Disturbed or Psychiatric Patients in the ED

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Question 1 of 10

1. Question
Which one of the following factors would favour hospital admission for psychiatric assessment and treatment?
- Living with friends
- Excess alcohol use
- First episode of psychosis
- High pressure job
- Co-existing depression and anxiety symptoms
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Question 2 of 10

2. Question
Which of the following should be a feature of the interview room for assessing a disturbed patient?
- One access point
- Door which opens inwardly
- Examination couch
- Secure locking mechanism
- Door with internal inspection window
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Question 3 of 10

3. Question
Which of the following makes an organic cause more likely?
- Below 25 years old
- Auditory hallucination
- Normal cognitive function
- Lethargy
- Obsessional behaviours
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Question 4 of 10

4. Question
What is the correct definition of delirium?
- Acute disorder of the mental processes accompanying organic disease
- Global impairment of brain functioning due to structural abnormality
- Alteration of mental state in which insight and contact with reality are lost
- Disorder of the mental processes associated with pyrexia
- Global impairment of brain functions with impairment of cognition and an insidious course
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Question 5 of 10

5. Question
Which of the following does NOT increase the risk of violence in a disturbed patient?⁶
- Diagnosis of schizophrenia
- Previous deliberate self-harm
- Male
- Unkempt appearance
- Intoxication
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Question 6 of 10

6. Question
Which of the following factors is associated with an increase in the risk of suicide?
- Male
- Aged between 25-40 years
- Depression
- Manual worker
- Living in a city
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Question 7 of 10

7. Question
Which one of the following is NOT a component of the abbreviated mental test (AMT) score?
- Recognition of two people
- Orientation to time
- Serial subtraction of 7 from 100
- Date of birth
- Date of WWI
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Question 8 of 10

8. Question
Which of the following would be the most appropriate investigation in the emergency department (ED) for a suspected organic cause of confusion?
- Bedside BM stick glucose
- Random cortisol
- Vitamin B6
- Free T3
- Serum bilirubin
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Question 9 of 10

9. Question
Which one of the following is NOT a component of the mental state examination?
- Pattern of speech
- Appearance
- Identification of obsessional thoughts
- Cranial nerve examination
- Suicidal intent
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Question 10 of 10

10. Question
A 33-year-old male comes to the department in an intoxicated state. He reports suicidal ideation and has taken an overdose of paracetamol. He lives alone and is unemployed. He regularly drinks 2 litres of cider a day. Paracetamol levels come back as below the treatment line at 4 hours.

How would you manage this patient?
- Admit to psychiatric unit for assessment
- Admit to medics for in-patient alcohol detoxification
- Discharge for GP follow up
- Observe until sober and re-assess
- Admit to medics for observation and follow up bloods
Correct

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Disturbed or Psychiatric Patients in the ED – Post Test

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