Sample ME Qs
Thanks to Dr Ed Theologis, consultant psychiatrist at the Austin Hospital in Melbourne, for the following Sample Modified Essay Question
(25 marks – 25 minutes)
Carol is a 34 y.o. married mother of three children (5,6 and 9) who is referred to by the neurology registrar of a general hospital for "assessment and management advice" during her inpatient stay in the neurology ward. Carol had a diagnosis of Multiple Sclerosis (MS) formally diagnosed 2 years ago, but initial onset of symptoms was probably 9 years ago. She is now suffering her third "MS relapse", with mild dysarthria and gait disturbance, and is on a weaning dose of steroids. It was noted in this admission that she presented as forgetful, impulsive, excessively angry, and admitting to having physically assaulted her children on two occasions in the last 2 months. Her husband reports that she has in fact threatened the children with knives on three occasions, and she claims that he is just trying to present her as a "bad mother" because he "does not love her" anymore. The neurology team would like to discharge her in two days time, since they feel that the severity of her physical symptoms are no longer severe enough to warrant inpatient admission, and the unit is short of beds.
Question 1
What is Carol’s differential diagnosis and what are the key issues which need clarification at this stage.
Question 2
Outline the management recommendations you would make to the referring unit and the other key players in this case.
......The neurology team has reluctantly allowed Carol to remain an inpatient another week, because of pressure from her husband, yourself and the social worker, but she is now being discharged back home.
Question 3
Describe the types of community linkages you would recommend for Carol, and the type of psychiatric and "crisis" plan you would put in place.