SHR Written paper 2

Six 5 marks questions

1. Side effects of haloperidol
2. Football player hit at head. GCS 3. Describe assessment, initial management and investigation
3. Key features of delirium
4. Key features of obsessive-compulsive disorder
5. Describe 3 risk factors of fall and give example for each factor.
6. Elderly men with recent cognitive impairment. Given diazepam to treat his ‘nerve’ problem. Give comment on his diazepam usage.

Six 15 marks questions

1. Elderly Italian lady with mental impairment. Lives in Shared Supported Accommodation. Unable to speak in English. Has diabetes, obesity and history of falls. List 5 issues in this lady. Describe your management.
2. Men with paracetamol overdose and found with empty whisky. Slightly intoxicated. Describe initial management, investigation. Mechanism of paracetamol toxicity. Tool to assess paracetamol toxicity. Management of paracetamol toxicity and route of administration. [Guidelines for the management of paracetamol poisoning]
3. Elderly women with advanced lung cancer. Want to die at home and family happy to support her. Describe your discharge planning.
4. Women present to GP with symptoms of 8 years history of binge eating and purging. Normal physical exam. Describe management of this patient.
5. 40 year old women with MS. Work as a telephonist and need to access computer as part of her job. Describe clinical features of MS that may interfere with her job (4 marks). Describe your assessment on finding out what are available at work to overcome this issue (4 marks). Recommendations on how to cope with work difficulty due to her MS-related disability (7 marks).
6. Elderly men with long history of ischaemic heart disease and now presents with depressive symptoms. Describe the relationship between medical illness and depression.
   

In this paper, there were few questions asking on DSM IV criteria of several psychiatry disorders. DSM IV is the manual published by the American Psychiatric Association and covers all mental health disorders for both children and adults. It tells you how to diagnose any mental illness and describe the relevant differential diagnosis. Most, if not all, psychiatrist were able to recite the DSM IV criteria for any mental illness. So, it is necessary for medical students, to memorise the DSM IV criteria for major mental disorders.

I'm not sure how to answer the question on MS. It is asking for specific answers related to work-related issues. I randomly put anything that might be relevant in answering this question. Hopefully, I could gain at least several points from this question.

Overall, I'm glad that the written exam is over. Now, I could look forward for my OSCE and the short winter break after that

Update 27/9/2009: Thanks to Intan for telling me the other questions.