Structured Patient Management Problems for the MRCPsych Part II
Sample from the pilot examination

Vignette Number GAP 02

Speciality:

General Psychiatry/Child Psychiatry

Date:

10 October 2001

Vignette:

The A & E Department has asked you as the Duty Psychiatrist, to assess a 32-year old woman, who has presented in a dishevelled state and is behaving oddly. She is clutching an infant who appears to have a number of bruises.

How would you assess and manage this situation?

Suggested Probes:

  1. How would you tackle any risk to the child?
  2. Who else would you involve?
  3. What impact might mother's clinical state have on the child?

 

 

  1. Child protection issues - including issues around confidentiality and disclosure.
  2. Child Protection procedures, involving Social Services and Paediatrics.
  3. Some knowledge of nature and injuries in physical abuse.
  4. Likely diagnoses and management plans for mother.
  5. Mother's ability to care for the child including the impact of clinical features/diagnosis on child.
© 2007 Royal College of Psychiatrists