-adherence, making them the preferred option for patients with a history of poor oral adherence.

Question 4

Under Section 136 of the Mental Health Act 1983, where can a police officer remove a person believed to have a mental disorder?

Accepted Answer

From a public place only

Answer

Section 136 applies only to public places; following the 2017 amendment, police can no longer use Section 136 to remove someone from a private dwelling.

Question 5

When assessing a patient using the Mini-Mental State Examination (MMSE), which cognitive domain is assessed by asking the patient to copy intersecting pentagons?

Accepted Answer

Visuospatial ability

Answer

The intersecting pentagons drawing task in the MMSE assesses visuospatial construction ability.

(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 4