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Question 1
Correct
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Which medical conditions have been linked to the potential involvement of nitric oxide in their development?
Your Answer: Depression
Explanation:Nitric Oxide and Depression
Recent research has indicated that nitric oxide (NO) may play a role in the development of depression. Inhibitors of NO synthase have been found to exhibit antidepressant-like effects in preclinical studies, suggesting that NO may be involved in the pathogenesis of depression. These findings suggest that targeting NO signaling pathways may be a potential therapeutic approach for treating depression. Further research is needed to fully understand the role of NO in depression and to develop effective treatments based on this knowledge.
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This question is part of the following fields:
- Neurosciences
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Question 2
Correct
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In Mahler's Separation-Individuation theory, during which developmental stage is object constancy typically attained?
Your Answer: 24-36 months
Explanation:Mahler’s Separation-Individuation theory of child development proposes that personality development occurs in distinct stages. The first stage, the Autistic phase, occurs during the first few weeks of life, where the child is mostly sleeping and cut off from the world. The second stage, the Symbiotic phase, lasts until around six months of age, where the child sees themselves and their mother as a single unit. The third stage, Separation-Individuation, has four subphases. The first subphase, Differentiation, occurs between six to ten months, where the child begins to see themselves as an individual and experiences separation anxiety. The second subphase, Practicing, occurs between ten to sixteen months, where the child explores connections with the external world and people other than the mother. The third subphase, Rapprochement, occurs between sixteen to twenty-four months, where the child struggles to balance their desire for independence and proximity to the mother, often resulting in tantrums and the use of transitional objects. The fourth subphase, Object constancy, occurs between twenty-four to thirty-six months, where the child accepts the idea of object constancy and is more comfortable with the mother being separate for periods of time.
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This question is part of the following fields:
- Psychological Development
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Question 3
Incorrect
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Which of the following is not commonly linked to restless legs syndrome?
Your Answer: Renal failure
Correct Answer: Chronic obstructive pulmonary disease
Explanation:RLS is not a risk factor for COPD, but COPD is a risk factor for sleep apnoea.
Sleep Disorders
The International Classification of Sleep Disorders (ISCD) categorizes sleep disorders into several main categories and subclasses. Dyssomnias are intrinsic sleep disorders that include narcolepsy, psychopsychologic insomnia, idiopathic hypersomnia, restless leg syndrome, periodic limb movement disorder, and obstructive sleep apnea. Extrinsic sleep disorders include inadequate sleep hygiene and alcohol-dependent sleep disorder. Circadian rhythm disorders consist of jet lag syndrome, shift work sleep disorder, irregular sleep-wake pattern, delayed sleep phase syndrome, and advanced sleep phase disorder. Parasomnias include arousal disorders such as sleepwalking and sleep terrors, sleep-wake transition disorders such as rhythmic movement disorder, sleep talking, and nocturnal leg cramps, and parasomnias associated with REM sleep such as nightmares and sleep paralysis. Sleep disorders associated with medical/psychiatric disorders and proposed sleep disorders are also included in the classification.
Narcolepsy is a disorder of unknown cause that is characterized by excessive sleepiness, cataplexy, and other REM sleep phenomena such as sleep paralysis and hypnagogic hallucinations. Periodic limb movement disorder is characterized by periodic episodes of repetitive and highly stereotyped limb movements that occur during sleep. Restless legs syndrome is a disorder characterized by disagreeable leg sensations that usually occur prior to sleep onset and that cause an almost irresistible urge to move the legs. Jet lag syndrome consists of varying degrees of difficulties in initiating or maintaining sleep, excessive sleepiness, decrements in subjective daytime alertness and performance, and somatic symptoms following rapid travel across multiple time zones. Shift work sleep disorder consists of symptoms of insomnia of excessive sleepiness that occur as transient phenomena in relation to work schedules. Non 24 hour sleep wake syndrome consists of a chronic steady pattern comprising one to two hour daily delays in sleep onset and wake times in an individual living in society. Sleepwalking consists of a series of complex behaviors that are initiated during slow-wave sleep and result in walking during sleep. Sleep terrors are characterized by a sudden arousal from slow wave sleep with a piercing scream of cry, accompanied by autonomic and behavioral manifestations of intense fear. Rhythmic movement disorder comprises a group of stereotyped, repetitive movements involving large muscles, usually of the head and neck. Sleep starts are sudden, brief contractions of the legs, sometimes also involving the arms and head, that occur at sleep onset. Nocturnal leg cramps are painful sensations of muscular tightness of tension, usually in the calf but occasionally in the foot, that occur during the sleep episode. Nightmares are frightening dreams that usually awaken the sleeper from REM sleep. Sleep paralysis is a common condition characterized by transient paralysis of skeletal muscles which occurs when awakening from sleep of less often while falling asleep.
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This question is part of the following fields:
- Social Psychology
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Question 4
Correct
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What is a known factor that can increase the risk of QTc prolongation?
Your Answer: Anorexia nervosa
Explanation:Amantadine and QTc Prolongation
Amantadine is a medication used to treat Parkinson’s disease and influenza. It has been associated with QTc prolongation, which can increase the risk of Torsades de points. Therefore, caution should be exercised when prescribing amantadine to patients with risk factors for QT prolongation. If a patient is already taking amantadine and develops a prolonged QTc interval, the medication should be discontinued and an alternative treatment considered. It is important to monitor the QTc interval in patients taking amantadine, especially those with risk factors for QT prolongation.
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This question is part of the following fields:
- Psychopharmacology
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Question 5
Correct
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A 35 year old woman has been referred to your clinic with suspected functional paralysis of the left leg. When you ask her to raise her unaffected leg while lying flat on the bed, you feel her pushing down on your hand as you place it under her affected leg.
What sign has been demonstrated?Your Answer: Hoover's sign
Explanation:– A Battle’s sign is a physical indication of a basal skull fracture.
– Babinski’s sign is a clinical sign that suggests an upper motor neuron lesion.
– Kernig’s sign is a clinical sign that indicates meningeal irritation.
– Russell’s sign is characterized by scarring on the knuckles and back of the hand, and it is indicative of repeated induced vomiting.Hoover’s Sign for Differentiating Organic and Functional Weakness
Functional weakness refers to weakness that is inconsistent with any identifiable neurological disease and may be diagnosed as conversion disorder of dissociative motor disorder. To differentiate between organic and functional weakness of pyramidal origin, Dr. Charles Franklin Hoover described Hoover’s sign over 100 years ago.
This test is typically performed on the lower limbs and is useful when the nature of hemiparesis is uncertain. When a person with organic hemiparesis is asked to flex the hip of their normal leg against resistance, they will not exert pressure on the examiner’s hand placed under the heel on the affected side. However, in hysterical weakness, the examiner will feel increased pressure on their hand. Hoover’s sign is a valuable tool for distinguishing between organic and functional weakness.
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This question is part of the following fields:
- Neurosciences
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Question 6
Incorrect
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Which tricyclic antidepressant has been demonstrated to have higher toxicity compared to others?
Your Answer: Trimipramine
Correct Answer: Dothiepin
Explanation:Tricyclic Antidepressants: Uses, Types, and Side-Effects
Tricyclic antidepressants (TCAs) are a type of medication used for depression and neuropathic pain. However, due to their side-effects and toxicity in overdose, they are not commonly used for depression anymore. TCAs can be divided into two types: first generation (tertiary amines) and second generation (secondary amines). The secondary amines have a lower side effect profile and act primarily on noradrenaline, while the tertiary amines boost serotonin and noradrenaline.
Some examples of secondary amines include desipramine, nortriptyline, protriptyline, and amoxapine. Examples of tertiary amines include amitriptyline, lofepramine, imipramine, clomipramine, dosulepin (dothiepin), doxepin, trimipramine, and butriptyline. Common side-effects of TCAs include drowsiness, dry mouth, blurred vision, constipation, and urinary retention.
Low-dose amitriptyline is commonly used for neuropathic pain and prophylaxis of headache. Lofepramine has a lower incidence of toxicity in overdose. However, amitriptyline and dosulepin (dothiepin) are considered the most dangerous in overdose. It is important to consult with a healthcare provider before taking any medication and to follow their instructions carefully.
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This question is part of the following fields:
- Psychopharmacology
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Question 7
Incorrect
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Which antidepressant is known for having a lower occurrence of sexual dysfunction as a side effect?
Your Answer: Venlafaxine
Correct Answer: Reboxetine
Explanation: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 8
Incorrect
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What is a true statement regarding the risks of developing schizophrenia based on the Gottesman data?
Your Answer: A fraternal twin has a 40% chance of developing schizophrenia is the other twin is affected
Correct Answer: A parent has a 6% chance of developing schizophrenia is their child is affected
Explanation:Schizophrenia Risk According to Gottesman
Irving I. Gottesman conducted family and twin studies in European populations between 1920 and 1987 to determine the risk of developing schizophrenia for relatives of those with the disorder. The following table displays Gottesman’s findings, which show the average lifetime risk for each relationship:
General population: 1%
First cousin: 2%
Uncle/aunt: 2%
Nephew/niece: 4%
Grandchildren: 5%
Parents: 6%
Half sibling: 6%
Full sibling: 9%
Children: 13%
Fraternal twins: 17%
Offspring of dual matings (both parents had schizophrenia): 46%
Identical twins: 48% -
This question is part of the following fields:
- Genetics
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Question 9
Incorrect
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Which psychologist proposed the law of effect, which suggests that the likelihood of a behavior occurring is influenced by the consequences it produces in the environment?
Your Answer: Skinner's
Correct Answer: Thorndike's
Explanation:Thorndike’s Law of Effect
Thorndike’s law of effect is a principle that explains how the likelihood of an action occurring is influenced by the effect it has on the environment.
In simpler terms, this law suggests that actions that result in pleasurable outcomes are more likely to be repeated, while actions that lead to discomfort of negative consequences are less likely to be repeated.
This law has significant implications for behavior and learning. It suggests that positive reinforcement is a powerful tool for shaping behavior, as it increases the likelihood of a behavior being repeated. On the other hand, punishment of negative consequences may not be as effective in changing behavior, as they may only serve to decrease the likelihood of a behavior being repeated, rather than promoting a desired behavior.
Overall, Thorndike’s law of effect highlights the importance of understanding the consequences of our actions and how they shape our behavior. By focusing on positive reinforcement and creating environments that promote desirable behaviors, we can increase the likelihood of success and positive outcomes.
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This question is part of the following fields:
- Social Psychology
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Question 10
Incorrect
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A 28-year-old woman has a history of drug addiction, but has been in recovery for the past year. She is now interested in becoming a bus driver and is undergoing training. What is the most probable outcome when she applies for a Group 2 (lorry/bus) licence through the DVLA?
Your Answer: He will be refused a licence to drive a lorry/bus for five years
Correct Answer: He will be refused a vocational licence to drive a lorry/bus
Explanation:The DVLA has guidelines for obtaining a vocational licence for Group 2 entitlement (LGV/PCV), which state that a licence will not be granted if there has been a history of alcohol dependence within the past three years. Alcohol dependence is a condition that develops after repeated alcohol use and includes a strong desire to consume alcohol, difficulty controlling its use, continued use despite harmful consequences, increased tolerance, and sometimes physical withdrawal symptoms. Indicators of alcohol dependence may include a history of withdrawal symptoms, tolerance, detoxification, and/of alcohol-related seizures. For Group 1 entitlement (car, motorcycle), confirmed alcohol dependence requires licence revocation of refusal until a one-year period free from alcohol problems has been achieved. Abstinence and normalization of blood parameters, if relevant, will typically be required.
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This question is part of the following fields:
- Basic Ethics And Philosophy Of Psychiatry
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