MRCPsych Patient Assessment and Evaluation 3

Question 1

A patient describes episodes of feeling detached from their surroundings as if watching the world through a glass wall. This is best classified as:

Accepted Answer

Derealization

Answer

Derealization refers to the subjective experience of the external world feeling unreal, dreamlike, or distant, while the sense of self remains intact.

Question 2

In assessing a patient with suspected alcohol use disorder, the CAGE questionnaire scores 2/4. The most appropriate next step is:

Accepted Answer

Conduct a full alcohol use history and further clinical assessment

Answer

A CAGE score of 2 or more is clinically significant and warrants a comprehensive alcohol use assessment including quantity, frequency, dependence features, and complications.

Question 3

Which of the following best describes 'circumstantiality' in the assessment of thought form?

Accepted Answer

Reaching the goal of speech only after excessive, unnecessary detail

Answer

Circumstantial speech reaches the final point but only after lengthy, over-inclusive, and tangential digressions, unlike tangential speech which never returns to the point.

Question 4

A clinician rates a patient's affect as 'blunted.' What does this specifically describe?

Accepted Answer

Reduced intensity and range of emotional expression

Answer

Blunted affect describes a significant reduction in the intensity of emotional expression, distinct from flat affect (complete absence) and labile affect (rapid shifts).

Question 5

The Mini-Mental State Examination (MMSE) has which significant limitation when used as a sole cognitive screening tool?

Accepted Answer

It has poor sensitivity for frontal lobe and executive dysfunction

Answer

The MMSE primarily assesses language, memory, and orientation, and is relatively insensitive to frontal-executive deficits, making the MoCA or additional frontal tests necessary for comprehensive screening.

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

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

MRCPsych Patient Assessment and Evaluation 3