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Question 1
Correct
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What is the method used to identify the mode of inheritance for a particular trait?
Your Answer: Segregation analysis
Explanation:Segregation and Linkage Analysis in Genetics
In genetics, segregation analysis is a statistical approach that helps determine the mode of inheritance of a specific phenotype using family data. On the other hand, linkage analysis is a method used to identify the genetic location of a disease gene. The primary objective of linkage analysis is to find a piece of DNA that is inherited by all affected family members and not by any unaffected members. Once this DNA segment is identified, it indicates that the disease gene is located nearby. Both segregation and linkage analysis are crucial tools in genetic research, helping scientists understand the inheritance patterns of genetic traits and diseases. By using these methods, researchers can identify the genetic basis of various disorders and develop effective treatments.
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This question is part of the following fields:
- Genetics
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Question 2
Correct
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What is an example of an adverse drug reaction that is related to the immune system?
Your Answer: Cytotoxic
Explanation:Out of these options, only the cytotoxic reaction is immunologic and specifically mediated by antibodies.
Adverse Drug Reactions (ADRs) refer to the harmful effects associated with the use of a medication at a normal dose. These reactions are classified into two types: Type A and Type B. Type A reactions can be predicted from the pharmacology of the drug and are dose-dependent, meaning they can be reversed by withdrawing the drug. On the other hand, Type B reactions cannot be predicted from the known pharmacology of the drug and include allergic reactions.
Type A reactions account for up to 80% of all ADRs, while Type B reactions are less common. Allergic reactions are a type of Type B reaction and are further subdivided by Gell and Coombs into four types: Type I (IgE-mediated) reactions, Type II (cytotoxic) reactions, Type III (immune complex) reactions, and Type IV (cell-mediated) reactions. Proper identification and management of ADRs are crucial in ensuring patient safety and optimizing treatment outcomes.
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This question is part of the following fields:
- Psychopharmacology
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Question 3
Incorrect
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Which statement about Williams syndrome is not true?
Your Answer: There is no recognised cure for the condition
Correct Answer: It results from a microdeletion in chromosome 8
Explanation:Understanding Williams Syndrome
Williams syndrome is a rare neurodevelopmental disorder that is characterized by distinct physical and behavioral traits. Individuals with this syndrome have a unique facial appearance, including a low nasal bridge and a cheerful demeanor. They also tend to have mild to moderate mental retardation and are highly sociable and verbal.
Children with Williams syndrome are particularly sensitive to sound and may overreact to loud of high-pitched noises. The syndrome is caused by a deletion in the q11.23 region of chromosome 7, which codes for more than 20 genes. This deletion typically occurs during the recombination phase of meiosis and can be detected using fluorescent in situ hybridization (FISH).
Although Williams syndrome is an autosomal dominant condition, most cases are not inherited and occur sporadically in individuals with no family history of the disorder. With a prevalence of around 1 in 20,000, Williams syndrome is a rare condition that requires specialized care and support.
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This question is part of the following fields:
- Genetics
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Question 4
Correct
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What is an example of an atypical antipsychotic medication?
Your Answer: Clozapine
Explanation:Antipsychotics can be classified in different ways, with the most common being typical (first generation) and atypical (second generation) types. Typical antipsychotics block dopamine (D2) receptors and have varying degrees of M1, Alpha-1, and H1 receptor blockade. Atypical antipsychotics have a lower propensity for extrapyramidal side-effects and are attributed to the combination of relatively lower D2 antagonism with 5HT2A antagonism. They are also classified by structure, with examples including phenothiazines, butyrophenones, thioxanthenes, diphenylbutylpiperidine, dibenzodiazepines, benzoxazoles, thienobenzodiazepine, substituted benzamides, and arylpiperidylindole (quinolone). Studies have found little evidence to support the superiority of atypicals over typicals in terms of efficacy, discontinuation rates, of adherence, with the main difference being the side-effect profile. The Royal College also favors classification by structure.
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This question is part of the following fields:
- Psychopharmacology
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Question 5
Incorrect
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The behavior of the cat expecting food when it hears a noise similar to the can opener is an example of:
Your Answer: Higher order conditioning
Correct Answer: Stimulus generalisation
Explanation:Classical Conditioning: A Learning Theory by Ivan Pavlov
Classical conditioning is a learning theory developed by Ivan Pavlov. It suggests that events that occur together are associated and acquire a similar meaning. Unlike operant conditioning, which focuses on responses to behavior, classical conditioning looks at responses to stimuli. In classical conditioning, animals behave as if they have learned to associate a stimulus with a significant event. Pavlov demonstrated that innate responses, such as a dog salivating when it sees food, can be associated with a neutral stimulus, such as ringing a bell, so that ringing the bell can cause salivation even in the absence of food.
Important terms used in classical conditioning include stimulus generalization and discrimination, higher order conditioning, spontaneous recovery, and aversive conditioning. Extinction is the laboratory analogue of exposure therapy for anxiety disorders, while Counterconditioning involves pairing a feared conditioned stimulus with a positive outcome. Incubation occurs in fear responses, and reciprocal inhibition is a technique that aims to replace an undesired response with a desired one by counterconditioning. Some stimuli are more prone to conditioning than others, which is referred to as stimulus/biological preparedness.
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This question is part of the following fields:
- Social Psychology
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Question 6
Incorrect
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Which of the following best describes the symptoms of the woman who visited A&E claiming that she had a chip implanted in her head by CIA and could hear voices reporting her every move back to headquarters?
Your Answer: Thought broadcast
Correct Answer: Running commentary
Explanation:The women’s movements are being narrated in real-time by the voices, which is known as ‘running commentary’. It does not appear that the voices are affecting her thoughts in any way.
First Rank Symptoms: Their Significance in Identifying Schizophrenia
First rank symptoms were introduced by Kurt Schneider in 1938 as a practical tool for non-psychiatrists to identify schizophrenia. While they are highly suggestive of schizophrenia, they are not pathognomonic and can also be seen in affective and personality disorders. Additionally, there is no evidence to support their prognostic significance.
A systematic review in 2015 found that first rank symptoms differentiated schizophrenia from nonpsychotic mental health disorders with a sensitivity of 61.8% and a specificity of 94.1%. They also differentiated schizophrenia from other types of psychosis with a sensitivity of 58% and a specificity of 74.7%.
The first rank symptoms include running commentary, thought echo, voices heard arguing, thought insertion, thought withdrawal, thought broadcast, delusional perception, somatic passivity, made affect, and made volition. While they can be helpful in identifying schizophrenia, they should not be relied upon as the sole diagnostic criteria.
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This question is part of the following fields:
- Classification And Assessment
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Question 7
Incorrect
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Which type of axon is responsible for the intense and sudden pain experienced during an injury?
Your Answer: C
Correct Answer: A-delta
Explanation:Primary Afferent Axons: Conveying Information about Touch and Pain
Primary afferent axons play a crucial role in conveying information about touch and pain from the surface of the body to the spinal cord and brain. These axons can be classified into four types based on their functions: A-alpha (proprioception), A-beta (touch), A-delta (pain and temperature), and C (pain, temperature, and itch). While all A axons are myelinated, C fibers are unmyelinated.
A-delta fibers are responsible for the sharp initial pain, while C fibers are responsible for the slow, dull, longer-lasting second pain. Understanding the different types of primary afferent axons and their functions is essential in diagnosing and treating various sensory disorders.
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This question is part of the following fields:
- Neurosciences
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Question 8
Correct
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A 32 year old man with schizophrenia explains the sensation of being able to hear discussions from the grocery store in the nearby city. Which of the options below accurately characterizes this occurrence?
Your Answer: Extracampine hallucinations
Explanation:Altered Perceptual Experiences
Disorders of perception can be categorized into sensory distortions and sensory deceptions. Sensory distortions involve changes in the intensity, spatial form, of quality of a perception. Examples include hyperaesthesia, hyperacusis, and micropsia. Sensory deceptions, on the other hand, involve new perceptions that are not based on any external stimulus. These include illusions and hallucinations.
Illusions are altered perceptions of a stimulus, while hallucinations are perceptions in the absence of a stimulus. Completion illusions, affect illusions, and pareidolic illusions are examples of illusions. Auditory, visual, gustatory, olfactory, and tactile hallucinations are different types of hallucinations. Pseudohallucinations are involuntary and vivid sensory experiences that are interpreted in a non-morbid way. They are different from true hallucinations in that the individual is able to recognize that the experience is an internally generated event.
Understanding the different types of altered perceptual experiences is important in the diagnosis and treatment of various mental health conditions.
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This question is part of the following fields:
- Classification And Assessment
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Question 9
Incorrect
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Which enzyme is responsible for the conversion of tyrosine to dihydroxyphenylalanine?
Your Answer: Catechol-O-methyltransferase
Correct Answer: Tyrosine hydroxylase
Explanation:Neurotransmitters are substances used by neurons to communicate with each other and with target tissues. They are synthesized and released from nerve endings into the synaptic cleft, where they bind to receptor proteins in the cellular membrane of the target tissue. Neurotransmitters can be classified into different types, including small molecules (such as acetylcholine, dopamine, norepinephrine, serotonin, and GABA) and large molecules (such as neuropeptides). They can also be classified as excitatory or inhibitory. Receptors can be ionotropic or metabotropic, and the effects of neurotransmitters can be fast of slow. Some important neurotransmitters include acetylcholine, dopamine, GABA, norepinephrine, and serotonin. Each neurotransmitter has a specific synthesis, breakdown, and receptor type. Understanding neurotransmitters is important for understanding the function of the nervous system and for developing treatments for neurological and psychiatric disorders.
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This question is part of the following fields:
- Neurosciences
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Question 10
Correct
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What is the closest estimate of heritability in bipolar disorder?
Your Answer: 50%
Explanation:Heritability: Understanding the Concept
Heritability is a concept that is often misunderstood. It is not a measure of the extent to which genes cause a condition in an individual. Rather, it is the proportion of phenotypic variance attributable to genetic variance. In other words, it tells us how much of the variation in a condition seen in a population is due to genetic factors. Heritability is calculated using statistical techniques and can range from 0.0 to 1.0. For human behavior, most estimates of heritability fall in the moderate range of .30 to .60.
The quantity (1.0 – heritability) gives the environment ability of the trait. This is the proportion of phenotypic variance attributable to environmental variance. The following table provides estimates of heritability for major conditions:
Condition Heritability estimate (approx)
ADHD 85%
Autism 70%
Schizophrenia 55%
Bipolar 55%
Anorexia 35%
Alcohol dependence 35%
Major depression 30%
OCD 25%It is important to note that heritability tells us nothing about individuals. It is a population-level measure that helps us understand the relative contributions of genetic and environmental factors to a particular condition.
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This question is part of the following fields:
- Genetics
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Question 11
Incorrect
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A drug that has a constant elimination rate regardless of its concentration exhibits what characteristic?
Your Answer: First order kinetics
Correct Answer: Zero order kinetics
Explanation:The half-life of a drug is the time taken for its concentration to fall to one half of its value. Drugs with long half-lives may require a loading dose to achieve therapeutic plasma concentrations rapidly. It takes about 4.5 half-lives to reach steady state plasma levels. Most drugs follow first order kinetics, where a constant fraction of the drug in the body is eliminated per unit time. However, some drugs may follow zero order kinetics, where the plasma concentration of the drug decreases at a constant rate, despite the concentration of the drug. For drugs with nonlinear kinetics of dose-dependent kinetics, the relationship between the AUC of CSS and dose is not linear, and the kinetic parameters may vary depending on the administered dose.
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This question is part of the following fields:
- Psychopharmacology
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Question 12
Correct
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Which of the following is not a risk factor associated with low socioeconomic class?
Your Answer: Anorexia nervosa
Explanation:Social Class and Mental Disorder
There is a consistent finding that shows an inverse relationship between social class and rates of mental illness. This means that individuals from lower social classes are more likely to experience mental health issues compared to those from higher social classes. However, this inverse relationship is not observed in the case of anorexia nervosa. This suggests that factors other than social class may play a more significant role in the development of this particular disorder. Overall, the relationship between social class and mental health is complex and requires further investigation to fully understand the underlying factors.
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This question is part of the following fields:
- Social Psychology
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Question 13
Correct
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A 45-year-old man, currently unemployed, has been experiencing frequent panic attacks over the past few months. These attacks seem to be triggered by social situations and he has become increasingly isolated as a result. He has a history of childhood trauma and has never sought help for it before.
He begins a form of therapy that involves individual sessions with a therapist, group therapy, and access to crisis support via phone. The therapy focuses on identifying and managing his emotions, improving his social skills in the group setting, and developing healthy coping mechanisms for times of stress.
What type of therapy is being described in this scenario?Your Answer: Dialectical behaviour therapy
Explanation:The therapy being discussed is dialectical behaviour therapy (DBT), which was created by Marsha Linehan, who had a personality disorder diagnosis and multiple hospital admissions. DBT involves mindfulness practice and the development of interpersonal skills through individual and group therapy sessions. All of the therapies mentioned are recognized treatments for personality disorders. Cognitive analytic therapy focuses on past relationships and object relations, while mentalisation-based therapy aims to improve mentalisation capacity through individual and group therapy. Schema-focused therapy builds on CBT to challenge cognitive coping strategies, and transference-focused therapy uses the therapist-client relationship to assess internal representations of past relational experiences.
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This question is part of the following fields:
- Advanced Psychological Processes And Treatments
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Question 14
Correct
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At what age and in what form does the earliest developmental fear typically manifest?
Your Answer: Strangers
Explanation:The fear of new things, such as unfamiliar people, can be observed in infants as young as 6 months old. Children between the ages of 3-5 years may develop fears of animals, monsters, and the dark. Around 6-11 years old, children may start to fear social embarrassment. Adolescents may begin to experience fear of death.
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This question is part of the following fields:
- Advanced Psychological Processes And Treatments
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Question 15
Incorrect
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What is the term used to describe the ratio of individuals who possess a specific gene variant and exhibit the corresponding trait?
Your Answer: Heterogeneity
Correct Answer: Penetrance
Explanation:Heterogeneity is characterized by the existence of multiple genetic abnormalities that result in the same disorder.
Understanding Penetrance in Genetic Diseases
Penetrance refers to the likelihood of individuals with a specific genetic mutation developing clinical symptoms of a disease. It is expressed as a percentage, indicating the proportion of individuals with the mutation who exhibit symptoms. For instance, if a mutation in a gene responsible for an autosomal dominant disorder has a penetrance of 90%, it means that 90% of individuals with the mutation will develop the disease, while the remaining 10% will not.
Penetrance is an essential concept in genetics, as it helps to predict the likelihood of a disease occurring in individuals with a specific genetic mutation. However, it is important to note that penetrance can vary depending on several factors, including age, gender, and environmental factors. Therefore, it is crucial to consider these factors when assessing the risk of developing a genetic disease. Understanding penetrance can also aid in genetic counseling and the development of personalized treatment plans for individuals with genetic mutations.
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This question is part of the following fields:
- Genetics
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Question 16
Incorrect
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Which attitude scale involves a group of evaluators who rate each statement to determine its level of positivity towards a particular concept?
Your Answer: Likert Scale
Correct Answer: Thurstone scale
Explanation:Attitude scales are used to measure a person’s feelings and thoughts towards something. There are several types of attitude scales, including the Thurstone scale, Likert scale, semantic differential scale, and Gutman scale. The Thurstone scale involves creating a list of statements and having judges score them based on their negativity of positivity towards an issue. Respondents then indicate whether they agree of disagree with each statement. The Likert scale asks respondents to indicate their degree of agreement of disagreement with a series of statements using a five-point scale. The semantic differential scale presents pairs of opposite adjectives and asks respondents to rate their position on a five- of seven-point scale. The Gutman scale involves a list of statements that can be ordered hierarchically, with each statement having a corresponding weight. Respondents’ scores on the scale indicate the number of statements they agree with.
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This question is part of the following fields:
- Classification And Assessment
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Question 17
Correct
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Which of the options is considered to have the highest potential to cause birth defects?
Your Answer: Valproate
Explanation:Teratogens and Their Associated Defects
Valproic acid is a teratogen that has been linked to various birth defects, including neural tube defects, hypospadias, cleft lip/palate, cardiovascular abnormalities, developmental delay, endocrinological disorders, limb defects, and autism (Alsdorf, 2005). Lithium has been associated with cardiac anomalies, specifically Ebstein’s anomaly. Alcohol consumption during pregnancy can lead to cleft lip/palate and fetal alcohol syndrome. Phenytoin has been linked to fingernail hypoplasia, craniofacial defects, limb defects, cerebrovascular defects, and mental retardation. Similarly, carbamazepine has been associated with fingernail hypoplasia and craniofacial defects. Diazepam has been linked to craniofacial defects, specifically cleft lip/palate (Palmieri, 2008). The evidence for steroids causing craniofacial defects is not convincing, according to the British National Formulary (BNF). Selective serotonin reuptake inhibitors (SSRIs) have been associated with congenital heart defects and persistent pulmonary hypertension (BNF). It is important for pregnant women to avoid exposure to these teratogens to reduce the risk of birth defects in their babies.
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This question is part of the following fields:
- Psychopharmacology
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Question 18
Incorrect
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The histopathological findings from a post-mortem of an older man with long standing memory difficulties reveals neuronal and glial tau aggregation in addition to pronounced atrophy of the frontal and temporal lobes.
What is the most probable diagnosis for an elderly man with these histopathological findings?Your Answer: Alzheimer's disease
Correct Answer: Pick's disease
Explanation:Alzheimer’s disease is not characterized by significant frontal lobe atrophy, but rather by early medial temporal lobe atrophy (MTA) on MRI, particularly in the hippocampus, entorhinal cortex, amygdala, and parahippocampus. In contrast, frontotemporal lobar degeneration (FTLD) typically affects the frontal and anterior temporal lobes in behavioral variant frontotemporal dementia (bvFTD of Pick’s disease), the left anterior temporal lobe in semantic dementia (SD), and the left perisylvian fissure in progressive nonfluent aphasia (PNFA).
Frontotemporal Lobar Degeneration (FTLD) is a pathological term that refers to a group of neurodegenerative disorders that affect the frontal and temporal lobes of the brain. FTLD is classified into several subtypes based on the main protein component of neuronal and glial abnormal inclusions and their distribution. The three main proteins associated with FTLD are Tau, TDP-43, and FUS. Each FTD clinical phenotype has been associated with different proportions of these proteins. Macroscopic changes in FTLD include atrophy of the frontal and temporal lobes, with focal gyral atrophy that resembles knives. Microscopic changes in FTLD-Tau include neuronal and glial tau aggregation, with further sub-classification based on the existence of different isoforms of tau protein. FTLD-TDP is characterized by cytoplasmic inclusions of TDP-43 in neurons, while FTLD-FUS is characterized by cytoplasmic inclusions of FUS.
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This question is part of the following fields:
- Neurosciences
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Question 19
Correct
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Your consultant inquires about the time it takes for aripiprazole to reach a steady state when prescribing it to a new patient. With knowledge of the drug's half-life of 75 hours, what is the expected duration for achieving a steady state?
Your Answer: 14 days
Explanation:The steady state for this scenario is 337.5 hours, which is equivalent to 14 days. This calculation was obtained by multiplying the half-life of 75 hours by a factor of 4.5, as per the given formula.
The half-life of a drug is the time taken for its concentration to fall to one half of its value. Drugs with long half-lives may require a loading dose to achieve therapeutic plasma concentrations rapidly. It takes about 4.5 half-lives to reach steady state plasma levels. Most drugs follow first order kinetics, where a constant fraction of the drug in the body is eliminated per unit time. However, some drugs may follow zero order kinetics, where the plasma concentration of the drug decreases at a constant rate, despite the concentration of the drug. For drugs with nonlinear kinetics of dose-dependent kinetics, the relationship between the AUC of CSS and dose is not linear, and the kinetic parameters may vary depending on the administered dose.
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This question is part of the following fields:
- Psychopharmacology
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Question 20
Correct
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What is a true statement about 'working memory'?
Your Answer: Its capacity increases with age during childhood
Explanation:Throughout childhood, there is an increase in working memory capacity. Additionally, research has demonstrated that working memory performance can be enhanced, particularly in individuals with ADHD.
Memory Forms
Memory is the ability to store, retain, and retrieve information. There are different forms of memory, including sensory memory, short-term/working memory, and long-term memory.
Sensory memory is the capacity for briefly retaining the large amounts of information that people encounter daily. It includes echoic memory (gathered through auditory stimuli), iconic memory (gathered through sight), and haptic memory (acquired through touch).
Short-term memory is the ability to keep a small amount of information available for a short period of time. Atkinson and Shiffrin’s multistore model (1968) suggests the existence of a short-term storehouse with limited capacity. Baddeley and Hitch (1974) further developed the concept of short-term memory, which eventually became known as Baddeley’s multi-storehouse model (2000). This model includes the central executive, visuospatial sketchpad, phonological buffer/loop, and episodic buffer.
Long-term memory includes declarative (of explicit) memories, which can be consciously retrieved, and nondeclarative (of implicit) memories, which cannot. Declarative memory includes episodic memory (stores personal experiences) and semantic memory (stores information about facts and concepts). Non-declarative memory includes procedural memory (recalls motor and executive skills), associative memory (storage and retrieval of information through association with other information), and non-associative memory (refers to newly learned behavior through repeated exposure to an isolated stimulus).
Overall, memory is a complex and essential cognitive function that plays a crucial role in learning, reasoning, and understanding.
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This question is part of the following fields:
- Social Psychology
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Question 21
Correct
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What is an example of a mixed state according to Kraepelin?
Your Answer: Manic stupor
Explanation:Kraepelin’s Mixed States: A Historical Overview
Kraepelin’s six types of mixed states were based on various combinations of mood, will, and thought processes. These mixed states are less common than pure mania of pure depression. Dysphoric mania and depressive mixed state are the two types of mixed states that have been reduced over the years. Other terms used to describe mixed states include agitated depression, anxious depression, irritable depression, and mixed hypomania. Despite the reduction in the number of mixed states, they remain a relevant psychopathological syndrome in modern times.
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This question is part of the following fields:
- Classification And Assessment
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Question 22
Incorrect
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A child is referred to a neurologist. On entering the neurologist's room, the child is observed to have a broad-based gait. When introduced, the child's speech is noted to be abnormal. When the child attempts to shake the doctor's hand, a tremor is observed. Which area of the brain is likely to be dysfunctional?
Your Answer: Left temporal lobe
Correct Answer: Cerebellum
Explanation:Cerebellar Dysfunction: Symptoms and Signs
Cerebellar dysfunction is a condition that affects the cerebellum, a part of the brain responsible for coordinating movement and balance. The symptoms and signs of cerebellar dysfunction include ataxia, intention tremor, nystagmus, broad-based gait, slurred speech, dysdiadochokinesis, and dysmetria (lack of finger-nose coordination).
Ataxia refers to the lack of coordination of voluntary movements, resulting in unsteady gait, difficulty with balance, and clumsiness. Intention tremor is a type of tremor that occurs during voluntary movements, such as reaching for an object. Nystagmus is an involuntary movement of the eyes, characterized by rapid, jerky movements.
Broad-based gait refers to a wide stance while walking, which is often seen in individuals with cerebellar dysfunction. Slurred speech, also known as dysarthria, is a common symptom of cerebellar dysfunction, which affects the ability to articulate words clearly. Dysdiadochokinesis is the inability to perform rapid alternating movements, such as tapping the fingers on the palm of the hand.
Dysmetria refers to the inability to accurately judge the distance and direction of movements, resulting in errors in reaching for objects of touching the nose with the finger. These symptoms and signs of cerebellar dysfunction can be caused by a variety of conditions, including stroke, multiple sclerosis, and alcoholism. Treatment depends on the underlying cause and may include medications, physical therapy, and surgery.
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This question is part of the following fields:
- Neurosciences
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Question 23
Incorrect
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Which type of nerve fiber lacks a myelin sheath?
Your Answer: None of the above
Correct Answer: C
Explanation:Primary Afferent Axons: Conveying Information about Touch and Pain
Primary afferent axons play a crucial role in conveying information about touch and pain from the surface of the body to the spinal cord and brain. These axons can be classified into four types based on their functions: A-alpha (proprioception), A-beta (touch), A-delta (pain and temperature), and C (pain, temperature, and itch). While all A axons are myelinated, C fibers are unmyelinated.
A-delta fibers are responsible for the sharp initial pain, while C fibers are responsible for the slow, dull, longer-lasting second pain. Understanding the different types of primary afferent axons and their functions is essential in diagnosing and treating various sensory disorders.
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This question is part of the following fields:
- Neurosciences
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Question 24
Incorrect
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What antidepressant belongs to the NaSSA classification?
Your Answer: Reboxetine
Correct Answer: Mirtazapine
Explanation:Mirtazapine and Mianserin are significant NaSSA’s (Noradrenergic and specific serotonergic antidepressants) that function by blocking adrenergic and serotonergic receptors. In contrast to the majority of antidepressants, they do not impact the reuptake of serotonin.
Mechanisms of Action of Different Drugs
Understanding the mechanisms of action of different drugs is crucial for medical professionals. It is a common topic in exams and can earn easy marks if studied well. This article provides a list of drugs and their mechanisms of action in different categories such as antidepressants, anti dementia drugs, mood stabilizers, anxiolytic/hypnotic drugs, antipsychotics, drugs of abuse, and other drugs. For example, mirtazapine is a noradrenaline and serotonin specific antidepressant that works as a 5HT2 antagonist, 5HT3 antagonist, H1 antagonist, alpha 1 and alpha 2 antagonist, and moderate muscarinic antagonist. Similarly, donepezil is a reversible acetylcholinesterase inhibitor used as an anti dementia drug, while valproate is a GABA agonist and NMDA antagonist used as a mood stabilizer. The article also explains the mechanisms of action of drugs such as ketamine, phencyclidine, buprenorphine, naloxone, atomoxetine, varenicline, disulfiram, acamprosate, and sildenafil.
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This question is part of the following fields:
- Psychopharmacology
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Question 25
Incorrect
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What is a true statement about the neocortex?
Your Answer: Grooves on the surface are called gyri
Correct Answer: It contains both pyramidal and nonpyramidal cells
Explanation:The Cerebral Cortex and Neocortex
The cerebral cortex is the outermost layer of the cerebral hemispheres and is composed of three parts: the archicortex, paleocortex, and neocortex. The neocortex accounts for 90% of the cortex and is involved in higher functions such as thought and language. It is divided into 6-7 layers, with two main cell types: pyramidal cells and nonpyramidal cells. The surface of the neocortex is divided into separate areas, each given a number by Brodmann (e.g. Brodmann’s area 17 is the primary visual cortex). The surface is folded to increase surface area, with grooves called sulci and ridges called gyri. The neocortex is responsible for higher cognitive functions and is essential for human consciousness.
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This question is part of the following fields:
- Neurosciences
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Question 26
Correct
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What is the most effective way to address sexual dysfunction in a male patient who is taking sertraline and wishes to continue its use due to positive response to the medication?
Your Answer: Sildenafil
Explanation:The medication with the strongest evidence is sildenafil.
Antidepressants can cause sexual dysfunction as a side-effect, although the rates vary. The impact on sexual desire, arousal, and orgasm can differ depending on the type of antidepressant. It is important to rule out other causes and consider non-pharmacological strategies such as reducing the dosage of taking drug holidays. If necessary, switching to a lower risk antidepressant of using pharmacological options such as phosphodiesterase inhibitors of mirtazapine augmentation can be considered. The Maudsley Guidelines 14th Edition provides a helpful table outlining the risk of sexual dysfunction for different antidepressants.
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This question is part of the following fields:
- Psychopharmacology
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Question 27
Correct
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Which antidepressant works by inhibiting the reuptake of dopamine?
Your Answer: Bupropion
Explanation:Bupropion inhibits the reuptake of noradrenaline and dopamine, making it an NDRI.
Mechanisms of Action of Different Drugs
Understanding the mechanisms of action of different drugs is crucial for medical professionals. It is a common topic in exams and can earn easy marks if studied well. This article provides a list of drugs and their mechanisms of action in different categories such as antidepressants, anti dementia drugs, mood stabilizers, anxiolytic/hypnotic drugs, antipsychotics, drugs of abuse, and other drugs. For example, mirtazapine is a noradrenaline and serotonin specific antidepressant that works as a 5HT2 antagonist, 5HT3 antagonist, H1 antagonist, alpha 1 and alpha 2 antagonist, and moderate muscarinic antagonist. Similarly, donepezil is a reversible acetylcholinesterase inhibitor used as an anti dementia drug, while valproate is a GABA agonist and NMDA antagonist used as a mood stabilizer. The article also explains the mechanisms of action of drugs such as ketamine, phencyclidine, buprenorphine, naloxone, atomoxetine, varenicline, disulfiram, acamprosate, and sildenafil.
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This question is part of the following fields:
- Psychopharmacology
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Question 28
Incorrect
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A 40 year old female is admitted to the ward with a diagnosis of depression. On admission the doctor notes skin changes consistent with erythema nodosum and also notes that the patient complains of being short of breath. Unfortunately the lady commits suicide shortly after admission. A post-mortem biopsy reveals Asteroid bodies. Which of the following diagnosis would you most suspect?:
Your Answer: Gerstmann-Sträussler syndrome
Correct Answer: Sarcoidosis
Explanation:Pathology Findings in Psychiatry
There are several pathology findings that are associated with various psychiatric conditions. Papp-Lantos bodies, for example, are visible in the CNS and are associated with multisystem atrophy. Pick bodies, on the other hand, are large, dark-staining aggregates of proteins in neurological tissue and are associated with frontotemporal dementia.
Lewy bodies are another common pathology finding in psychiatry and are associated with Parkinson’s disease and Lewy Body dementia. These are round, concentrically laminated, pale eosinophilic cytoplasmic inclusions that are aggregates of alpha-synuclein.
Other pathology findings include asteroid bodies, which are associated with sarcoidosis and berylliosis, and are acidophilic, stellate inclusions in giant cells. Barr bodies are associated with stains of X chromosomes and are inactivated X chromosomes that appear as a dark staining mass in contact with the nuclear membrane.
Mallory bodies are another common pathology finding and are associated with alcoholic hepatitis, alcoholic cirrhosis, Wilson’s disease, and primary-biliary cirrhosis. These are eosinophilic intracytoplasmic inclusions in hepatocytes that are made up of intermediate filaments, predominantly prekeratin.
Other pathology findings include Schaumann bodies, which are associated with sarcoidosis and berylliosis, and are concentrically laminated inclusions in giant cells. Zebra bodies are associated with Niemann-Pick disease, Tay-Sachs disease, of any of the mucopolysaccharidoses and are palisaded lamellated membranous cytoplasmic bodies seen in macrophages.
LE bodies, also known as hematoxylin bodies, are associated with SLE (lupus) and are nuclei of damaged cells with bound anti-nuclear antibodies that become homogeneous and loose chromatin pattern. Verocay bodies are associated with Schwannoma (Neurilemoma) and are palisades of nuclei at the end of a fibrillar bundle.
Hirano bodies are associated with normal aging but are more numerous in Alzheimer’s disease. These are eosinophilic, football-shaped inclusions seen in neurons of the brain. Neurofibrillary tangles are another common pathology finding in Alzheimer’s disease and are made up of microtubule-associated proteins and neurofilaments.
Kayser-Fleischer rings are associated with Wilson’s disease and are rings of discoloration on the cornea. Finally, Kuru plaques are associated with Kuru and Gerstmann-Sträussler syndrome and are sometimes present in patients with Creutzfeldt-Jakob disease (CJD). These are composed partly of a host-encoded prion protein.
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This question is part of the following fields:
- Neurosciences
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Question 29
Correct
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What is the main structural component of alpha-synuclein?
Your Answer: Lewy bodies
Explanation:Parkinson’s Disease Pathology
Parkinson’s disease is a neurodegenerative disorder that affects the central nervous system. The pathology of Parkinson’s disease is very similar to that of Lewy body dementia. The macroscopic features of Parkinson’s disease include pallor of the substantia nigra (midbrain) and locus coeruleus (pons). The microscopic changes include the presence of Lewy bodies, which are intracellular aggregates of alpha-synuclein. Additionally, there is a loss of dopaminergic cells from the substantia nigra pars compacta. These changes contribute to the motor symptoms of Parkinson’s disease, such as tremors, rigidity, and bradykinesia. Understanding the pathology of Parkinson’s disease is crucial for developing effective treatments and improving the quality of life for those affected by this condition.
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This question is part of the following fields:
- Neurosciences
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Question 30
Incorrect
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A 10-year-old girl has been referred to your clinic for assessment in relation to difficulties with attention at school and challenging behaviour on interaction with peers.
She describes struggling to maintain attention and to complete her assigned work in a timely manner. She often reaches the correct answer but some time after her peers have done so. This leads to frustration and at times she struggles to express her feelings and will lash out at her peers.
At home she manages her own dressing and chores unaided, although sometimes she requires occasional prompting to maintain on task.
Based on a full clinical history and previous meeting with her mother you suspect a degree of learning disability and request full scale IQ assessment.
What FSIQ value will most likely be returned?Your Answer: 49
Correct Answer: 65
Explanation:This boy may need some assistance with tasks, but he is able to complete them on his own. He may take longer to reach the correct answer compared to his peers, which is indicative of a mild learning disability. Individuals with more severe learning disabilities may require more support in their daily lives, and may also experience motor deficits. IQ levels can be described as follows: profound (below 20), severe (20-34), moderate (35-49), mild (50-70), and normal range (above 70).
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This question is part of the following fields:
- Description And Measurement
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