-
Question 1
Incorrect
-
What is the lowest amount of fluoxetine that can effectively treat adults?
Your Answer: 10 mg
Correct Answer: 20 mg
Explanation:Adults require a minimum effective dose of 20 mg of fluoxetine.
Antidepressants: Minimum Effective Doses
According to the Maudsley 13th, the following are the minimum effective doses for various antidepressants:
– Citalopram: 20 mg/day
– Fluoxetine: 20 mg/day
– Fluvoxamine: 50 mg/day
– Paroxetine: 20 mg/day
– Sertraline: 50 mg/day
– Mirtazapine: 30 mg/day
– Venlafaxine: 75 mg/day
– Duloxetine: 60 mg/day
– Agomelatine: 25 mg/day
– Moclobemide: 300 mg/day
– Trazodone: 150 mg/dayNote that these are minimum effective doses and may vary depending on individual factors and response to treatment. It is important to consult with a healthcare professional before starting of changing any medication regimen.
-
This question is part of the following fields:
- Psychopharmacology
-
-
Question 2
Incorrect
-
What is the definition of secondary deviance?
Your Answer: Telling people about a stigmatised diagnosis in an effort to educate them and so reduce the stigma
Correct Answer: An individual's reaction to experiences resulting from being labelled as deviant
Explanation:Primary deviance refers to the initial act of breaking a social rule of expectation, which may include health-related norms. On the other hand, secondary deviance describes the consequences of being stigmatized as a result of the primary deviant behavior. An example of this could be an individual joining a gang as a means of finding acceptance after being rejected by mainstream society. For more information on this topic, one can refer to resources such as SOS Sociology.
-
This question is part of the following fields:
- Stigma And Culture
-
-
Question 3
Incorrect
-
What is the purpose of the blood brain barrier in keeping the blood separated from what?
Your Answer: The pia mater
Correct Answer: Cerebrospinal fluid
Explanation:The blood retinal barrier refers to the membrane that separates the aqueous humour from the blood.
Understanding the Blood Brain Barrier
The blood brain barrier (BBB) is a crucial component of the brain’s defense system against harmful chemicals and ion imbalances. It is a semi-permeable membrane formed by tight junctions of endothelial cells in the brain’s capillaries, which separates the blood from the cerebrospinal fluid. However, certain areas of the BBB, known as circumventricular organs, are fenestrated to allow neurosecretory products to enter the blood.
When it comes to MRCPsych questions, the focus is on the following aspects of the BBB: the tight junctions between endothelial cells, the ease with which lipid-soluble molecules pass through compared to water-soluble ones, the difficulty large and highly charged molecules face in passing through, the increased permeability of the BBB during inflammation, and the theoretical ability of nasally administered drugs to bypass the BBB.
It is important to remember the specific circumventricular organs where the BBB is fenestrated, including the posterior pituitary and the area postrema. Understanding the BBB’s function and characteristics is essential for medical professionals to diagnose and treat neurological disorders effectively.
-
This question is part of the following fields:
- Neurosciences
-
-
Question 4
Correct
-
A child you grounded for misbehaving throws a tantrum at their sibling, but behaves politely with you despite feeling angry about the punishment.
Which defense mechanism is demonstrated?Your Answer: Displacement
Explanation:In order for splitting to be present, the patient must demonstrate an inability to recognize others as multifaceted individuals with both positive and negative qualities, and instead resort to idealizing of devaluing them. Additionally, the patient may project their emotions onto an object they deem less significant.
Intermediate Mechanism: Rationalisation
Rationalisation is a defense mechanism commonly used by individuals to create false but credible justifications for their behavior of actions. It involves the use of logical reasoning to explain away of justify unacceptable behavior of feelings. The individual may not be aware that they are using this mechanism, and it can be difficult to identify in oneself.
Rationalisation is considered an intermediate mechanism, as it is common in healthy individuals from ages three to ninety, as well as in neurotic disorders and in mastering acute adult stress. It can be dramatically changed by conventional psychotherapeutic interpretation.
Examples of rationalisation include a student who fails an exam and blames the teacher for not teaching the material well enough, of a person who cheats on their partner and justifies it by saying their partner was neglectful of unaffectionate. It allows the individual to avoid taking responsibility for their actions and to maintain a positive self-image.
Overall, rationalisation can be a useful defense mechanism in certain situations, but it can also be harmful if it leads to a lack of accountability and an inability to learn from mistakes.
-
This question is part of the following fields:
- Classification And Assessment
-
-
Question 5
Correct
-
What is the most consistently observed pathology in schizophrenia?
Your Answer: Reduced total grey matter volume
Explanation:Alzheimer’s disease is associated with the presence of Hirano bodies.
Schizophrenia is a pathology that is characterized by a number of structural and functional brain alterations. Structural alterations include enlargement of the ventricles, reductions in total brain and gray matter volume, and regional reductions in the amygdala, parahippocampal gyrus, and temporal lobes. Antipsychotic treatment may be associated with gray matter loss over time, and even drug-naïve patients show volume reductions. Cerebral asymmetry is also reduced in affected individuals and healthy relatives. Functional alterations include diminished activation of frontal regions during cognitive tasks and increased activation of temporal regions during hallucinations. These findings suggest that schizophrenia is associated with both macroscopic and functional changes in the brain.
-
This question is part of the following fields:
- Neurosciences
-
-
Question 6
Incorrect
-
Which of the big five personality traits is synonymous with the term Surgency?
Your Answer: Agreeableness
Correct Answer: Extraversion
Explanation:The Big Five Personality Traits, also known as OCEAN, are five broad categories that can be used to describe an individual’s personality. These categories include Openness to Experience, Conscientiousness, Extraversion (also known as Surgency), Agreeableness, and Neuroticism (also known as Emotional Stability). Each of these traits can be further broken down into specific characteristics that help to define an individual’s personality. For example, Openness to Experience includes traits such as imagination, creativity, and a willingness to try new things. Conscientiousness includes traits such as organization, responsibility, and dependability. Extraversion includes traits such as sociability, assertiveness, and energy level. Agreeableness includes traits such as kindness, empathy, and cooperation. Finally, Neuroticism includes traits such as anxiety, moodiness, and emotional instability. Understanding these personality traits can be helpful in a variety of settings, such as in the workplace of in personal relationships.
-
This question is part of the following fields:
- Classification And Assessment
-
-
Question 7
Incorrect
-
Which of the following conditions is not associated with an abnormality in the tau protein?
Your Answer: Alzheimer's
Correct Answer: Hepatolenticular degeneration
Explanation:Wilson’s disease, also known as hepatolenticular degeneration, is identified by the accumulation of copper in the liver and brain.
Tau and Tauopathies
Tau proteins are essential for maintaining the stability of microtubules in neurons. Microtubules provide structural support to the cell and facilitate the transport of molecules within the cell. Tau proteins are predominantly found in the axons of neurons and are absent in dendrites. The gene that codes for tau protein is located on chromosome 17.
When tau proteins become hyperphosphorylated, they clump together, forming neurofibrillary tangles. This process leads to the disintegration of cells, which is a hallmark of several neurodegenerative disorders collectively known as tauopathies.
The major tauopathies include Alzheimer’s disease, Pick’s disease (frontotemporal dementia), progressive supranuclear palsy, and corticobasal degeneration. These disorders are characterized by the accumulation of tau protein in the brain, leading to the degeneration of neurons and cognitive decline. Understanding the role of tau proteins in these disorders is crucial for developing effective treatments for these devastating diseases.
-
This question is part of the following fields:
- Genetics
-
-
Question 8
Incorrect
-
Which of the following statements is false about individuals with obsessive-compulsive disorder (OCD)?
Your Answer: Males with OCD have a poorer outcome than females
Correct Answer: Female to male ratio is 3:1
Explanation:While many neuroses are more prevalent in women, OCD only has a slightly higher occurrence in women with a ratio of 1.5 females to every male. Individuals with an anankastic personality may display temporary obsessional symptoms, but they are not more susceptible to OCD than other neurotic disorders. Studies indicate that males with OCD tend to experience symptoms earlier in life, have a greater tendency towards tics, and may have a less favorable prognosis compared to females.
-
This question is part of the following fields:
- Epidemiology
-
-
Question 9
Incorrect
-
Which of the following statements is true about OCD?
Your Answer: Is related to oedipal fixation
Correct Answer: Can be diagnosed in the presence of delusions and hallucinations
Explanation:According to current diagnostic criteria in both the ICD-10 and DSM IV, OCD can co-occur with psychotic disorders. OCD is a chronic and debilitating disorder characterized by intrusive and distressing obsessions and/of compulsions that cause significant distress to the individual and their loved ones. Obsessions are recurrent and unpleasant thoughts, images, of impulses, while compulsions are repetitive behaviors that a person feels compelled to perform. These behaviors are often ritualistic and follow intrusive thoughts, with resistance to carrying out compulsions resulting in increased anxiety. Patients with OCD typically recognize that their obsessions and compulsions are irrational and experience them as ego dystonic. While an obsessional personality is over-represented among OCD patients, about a third of patients have other types of personality. While magnetic resonance imaging has not revealed any consistent structural brain abnormality specific to OCD patients, studies using SPECT and PET have shown increased activity in certain brain regions, such as the frontal lobe and orbitofrontal activity. Contrary to Freud’s theory, OCD has been linked to anal fixation rather than oedipal fixation, with obsessional symptoms occurring as a way of avoiding impulses related to the subsequent genital and oedipal stages.
-
This question is part of the following fields:
- Diagnosis
-
-
Question 10
Incorrect
-
A patient with no significant psychiatric history develops an unexpected episode of mania at the age of 50. When you are admitting her it comes to your attention that she has recently been started on a number of new medications. Which of the following would be most likely to precipitate an episode of mania?
Your Answer: Amoxicillin
Correct Answer: Prednisolone
Explanation:Drug-Induced Mania: Evidence and Precipitating Drugs
There is strong evidence that mania can be triggered by certain drugs, according to Peet (1995). These drugs include levodopa, corticosteroids, anabolic-androgenic steroids, and certain classes of antidepressants such as tricyclic and monoamine oxidase inhibitors.
Additionally, Peet (2012) suggests that there is weaker evidence that mania can be induced by dopaminergic anti-Parkinsonian drugs, thyroxine, iproniazid and isoniazid, sympathomimetic drugs, chloroquine, baclofen, alprazolam, captopril, amphetamine, and phencyclidine.
It is important for healthcare professionals to be aware of the potential for drug-induced mania and to monitor patients closely for any signs of symptoms. Patients should also be informed of the risks associated with these medications and advised to report any unusual changes in mood of behavior.
-
This question is part of the following fields:
- Psychopharmacology
-
-
Question 11
Incorrect
-
What is the truth about polyuria and polydipsia caused by lithium?
Your Answer:
Correct Answer: It is improved by once daily versus twice daily dosing of lithium
Explanation:Daily administration results in increased maximum concentration but more importantly decreased minimum concentration, which is believed to facilitate renal restoration.
Lithium – Pharmacology
Pharmacokinetics:
Lithium salts are rapidly absorbed following oral administration and are almost exclusively excreted by the kidneys unchanged. Blood samples for lithium should be taken 12 hours post-dose.Ebstein’s:
Ebstein’s anomaly is a congenital malformation consisting of a prolapse of the tricuspid valve into the right ventricle. It occurs in 1:20,000 of the general population. Initial data suggested it was more common in those using lithium but this had not held to be true.Contraindications:
Addison’s disease, Brugada syndrome, cardiac disease associated with rhythm disorders, clinically significant renal impairment, untreated of untreatable hypothyroidism, low sodium levels.Side-effects:
Common side effects include nausea, tremor, polyuria/polydipsia, rash/dermatitis, blurred vision, dizziness, decreased appetite, drowsiness, metallic taste, and diarrhea. Side-effects are often dose-related.Long-term use is associated with hypothyroidism, hyperthyroidism, hypercalcemia/hyperparathyroidism, irreversible nephrogenic diabetes insipidus, and reduced GFR.
Lithium-induced diabetes insipidus:
Treatment options include stopping lithium (if feasible), keeping levels within 0.4-0.8 mmol/L, once-daily dose of the drug taken at bedtime, amiloride, thiazide diuretics, indomethacin, and desmopressin.Toxicity:
Lithium salts have a narrow therapeutic/toxic ratio. Risk factors for lithium toxicity include drugs altering renal function, decreased circulating volume, infections, fever, decreased oral intake of water, renal insufficiency, and nephrogenic diabetes insipidus. Features of lithium toxicity include GI symptoms and neuro symptoms.Pre-prescribing:
Before prescribing lithium, renal function, cardiac function, thyroid function, FBC, and BMI should be checked. Women of childbearing age should be advised regarding contraception, and information about toxicity should be provided.Monitoring:
Lithium blood levels should be checked weekly until stable, and then every 3-6 months once stable. Thyroid and renal function should be checked every 6 months. Patients should be issued with an information booklet, alert card, and record book. -
This question is part of the following fields:
- Psychopharmacology
-
-
Question 12
Incorrect
-
How do an organism's genes and environmental factors interact to produce certain outcomes?
Your Answer:
Correct Answer: Phenotype
Explanation:Inheritance: Phenotype and Genotype
Phenotype refers to the observable traits of an individual, such as height, eye colour, and blood type. These traits are a result of the interaction between an individual’s genotype and the environment. The term ‘pheno’ comes from the same root as ‘phenomenon’ and simply means ‘observe’.
On the other hand, genotype refers to an individual’s collection of genes. These genes determine the traits that an individual will inherit from their parents. A haplotype, on the other hand, is a set of DNA variations of polymorphisms that tend to be inherited together.
Finally, a karyotype refers to an individual’s collection of chromosomes. These chromosomes contain the genetic information that determines an individual’s traits. By examining an individual’s karyotype, scientists can determine if there are any genetic abnormalities of disorders present.
-
This question is part of the following fields:
- Genetics
-
-
Question 13
Incorrect
-
Piaget's theory of child development suggests that when a child attempts to feed from a bottle for the first time, they must adjust their sucking technique. What is this an example of according to Piaget's theory?
Your Answer:
Correct Answer: Accommodation
Explanation:Piaget’s Stages of Development and Key Concepts
Piaget developed four stages of development that describe how children think and acquire knowledge. The first stage is the Sensorimotor stage, which occurs from birth to 18-24 months. In this stage, infants learn through sensory observation and gain control of their motor functions through activity, exploration, and manipulation of the environment.
The second stage is the Preoperational stage, which occurs from 2 to 7 years. During this stage, children use symbols and language more extensively, but they are unable to think logically of deductively. They also use a type of magical thinking and animistic thinking.
The third stage is the Concrete Operational stage, which occurs from 7 to 11 years. In this stage, egocentric thought is replaced by operational thought, which involves dealing with a wide array of information outside the child. Children in this stage begin to use limited logical thought and can serialise, order, and group things into classes on the basis of common characteristics.
The fourth and final stage is the Formal Operations stage, which occurs from 11 through the end of adolescence. This stage is characterized by the ability to think abstractly, to reason deductively, to define concepts, and also by the emergence of skills for dealing with permutations and combinations.
Piaget also developed key concepts, including schema, assimilation, and accommodation. A schema is a category of knowledge and the process of obtaining that knowledge. Assimilation is the process of taking new information into an existing schema, while accommodation involves altering a schema in view of additional information.
Overall, Piaget’s stages of development and key concepts provide a framework for understanding how children learn and acquire knowledge.
-
This question is part of the following fields:
- Psychological Development
-
-
Question 14
Incorrect
-
Which cranial nerve travels through the cribriform plate of the ethmoid bone on its way to the brain?
Your Answer:
Correct Answer: Olfactory nerve
Explanation:The olfactory nerves are responsible for the sense of smell. They originate in the upper part of the nose’s mucous membrane and travel through the ethmoid bone’s cribriform plate. From there, they reach the olfactory bulb, where nerve cells synapse and transmit the impulse to a second neuron. Finally, the nerves travel to the temporal lobe of the cerebrum, where the perception of smell occurs.
Overview of Cranial Nerves and Their Functions
The cranial nerves are a complex system of nerves that originate from the brain and control various functions of the head and neck. There are twelve cranial nerves, each with a specific function and origin. The following table provides a simplified overview of the cranial nerves, including their origin, skull exit, modality, and functions.
The first cranial nerve, the olfactory nerve, originates from the telencephalon and exits through the cribriform plate. It is a sensory nerve that controls the sense of smell. The second cranial nerve, the optic nerve, originates from the diencephalon and exits through the optic foramen. It is a sensory nerve that controls vision.
The third cranial nerve, the oculomotor nerve, originates from the midbrain and exits through the superior orbital fissure. It is a motor nerve that controls eye movement, pupillary constriction, and lens accommodation. The fourth cranial nerve, the trochlear nerve, also originates from the midbrain and exits through the superior orbital fissure. It is a motor nerve that controls eye movement.
The fifth cranial nerve, the trigeminal nerve, originates from the pons and exits through different foramina depending on the division. It is a mixed nerve that controls chewing and sensation of the anterior 2/3 of the scalp. It also tenses the tympanic membrane to dampen loud noises.
The sixth cranial nerve, the abducens nerve, originates from the pons and exits through the superior orbital fissure. It is a motor nerve that controls eye movement. The seventh cranial nerve, the facial nerve, also originates from the pons and exits through the internal auditory canal. It is a mixed nerve that controls facial expression, taste of the anterior 2/3 of the tongue, and tension on the stapes to dampen loud noises.
The eighth cranial nerve, the vestibulocochlear nerve, originates from the pons and exits through the internal auditory canal. It is a sensory nerve that controls hearing. The ninth cranial nerve, the glossopharyngeal nerve, originates from the medulla and exits through the jugular foramen. It is a mixed nerve that controls taste of the posterior 1/3 of the tongue, elevation of the larynx and pharynx, and swallowing.
The tenth cranial nerve, the vagus nerve, also originates from the medulla and exits through the jugular foramen. It is a mixed nerve that controls swallowing, voice production, and parasympathetic supply to nearly all thoracic and abdominal viscera. The eleventh cranial nerve, the accessory nerve, originates from the medulla and exits through the jugular foramen. It is a motor nerve that controls shoulder shrugging and head turning.
The twelfth cranial nerve, the hypoglossal nerve, originates from the medulla and exits through the hypoglossal canal. It is a motor nerve that controls tongue movement. Overall, the cranial nerves play a crucial role in controlling various functions of the head and neck, and any damage of dysfunction can have significant consequences.
-
This question is part of the following fields:
- Neurosciences
-
-
Question 15
Incorrect
-
What is the correct statement about the recombination fraction?
Your Answer:
Correct Answer: It is a measure of the distance between two loci
Explanation:Recombination Fraction: A Measure of Distance Between Loci
When two loci are located on different chromosomes, they segregate independently during meiosis. However, if they are on the same chromosome, they tend to segregate together, unless crossing over occurs. Crossing over is a process in meiosis where two homologous chromosomes exchange genetic material, resulting in the shuffling of alleles. The likelihood of crossing over between two loci on a chromosome decreases as their distance from each other increases.
Hence, blocks of alleles on a chromosome tend to be transmitted together through generations, forming a haplotype. The recombination fraction is a measure of the distance between two loci on a chromosome. The closer the loci are, the lower the recombination fraction, and the more likely they are to be transmitted together. Conversely, the further apart the loci are, the higher the recombination fraction, and the more likely they are to be separated by crossing over. The recombination fraction can range from 0% if the loci are very close to 50% if they are on different chromosomes.
-
This question is part of the following fields:
- Genetics
-
-
Question 16
Incorrect
-
What is the number of centromeres present in a cell containing 20 chromatids?
Your Answer:
Correct Answer: 10
Explanation:Cytokinesis: The Final Stage of Cell Division
Cytokinesis is the final stage of cell division, where the cell splits into two daughter cells, each with a nucleus. This process is essential for the growth and repair of tissues in multicellular organisms. In mitosis, cytokinesis occurs after telophase, while in meiosis, it occurs after telophase I and telophase II.
During cytokinesis, a contractile ring made of actin and myosin filaments forms around the cell’s equator, constricting it like a belt. This ring gradually tightens, pulling the cell membrane inward and creating a furrow that deepens until it reaches the center of the cell. Eventually, the furrow meets in the middle, dividing the cell into two daughter cells.
In animal cells, cytokinesis is achieved by the formation of a cleavage furrow, while in plant cells, a cell plate forms between the two daughter nuclei, which eventually develops into a new cell wall. The timing and mechanism of cytokinesis are tightly regulated by a complex network of proteins and signaling pathways, ensuring that each daughter cell receives the correct amount of cytoplasm and organelles.
Overall, cytokinesis is a crucial step in the cell cycle, ensuring that genetic material is equally distributed between daughter cells and allowing for the growth and development of multicellular organisms.
-
This question is part of the following fields:
- Genetics
-
-
Question 17
Incorrect
-
What is a true statement about the endocannabinoid system?
Your Answer:
Correct Answer: CB2 receptors are expressed at much lower levels in the central nervous system compared to CB1
Explanation:The Endocannabinoid System and its Role in Psychosis
The endocannabinoid system (ECS) plays a crucial role in regulating various physiological functions in the body, including cognition, sleep, energy metabolism, and inflammation. It is composed of endogenous cannabinoids, cannabinoid receptors, and proteins that transport, synthesize, and degrade endocannabinoids. The two best-characterized cannabinoid receptors are CB1 and CB2, which primarily couple to inhibitory G proteins and modulate different neurotransmitter systems in the brain.
Impairment of the ECS after cannabis consumption has been linked to an increased risk of psychotic illness. However, enhancing the ECS with cannabidiol (CBD) has shown anti-inflammatory and antipsychotic outcomes in both healthy study participants and in preliminary clinical trials on people with psychotic illness of at high risk of developing psychosis. Studies have also found increased anandamide levels in the cerebrospinal fluid and blood, as well as increased CB1 expression in peripheral immune cells of people with psychotic illness compared to healthy controls. Overall, understanding the role of the ECS in psychosis may lead to new therapeutic approaches for treating this condition.
-
This question is part of the following fields:
- Neurosciences
-
-
Question 18
Incorrect
-
Which process breaks down dopamine?
Your Answer:
Correct Answer: COMT and both forms of MAO
Explanation:COMT and both types of MAO are responsible for the metabolism of dopamine.
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.
-
This question is part of the following fields:
- Neurosciences
-
-
Question 19
Incorrect
-
What is located within Brodmann area 22?
Your Answer:
Correct Answer: Wernicke's area
Explanation:Broca’s and Wernicke’s are two types of expressive dysphasia, which is characterized by difficulty producing speech despite intact comprehension. Dysarthria is a type of expressive dysphasia caused by damage to the speech production apparatus, while Broca’s aphasia is caused by damage to the area of the brain responsible for speech production, specifically Broca’s area located in Brodmann areas 44 and 45. On the other hand, Wernicke’s aphasia is a type of receptive of fluent aphasia caused by damage to the comprehension of speech, while the actual production of speech remains normal. Wernicke’s area is located in the posterior part of the superior temporal gyrus in the dominant hemisphere, within Brodmann area 22.
-
This question is part of the following fields:
- Neurosciences
-
-
Question 20
Incorrect
-
What is the term used to describe the experience of a male patient withdrawing from alcohol who sees small people walking on top of his bed sheets?
Your Answer:
Correct Answer: Lilliputian hallucinations
Explanation:Lilliputian hallucinations are commonly observed in conditions caused by organic factors, such as withdrawal and intoxication.
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.
-
This question is part of the following fields:
- Classification And Assessment
-
-
Question 21
Incorrect
-
Under what circumstances would it be legal to violate the confidentiality of a minor patient and reveal their personal information without their permission?
Your Answer:
Correct Answer: To the police when the patient poses a significant risk to a specific victim
Explanation:Patient information can only be shared in certain situations, such as when required by law, with the patient’s consent, of if it is deemed to be in the public interest. Even after a patient has passed away, confidentiality must still be maintained. In the case of children of young adults, information may be disclosed if it is believed to be in their best interests and they are not capable of making the decision themselves.
-
This question is part of the following fields:
- Basic Ethics And Philosophy Of Psychiatry
-
-
Question 22
Incorrect
-
Which statement accurately describes the placebo effect?
Your Answer:
Correct Answer: Placebo response tends to be greater in milder forms of illness
Explanation:Understanding the Placebo Effect
In general, a placebo is an inert substance that has no pharmacological activity but looks, smells, and tastes like the active drug it is compared to. The placebo effect is the observable improvement seen when a patient takes a placebo, which results from patient-related factors such as expectations rather than the placebo itself. Negative effects due to patient-related factors are termed the nocebo effect.
Active placebos are treatments with chemical activity that mimic the side effects of the drug being tested in a clinical trial. They are used to prevent unblinding of the drug versus the placebo control group. Placebos need not always be pharmacological and can be procedural, such as sham electroconvulsive therapy.
The placebo effect is influenced by factors such as the perceived strength of the treatment, the status of the treating professional, and the branding of the compound. The placebo response is greater in mild illness, and the response rate is increasing over time. Placebo response is usually short-lived, and repeated use can lead to a diminished effect, known as placebo sag.
It is difficult to separate placebo effects from spontaneous remission, and patients who enter clinical trials generally do so when acutely unwell, making it challenging to show treatment effects. Breaking the blind may influence the outcome, and the expectancy effect may explain why active placebos are more effective than inert placebos. Overall, understanding the placebo effect is crucial in clinical trials and personalized medicine.
-
This question is part of the following fields:
- Classification And Assessment
-
-
Question 23
Incorrect
-
What was the main reason for categorizing antipsychotics into typical and atypical groups?
Your Answer:
Correct Answer: Propensity for EPS
Explanation:Antipsychotics were initially classified as typical of atypical based on their propensity for EPS, with only clozapine and quetiapine being considered fully atypical due to their low risk of EPS. However, a more recent classification system categorizes antipsychotics as first- of second-generation (FGAs/SGAs) based on their introduction date.
-
This question is part of the following fields:
- Psychopharmacology
-
-
Question 24
Incorrect
-
How would Marcia classify the following as identity foreclosure?
Your Answer:
Correct Answer: A teenage boy tells you that they will be a doctor when they are older. It is clear that this represents the preference of the boy’s parents who have applied pressure and that the boy has not yet explored his options
Explanation:Erikson and Marcia acknowledge that identity development is a lifelong process, but they also agree that adolescence is the period of most significant growth in this area. Individuals who are in a state of identity foreclosure have already made a commitment to an identity without fully exploring their options. This often occurs during early adolescence when individuals may feel anxious about uncertainty of change, of when they face pressure from their parents, peers, of cultural norms. As a result, they may make a preliminary commitment to an identity without investing in the exploration process.
Development: Erikson and Marcia
Erikson’s theory of psychosocial development outlines eight stages of ego growth, each marked by a specific crisis that must be resolved for positive development. These stages range from trust vs. mistrust in infancy to integrity vs. despair in old age. Successful resolution of each crisis leads to positive growth and development.
Marcia expanded on Erikson’s theory, focusing on identity formation during adolescence. He described four separate identity statuses, which represent the four possible combinations of commitment and exploration. Identity confusion/diffusion occurs when adolescents neither explore nor commit to any identities. Foreclosure occurs when an individual commits to an identity without exploring options. A moratorium is a state in which adolescents are actively exploring options but have not yet made commitments. Individuals who have explored different options, discovered their purpose, and have made identity commitments are in a state of identity achievement.
Overall, both Erikson and Marcia’s theories emphasize the importance of positive resolution of developmental crises and the role of exploration and commitment in identity formation.
-
This question is part of the following fields:
- Psychological Development
-
-
Question 25
Incorrect
-
What psychological process is referred to by the term 'cocktail party effect'?
Your Answer:
Correct Answer: Focussed attention in presence of multiple stimuli
Explanation:The term phatic communication is used to describe casual conversation. The ‘cocktail party effect’ is the ability to concentrate on one person’s voice in any setting, such as a classroom, sports game, of coffee shop, even if there is a lot of background noise.
The Cocktail Party Effect: Selective Attention in Noisy Environments
The cocktail party effect is a phenomenon that allows individuals to selectively focus on a single conversation in a noisy environment, while ignoring other competing conversations. This feature of selective attention is particularly useful in social situations, such as parties, where multiple conversations are taking place simultaneously. For instance, if you are conversing with a friend at a noisy party, you can effectively tune out the surrounding noise and concentrate on your friend’s conversation. This ability to filter out irrelevant information and focus on relevant information is a crucial aspect of human cognition. It enables us to navigate complex social environments and engage in meaningful interactions with others.
-
This question is part of the following fields:
- Social Psychology
-
-
Question 26
Incorrect
-
What benzodiazepine is recommended as the preferred medication for patients who have significant liver damage?
Your Answer:
Correct Answer: Oxazepam
Explanation:Sedatives and Liver Disease
Sedatives are commonly used for their calming effects, but many of them are metabolized in the liver. Therefore, caution must be taken when administering sedatives to patients with liver disease. The Maudsley Guidelines recommend using low doses of the following sedatives in patients with hepatic impairment: lorazepam, oxazepam, temazepam, and zopiclone. It is important to note that zopiclone should also be used with caution and at low doses in this population. Proper management of sedative use in patients with liver disease can help prevent further damage to the liver and improve overall patient outcomes.
-
This question is part of the following fields:
- Psychopharmacology
-
-
Question 27
Incorrect
-
Which of these is not a part of MELAS syndrome?
Your Answer:
Correct Answer: Asystole
Explanation:Non-Mendelian inheritance patterns include mitochondrial inheritance, trinucleotide expansion, mosaicism, and genomic imprinting. These patterns do not follow the typical Mendelian principles. Examples of non-Mendelian mitochondrial inheritance include Leber’s hereditary optic neuropathy and MELAS syndrome, which is characterized by mitochondrial myopathy, encephalopathy, lactic acidosis, and recurrent stroke.
On the other hand, Mendelian genetic inheritance patterns include autosomal dominant, autosomal recessive, and sex-linked disorders such as X-linked dominant and X-linked recessive.
Mitochondrial DNA abnormalities can lead to various diseases, including MELAS syndrome. Mitochondrial DNA is inherited solely from the mother’s ovum, and the embryo’s mitochondria are entirely maternally derived. Most mitochondrial diseases manifest as myopathies and neuropathies.
-
This question is part of the following fields:
- Genetics
-
-
Question 28
Incorrect
-
Which of the following is not considered a characteristic of Klüver-Bucy syndrome?
Your Answer:
Correct Answer: Visual apraxia
Explanation:Kluver-Bucy Syndrome: Causes and Symptoms
Kluver-Bucy syndrome is a neurological disorder that results from bilateral medial temporal lobe dysfunction, particularly in the amygdala. This condition is characterized by a range of symptoms, including hyperorality (a tendency to explore objects with the mouth), hypersexuality, docility, visual agnosia, and dietary changes.
The most common causes of Kluver-Bucy syndrome include herpes, late-stage Alzheimer’s disease, frontotemporal dementia, trauma, and bilateral temporal lobe infarction. In some cases, the condition may be reversible with treatment, but in others, it may be permanent and require ongoing management. If you of someone you know is experiencing symptoms of Kluver-Bucy syndrome, it is important to seek medical attention promptly to determine the underlying cause and develop an appropriate treatment plan.
-
This question is part of the following fields:
- Neurosciences
-
-
Question 29
Incorrect
-
Which topic is covered by the Fraser Guidelines?
Your Answer:
Correct Answer: The provision of contraceptives to people 16 and under
Explanation:Gillick Competency and Fraser Guidelines
Gillick competency and Fraser guidelines refer to a legal case which looked specifically at whether doctors should be able to give contraceptive advice of treatment to under 16-year-olds without parental consent. But since then, they have been more widely used to help assess whether a child has the maturity to make their own decisions and to understand the implications of those decisions.
In 1982, Mrs Victoria Gillick took her local health authority (West Norfolk and Wisbech Area Health Authority) and the Department of Health and Social Security to court in an attempt to stop doctors from giving contraceptive advice of treatment to under 16-year-olds without parental consent.
The case went to the High Court where Mr Justice Woolf dismissed Mrs Gillick’s claims. The Court of Appeal reversed this decision, but in 1985 it went to the House of Lords and the Law Lords (Lord Scarman, Lord Fraser and Lord Bridge) ruled in favour of the original judgement delivered by Mr Justice Woolf.
The Fraser Guidelines were laid down by Lord Fraser in the House of Lords’ case and state that it is lawful for doctors to provide contraceptive advice and treatment without parental consent providing that they are satisfied that:
– The young person will understand the professional’s advice
– The young person cannot be persuaded to inform their parents
– The young person is likely to begin, of to continue having, sexual intercourse with of without contraceptive treatment
– Unless the young person receives contraceptive treatment, their physical of mental health, of both, are likely to suffer
– The young person’s best interests require them to receive contraceptive advice of treatment with of without parental consent. -
This question is part of the following fields:
- Classification And Assessment
-
-
Question 30
Incorrect
-
In what field did Thomas and Chess have the greatest impact?
Your Answer:
Correct Answer: Temperament
Explanation:Temperament is the innate aspect of an individual’s personality that is believed to be influenced by genetics, while character is shaped by learned experiences. Thomas and Chess developed a classification system that assesses children’s behavior based on nine traits, including activity level, adaptability, and emotional response. They found that 65% of children fall into one of three temperament types: easy, difficult, of slow to warm up. Thomas and Chess also introduced the concept of goodness of fit, which refers to the compatibility between a child’s temperament and their environment. When there is a good fit, children are more likely to reach their potential. For example, teachers can provide active learning experiences for children with high activity levels instead of seat work.
-
This question is part of the following fields:
- Social Psychology
-
00
Correct
00
Incorrect
00
:
00
:
00
Session Time
00
:
00
Average Question Time (
Mins)