Mental health quiz – The Emergency Medicine Manual

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Mental health

This is a 10 question quiz about Mental health.

The questions are randomly drawn from a bank of 25 questions so will be different each time you take it.

1 / 10

1. The most common differential diagnosis of schizophrenia in Australia is

a) Serotonin syndrome

b) Temporal lobe epilepsy

c) Limbic encephalitis

d) Drug induced psychosis

The most common differential diagnosis for Schizophrenia in Australia is drug induced psychosis (metamphetamine +/- THC induced particularly). The other listed causes are far less common and serotonin syndrome tends to present with anxiety and agitation rather than psychosis.

The most common differential diagnosis for Schizophrenia in Australia is drug induced psychosis (metamphetamine +/- THC induced particularly). The other listed causes are far less common and serotonin syndrome tends to present with anxiety and agitation rather than psychosis.

2 / 10

2. Which one of the following questions would be the most appropriate for assessing negative symptoms in a patient with schizophrenia?

a) Have you ever thought about hurting yourself or someone else?

b) Have the voices you’ve heard persisted or returned?

c) Have you had difficulty concentrating?

d) How often have you visited your friends in the past week?

How often have you visited with friends in the past week? is the most useful as an important component of negative symptoms is reduced social drive.
Asking about suicidality is helpful for a risk assessment, but suicidality is not considered a 'negative' symptom in Schizophrenia.

How often have you visited with friends in the past week? is the most useful as an important component of negative symptoms is reduced social drive.
Asking about suicidality is helpful for a risk assessment, but suicidality is not considered a 'negative' symptom in Schizophrenia.

3 / 10

3. Which one of the following actions is most likely to escalate a potentially violent patient.

a) An explanation of the rules of expected behaviour

b) Stating that you are concerned about your safety

c) Offering them choices of what will happen

d) Validate the patient's feelings of anger

An explanation of the rules of expected behaviour is most likely to escalate the situation, as it will likely be perceived as a challenge. The other actions are most likely to de-escalate it.

An explanation of the rules of expected behaviour is most likely to escalate the situation, as it will likely be perceived as a challenge. The other actions are most likely to de-escalate it.

4 / 10

4. Which one of the following would be most appropriate when attempting to de-escalate an agitated patient.

a) Put your arm on their shoulder as a gesture of kindness

b) Be informal to help ease tension

c) Ask them why they are behaving this way

d) Have a single staff member talk with the patient

Have a single staff member talk with the patient is the most appropriate action of those listed. Touching the patient may lead to a violent reaction, a formal approach (to convey respect) is usually preferred over a casual one, and asking the patient why they are behaving as they is usually perceived as a challenge and is likely to lead to further escalation.

Have a single staff member talk with the patient is the most appropriate action of those listed. Touching the patient may lead to a violent reaction, a formal approach (to convey respect) is usually preferred over a casual one, and asking the patient why they are behaving as they is usually perceived as a challenge and is likely to lead to further escalation.

5 / 10

5. SSRI use in pregnancy is

a) Associated with an increased risk of cardiovascular malformations

b) Associated with an increased risk of autism spectrum disorder.

c) Not associated with a significant risk of congenital disorders.

d) Associated with an increased risk of pulmonary hypertension.

SSRI use in pregnancy is not associated with a significant increased risk of congenital abnormalities.

SSRI use in pregnancy is not associated with a significant increased risk of congenital abnormalities.

6 / 10

6. The benefits of ECT are usually maximal at

a) 1 week following treatment

b) 6 months following treatment

c) 3 months following treatment

d) 3 weeks following treatment

The benefits of ECT are usually maximal at 3 weeks after treatment.

The benefits of ECT are usually maximal at 3 weeks after treatment.

7 / 10

7. Thought blocking in drug induced psychosis is

a) Common

b) Very common

c) Uncommon

d) Rare

Thought blocking in drug induced psychosis is rare, unlike Schizophrenia.

Thought blocking in drug induced psychosis is rare, unlike Schizophrenia.

8 / 10

8. Which one of the following is not consistent with a diagnosis of post traumatic stress disorder?

a) Symptoms present for 2 weeks

b) Memory loss

c) Hypervigilance

d) Disturbed sleep

The diagnosis of PTSD requires symptoms to be present for > 1 month. Symptoms include: re-experience of the trauma; recurrent intrusive recollections; recurrent dreams and nightmares; acting out or feeling as if the traumatic event were recurring; social numbness or withdrawal; hyper alertness or hyperactive startle reaction; sleep disorders; guilt; memory impairment.

The diagnosis of PTSD requires symptoms to be present for > 1 month. Symptoms include: re-experience of the trauma; recurrent intrusive recollections; recurrent dreams and nightmares; acting out or feeling as if the traumatic event were recurring; social numbness or withdrawal; hyper alertness or hyperactive startle reaction; sleep disorders; guilt; memory impairment.

9 / 10

9. Which of the following symptoms would make you most likely to seek an alternative diagnosis in a patient labelled as having a panic attack

a) Constant abdominal pain

b) Light headedness

c) Difficulty swallowing

d) Nausea

The most common symptoms of panic attacks are lightheadedness, paraesthesia, chest tightness, sensation of palpitations, difficulty breathing and choking/difficulty swallowing. Less common symptoms include flushes or sensation of chills, nausea or abdominal distress. True abdominal pain is very uncommon and not usually constant, so should initiate a search for an alternative cause.

The most common symptoms of panic attacks are lightheadedness, paraesthesia, chest tightness, sensation of palpitations, difficulty breathing and choking/difficulty swallowing. Less common symptoms include flushes or sensation of chills, nausea or abdominal distress. True abdominal pain is very uncommon and not usually constant, so should initiate a search for an alternative cause.

10 / 10

10. Which one of the following would be expected to be the earliest indicator that a person is about to be violent.

a) Difficulty holding a conversation

b) Intusion into personal space

c) Pacing and agitation

d) Personal threats

Difficulty holding a conversation is usually the earliest feature of those listed indicating that violence may occur - however these features can vary in sequence.

Difficulty holding a conversation is usually the earliest feature of those listed indicating that violence may occur - however these features can vary in sequence.

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The average score is 63%
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