ABSTRACT
Identify two factors, each linked to the following aspects of prognosis in schizophrenia:
1. No clearly established relation to prognosis 2. Short-term poor prognosis 3. Short-term good prognosis 4. Long-term poor prognosis 5. Long-term good prognosis
a. Action b. Awareness c. Contemplation d. Early intervention e. Maintenance f. Motivation g. Pre-contemplation h. Ready for action i. Relapse prevention j. Understanding
Identify the stages of behaviour change as per Prochaska and DiClemente:
1. Plans behaviour change, sets goals and assesses past successes and failures
2. Makes an initial attempt at modifying the problematic behaviour 3. Begins to realise that their behaviour has both costs and benefits and
they are beginning to feel “two ways” about their behaviour 4. The final stage in the process of change 5. Content with one’s behaviour and unlikely to express any need for
change
a. Augmentation with thyroid hormone b. Buspirone c. CBT d. ECT e. Lithium f. Lorazepam g. Reassurance and education h. Risperidone i. Sertraline j. Venlafaxine
Choose treatment options for the following clinical presentations:
1. A young woman with the first episode of depression of four weeks’ duration (3)
2. A middle-aged woman with moderately severe depression that did not respond to amitriptyline, but showed a partial response to fluoxetine. Laboratory investigations showed subclinical hypothyroidism (1)
3. A middle-aged man with a diagnosis of bipolar affective disorder presenting with a relapse of hypomania. He had stopped all his medication a year ago (2)
4. An elderly man with severe depression with somatic syndrome (3) 5. A 38-year-old man presenting one week after losing his job. He was
feeling low in mood, but is now starting to feel better as he has been getting other job offers (1)
a. CBT b. Consider feeding against will c. Diuretics d. Family therapy e. Gastric bypass f. Fluoxetine 60 mg g. Inpatient treatment h. Oestrogen i. Orlistat j. Tricyclic antidepressant
Choose the treatments for following cases:
1. A 20-year-old female with a body mass index (BMI) of 17.5 has a morbid fear of fatness and is restricting her diet. She has a transient low mood but no suicidal ideation. Her recent bone scan was normal. (1)
2. A 25-year-old woman with a past history of deliberate self-harm and substance misuse has become preoccupied with her weight. She indulges in episodes of uncontrolled excessive eating and then compensates for this by self-induced vomiting and use of laxatives. (2)
3. A 15-year-old girl with a BMI of 13 has been refusing food. She is now restricting her fluid intake as it makes her feel bloated. She has significant gastrointestinal and cardiac disturbance, potassium <2.5, and an abnormal bone scan. She is expressing suicidal intent. Her family is unsupportive. (4)
4. A 38-year-old man with high cholesterol and a BMI of 32 has reduced his weight by 5 kg in the past month by following his GP’s dietary and exercise advice. (1)
5. A 22-year-old overweight girl has chronic low self-esteem issues but is
a. Chlordiazepoxide b. Chlormethiazole c. Coronary artery disease d. Diabetes mellitus e. Intramuscular f. Intravenous g. Subtly lit h. Vitamin B6 i. Vitamin B12 j. Well-lit
Please find one option each that best fits the statements below:
1. Fewer adverse reactions are associated with thiamine given by this route
2. Nursing care in delirium tremens should be in this environment 3. Thiamine is also known as ___ 4. This is a contraindication to disulfiram 5. This drug can have a dangerous interaction with alcohol
a. Acamprosate b. Buprenorphine c. Chlordiazepoxide d. Disulfiram e. Lofexidine f. Methadone ampoules g. Methadone liquid h. Naloxone i. Naltrexone j. Urine drug screen
Select one first-line treatment for the following clinical scenarios:
1. A 45-year-old man with alcohol dependence, hypertension and ischemic heart disease, has completed an inpatient detoxification and is motivated to stay ‘dry’. He is requesting medication as an adjunct to counselling.
