DHA Mental Health & Psychiatry Flashcards

A patient with bipolar disorder type I is in an acute manic episode. The MOST appropriate initial pharmacological intervention is:

Answer: Administer a mood stabiliser such as lithium or valproate

Mood stabilisers (lithium, valproate, or atypical antipsychotics) are first-line treatment for acute mania in bipolar type I disorder.

Lithium toxicity is MOST likely to develop when a patient:

Answer: Becomes dehydrated or sodium-depleted

Lithium and sodium compete for renal reabsorption; dehydration or low sodium intake causes increased lithium reabsorption and toxicity.

Which feature is a hallmark characteristic of borderline personality disorder (BPD)?

Answer: Intense fear of abandonment and unstable interpersonal relationships

BPD is characterised by an intense fear of abandonment, unstable relationships, emotional dysregulation, and impulsivity.

Which psychotherapy has the strongest evidence base as a treatment for borderline personality disorder?

Answer: Dialectical Behaviour Therapy (DBT)

DBT, developed specifically for BPD, is the gold-standard evidence-based treatment, focusing on distress tolerance and emotion regulation skills.

Which antipsychotic medication is associated with the HIGHEST risk of metabolic syndrome?

Answer: Clozapine

Clozapine carries the highest risk of metabolic syndrome — including significant weight gain, hyperglycaemia, and dyslipidaemia — requiring regular metabolic monitoring.

A patient discloses command hallucinations to harm a specific named individual. The clinician's MOST appropriate response is:

Answer: Assess duty-to-warn obligations and consider inpatient admission

Command hallucinations to harm an identifiable third party require risk assessment, potential Tarasoff duty-to-warn notification, and serious consideration of inpatient admission.