Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

C. Year 3: Neurology Random NOT on MLA Map > Risk assessment and Formulation > Flashcards

Risk assessment and Formulation Flashcards

1
Q

When talking about risk in psychiatry, which of the following is true?

1 - risk of something occurring (good or bad), but unrelated to danger
2 - chance of something happening, with a negative outcome
3 - risk as a hazard that results in any negative outcome
4 - all of the above

A

2 - chance of something happening, with a negative outcome

  • the negative outcome needs quantifying, self harm, self neglect, severity of negative outcome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Risk factors can be static or dynamic. Which of the following is an static risk factor?

1 - alcohol dependence
2 - drug addiction
3 - childhood abuse
4 - mental state

A

3 - childhood abuse
- this is static as it cannot be changed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What of the following is NOT a static demographic risk factor?

1 - gender (Male)
2 - previous self harm
3 - (middle aged/elderly (>80)
4 - marital status
5 - social network (living alone)
6 - employment (unemployed)

A

2 - previous self harm

  • employment is important because some jobs have means of suicide like dentists and farmers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Risk factors can be static or dynamic. Which of the following is a dynamic factor?

1 - alcohol dependence
2 - death of parent at young age
3 - childhood abuse
4 - history of self harm

A

1 - alcohol dependence
- this develops over time
- these can be chronic or acute

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What of the following is NOT a static personal history risk factor?

1 - previous self-harm/suicide
2 - mental illness
3 - physical illness
4 - family history
5 - substance misuse/dependency
6 - personality disturbance
7 - history of loss or trauma
8 - employment (unemployed)

A

8 - employment (unemployed)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

There are a number of different approaches to risk assessment. Which of the following are definitions actuarial approach?

1 - risk factors are collected and assessed using clinical experience
2 - mathematical approach to combine risk factors and predict negative outcome
3 - structured pro-forma based on risk factors from research combined with clinical expertise and knowledge of patient

A

2 - mathematical approach to combine risk factors and predict negative outcome

  • cumbersome and slow
  • low prevalence of predicted outcomes (suicide/homicide are relatively rare), risk factors have low predictive value even in high-risk groups
    -predictive capacity only applies when patient comes from the sample population
  • emphasises static risk factors, limiting clinical usefulness
  • ignores less common risk factors without accounting for the inevitable uncertainty of an individual behaviour.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

There are a number of different approaches to risk assessment. Which of the following are definitions unstructured clinical approach?

1 - risk factors are collected and assessed using clinical experience
2 - mathematical approach to combine risk factors and predict negative outcome
3 - structured pro-forma based on risk factors from research combined with clinical expertise and knowledge of patient

A

1 - risk factors are collected and assessed using clinical experience

  • clinician uses their preferences or gut feeling with presence or absence of specific risk factors
  • important risk and protective may be missed
  • notoriously over estimate risk
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

There are a number of different approaches to risk assessment. Which of the following are definitions structured professional judgement approach?

1 - risk factors are collected and assessed using clinical experience
2 - mathematical approach to combine risk factors and predict negative outcome
3 - structured pro-forma based on risk factors from research combined with clinical expertise and knowledge of patient

A

4 - structured pro-forma based on risk factors from research combined with clinical expertise and knowledge of patient

  • offers most potential for objective risk management
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Risk formulation is a way of bringing together an understanding of personality, history, mental state, environment, risk factors and protective factors. It can be remembered using the 5Ps, which of the following is NOT one of these 5 Ps?

1 - Presenting problem
2 - Predisposing factors
3 - Precipitating factors
4 - Perpetuating factors
5 - Possessive factors
6 - Protective/positive factors

A

5 - Possessive factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Can risk be eliminated altogether?

A
  • no
  • BUT you can try to minimise risk
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

When assessing and trying to manage risk in an attempt to minimise risk, once the risk assessment is completed will it always remain the same?

A
  • no
  • risk is fluid and things change
  • risk management is an ongoing process
  • someone to act as a sponsor for support if they are in a crisis and fear risk is increasing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

A trusting therapeutic relationship, based on empathy and compassion, can allow the patient to feel understood and more contained, and can mitigate risk. Which of the following are additional management plans that can be used?

1 - Medication.
2 - Psychological interventions.
3 - Interventions for substance or alcohol misuse.
4 - Opportunities for social recovery
5 - all of the above

A

5 - all of the above

  • special needs must be considered
  • carers and family’s should be involved and offered support
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

In psychiatry, how many levels of risk are there when performing a risk assessment?

1 - 2
2 - 3
3 - 5
4 - >5

A

2 - 3

  • low = no intervention needed
  • medium = watch and wait with some monitoring to prevent self and harm to others
  • high = urgent intervention needed to avoid loss of life
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

When we assess risk, we must include all of the following:

  • To self
  • To others
  • From others
  • From self-neglect
  • From physical health factors
  • From behavioural factors
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When assessing the risk for a patient, does the risk assessment information come from just the patient?

A
  • no
  • Patients
  • Parents / carers
  • Teachers
  • Employers
  • Social services
  • Other healthcare professionals
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which of the following is the correct term to use if someone has taken their own life via suicide?

1 - parasuicide
2 - committed suicide
3 - successful suicide
4 - completed suicide

A

4 - completed suicide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the lifetime risk of self harm?

1 - 1-2%
2 - 7-13%
3 - 25-40%
4 - >55%

A

2 - 7-13%
- accounts for 10% of medical admissions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the average rate of completed suicides in the UK annually?

1 - >60
2 - >600
3 - >6000
4 - >60,000

A

3 - >6000
- specifically 6090
- 60% of successful suicides have a history or self harm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Do men or women have a higher success rate of suicides?

A
  • men (3-4x more likely)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What % of completed suicides occur in an acute clinical setting?
1 - 49%
2 - 29%
3 - 2.9%
4 - 0.29%

A

2 - 29%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

When is the risk of suicide greatest following discharge?

1 - <12h
2 - <48h
3 - <72h
4 - <1 wk

A

3 - <72h
- now have the 72h follow up

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

When assessing the risk of an individual are we able to use the risk assessment from the first consultation with a patient?

A
  • at that specific time yes
  • BUT, risk is dynamic and will need repeating
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

When we speak to a patient about self harm, we must include which of the following:

  • Deliberate self-harm
  • Methods used/Frequency
  • suicidal thoughts
  • suicidal intention
  • suicidal plans
  • suicidal methods tried/considered
  • suicidal previous attempts
  • all of the above
A
  • all of the above
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

When we talk about risk to others we must include which of the following:

  • Aggression
  • Violence
  • Access to weapons
  • Access to potential victims
  • Forensic history
  • all of the above
A
  • all of the above
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

When we talk about risk from others we must include all of the following:

  • Bullying
  • Psychological Abuse
  • Physical Abuse
  • Sexual Abuse
  • Retaliation from aggression
  • Radicalisation
  • All of the above
A
  • All of the above
26
Q

Is their an association between physical co-morbidities and mental health?

A
  • yes
  • poor physical health can cause or accentuate poor mental health
27
Q

What % of patients who die from suicide have a mental disorder?

1 - 10%
2 - 25%
3 - 45%
4 - 90%

A

4 - 90%

28
Q

Psychotic illnesses are associated with an increased risk of death from which 2 of the following physical illnesses?

1 - coronary artery disease
2 - diabetes
3 - respiratory disease
4 - liver disease

A

1 - coronary artery disease
3 - respiratory disease

  • patients with depression are also at increased risk of death from coronary artery disease
29
Q

When considering behavioural factors in a risk assessment of a patient, we must include the following:

  • Drug misuse such as unintentional overdose and the impact on mental health
  • Alcohol misuse used as a depressant and to reduce inhibitions
  • Impulsivity and increase change of risky behaviours that could end their lives
A
30
Q

What is formulation?

1 - letting the patient identify what they think is wrong with them
2 - working with the patient to identify treatment plans
3 - use all information to understand the patient, diagnose and manage the patient

A

3 - use all information to understand the patient, diagnose and manage the patient

31
Q

To help remember all of the things we should include in a psychiatric history we can use the 5 Ps. Which of the following is NOT one of the five Ps?

5 Ps of assessment

1 - Presentation
2 - Predisposing
3 - Precipitating
4 - Perpetuating
5 - Person
6 - Protective

A

5 - Person

32
Q

To help remember all of the things we should include in a psychiatric history we can use the 5 Ps:

1 - Presentation
2 - Predisposing
3 - Precipitating
4 - Perpetuating
5 - Person

A

Presentation includes:

  • What is the problem?
  • Symptoms reported (subjective)
  • Signs noted (objective)
  • How did they present?
  • Self-presented to A&E
  • Brought in by ambulance
  • Picked up by police under Section 136 of MHA
33
Q

To help remember all of the things we should include in a psychiatric history we can use the 5 Ps:

1 - Presentation
2 - Predisposing
3 - Precipitating
4 - Perpetuating
5 - Person

A

Predisposing includes:

  • What makes this person more likely to present like this?
  • Biological factors such as genetic vulnerability
  • Psychological factors such as trauma, abuse
  • Social factors such as poverty, family environment
34
Q

To help remember all of the things we should include in a psychiatric history we can use the 5 Ps:

1 - Presentation
2 - Predisposing
3 - Precipitating
4 - Perpetuating
5 - Person

A

Precipitating includes:

  • Why now?
  • Recent significant events
  • Psychoactive substances
  • Illness
35
Q

To help remember all of the things we should include in a psychiatric history we can use the 5 Ps:

1 - Presentation
2 - Predisposing
3 - Precipitating
4 - Perpetuating
5 - Person

A

Perpetuating includes:

  • Why is it continuing?
  • Ongoing stresses
36
Q

To help remember all of the things we should include in a psychiatric history we can use the 5 Ps:

1 - Presentation
2 - Predisposing
3 - Precipitating
4 - Perpetuating
5 - Person

A

Protective includes:

  • What would prevent it?
  • Internal
  • Resilience
  • Personality
  • External
  • Social supports
37
Q

What is positive risk management?

1 - identifying positive emotions when assessing risk
2 - identifying protective risk factors
3 - being aware that all risks can never be completely eliminated

A

3 - being aware that all risks can never be completely eliminated

  • BUT try to reduce risks wherever possible
  • discuss plans with patients and support
38
Q

In risk management we can utilise 3 main types of management: Biological, Psychological and Social interventions. Which of the following is NOT a typical social intervention?

1 - hospital admissions
2 - placements/respite
3 - GP appointment
4 - addiction services
5 - financial support

A

3 - GP appointment

  • Biological interventions include: optimisation of mental health / physical health medications
  • Psychological interventions include
    psychotherapy and bereavement support
39
Q

If a patient is presenting with a risk to themselves or others we can offer rapid tranquillisation to sedate them. Is this voluntary and require consent?

A
  • does not have to be
  • can be administered without consent
40
Q

If a patient is presenting with a risk to themselves or others we can offer rapid tranquillisation to sedate them, which can be voluntary or against their will either orally or intramuscularly. Which 2 of the following non-psychotic drug groups are used to tranquillise patients in these settings?

1 - benzodiazepine
2 - antihistamine
3 - anti-depressants
4 - anti-epileptics

A

1 - benzodiazepine
- short acting like Lorazepam

2 - antihistamine

  • if patient is psychotic then a psychotic can be used alongside of these drugs
41
Q

When a patient is discharged from a mental health hospital, we should consider follow up with a community team. But if someone presents with suicidal thoughts how long must they be following up by a community team?

1 - 24h
2 - 48h
3 - 72h
4 - 7 days

A

4 - 7 days

42
Q

When assessing a patient who has thoughts or plans to end their life we should use a holistic psychosocial model. How quickly should this patient be seen by a a mental health team member?

1 - <1h
2 - <12h
3 - <24h
4 - <72h

A

1 - <1h
- and assessed <4 hours

43
Q

Does asking a patient about suicide increase the risk of that patient ending their own life?

A
  • no
44
Q

The principles of a management plan for self harm should be a collaboratively agreed management plan that can revive hope about the future and mitigate risk. This can be achieved by including which of the following management plans?

1 - holistic/biopsychosocial.
2 - access to emergency contact
3 - be in accessible format
4 - shared with individual, GP and relevant professionals
5 - all of the above

A

5 - all of the above

45
Q

If a patient is at risk of self harm of suicide, is their mental or physical health the priority?

A
  • physical health
  • patient can be administered to hospital in some circumstances
46
Q

Which of following are effective psychological interventions for a patient at risk of self harm of ending their own lives?

1 - CBT
2 - coping strategies
3 - Dialectical behaviour therapy
4 - Emotionally unstable personality disorder therapy
5 - all of the above

A

5 - all of the above

  • additional social support may include:
  • problem solving techniques
  • self care
  • physical activity
  • pleasurable activities – referral to community/charitable org e.g. MIND
  • sleep hygiene
47
Q

When should a child be admitted to a mental health hospital?

1 - when they want to be admitted
2 - when parents are unable to cope
3 - when parents and management in the community isn’t possible

A

3 - when parents and management in the community isn’t possible

48
Q

What is section 136 of the mental health act?

1 - police can remove person from public and transport to place of safety to be assessed for mental health
2 - detention for assessment and treatment for up to 28 days
3 - detention and treatment for up to 6 months
4 - police can enter your home and transport to place of safety to be assessed for mental health

A

1 - police can remove person from public and transport to place of safety to be assessed for mental health

  • 2 doctors, 1 with section 12 approval and 1 approved mental health professional (AMHP)
49
Q

What is section 135 of the MHA?

1- doctor can recommend compulsory admission for assessment or treatment
2 - detention for assessment and treatment for up to 28 days
3 - detention and treatment for up to 6 months
4 - police can enter your home and transport to place of safety to be assessed for mental health

A

4 - police can enter your home and transport to place of safety to be assessed for mental health

50
Q

What is section 12 of the MHA?

1- doctor can recommend compulsory admission for assessment or treatment
2 - detention for assessment and treatment for up to 28 days
3 - detention and treatment for up to 6 months
4 - police can enter your home and transport to place of safety to be assessed for mental health

A

1- doctor can recommend compulsory admission for assessment or treatment

51
Q

What is section 2 of the MHA?

1- doctor can recommend compulsory admission for assessment or treatment
2 - detention for assessment and treatment for up to 28 days
3 - detention and treatment for up to 6 months
4 - police can enter your home and transport to place of safety to be assessed for mental health

A

2 - detention for assessment and treatment for up to 28 days

52
Q

What is section 3 of the MHA?

1- doctor can recommend compulsory admission for assessment or treatment
2 - detention for assessment and treatment for up to 28 days
3 - detention and treatment for up to 6 months
4 - police can enter your home and transport to place of safety to be assessed for mental health

A

3 - detention and treatment for up to 6 months

53
Q

Safeguarding treatment has the key aim of ensuring children are safe and kept away from the risk of harm. It includes:

  • Protecting children from abuse and maltreatment
  • Preventing harm to children’s health or development
  • Ensuring children grow up with the provision of safe and effective care
  • Taking action to enable all children and young people have the best outcomes
  • Multiagency working
    Reviews into adverse events
A
54
Q

Sex with a child under the age of 13 is a criminal offence. Does this need referring to safeguarding even if both children involved are under 13?

A
  • yes
  • doesn’t matter if both are under 13, still needs referring
55
Q

What % of homicides are committed by patients with mental health disorders?

1 - 1%
2 - 11%
3 - 44%
4 - 90%

A

2 - 11%

  • most patients are diagnosed with schizophrenia
  • BUT mental health patients are more likely t be victims than perpetrator
56
Q

Are patients with a mental disorder more or less likely to be a victim of violence?

A
  • more likely
  • x5 more likely to be victims of homicide
  • x2.7 more likely to be victims of domestic abuse (female)
  • x2.9 more likely to be victims of sexual violence (female)
57
Q

Which of the following is NOT a global risk factor for violence?

1 - female
2 - income inequality
3 - lack of investment in education
4 - drug and alcohol use

A

1 - female
- 90% of homicide suspects are male
- aged 15-29 are most at risk

58
Q

Which of the following groups of patients is more likely to be violent?

1 - triple morbidity
2 - schizophrenia/bipolar
3 - anxiety
4 - depression

A

1 - triple morbidity
- severe mental illness
- substance use disorder
- antisocial personality disorder

  • the above combination patient is much more likely to cause violence
59
Q

Which of the following is NOT a stable/historical risk factor for violence in patients with a mental health disorder?

1 - Youth
2 - Male gender
3 - Past violence
4 - Antisocial personality disorder
5 - Abstinence

A

5 - Abstinence
- Poly-substance is a key risk factor

60
Q

Which of the following is NOT a dynamic/clinical risk factor for violence in patients with a mental health disorder?

1 - Emotional arousal (hostility, anger, agitation, irritability)
2 - positive symptoms of psychosis – (delusions and hallucinations)
3 - Suspiciousness
4 - Poly-substance abuse

A

4 - Poly-substance abuse
- this is classed as a stable factor

61
Q

Are dynamic or static risk factors more of a risk factor for violence in patients with mental health disorders?

A
  • dynamic

C. Year 3: Neurology Random NOT on MLA Map (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions