skip to main content

MARSIPAN Risk Stratification — MRCPsych Paper B MCQ

Instant feedback + full explanation. One question, done properly.

HardEating DisordersMARSIPAN Risk StratificationMRCPsych Paper B

A 32-year-old woman with anorexia nervosa has a BMI of exactly 13.0 kg/m² and a corrected QT interval (QTc) of 500 ms. She is in sinus rhythm, with no other ECG abnormality, normal serum electrolytes and no use of medication known to prolong the QT interval. According to the current Royal College of Psychiatrists Medical Emergencies in Eating Disorders (MEED) risk framework, which is the most appropriate overall risk interpretation?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — High risk overall: the two findings each meet amber criteria

Explanation lettering: D = shown as A · E = shown as B · B = shown as D · A = shown as E

The correct answer is B. In an adult, a BMI of exactly 13.0 kg/m² lies in the MEED amber range of 13–14.9; the red threshold is strictly below 13. A QTc of 500 ms in an adult woman is prolonged, but where there is no other ECG anomaly, electrolyte disturbance or QT-prolonging medication, it meets the amber description. MEED states that two or more amber ratings should probably be considered high risk. C is therefore incorrect because risks are combined rather than only the single worst parameter being counted. D and E incorrectly classify the individual findings as red. A is incompatible with both measurements. Clinical evaluation and the required monitoring and location of care must then be individualised.

Reference: Royal College of Psychiatrists. Medical Emergencies in Eating Disorders: Guidance on Recognition and Management (CR233), section 2, Table 1: Risk assessment framework for assessing impending risk to life. May 2022. https://www.rcpsych.ac.uk/docs/default-source/improving-care/better-mh-policy/college-reports/college-report-cr233-medical-emergencies-in-eating-disorders-%28meed%29-guidance.pdf?sfvrsn=2d327483_59