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A. 25 years old male, presents in the emergency after a recent suicidal attempt- according
to the family he has recently lost his job, is socially withdrawn, and his appetite is
decreased and he is smoking excessively.
Key:
1. Depressive disorder
2. Acute stress disorder
3. Substance abuse disorder
B. What particular area a would you to focus while assessing the patient.
Key:
C. Patient confide in you that he is still suicidal and has access to means. He requests you
to not share the information with the family. How will you respond.
Key:
Let the patient know that though you respect his right of confidentiality – In this
particular situation you are ethically bound to show to show the information with all
concerned.
A 69 years old man presents with psychomotor retardation, tremors, low mood and
failing memory which three condition come to your mind?
1. Parkinsonism
2. Depression
3. Dementia
What are the changes in brain chemistry in old age related to illness in old age.
1. ↑Acetylcholineastrase {Dementia}
2. ↑ Cholin acetyltranserase
3. ↑Monoumie oxidase {Depression}
You have been asked to write the standing instructions on admission of psychiatric
patients in a long- stay mental health facility
1. What are the grounds on which you will choose to advise admission of a patient
in a high security unit?
Key:
1.
• The predictors of a high risk of threat to others and violence potential include:
• Past history of violence/aggression
• Convictions for violent crimes
• Psychopathy, Impulsivity, Borderline personality disorder
• Male gender
• Younger age
• A diagnosis of psychosis with command auditory hallucinations with accusatory
content
• Paranoid schizophrenia
• History of alcoholism and drug abuse
• An articulated plan to harm others
Research Methodology
Key:
Ethics
A patient of paranoid schizophrenia Has shored with you that he plans to execute his
brother in law.
He has stopped you from sharing this information with anybody.
Key: Confidentiality
A 30 year old man who has 10 year History of Bipolar Disorder, and has maintained a
stable mood for one year has been brought to emergency room with a one week history
of insomnia, agitation, excessive pressured speech and paranoid persecutory delusions.
What are the possible factors which may have contributed to relapse of his illness.
Key;
Discontinuation of mood stabilizer
Acute severe stressor
Use of alcohol/ cannabis/ amphetamines
Concomitant use of antidepressant
Recent Advances
Family of 65 years old man suffering from dementia consult your regarding availability
of latest drugs for dementia. What would be your reply?
Key:
Galentamaine
Rivostigmine
Donepzil
Key:
Key:
Memantine
Community Psychiatry
You have been appointed in the health ministry as an advise while planning a community
mental health services for a semi urban community of10,000 population. What are the
various aspects you would consider?
Key: Complete demographic data with details of socio economic relation, gender, age
distribution
What services/ facilities are already available.
Needs assessment with the help of elders of the community and by doing focus groups
with different groups in the community e.g. women, adolescents, workers etc.
Planning appropriate preventive and treatment facilities which are cost effective,
acceptable and accessible to the whole population.
Liaison with existing facilities e.g schools health centers where possible, arranging for
training.
Communication Skills
Removal of misconceptions
Removal of weaknesses/ deficiency in our health care.
Introduction of well integrated mental health program
Public awareness and education program
Proper training of doctors at undergraduate and postgraduate level.
Training of GPs
Involvement of Government and non Government organization.
Use of Media for education of community regarding mental health.
45 years old man getting treatment from psychiatrist for Paranoid Schizophrenia is
arrested for first degree murder.
Key