Best of Five MCQs for MRCPsych Paper 1 This page intentionally left blank Best of Five MCQs for MRCPsych Paper 1

Best of Five MCQs for MRCPsych Paper 1 This page intentionally left blank Best of Five MCQs for MRCPsych Paper 1 Lena Palaniyappan Academic Clinical Fellow, Institute of Neurosciences, Newcastle University and Specialty Registrar, Division of Psychiatry, Royal Victoria Infi rmary, Newcastle, UK Rajeev Krishnadas Clinical Lecturer, Sackler Institute of Psychobiological Research, University of Glasgow, Glasgow, UK 1 1 Great Clarendon Street, Oxford OX2 6DP Oxford University Press is a department of the University of Oxford. It furthers the University’s objective of excellence in research, scholarship, and education by publishing worldwide in Oxford New York Auckland Cape Town Dar es Salaam Hong Kong Karachi Kuala Lumpur Madrid Melbourne Mexico City Nairobi New Delhi Shanghai Taipei Toronto With offi ces in Argentina Austria Brazil Chile Czech Republic France Greece Guatemala Hungary Italy Japan Poland Portugal Singapore South Korea Switzerland Thailand Turkey Ukraine Vietnam Oxford is a registered trade mark of Oxford University Press in the UK and in certain other countries Published in the United States by Oxford University Press Inc., New York © Oxford University Press, 2009 The moral rights of the author have been asserted Database right Oxford University Press (maker) First published 2009 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, without the prior permission in writing of Oxford University Press, or as expressly permitted by law, or under terms agreed with the appropriate reprographics rights organization. Enquiries concerning reproduction outside the scope of the above should be sent to the Rights Department, Oxford University Press, at the address above You must not circulate this book in any other binding or cover and you must impose this same condition on any acquirer British Library Cataloguing in Publication Data Data available Library of Congress Cataloguing in Publication Data Data available Typeset by Cepha Imaging Private Ltd., Bangalore, India Printed in China on acid-free paper by Ashford Colour Press ISBN 978–0–19––7 10 9 8 7 6 5 4 3 2 1 Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up to date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work. FOREWORD I am delighted and honoured to be asked to write a foreword for this excellent book. The authors are to be commended in producing an excellent series of relevant MCQ questions. These will form about 70% of Papers I to III in the revised MRCPsych examination. Many trainees have diffi culties with this kind of question – particularly with the harder ones which will only increase in frequency as the examiners struggle to make up new questions with each diet! The MCQs in this volume have the characteristics of being both fair and stretching. Comprehensive and clear answers to these questions with references from easily available, standard text books are included. The whole of the prescribed MRCPsych syllabus has been covered in these questions and answers. The best answer to many questions like this is ‘I’ll look it up’, but this is not a recourse that one can use in exams and this book should help considerably in passing them. Professor Nicol Ferrier Newcastle University ACKNOWLEDGEMENT This work began with an idea of a producing revision aids for new MRCPsych exams. A number of people helped us to conceive, nurture and develop this idea, and transform it to its current physical form. We are thankful to all those who have taught us and supervised us over the years, imparting curiosity to learn, and to teach psychiatry. Dr Thambirajah provided the much needed dopamine to our brains’ reward areas! In addition he reviewed a few chapters in this series. We are deeply indebted to our other reviewers Dr David Christmas, Dr Niraj Ahuja and Dr Ranjit Krishnadas. A special thanks to Prof Ferrier for writing the foreword. Chris Reid, Jo Hardern & Fiona Goodgame from OUP deserve special mention for their patience and perseverance. Heartfelt thanks to Priya and Sindhu; we could not have seen this book as it is now but for their sacrifi ce of many relaxing evenings and leisurely weekends! This page intentionally left blank CONTENTS Introduction 1 1 Clinical skills Questions 7 Answers 23 2 Core clinical psychiatry Questions 39 Answers 59 3 Psychopathology Questions 79 Answers 95 4 Psychology Questions 113 Answers 127 5 Psychopharmacology Questions 147 Answers 159 6 History, social psychiatry, and ethics Questions 171 Answers 183 Index 193 This page intentionally left blank MRCPsych exams are the most important exams a psychiatry trainee in the UK will sit during his or her career. Passing the MRCPsych is the most visible of the criteria that demonstrate the achievement of a number of competencies during the training. Since spring 2008, there has been a signifi cant change in the pattern of the exam. The structure, syllabus, and the format of questions have changed signifi cantly. WHO CAN SIT THE EXAM? The details are clearly given in the Royal College website. They are summarized below for quick reference. Please note that these are subject to change and so we recommend checking with information at before you apply. Training requirements1 The college has brought out new exam regulations that are to come into effect from January 2009. Candidates must have completed the mandatory training period of 12 months of post foundation training in psychiatry by the date of sitting the written exams. Posts must be part of a programme of training approved by PMETB OR recognised by the Hospital or Trusts as having specifi c time, programme (journal clubs, grand rounds, teaching, supervision, etc.) and funds allocated for training. Individual posts can be of either 4 or 6 months duration. It could be a 12 month post in adult psychiatry OR a 6 month post in old age psychiatry and a 6 month post of adult psychiatry OR a combination of 4 month posts in adult or old age psychiatry but with a minimum of 6 months in adult psychiatry. Although the college has taken out the time limit beyond 12 months up to when a person can take the exam, they still recommend certain time frames when these exams can be taken ideally. For paper 1, it is 12-18 months, for paper 2, 18-24 months and for paper 3, it is 18-30 months. Paper 1 and 2 are passed permanently, but the results of paper 3 can be banked only for 635 days. Because the practical exam (CASC) can be sat only after 30 months (even if you pass all the theory exams in 12 months), it would make sense to delay taking the paper 3 after fulfi lling the 30 month requirement for CASC. A person can sit the written exam any number of times.