100+ Free FC Psych(SA) Part II Practice Questions

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Key Facts: FC Psych(SA) Part II Exam

Exit Exam

Credential Level

CMSA College of Psychiatrists

R21 500

Exam Fee

CMSA Fee Schedule

Overall 50%

Passing Standard

CMSA Examination Regulations

MHCA 2002

Legal Basis

South African National Legislation

The FC Psych(SA) Part II is the final specialist exit examination for South African psychiatrists, covering comprehensive general adult psychiatry, neuropsychiatry, MHCA legal frameworks, child & adolescent, geriatric, forensic, and advanced psychopharmacology.

Sample FC Psych(SA) Part II Practice Questions

Try these sample questions to test your FC Psych(SA) Part II exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 28-year-old male with treatment-resistant schizophrenia is receiving clozapine maintenance therapy. According to South African clinical monitoring guidelines, at what absolute neutrophil count (ANC) threshold must clozapine treatment be immediately withheld?

A.ANC less than 1.5 x 10^9/L

B.ANC less than 2.0 x 10^9/L

C.ANC less than 2.5 x 10^9/L

D.ANC less than 3.0 x 10^9/L

Explanation: Clozapine therapy must be immediately interrupted if the absolute neutrophil count (ANC) drops below 1.5 x 10^9/L (1500/mm³). If the ANC falls below 1.0 x 10^9/L, clozapine must be stopped permanently to prevent life-threatening agranulocytosis and daily blood monitoring must be instituted.

2A 45-year-old female patient with severe catatonic depression is being evaluated for emergency electroconvulsive therapy (ECT). Which of the following conditions represents an absolute contraindication to ECT?

A.Raised intracranial pressure due to an intracranial space-occupying lesion

B.Controlled essential hypertension

C.Stable ischemic heart disease

D.Uncomplicated first-trimester pregnancy

Explanation: Increased intracranial pressure (ICP) secondary to a space-occupying lesion is an absolute contraindication to ECT because the transient increase in cerebral blood flow during the seizure can trigger brain herniation. Other medical conditions require stabilization but are relative contraindications.

3What is the standard clinical definition of treatment-resistant depression (TRD) in adult psychiatric practice?

A.Failure to respond to at least two adequate trials of different antidepressant classes at adequate doses and duration

B.Failure to respond to a single 4-week trial of a selective serotonin reuptake inhibitor (SSRI)

C.Persistence of depressive symptoms despite psychotherapy alone for 6 months

D.Failure to achieve full symptom remission following low-dose tricyclic antidepressant monotherapy

Explanation: Treatment-resistant depression is defined clinically as the failure to achieve symptomatic remission despite at least two adequate trials of different antidepressant pharmacological classes administered at therapeutic doses for an adequate duration (typically 6 to 8 weeks per trial).

4A 24-year-old male is admitted with acute manic excitement, grandiosity, and auditory hallucinations. He is severely agitated. What is the recommended initial pharmacological strategy for rapid control of severe manic agitation?

A.Combination of an atypical antipsychotic (or haloperidol) with a short-acting benzodiazepine

B.Monotherapy with oral lithium carbonate titrated slowly over two weeks

C.Oral lamotrigine monotherapy starting at 25 mg daily

D.High-dose oral fluoxetine monotherapy

Explanation: In acute manic agitation with psychotic features, the combination of an antipsychotic (such as haloperidol, olanzapine, or risperidone) and a short-acting benzodiazepine (such as lorazepam) provides rapid sedation and anti-manic symptom control. Mood stabilizers like lithium take 7-14 days to exert therapeutic effects.

5A 32-year-old female presents with mutism, immobility, waxy flexibility, and negativism. What is the rapid bedside diagnostic challenge and first-line pharmacological treatment of choice for catatonia?

A.Intravenous or oral Lorazepam challenge

B.Intravenous Haloperidol bolus

C.Intramuscular Chlorpromazine administration

D.Oral Sodium Valproate loading dose

Explanation: The Lorazepam challenge test (1 to 2 mg IV or IM) is the rapid bedside diagnostic test for catatonia; dramatic resolution of catatonic signs within 15-30 minutes confirms the diagnosis. Lorazepam is also the first-line treatment for catatonia.

6A 22-year-old female presents with rapid-onset psychosis, prominent memory deficits, oro-facial dyskinesias, autonomic instability, and hypoventilation. Which autoantibody encephalopathy and associated neoplasm must be urgently investigated?

A.Anti-NMDA receptor encephalitis associated with ovarian teratoma

B.Anti-LGI1 encephalitis associated with small cell lung carcinoma

C.Anti-Hu encephalitis associated with neuroblastoma

D.Anti-VGKC encephalitis associated with thymoma

Explanation: Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis typically affects young females, presenting with acute psychiatric symptoms, seizures, dyskinesias, autonomic instability, and hypoventilation. It is strongly associated with ovarian teratomas (found in over 50% of young adult female cases).

7A 40-year-old man presents with choreiform movements, progressive executive dysfunction, and severe irritability. A diagnosis of Huntington's disease is suspected. What neuroimaging finding on brain MRI is pathognomonic?

A.Bilateral atrophy of the caudate nuclei causing enlargement of the frontal horns of the lateral ventricles

B.Severe temporal lobe atrophy with sparing of the parietal cortex

C.Diffusely scattered subcortical white matter hyperintensities on T2-FLAIR

D.Midbrain tectal atrophy with the 'hummingbird sign'

Explanation: Huntington's disease causes selective neurodegeneration of GABAergic medium spiny neurons in the striatum, leading to striking bilateral caudate nucleus atrophy and compensatory enlargement ('boxing') of the frontal horns of the lateral ventricles.

8What is the dominant clinical feature of HIV-Associated Neurocognitive Disorder (HAND) in its severe form (HIV-associated dementia)?

A.Subcortical pattern of cognitive impairment characterized by psychomotor slowing, executive dysfunction, and motor deficits

B.Cortical amnesia with prominent early severe dysphasia and apraxia

C.Isolated visual agnosia and spatial disorientation

D.Rapidly progressive fluent aphasia with preserved motor function

Explanation: HIV-associated dementia (HAD) is a classic subcortical dementia caused by HIV infection of microglial cells and subcortical basal ganglia structures. It is characterized by marked psychomotor slowing, executive dysfunction, impaired concentration, and subcortical motor signs (bradykinesia, hyperreflexia).

9A 19-year-old male presents with dysarthria, resting tremor, personality changes, and depression. Slit-lamp examination reveals brownish-yellow corneal rings. What initial laboratory finding confirms Wilson's disease?

A.Decreased serum ceruloplasmin and elevated 24-hour urinary copper excretion

B.Elevated serum iron and transferrin saturation

C.Low serum ferritin and elevated total iron-binding capacity

D.Elevated plasma phenylalanine levels

Explanation: Wilson's disease (hepatolenticular degeneration) is an autosomal recessive disorder of copper transport caused by ATP7B mutations. Diagnostic laboratory findings include low serum ceruloplasmin (<200 mg/L), elevated 24-hour urinary copper excretion, and Kayser-Fleischer rings on slit-lamp exam.

10Under the South African Mental Health Care Act 17 of 2002 (MHCA), what is the statutory purpose and duration of the 72-hour assessment period for an involuntary mental health care user?

A.To assess the user's state of health and determine whether involuntary care is required, conducted by 2 health care providers

B.To detain the user indefinitely without medical review until a magistrate orders release

C.To perform mandatory forensic psychiatric evaluation for criminal trial fitness

D.To administer compulsory electroconvulsive therapy without surrogate consent

Explanation: Under Section 34 of the MHCA 17 of 2002, the 72-hour assessment period allows the head of a health establishment to admit an involuntary user for evaluation by two registered health care providers (at least one being a medical practitioner) to determine whether physical and mental health status requires ongoing involuntary care.

About the FC Psych(SA) Part II Exam

The Fellowship of the College of Psychiatrists of South Africa Part II — FC Psych(SA) Part II is the exit specialist qualification in South Africa. Candidates are assessed on advanced clinical diagnosis, psychopharmacology, neuropsychiatry, child & adolescent psychiatry, forensic psychiatry and South African Mental Health Care Act 17 of 2002, geriatric psychiatry, addiction, and psychotherapy modalities.

Assessment

Written examination papers (modified essay and short answer questions), clinical patient evaluations, and viva voce oral examinations.

Time Limit

Written & Clinical components across exam week

Passing Score

Overall 50% with written subminimum

Exam Fee

R24 650 (College of Psychiatrists of South Africa (Colleges of Medicine of South Africa))

FC Psych(SA) Part II Exam Content Outline

20%

General Adult Psychiatry & Mood/Psychotic Disorders

Schizophrenia spectrum, treatment-resistant depression, bipolar disorder, catatonia, anxiety, and obsessive-compulsive disorders.

15%

Neuropsychiatry & Organic Mental Disorders

Anti-NMDA encephalitis, HIV-associated neurocognitive disorders (HAND), epilepsy-associated psychosis, autoimmune encephalitis, and movement disorders.

15%

Forensic Psychiatry & Mental Health Care Act SA

Mental Health Care Act 17 of 2002 (Assisted, Involuntary, State Patients), Criminal Procedure Act 51 of 1977 Sections 77/78, and criminal capacity evaluations.

15%

Child & Adolescent Psychiatry

ADHD, Autism Spectrum Disorder, paediatric mood and anxiety disorders, conduct disorders, and early-onset psychosis.

12%

Geriatric Psychiatry & Neurodegenerative Disorders

Major neurocognitive disorders (Alzheimer, Vascular, Lewy Body, Frontotemporal), BPSD management, and delirium diagnostics.

12%

Advanced Psychopharmacology & Somatic Therapies

Clozapine protocols, Lithium monitoring, rapid tranquillisation, neuroleptic malignant syndrome, electroconvulsive therapy (ECT), and teratogenicity.

11%

Addiction Psychiatry & Substance Use Disorders

Alcohol withdrawal delirium, Wernicke-Korsakoff syndrome, methamphetamine ('Tik') psychosis, opioid substitution therapy, and dual diagnosis.

How to Pass the FC Psych(SA) Part II Exam

What You Need to Know

Passing score: Overall 50% with written subminimum
Assessment: Written examination papers (modified essay and short answer questions), clinical patient evaluations, and viva voce oral examinations.
Time limit: Written & Clinical components across exam week
Exam fee: R24 650

Keys to Passing

Work through all 100 available questions
Review every answer and explanation
Track weak areas and revisit them
Use our AI tutor for tough concepts

FC Psych(SA) Part II Study Tips from Top Performers

1Thoroughly review the Mental Health Care Act 17 of 2002, including forms, 72-hour assessment rules, MHRB functions, and High Court review requirements.

2Master evidence-based guidelines for treatment-resistant schizophrenia (Clozapine management and neutropenia protocols) and bipolar maintenance.

3Integrate neuropsychiatric conditions common in South Africa, particularly HIV-associated neurocognitive disorders (HAND) and neurosyphilis.

Frequently Asked Questions

What is the assessment format for FC Psych(SA) Part II?

The examination comprises written papers (covering general psychiatry, neuropsychiatry, child psychiatry, forensic psychiatry, and psychopharmacology), clinical bedside evaluations, and structured viva voce examinations.

How does South African law apply to the FC Psych(SA) Part II examination?

Candidates are expected to demonstrate thorough legal knowledge of the Mental Health Care Act 17 of 2002, Criminal Procedure Act 51 of 1977 (Sections 77 and 78), Children's Act 38 of 2005, and relevant HPCSA ethical rulings.

What is the passing criteria for FC Psych(SA) Part II?

Candidates must achieve an overall pass mark of 50% with subminimum requirements across the written and clinical/viva examination sections.

100+ Free FC Psych(SA) Part II Practice Questions

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