RANZCP MCQ Exam key terms

An acute, fluctuating disturbance of attention and awareness, usually caused by a medical condition, medication, or withdrawal, with altered cognition not better explained by a pre-existing dementia.

A syndrome of abnormal movement and behaviour, such as stupor, mutism, posturing, waxy flexibility, or excitement, occurring in psychotic, mood, and medical disorders and often responding to benzodiazepines or ECT.

Disruption in the form or flow of thinking, evident in speech that is derailed, tangential, incoherent, or pressured, most classically associated with schizophrenia and mania.

Schneiderian phenomena such as audible thoughts, voices arguing or commenting, thought insertion or withdrawal, made feelings and impulses, and delusional perception, historically regarded as strongly suggestive of schizophrenia.

Structured assessment of the form of speech and thinking, for example using the Thought and Language Index, distinguishing positive features such as derailment from negative features such as poverty of speech.

A state of impaired reality testing marked by hallucinations, delusions, or disorganised thinking, with reduced insight, arising from primary psychiatric illness, substances, or medical causes.

A person's awareness of having an illness, of its nature and cause, and of the need for treatment; poor insight predicts non-adherence and is common in psychotic disorders.

Valid consent requires information, voluntariness, and decision-making capacity: the ability to understand, retain, weigh, and communicate a decision about the specific proposed treatment.

A potentially fatal toxidrome of autonomic instability, neuromuscular hyperactivity such as clonus and hyperreflexia, and altered mental state, caused by serotonergic excess, often from drug combinations.

A rare idiosyncratic reaction to dopamine antagonists featuring rigidity, hyperthermia, autonomic instability, and altered consciousness, with raised creatine kinase, requiring drug cessation and supportive care.

The heart-rate-corrected QT interval on ECG; prolongation above roughly 450–500 ms raises the risk of torsades de pointes, relevant to antipsychotics, some antidepressants, and methadone.

Mandatory regular full blood counts for agranulocytosis risk, plus checks of troponin, weight, glucose, and lipids, with dose titration and caution regarding constipation and myocarditis.

Schizophrenia with persistent, clinically significant symptoms despite adequate trials of at least two different antipsychotics at therapeutic doses for sufficient duration, typically prompting a clozapine trial.

A controlled general-anaesthetic procedure delivering brief electrical stimulation to induce a seizure, used for severe depression, catatonia, and other acute conditions, with cognitive side effects as the main limitation.

Clinical features such as tremor, ataxia, confusion, vomiting, and seizures when serum lithium rises, commonly triggered by dehydration, renal impairment, or interacting drugs; management includes dialysis in severe cases.

The collaborative emotional bond and agreement on goals and tasks between clinician and patient, consistently predictive of psychotherapy outcome across modalities.

The displacement onto the clinician of feelings, expectations, and relational patterns originally linked to significant figures from the patient's past, used as clinical material in psychodynamic work.

The clinician's emotional responses to the patient, which may reflect the patient's relational impact or the clinician's own unresolved conflicts and can inform or distort treatment.

The capacity to understand one's own and others' behaviour in terms of underlying mental states, which is impaired under stress and is a target of mentalization-based treatment for borderline personality disorder.

A cognitive therapy technique that identifies and tests the evidence for and against unhelpful automatic thoughts and beliefs, then develops balanced alternatives.

Systematic, repeated, and prolonged confrontation with feared stimuli without avoidance, allowing anxiety to habituate or inhibitory learning to occur; a first-line treatment for anxiety disorders and OCD.

A persistent pattern of inattention and/or hyperactivity-impulsivity, present before age twelve and causing impairment across settings, treated with behavioural strategies and stimulant or non-stimulant medication.

A repetitive pattern of behaviour violating others' rights or major age-appropriate norms, such as aggression, theft, and rule-breaking, with high overlap with callous-unemotional traits and later antisocial personality disorder.

Developmentally inappropriate, persistent distress about separation from attachment figures, with worry about harm befalling them, refusal of school or sleepovers, and physical symptoms.

Acute worsening of attention and awareness in a person with established cognitive impairment; recognition requires knowing baseline function and is often missed in older inpatients.

Non-cognitive features such as agitation, psychosis, apathy, and sleep disturbance in dementia, managed first with environmental and psychosocial measures, reserving medication for severe or dangerous symptoms.

The defendant's present ability to understand the charges and proceedings and to instruct counsel; unfitness is usually temporary and addressed through treatment or diversion rather than a verdict on guilt.

A verdict that the accused committed the act but was, at the time, suffering a mental impairment depriving them of the capacity to know the nature of the act or that it was wrong, leading to supervision rather than punishment.

Structured estimation of the likelihood and nature of future harm, combining actuarial tools with clinical judgement and dynamic factors, and linked to management planning rather than prediction alone.

A time-limited syndrome after cessation or reduction of heavy alcohol use, ranging from tremor and anxiety to seizures and delirium tremens, managed with benzodiazepines, thiamine, and supportive care.

A thiamine-deficiency emergency causing ophthalmoplegia, ataxia, and confusion, common in alcohol use disorder and malnutrition; untreated it can progress to Korsakoff syndrome.

Prescribing a long-acting opioid agonist such as methadone or buprenorphine to reduce illicit use, craving, and overdose risk, with supervised dosing and psychosocial support.

The proposal that positive psychotic symptoms arise from excessive mesolimbic dopamine transmission, supported by antipsychotic potency and stimulant effects, though it does not fully explain negative and cognitive symptoms.

The endocrine stress system in which hypothalamic corticotropin-releasing hormone drives pituitary ACTH and adrenal cortisol release, implicated in mood and anxiety disorders and in cognitive effects of chronic stress.

The brain's capacity to modify synaptic connections and structure in response to experience, learning, injury, and treatment, underpinning recovery and the effects of psychotherapy.