RANZCP MCQ Exam flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

First-rank symptoms

Schneiderian phenomena including audible thoughts, voices arguing or commenting, thought insertion, withdrawal or broadcast, made feelings, impulses or acts, and somatic passivity. Suggestive of schizophrenia but not diagnostic.

Hypomania duration criterion

Elevated or irritable mood with increased energy lasting at least four consecutive days, with unequivocal change, no marked impairment, no psychosis, and no need for hospitalisation.

Serotonin syndrome features

Neuromuscular hyperactivity with clonus, hyperreflexia, agitation, and hyperthermia, usually after serotonergic drugs. Clonus distinguishes it from neuroleptic malignant syndrome.

Neuroleptic malignant syndrome

Life-threatening reaction to dopamine antagonists with lead-pipe rigidity, hyperthermia, autonomic instability, raised creatine kinase, and leukocytosis, developing over one to three days.

Overvalued idea

A solitary, understandable belief pursued with unusual intensity that is less fixed than a delusion and partially responsive to reasoning, often seen in personality disorder.

Four abilities of capacity

Appelbaum and Grisso's framework: communicating a choice, understanding relevant information, appreciating the situation and its consequences, and reasoning about treatment options.

Circumstantiality versus tangentiality

Circumstantiality is overly detailed speech that eventually reaches the goal, whereas tangentiality drifts away and never answers the original question.

MoCA versus MMSE

Both score to 30; the Montreal Cognitive Assessment is more sensitive to mild cognitive impairment and executive dysfunction, while the Mini-Mental State Examination is more influenced by education.

Clozapine monitoring requirements

Regular full blood counts for neutropenia, plus cardiac monitoring for myocarditis and cardiomyopathy, in patients with schizophrenia resistant to at least two other antipsychotics.

Lithium therapeutic range

Maintenance serum levels of 0.6 to 0.8 mmol/L, sampled twelve hours after the dose, with monitoring of renal, thyroid, and calcium status and interaction with diuretics and NSAIDs.

Tardive dyskinesia

Involuntary orofacial choreoathetoid movements appearing after prolonged dopamine antagonist exposure, treated with vesicular monoamine transporter 2 inhibitors such as valbenazine.

MAOI tyramine interaction

Tyramine-rich foods with monoamine oxidase inhibitors can cause hypertensive crisis; washout periods of about two weeks are needed, and five weeks after fluoxetine.

Exposure therapy mechanism

Graded, repeated, prolonged contact with a feared stimulus without safety behaviours, allowing habituation and corrective learning that anxiety does not lead to catastrophe.

Dialectical behaviour therapy modules

Linehan's skills modules are mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness, targeting self-harm and therapy-interfering behaviour first.

Transference and countertransference

Transference is the patient's displaced feelings toward the therapist; countertransference is the therapist's emotional response, useful as information about the therapeutic relationship.

Motivational interviewing stance

A collaborative, evocative, autonomy-supportive style that explores ambivalence using open questions, affirmations, reflections, and summaries rather than confrontation.

ADHD diagnostic thresholds

At least six inattentive or hyperactive-impulsive symptoms, or five if aged seventeen or older, onset before twelve, across two settings with impairment.

Tourette disorder criteria

Multiple motor tics plus at least one vocal tic persisting more than one year, with onset before age eighteen; coprolalia occurs in only a minority.

Refeeding syndrome

Potentially fatal electrolyte shift, especially hypophosphataemia, during reintroduction of nutrition in malnourished patients, requiring cautious caloric advancement and electrolyte monitoring.

Lewy body dementia sensitivity

Severe neuroleptic sensitivity with marked extrapyramidal reactions; core features include fluctuating cognition, visual hallucinations, parkinsonism, and REM sleep behaviour disorder.

Delirium core features

Acute onset with fluctuating course, inattention, and altered consciousness, usually caused by infection, medication, pain, or metabolic disturbance in vulnerable older patients.

Pseudodementia

Cognitive impairment accompanying depression in older adults that improves when the mood disorder is treated, mimicking dementia but with different onset and effort.

Acetylcholinesterase inhibitor indications

Donepezil, rivastigmine, and galantamine are used for mild to moderate Alzheimer disease; memantine, an NMDA antagonist, is used in moderate to severe disease.

Alcohol withdrawal timeline

Tremor and anxiety from about six to twelve hours, hallucinations at twelve to twenty-four, seizures at twelve to forty-eight, and delirium tremens at forty-eight to ninety-six hours.

Wernicke encephalopathy triad

Ophthalmoplegia, ataxia, and confusion caused by thiamine deficiency, treated promptly with parenteral thiamine to prevent Korsakoff syndrome and death.

Steroid-induced psychosis

Dose-related affective or mixed psychotic symptoms appearing within days to weeks of corticosteroid use, managed by dose reduction and antipsychotics if required.

M'Naghten rule

A defence requiring a defect of reason from disease of the mind such that the accused did not know the nature and quality of the act or that it was wrong.

Fitness to stand trial

Ability to understand the charges and proceedings, instruct counsel, follow evidence, and appreciate the significance of the hearing; distinct from criminal responsibility.

HCR-20 risk tool

Structured professional judgement instrument for violence risk covering historical, clinical, and risk-management domains, used to inform rather than replace clinical decisions.

Disulfiram contraindications

Avoid in cardiac disease, psychosis, and pregnancy; it deters drinking by inhibiting aldehyde dehydrogenase, causing flushing, nausea, and hypotension with alcohol.

Buprenorphine properties

A partial mu-opioid agonist with high affinity and a ceiling effect on respiratory depression, used for opioid substitution with lower overdose risk than methadone.

Korsakoff syndrome

Anterograde amnesia with confabulation following untreated thiamine deficiency, caused by damage to mammillary bodies and anterior thalamic nuclei.