MRCPsych: Passing the CASC Exam, Second Edition

531 Pages·2017·14.521 MB·English

by  Babu Sandilyan, Malarvizhi, Sauer, Justin

MRCPsych:

Passing the CASC Exam
SECOND EDITION

MRCPsych:

Passing the CASC Exam
SECOND EDITION
Edited by

Justin Sauer
Maudsley Hospital, London, UK
Malarvizhi Babu Sandilyan
Prospect Park Hospital, Reading, UK
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Library of Congress Cataloging‑in‑Publication Data
Names: Sauer, Justin, editor. | Babu Sandilyan, Malarvizhi, editor.
Title: MRCPsych : passing the CASC exam / [edited by] Justin Sauer and
Malarvizhi Babu Sandilyan.
Description: Second edition. | Boca Raton : Taylor & Francis, 2017. |
Includes bibliographical references and index.
Identifiers: LCCN 2016019550 | ISBN 9781498722186 (alk. paper)
Subjects: | MESH: Psychiatry | Mental Disorders | Examination Questions
Classification: LCC RC457 | NLM WM 18.2 | DDC 616.890076--dc23
LC record available at https://lccn.loc.gov/2016019550
Visit the Taylor & Francis Web site at
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Contents
Preface xi
Acknowledgements xiii
Editors xv
Contributors xvii
Exam guidance xix
1 Old age psychiatry Oliver Bashford 1
Linked stations 1
Station 1(a): Treatment-resistant depression 1
Station 1(b): ECT 5
Station 2(a): Memory loss 8
Station 2(b): Frontal/temporal/parietal lobes 13
Single stations 17
Station 3: Wandering 17
Station 4: Testamentary capacity 21
Station 5: Cognitive assessment 23
Station 6: Behavioural and psychological symptoms of dementia 26
Station 7: Psychotic depression in the elderly 29
Station 8: Lewy body dementia 32
2 Anxiety disorders Priyadarshini Natarajan 37
Linked stations 37
Station 1(a): Somatisation disorder 37
Station 1(b): Discuss diagnosis and management with the patient 40
Station 2(a): Generalised anxiety disorder 43
Station 2(b): Generalised anxiety disorder – Aetiology 46
Single stations 49
Station 3: Phobia 49
Station 4: Obsessive compulsive disorder 51
3 Child and adolescent psychiatry Matthew Fernando and Dennis Ougrin 57
Linked stations 57
Station 1(a): School refusal 57
Station 1(b): Explaining a diagnosis 60
Station 2(a): Mood disturbance 63
Station 2(b): Explaining treatment and prognosis 67
Station 3(a): Suicidality 71
Station 3(b): Engaging a parent 76
Station 4(a): Self-harm 79
Station 4(b): Addressing bullying 83
Single stations 85
Station 5: Learning disability 85
Station 6: Autism spectrum disorder 90
Station 7: Medically unexplained symptoms 93
Station 8: Attention deficit hyperactivity disorder 97
Station 9: Fire-setting/abuse 102
vi Contents
4 Eating disorders Thomas Gilberthorpe 107
Linked stations 107
Station 1(a): Anorexia nervosa – History taking 107
Station 1(b): Communication with a professional colleague 110
Single stations 114
Station 2: Anorexia nervosa – Dietary and weight history in a first
presentation 114
Station 3: Bulimia nervosa – Communication and explanation to a relative 117
5 Addiction disorders Mark Parry 123
Linked stations 123
Station 1(a): Opioid dependence 123
Station 1(b): Discussion with probation officer 126
Station 2(a): Physical examination of drug intoxication/withdrawal state 128
Station 2(b): Discussion with consultant 131
Station 3(a): Cannabis and schizophrenia – Discussion with family 133
Station 3(b): Cannabis and schizophrenia 136
Single stations 139
Station 4: Alcohol dependence – History taking 139
Station 5: Alcohol dependence – Management 143
Station 6: Benzodiazepine misuse 146
Station 7: Motivational interviewing 150
Station 8: Substance misuse – Management in pregnancy 153
Station 9: Substance misuse history and managing withdrawal 156
6 Forensic psychiatry Marc Lyall 161
Linked stations 161
Station 1(a): Self-harm in custody 161
Station 1(b): Discussion with police officer 164
Station 2(a): Duty to warn 166
Station 2(b): Discussion with relative 169
Station 3(a): Prison assessment 171
Station 3(b): Discussion with consultant 174
Station 4(a): Schizophrenia and violence 176
Station 4(b): Discussion with colleague 179
Station 5(a): Erotomania 181
Station 5(b): Discussion with colleague 183
Single stations 185
Station 6: Arson 185
Station 7: Dissocial personality disorder 188
Station 8: Morbid jealousy 191
Station 9: Indecent exposure 194
7 Learning disability psychiatry Sharada Deepak 199
Linked stations 199
Station 1(a): Behavioural change – History taking 199
Station 1(b): Behavioural change – Discussion 202
Single stations 204
Station 2: Learning disability and capacity to consent 204
Station 3: Behavioural disturbance in LD 207
Station 4: Fragile X syndrome 210
Contents vii
8 Liaison psychiatry Babu Mani 215
Linked stations 215
Station 1(a): Psychiatric lupus 215
Station 1(b): SLE – Discussion with rheumatologist 217
Station 2(a): Capacity to consent 220
Station 2(b): Discussion with relative 223
Station 3(a): Conversion disorder – History taking 225
Station 3(b): Conversion disorder – Explanation 229
Station 4(a): Alcohol withdrawal – Collateral history 231
Station 4(b): Alcohol withdrawal – Management 235
Single stations 238
Station 5: Delirium – History taking 238
Station 6: Adjustment disorder 241
Station 7: Korsakoff syndrome – Explanation 244
Station 8: Neuroleptic malignant syndrome 248
9 General adult psychiatry David Okai 253
Linked stations 253
Station 1(a): Bipolar affective disorder – Type II 253
Station 1(b): Bipolar affective disorder – Discussion with consultant 256
Station 2(a): Depression 259
Station 2(b): Depression – Discussion with colleague 262
Station 3(a): First onset psychosis 264
Station 3(b): First onset psychosis – Discussion with relative 267
Station 4(a): Rapid tranquilisation 270
Station 4(b): Rapid tranquilisation – Discussion with nurse 273
Single stations 276
Station 5: SSRI discontinuation syndrome 276
Station 6: Treatment-resistant schizophrenia 278
Station 7: Post-traumatic stress disorder 281
10 Neuropsychiatry Derek Tracy 285
Linked stations 285
Station 1(a): Assessment of a head injury 285
Station 1(b): Testing of a head injury 288
Station 2(a): Assessment of non-epileptic seizures 292
Station 2(b): Discussing non-epileptic seizures with a relative 295
Station 3(a): Unusual behaviour in Parkinson’s disease 298
Station 3(b): Discussing unusual behaviour in Parkinson’s disease
with a relative 301
Single stations 305
Station 4: Assessment of temporal lobe epilepsy 305
Station 5: Explanation of the neuropsychiatry of a glioma 309
Station 6: Medically unexplained symptoms 312
Station 7: Low mood in multiple sclerosis 316
11 Personality disorder Pranathi Ramachandra 321
Linked stations 321
Station 1(a): Borderline personality disorder – Assessment 321
Station 1(b): Borderline personality disorder – Management 325
viii Contents
Single stations 328
Station 2: Paranoid personality disorder 328
Station 3: Personality assessment 331
12 Perinatal psychiatry Ruaidhri McCormack 337
Linked stations 337
Station 1(a): Postnatal depression 337
Station 1(b): Discussion with partner 340
Station 2(a): Puerperal psychosis 344
Station 2(b): Discussing the management plan with a professional
colleague 348
Single stations 351
Station 3: Bipolar disorder and pregnancy 351
Station 4: Baby blues 355
Station 5: Methadone in pregnancy 357
13 Psychotherapy Dinesh Sinha 361
Linked stations 361
Station 1(a): Psychotherapeutic techniques in patient management 361
Station 1(b): Assessment for psychodynamic psychotherapy 364
Station 2(a): CBT first session 367
Station 2(b): Behavioural experiment in CBT 369
Station 3(a): Overdose in accident and emergency 372
Station 3(b): Borderline personality disorder 374
Single stations 377
Station 4: Post-traumatic stress disorder – Treatment options 377
Station 5: Psychodynamic psychotherapy 380
Station 6: Managing anger 383
Station 7: Psychodynamic interpretation 386
Station 8: Cognitive distortions 389
Station 9: Patient experiencing transference reaction in
psychodynamic therapy 391
14 Physical examinations Sangita Agarwal and Justin Sauer 395
General points for all physical examination stations 395
Station 1: Alcohol examination 395
Station 2: Eating disorder 398
Station 3: Extrapyramidal side effects 401
Station 4: Thyroid dysfunction 404
Station 5: Lower limbs 408
Station 6: Upper limbs 411
Station 7: Cranial nerves 414
Station 8: Cardiovascular system 417
Station 9: Eye examination 419
Station 10: Basic life support 422
15 Investigations and procedures Russell Foster 427
Single stations 427
Station 1: Advising IVDU on injection technique and risk minimisation 427
Station 2: Abnormal blood results in an alcoholic patient 432
Contents ix
Station 3: Physical examination and laboratory investigation
of eating disorders 435
Station 4: Basic electrocardiogram interpretation 439
Station 5: Initiation and monitoring of clozapine 443
Station 6: Interpreting thyroid function tests 446
Station 7: Interpretation of lithium levels 448
Station 8: Interpretation of laboratory results (metabolic syndrome) 452
Station 9: Diagnosis and management of neuroleptic malignant syndrome 455
Station 10: Diagnosis and management of serotonin syndrome 459
Station 11: Diagnosis and management of hyperprolactinaemia 463
16 Miscellaneous disorders James Main 467
Single stations 467
Station 1: Gender reassignment 467
Station 2: Grief reaction 471
Station 3: Selective serotonin reuptake inhibitors and sexual dysfunction 475
Station 4: Body dysmorphic disorder 479
Station 5: Seasonal affective disorder 483
Station 6: Urine drug screen 486
Station 7: Psychotic depression in an older adult 489
Index 495