Anki

Question 1

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Answer 1

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Question 2

Definition of schizophrenia

Answer 2

Chronic psychiatric disorder with ≥6 months of psychotic symptoms + functional decline

Question 3

DSM-5 diagnostic criteria for schizophrenia

Answer 3

≥2 symptoms (≥1 must be delusions, hallucinations, or disorganized speech) for ≥6 months

Question 4

First-rank Schneider symptoms in schizophrenia

Answer 4

Thought insertion, thought withdrawal, thought broadcasting, 3rd person commentary voices

Question 5

Definition of schizoaffective disorder

Answer 5

Psychotic disorder with features of both schizophrenia and mood disorder, with ≥2 weeks of psychosis without mood symptoms

Question 6

Difference between schizophrenia, bipolar with psychosis, and schizoaffective disorder

Answer 6

• Schizophrenia = Psychosis dominates, mood symptoms not pervasive
• Bipolar with psychosis = Psychosis only during mood episodes
• Schizoaffective = Both present, with ≥2 weeks of psychosis without mood symptoms

Question 7

Mnemonic for manic symptoms in bipolar disorder

Answer 7

DIGFAST – Distractibility, Indiscretion, Grandiosity, Flight of ideas, Activity ↑, Sleep ↓, Talkative

Question 8

Gold standard maintenance treatment for bipolar disorder

Answer 8

Lithium

Question 9

DSM-5 diagnostic criteria for major depressive disorder

Answer 9

≥5 symptoms for ≥2 weeks, one must be depressed mood or anhedonia

Question 10

Most important risk in MDD to always assess

Answer 10

Suicidal ideation, intent, plan, and means

Question 11

Core features of borderline personality disorder

Answer 11

Instability of affect, relationships, self-image, and impulse control

Question 12

Definition of OCD

Answer 12

Disorder of intrusive thoughts (obsessions) and repetitive behaviors (compulsions)

Question 13

First-line pharmacological treatment for OCD

Answer 13

High-dose SSRIs

Question 14

How to differentiate dementia from delirium

Answer 14

Delirium = acute onset, fluctuating consciousness, reversible cause; Dementia = insidious, progressive, not reversible

Question 15

Most important factors to assess in suicidal ideation

Answer 15

Ideation, intent, plan, means, and protective factors

Question 16

Most common causes of acute psychosis in Singapore ED

Answer 16

First-episode schizophrenia, mania, substance-induced psychosis (esp. methamphetamine, cannabis)

Question 17

Stepwise management of violent/aggressive psychiatric patient

Answer 17

De-escalation → Physical restraint (if needed) → IM antipsychotics/benzodiazepines

Question 18

Most common cause of drug-induced psychosis in Singapore

Answer 18

Methamphetamine

Question 19

Definition of adjustment disorder

Answer 19

Emotional/behavioral symptoms within 3 months of a stressor, not meeting criteria for another disorder

Question 20

Key clinical feature distinguishing delirium from dementia

Answer 20

Fluctuating consciousness and inattention

Question 21

OSCE: What 3 key suicide risk questions must you always ask on call?

Answer 21

Do you have thoughts of harming yourself? Do you have a plan? Do you have access to means?

Question 22

OSCE: In a patient presenting with first-episode psychosis, what 3 organic causes should you rule out immediately?

Answer 22

Substance intoxication/withdrawal, metabolic causes (thyroid, electrolytes, glucose), CNS infection or structural lesion

Question 23

OSCE: What are the 3 steps in managing an acutely violent psychiatric patient?

Answer 23

Verbal de-escalation, physical restraint if required, IM antipsychotics/benzodiazepines

Question 24

OSCE: How do you differentiate delirium from dementia on history?

Answer 24

Delirium = acute onset, fluctuating course, impaired attention; Dementia = insidious, progressive decline, attention usually preserved early

Question 25

OSCE: What 3 clinical features should you look for in mania during mental state exam?

Answer 25

Elevated/irritable mood, pressured speech, flight of ideas

Question 26

OSCE: What 3 core symptoms must you always screen for in suspected depression?

Answer 26

Low mood, anhedonia, low energy

Question 27

Most common cause of drug-induced psychosis in Singapore

Answer 27

Methamphetamine

Question 28

Definition of adjustment disorder

Answer 28

Emotional/behavioral symptoms within 3 months of a stressor, not meeting criteria for another disorder

Question 29

Key clinical feature distinguishing delirium from dementia

Answer 29

Fluctuating consciousness and inattention

Question 30

OSCE: What 3 key suicide risk questions must you always ask on call?

Answer 30

Do you have thoughts of harming yourself? Do you have a plan? Do you have access to means?

Question 31

OSCE: In a patient presenting with first-episode psychosis, what 3 organic causes should you rule out immediately?

Answer 31

Substance intoxication/withdrawal, metabolic causes (thyroid, electrolytes, glucose), CNS infection or structural lesion

Question 32

OSCE: What are the 3 steps in managing an acutely violent psychiatric patient?

Answer 32

Verbal de-escalation, physical restraint if required, IM antipsychotics/benzodiazepines

Question 33

OSCE: How do you differentiate delirium from dementia on history?

Answer 33

Delirium = acute onset, fluctuating course, impaired attention; Dementia = insidious, progressive decline, attention usually preserved early

Question 34

OSCE: What 3 clinical features should you look for in mania during mental state exam?

Answer 34

Elevated/irritable mood, pressured speech, flight of ideas

Question 35

OSCE: What 3 core symptoms must you always screen for in suspected depression?

Answer 35

Low mood, anhedonia, low energy

Question 36

Vignette: A 22-year-old male presents with auditory hallucinations for 8 months, functional decline, and poor self-care. What is the most likely diagnosis?

Answer 36

Schizophrenia

Question 37

Vignette: A 25-year-old woman has alternating episodes of elevated mood with ↓ sleep and pressured speech, and episodes of low mood with anhedonia and suicidality. Diagnosis?

Answer 37

Bipolar disorder

Question 38

Vignette: A 30-year-old man reports intrusive thoughts about contamination and spends 5 hours daily washing his hands. He knows it is unreasonable but cannot stop. Diagnosis?

Answer 38

Obsessive-Compulsive Disorder (OCD)

Question 39

Vignette: A 19-year-old female presents after overdosing on paracetamol following a fight with her boyfriend. She has a history of unstable relationships, self-harm, and impulsivity. Most likely diagnosis?

Answer 39

Borderline Personality Disorder

Question 40

Vignette: A 70-year-old male is brought in for aggression and hallucinations. His family reports a 2-year history of worsening memory and disorientation. Likely diagnosis?

Answer 40

Dementia with behavioral disturbance

Question 41

Vignette: A 45-year-old man presents to ED with fluctuating confusion, disorientation, and visual hallucinations after a pneumonia diagnosis. Likely diagnosis?

Answer 41

Delirium

Question 42

Vignette: A 23-year-old male is brought in by police for shouting at strangers. He has persecutory delusions and recently used methamphetamine. Likely cause of psychosis?

Answer 42

Substance-induced psychosis (Methamphetamine)

Question 43

Vignette: A 28-year-old female presents with low mood, hopelessness, and suicidal ideation after failing exams. Symptoms began 1 month ago and do not meet full MDD criteria. Most likely diagnosis?

Answer 43

Adjustment Disorder

Question 44

Vignette: A 27-year-old man reports both auditory hallucinations and depressive episodes. He has had 3 weeks of psychotic symptoms without mood features. Most likely diagnosis?

Answer 44

Schizoaffective Disorder