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  • Question 1 - Which drug is accurately paired with its corresponding half-life? ...

    Incorrect

    • Which drug is accurately paired with its corresponding half-life?

      Your Answer: Temazepam - 100-150 hours

      Correct Answer: Lorazepam - 10-20 hours

      Explanation:

      It is important to be aware of the half-lives of certain benzodiazepines, including diazepam with a half-life of 20-100 hours (36-200 hours for active metabolite), lorazepam with a half-life of 10-20 hours, chlordiazepoxide with a half-life of 5-30 hours (36-200 hours for active metabolite), nitrazepam with a half-life of 15-38 hours, temazepam with a half-life of 8-22 hours, zopiclone with a half-life of 4-6 hours, and zolpidem with a half-life of 2-6 hours.

      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.

    • This question is part of the following fields:

      • Psychopharmacology
      95
      Seconds
  • Question 2 - As a teenager, Sarah struggled with her relationship with her mother who was...

    Incorrect

    • As a teenager, Sarah struggled with her relationship with her mother who was emotionally and verbally abusive. Now, as a young adult, she finds herself constantly quitting relationships within a few weeks of starting, claiming that her partner is controlling and manipulative. What underlying psychodynamic mechanism could be contributing to this pattern of behavior?

      Your Answer: Countertransference

      Correct Answer: Transference

      Explanation:

      Transference: Attributing Characteristics to People in Similar Roles

      Transference is a psychological phenomenon where individuals attribute characteristics of important figures from their early life to people who resemble them of have roles echoing theirs. For instance, doctors, teachers, and bosses may be imbued with the characteristics of parents. This can lead to individuals projecting their feelings, attitudes, and expectations onto others, which can impact their relationships and interactions. Understanding transference can help individuals recognize and manage their emotions and reactions towards others.

    • This question is part of the following fields:

      • Dynamic Psychopathology
      42.9
      Seconds
  • Question 3 - Which type of brain lesion is typically associated with Alexia without agraphia? ...

    Incorrect

    • Which type of brain lesion is typically associated with Alexia without agraphia?

      Your Answer: Middle cerebral artery

      Correct Answer: Posterior cerebral artery

      Explanation:

      Aphasia is a language impairment that affects the production of comprehension of speech, as well as the ability to read of write. The areas involved in language are situated around the Sylvian fissure, referred to as the ‘perisylvian language area’. For repetition, the primary auditory cortex, Wernicke, Broca via the Arcuate fasciculus (AF), Broca recodes into articulatory plan, primary motor cortex, and pyramidal system to cranial nerves are involved. For oral reading, the visual cortex to Wernicke and the same processes as for repetition follows. For writing, Wernicke via AF to premotor cortex for arm and hand, movement planned, sent to motor cortex. The classification of aphasia is complex and imprecise, with the Boston Group classification and Luria’s aphasia interpretation being the most influential. The important subtypes of aphasia include global aphasia, Broca’s aphasia, Wernicke’s aphasia, conduction aphasia, anomic aphasia, transcortical motor aphasia, and transcortical sensory aphasia. Additional syndromes include alexia without agraphia, alexia with agraphia, and pure word deafness.

    • This question is part of the following fields:

      • Neurosciences
      100.3
      Seconds
  • Question 4 - What is a true statement about Levinson's theory of development? ...

    Incorrect

    • What is a true statement about Levinson's theory of development?

      Your Answer: It consisted of 4 stages

      Correct Answer: Development is considered to always move through stages in a defined order

      Explanation:

      Erik Erikson and Daniel Levinson expanded the understanding of adult development. Erikson proposed a life-span model of human development consisting of eight successive psychosocial stages, each associated with an inherent conflict of crisis that the individual must encounter and successfully resolve to proceed with development. Levinson proposed a developmental theory consisting of universal stages of phases that extend from the infancy state to the elderly state, based on biographical interviews of 40 men in America. Both theorists maintained that personality develops in a predetermined order and builds upon each previous stage, and that failure to successfully negotiate a stage can result in a reduced ability to complete further stages and therefore a more unhealthy personality and sense of self. However, Levinson’s theory is age-based rather than event-based, and his model proposed a ‘life sequence’ consisting of a series of alternating stable (structure-building) periods and cross-era transitional (structure-changing) periods, with transitional periods typically lasting 5 years.

    • This question is part of the following fields:

      • Psychological Development
      10.8
      Seconds
  • Question 5 - With which of the following is John Bowlby most closely associated? ...

    Incorrect

    • With which of the following is John Bowlby most closely associated?

      Your Answer: Group dynamics

      Correct Answer: Attachment theory

      Explanation:

      Neo-Freudians were therapists who developed their own theories while still retaining core Freudian components. Some important neo-Freudians include Alfred Adler, Carl Jung, Erik Erickson, Harry Stack Sullivan, Wilfred Bion, John Bowlby, Anna Freud, Otto Kernberg, Margaret Mahler, and Donald Winnicott. Each of these individuals contributed unique ideas to the field of psychology. For example, Carl Jung introduced the concept of the persona and differentiated between the personal and collective unconscious, while Erik Erickson is known for his stages of psychosocial development. Margaret Mahler developed theories on child development, including the three main phases of autistic, symbiotic, and separation-individuation. Donald Winnicott introduced the concept of the transitional object and the good enough mother. Overall, neo-Freudians expanded upon Freud’s ideas and helped to shape modern psychotherapy.

    • This question is part of the following fields:

      • Social Psychology
      133.9
      Seconds
  • Question 6 - Which statement accurately describes modafinil? ...

    Incorrect

    • Which statement accurately describes modafinil?

      Your Answer: It tends to precipitate psychosis

      Correct Answer: It lacks the euphoric effects of amphetamines

      Explanation:

      Modafinil: A Psychostimulant for Wakefulness and Attention Enhancement

      Modafinil is a type of psychostimulant that is known to improve wakefulness, attention, and vigilance. Although it is similar to amphetamines, it does not produce the same euphoric effects and is not associated with dependence of tolerance. Additionally, it does not seem to cause psychosis. Modafinil is approved for the treatment of narcolepsy, obstructive sleep apnea, and chronic shift work. It is also suggested as an adjunctive treatment for depression by the Maudsley. Recently, it has gained popularity as a smart drug due to its potential to enhance cognitive functioning in healthy individuals.

    • This question is part of the following fields:

      • Psychopharmacology
      10.8
      Seconds
  • Question 7 - What is the characteristic feature of EEG in individuals with Huntington's disease? ...

    Correct

    • What is the characteristic feature of EEG in individuals with Huntington's disease?

      Your Answer: Shows a flattened trace

      Explanation:

      Huntington’s Disease: Genetics and Pathology

      Huntington’s disease is a genetic disorder that follows an autosomal dominant pattern of inheritance. It is caused by a mutation in the Huntington gene, which is located on chromosome 4. The mutation involves an abnormal expansion of a trinucleotide repeat sequence (CAG), which leads to the production of a toxic protein that damages brain cells.

      The severity of the disease and the age of onset are related to the number of CAG repeats. Normally, the CAG sequence is repeated less than 27 times, but in Huntington’s disease, it is repeated many more times. The disease shows anticipation, meaning that it tends to worsen with each successive generation.

      The symptoms of Huntington’s disease typically begin in the third of fourth decade of life, but in rare cases, they can appear in childhood of adolescence. The most common symptoms include involuntary movements (chorea), cognitive decline, and psychiatric disturbances.

      The pathological hallmark of Huntington’s disease is the gross bilateral atrophy of the head of the caudate and putamen, which are regions of the brain involved in movement control. The EEG of patients with Huntington’s disease shows a flattened trace, indicating a loss of brain activity.

      Macroscopic pathological findings include frontal atrophy, marked atrophy of the caudate and putamen, and enlarged ventricles. Microscopic findings include neuronal loss and gliosis in the cortex, neuronal loss in the striatum, and the presence of inclusion bodies in the neurons of the cortex and striatum.

      In conclusion, Huntington’s disease is a devastating genetic disorder that affects the brain and causes a range of motor, cognitive, and psychiatric symptoms. The disease is caused by a mutation in the Huntington gene, which leads to the production of a toxic protein that damages brain cells. The pathological changes in the brain include atrophy of the caudate and putamen, neuronal loss, and the presence of inclusion bodies.

    • This question is part of the following fields:

      • Genetics
      14.6
      Seconds
  • Question 8 - What statement accurately describes the trigeminal nerve? ...

    Correct

    • What statement accurately describes the trigeminal nerve?

      Your Answer: It is a mixed nerve with both sensory and motor functions

      Explanation:

      The trigeminal nerve, which is the largest cranial nerve, serves both sensory and motor functions. It is composed of three primary branches, namely the ophthalmic, maxillary, and mandibular branches. This nerve is responsible for providing sensory information to the face and head, while also controlling the muscles involved in chewing. On the other hand, the facial nerve is responsible for controlling the muscles that enable facial expressions and transmitting information from the front two-thirds of the tongue.

      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
      11.4
      Seconds
  • Question 9 - What is a known risk factor for QT prolongation when analyzing an ECG?...

    Correct

    • What is a known risk factor for QT prolongation when analyzing an ECG?

      Your Answer: Hypokalemia

      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.

    • This question is part of the following fields:

      • Psychopharmacology
      2540.9
      Seconds
  • Question 10 - What is the most probable diagnosis for a patient undergoing neuropsychiatric evaluation with...

    Correct

    • What is the most probable diagnosis for a patient undergoing neuropsychiatric evaluation with a CT scan revealing atrophy of the head of the caudate nucleus?

      Your Answer: Huntington's disease

      Explanation:

      The Basal Ganglia: Functions and Disorders

      The basal ganglia are a group of subcortical structures that play a crucial role in controlling movement and some cognitive processes. The components of the basal ganglia include the striatum (caudate, putamen, nucleus accumbens), subthalamic nucleus, globus pallidus, and substantia nigra (divided into pars compacta and pars reticulata). The putamen and globus pallidus are collectively referred to as the lenticular nucleus.

      The basal ganglia are connected in a complex loop, with the cortex projecting to the striatum, the striatum to the internal segment of the globus pallidus, the internal segment of the globus pallidus to the thalamus, and the thalamus back to the cortex. This loop is responsible for regulating movement and cognitive processes.

      However, problems with the basal ganglia can lead to several conditions. Huntington’s chorea is caused by degeneration of the caudate nucleus, while Wilson’s disease is characterized by copper deposition in the basal ganglia. Parkinson’s disease is associated with degeneration of the substantia nigra, and hemiballism results from damage to the subthalamic nucleus.

      In summary, the basal ganglia are a crucial part of the brain that regulate movement and some cognitive processes. Disorders of the basal ganglia can lead to significant neurological conditions that affect movement and other functions.

    • This question is part of the following fields:

      • Neurosciences
      16.4
      Seconds
  • Question 11 - What is the main way in which galantamine works? ...

    Correct

    • What is the main way in which galantamine works?

      Your Answer: Competitive and reversible inhibitor of acetylcholinesterase

      Explanation:

      Pharmacological management of dementia involves the use of acetylcholinesterase inhibitors (AChE inhibitors) and memantine. AChE inhibitors prevent the breakdown of acetylcholine, which is deficient in Alzheimer’s due to the loss of cholinergic neurons. Donepezil, galantamine, and rivastigmine are commonly used AChE inhibitors in the management of Alzheimer’s. However, gastrointestinal side effects such as nausea and vomiting are common with these drugs.

      Memantine, on the other hand, is an NMDA receptor antagonist that blocks the effects of pathologically elevated levels of glutamate that may lead to neuronal dysfunction. It has a half-life of 60-100 hours and is primarily renally eliminated. Common adverse effects of memantine include somnolence, dizziness, hypertension, dyspnea, constipation, headache, and elevated liver function tests.

      Overall, pharmacological management of dementia aims to improve cognitive function and slow down the progression of the disease. However, it is important to note that these drugs do not cure dementia and may only provide temporary relief of symptoms.

    • This question is part of the following fields:

      • Psychopharmacology
      32.6
      Seconds
  • Question 12 - A concerned parent of a 25-year-old daughter with schizophrenia wants to know what...

    Incorrect

    • A concerned parent of a 25-year-old daughter with schizophrenia wants to know what the biggest challenge is for individuals living with this condition and how it affects their overall quality of life.

      Your Answer: Non-compliance to medication by the patients

      Correct Answer: People with schizophrenia live with the stigma of the illness and are often seen as dangerous by society

      Explanation:

      Norman Sartorius highlights the iatrogenic stigma of mental illness as the main obstacle to a better life for those suffering from mental disorders. NICE guidelines on schizophrenia also acknowledge the stigma associated with the condition, which is often seen as dangerous and best dealt with away from society. However, research has shown that the fear of violence arising from people with schizophrenia is misplaced. Other factors that may contribute to feelings of exclusion and isolation include compulsory treatment under mental health legislation, medication side effects, and less careful use of diagnostic labels.

    • This question is part of the following fields:

      • Stigma And Culture
      24.7
      Seconds
  • Question 13 - What is a true statement about 'working memory'? ...

    Incorrect

    • What is a true statement about 'working memory'?

      Your Answer: It has a fixed capacity that does not vary between individuals

      Correct 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.

    • This question is part of the following fields:

      • Social Psychology
      35.1
      Seconds
  • Question 14 - What is the accurate statement about renowned psychologists and their associated theories? ...

    Incorrect

    • What is the accurate statement about renowned psychologists and their associated theories?

      Your Answer: Erik Erikson is associated with transactional analysis

      Correct Answer: Margaret Mahler is associated with separation-individuation

      Explanation:

      Historical Figures in Psychology

      Melanie Klein is known for developing play therapy, which involves interpreting the symbolic meaning of a child’s actions during play and relating them to their feelings towards their parents. Margaret Mahler, on the other hand, focused on the development of the ego within the context of object relationships. She emphasized how interpersonal relationships become internalized within the self, rather than the gratification of instincts of biological needs. Mahler coined the term separation-individuation to describe the process by which internal maps of the self and others are formed during the first three years of life.

      Transactional analysis, developed by Dr. Eric Berne in the 1960s, is based on the idea that we have three parts to our personality (child, adult, and parent) and that these converse with one another in transactions. Finally, Jean-Martin Charcot and Pierre Janet are both associated with hysteria, with Charcot being known for his work with hypnosis.

    • This question is part of the following fields:

      • History Of Psychiatry
      11.9
      Seconds
  • Question 15 - A 65-year-old individual on lithium treatment experiences a fine tremor that is affecting...

    Correct

    • A 65-year-old individual on lithium treatment experiences a fine tremor that is affecting their handwriting and causing embarrassment. Despite having normal lithium levels, what is the most effective solution to alleviate this issue?

      Your Answer: Propranolol

      Explanation:

      Lithium-induced tremor is a prevalent issue that can be resolved by discontinuing the medication. Propranolol is the most effective treatment option based on available evidence, while levodopa and anticholinergic agents have not been shown to be effective.

      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
      30.4
      Seconds
  • Question 16 - A 68-year-old woman is experiencing changes in her personality and difficulty remembering things....

    Incorrect

    • A 68-year-old woman is experiencing changes in her personality and difficulty remembering things. What cognitive assessment would be suitable for evaluating her frontal lobe function?

      Your Answer: Benton visual retention test

      Correct Answer: Wisconsin card sorting test

      Explanation:

      The WCST is a test that assesses frontal lobe function by presenting the patient with cards that vary in shape, color, and number. The patient is asked to sort the cards based on one of these dimensions and then switch to another dimension. Patients with frontal lobe damage may struggle with inflexible thinking and inhibiting previously correct answers.

      The Benton visual retention test is a test of visual memory that does not assess frontal lobe function. The patient is shown geometric shapes for ten seconds and then asked to draw them from memory.

      The NART is a test that measures premorbid IQ.

      The Rorschach inkblot test is a projective personality test.

      The Rey-Osterrieth complex figure test assesses visuospatial skills. The patient is asked to copy a complex figure and then reproduce it from memory.

    • This question is part of the following fields:

      • Assessment
      25.4
      Seconds
  • Question 17 - A 35-year-old man is experiencing anxiety and wants to rate his level of...

    Incorrect

    • A 35-year-old man is experiencing anxiety and wants to rate his level of anxiety. Which rating scale would be most suitable for him to use?

      Your Answer: Hamilton rating scale for depression (HAM-D)

      Correct Answer: Beck's depression inventory (BDI)

      Explanation:

      The Beck depression inventory (BDI of BDI-II) was created by Dr. Aaron T. Beck to measure the severity of depression. It consists of 21 multiple choice questions, with each answer being assigned a score from 0-3. The total score ranges from 0-63, with scores of 0-9 indicating minimal depression, 10-18 indicating mild depression, 19-29 indicating moderate depression, and 30-63 indicating severe depression.

      The Hamilton rating scale for depression (HAM-D) is a clinician-rated scale used to monitor the severity of depression and assess the effects of treatment.

      The standard assessment of depressive disorders (SADD) is a semi-structured, clinician-rated instrument developed by the WHO for assessing depressive disorders.

      The Montgomery-Asberg depression rating scale (MADRS) is a clinician-rated diagnostic questionnaire consisting of 10 items used to measure the severity of depressive episodes in patients with mood disorders. Each item can be scored from 0-6, with a maximum score of 60. There is also a self-rated version of MADRS called MADRS-S, which consists of 9 questions and has a maximum score of 54.

    • This question is part of the following fields:

      • Description And Measurement
      8.9
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  • Question 18 - What type of antidepressant medication did Carlsson create in the late 1960s? ...

    Correct

    • What type of antidepressant medication did Carlsson create in the late 1960s?

      Your Answer: SSRI

      Explanation:

      A Historical Note on the Development of Zimelidine, the First Selective Serotonin Reuptake Inhibitor

      In 1960s, evidence began to emerge suggesting a significant role of serotonin in depression. This led to the development of zimelidine, the first selective serotonin reuptake inhibitor (SSRI). Zimelidine was derived from pheniramine and was marketed in Europe in 1982. However, it was removed from the market in 1983 due to severe side effects such as hypersensitivity reactions and Guillain-Barre syndrome.

      Despite its short-lived availability, zimelidine paved the way for the development of other SSRIs such as fluoxetine, which was approved by the FDA in 1987 and launched in the US market in 1988 under the trade name Prozac. The development of SSRIs revolutionized the treatment of depression and other mood disorders, providing a safer and more effective alternative to earlier antidepressants such as the tricyclics and MAO inhibitors.

    • This question is part of the following fields:

      • Psychopharmacology
      21.6
      Seconds
  • Question 19 - At what threshold does the membrane potential of a cell need to reach...

    Incorrect

    • At what threshold does the membrane potential of a cell need to reach in order to trigger an action potential?

      Your Answer: +45 mV

      Correct Answer: -55 mV

      Explanation:

      Understanding Action Potentials in Neurons and Muscle Cells

      The membrane potential is a crucial aspect of cell physiology, and it exists across the plasma membrane of most cells. However, in neurons and muscle cells, this membrane potential can change over time. When a cell is not stimulated, it is in a resting state, and the inside of the cell is negatively charged compared to the outside. This resting membrane potential is typically around -70mV, and it is maintained by the Na/K pump, which maintains a high concentration of Na outside and K inside the cell.

      To trigger an action potential, the membrane potential must be raised to around -55mV. This can occur when a neurotransmitter binds to the postsynaptic neuron and opens some ion channels. Once the membrane potential reaches -55mV, a cascade of events is initiated, leading to the opening of a large number of Na channels and causing the cell to depolarize. As the membrane potential reaches around +40 mV, the Na channels close, and the K gates open, allowing K to flood out of the cell and causing the membrane potential to fall back down. This process is irreversible and is critical for the transmission of signals in neurons and the contraction of muscle cells.

    • This question is part of the following fields:

      • Neurosciences
      19.7
      Seconds
  • Question 20 - What is the accurate statement about the pathology of Parkinson's disease? ...

    Correct

    • What is the accurate statement about the pathology of Parkinson's disease?

      Your Answer: Pallor of the locus coeruleus is seen

      Explanation:

      Lewy bodies are not exclusively indicative of a particular disease, as they can also be present in individuals with Alzheimer’s and even in those who do not exhibit any noticeable symptoms.

      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.

    • This question is part of the following fields:

      • Neurosciences
      22.2
      Seconds
  • Question 21 - How can the immaturity of a defense mechanism be identified? ...

    Incorrect

    • How can the immaturity of a defense mechanism be identified?

      Your Answer: Intellectualization

      Correct Answer: Projection

      Explanation:

      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
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  • Question 22 - Which factor was not identified as a vulnerability for depression by Brown and...

    Correct

    • Which factor was not identified as a vulnerability for depression by Brown and Harris?

      Your Answer: Significant accumulation of debt resulting in threat of eviction

      Explanation:

      Depression (Brown and Harris)

      In 1978, Brown and Harris conducted a study on 458 women in the inner London area of Camberwell to investigate the causes of depression. The study resulted in the development of a model that identified four vulnerability factors for depressive illness in women. These factors included having three of more children under the age of 14 at home, lacking an intimate relationship with a husband of boyfriend, lacking employment outside of the home, and experiencing the loss of a mother before the age of 11 years. The model emphasized the role of psychosocial factors in the development of depression.

    • This question is part of the following fields:

      • Social Psychology
      7.1
      Seconds
  • Question 23 - To which category does the dentate gyrus belong? ...

    Incorrect

    • To which category does the dentate gyrus belong?

      Your Answer: Striatum

      Correct Answer: Hippocampus

      Explanation:

      The dentate gyrus is a component of the hippocampal formation.

      A gyrus is a ridge on the cerebral cortex, and there are several important gyri to be aware of in exams. These include the angular gyrus in the parietal lobe for language, mathematics, and cognition; the cingulate gyrus adjacent to the corpus callosum for emotion, learning, and memory; the fusiform gyrus in the temporal lobe for face and body recognition, as well as word and number recognition; the precentral gyrus in the frontal lobe for voluntary movement control; the postcentral gyrus in the parietal lobe for touch; the lingual gyrus in the occipital lobe for dreaming and word recognition; the superior frontal gyrus in the frontal lobe for laughter and self-awareness; the superior temporal gyrus in the temporal lobe for language and sensation of sound; the parahippocampal gyrus surrounding the hippocampus for memory; and the dentate gyrus in the hippocampus for the formation of episodic memory.

    • This question is part of the following fields:

      • Neurosciences
      12.9
      Seconds
  • Question 24 - What is the term that describes the process when a teenager strongly holds...

    Incorrect

    • What is the term that describes the process when a teenager strongly holds onto their own beliefs and adopts few of their parents' values and practices?

      Your Answer: Acculturation

      Correct Answer: Separation

      Explanation:

      Assimilation refers to the process in which immigrants adopt the practices and values of their new culture while abandoning their own cultural heritage. Marginalization, on the other hand, occurs when immigrants neither adopt the new culture nor retain their own cultural values, resulting in social exclusion and isolation. These two outcomes are on opposite ends of the spectrum in terms of the degree of adoption and retention of cultural values.

    • This question is part of the following fields:

      • Advanced Psychological Processes And Treatments
      113.3
      Seconds
  • Question 25 - Which statement accurately describes the Patient Health Questionnaire (PHQ-9) as an assessment tool...

    Correct

    • Which statement accurately describes the Patient Health Questionnaire (PHQ-9) as an assessment tool for depression?

      Your Answer: Includes questions about thoughts of self-harm

      Explanation:

      Depression screening can be done using two questions that ask about feeling down, depressed, of hopeless and having little interest of pleasure in doing things. A ‘yes’ answer to either question prompts a more in-depth assessment using tools such as the Hospital Anxiety and Depression (HAD) scale of the Patient Health Questionnaire (PHQ-9). The HAD scale consists of 14 questions, while the PHQ-9 asks about 9 problems over the last 2 weeks. NICE grades depression into ‘less severe’ and ‘more severe’ based on a PHQ-9 score of <16 and >16, respectively. The severity of depression can range from subthreshold and mild to moderate and severe. It is important to assess depression severity to determine appropriate treatment options.

    • This question is part of the following fields:

      • Classification And Assessment
      157.6
      Seconds
  • Question 26 - A teenager presents to A&E in distress. She claims that she has been...

    Correct

    • A teenager presents to A&E in distress. She claims that she has been transformed into a wolf by a witch doctor. What type of delusion does this represent?

      Your Answer: Lycanthropic

      Explanation:

      Types of Delusions

      Delusions come in many different forms. It is important to familiarize oneself with these types as they may be tested in an exam. Some of the most common types of delusions include:

      – Folie a deux: a shared delusion between two or more people
      – Grandiose: belief that one has special powers, beliefs, of purpose
      – Hypochondriacal: belief that something is physically wrong with the patient
      – Ekbom’s syndrome: belief that one has been infested with insects
      – Othello syndrome: belief that a sexual partner is cheating on them
      – Capgras delusion: belief that a person close to them has been replaced by a double
      – Fregoli delusion: patient identifies a familiar person (usually suspected to be a persecutor) in other people they meet
      – Syndrome of subjective doubles: belief that doubles of him/her exist
      – Lycanthropy: belief that one has been transformed into an animal
      – De Clérambault’s syndrome: false belief that a person is in love with them
      – Cotard’s syndrome/nihilistic delusions: belief that they are dead of do not exist
      – Referential: belief that others/TV/radio are speaking directly to of about the patient
      – Delusional perception: belief that a normal percept (product of perception) has a special meaning
      – Pseudocyesis: a condition whereby a woman believes herself to be pregnant when she is not. Objective signs accompany the belief such as abdominal enlargement, menstrual disturbance, apparent foetal movements, nausea, breast changes, and labour pains.

      Remembering these types of delusions can be helpful in understanding and diagnosing patients with delusional disorders.

    • This question is part of the following fields:

      • Classification And Assessment
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  • Question 27 - A teenage boy who has experienced trauma in his past has been in...

    Incorrect

    • A teenage boy who has experienced trauma in his past has been in the hospital for several weeks. You have developed a rapport with him and often stay after your shift to talk with him. However, he finds it difficult to communicate with the other nurses who do not seem to grasp the severity of his issues. During ward rounds, there are frequent disagreements between staff members about whether he should be discharged of if more support should be provided on the ward.
      What is the most appropriate psychodynamic mechanism to explain this scenario?

      Your Answer: Projective identification

      Correct Answer: Splitting

      Explanation:

      The process at play in this situation can be fully described as splitting. While the young woman may experience idealisation and denigration towards staff, these terms do not fully capture the impact on the team. Splitting can lead to a division within the staff team, with those who are idealised wanting to rescue the patient and those who are denigrated wanting to punish of remove them. This process likely involves both transference and projective identification. It is important to note that the concept of black and white thinking, commonly used in cognitive-behavioral therapy, is related but not the most accurate description of this phenomenon.

    • This question is part of the following fields:

      • Dynamic Psychopathology
      15.9
      Seconds
  • Question 28 - Which of the following conditions is not licensed for the use of duloxetine?...

    Incorrect

    • Which of the following conditions is not licensed for the use of duloxetine?

      Your Answer: Diabetic neuropathy

      Correct Answer: Acne vulgaris

      Explanation:

      Duloxetine is also licensed for the treatment of generalised anxiety disorder.

      Antidepressants (Licensed Indications)

      The following table outlines the specific licensed indications for antidepressants in adults, as per the Maudsley Guidelines and the British National Formulary. It is important to note that all antidepressants are indicated for depression.

      – Nocturnal enuresis in children: Amitriptyline, Imipramine, Nortriptyline
      – Phobic and obsessional states: Clomipramine
      – Adjunctive treatment of cataplexy associated with narcolepsy: Clomipramine
      – Panic disorder and agoraphobia: Citalopram, Escitalopram, Sertraline, Paroxetine, Venlafaxine
      – Social anxiety/phobia: Escitalopram, Paroxetine, Sertraline, Moclobemide, Venlafaxine
      – Generalised anxiety disorder: Escitalopram, Paroxetine, Duloxetine, Venlafaxine
      – OCD: Escitalopram, Fluoxetine, Fluvoxamine, Paroxetine, Sertraline, Clomipramine
      – Bulimia nervosa: Fluoxetine
      – PTSD: Paroxetine, Sertraline

    • This question is part of the following fields:

      • Psychopharmacology
      51.6
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  • Question 29 - How can we measure the discontinuation symptoms that occur when someone stops taking...

    Correct

    • How can we measure the discontinuation symptoms that occur when someone stops taking antidepressants?

      Your Answer: DESS

      Explanation:

      The DESS scale is utilized to measure the symptoms that arise when antidepressants are discontinued.

      In psychiatry, various questionnaires and interviews are used to assess different conditions and areas. It is important for candidates to know whether certain assessment tools are self-rated of require clinical assistance. The table provided by the college lists some of the commonly used assessment tools and indicates whether they are self-rated of clinician-rated. For example, the HAMD and MADRS are clinician-rated scales used to assess the severity of depression, while the GDS is a self-rated scale used to screen for depression in the elderly. The YMRS is a clinician-rated scale used to assess the severity of mania in patients with bipolar disorder, while the Y-BOCS is used to measure both the severity of OCD and the response to treatment. The GAF provides a single measure of global functioning, while the CGI requires the clinician to rate the severity of the patient’s illness at the time of assessment. The CAMDEX is a tool developed to assist in the early diagnosis and measurement of dementia in the elderly.

    • This question is part of the following fields:

      • Classification And Assessment
      29.1
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  • Question 30 - Which statement accurately describes ribonucleic acid (RNA)? ...

    Incorrect

    • Which statement accurately describes ribonucleic acid (RNA)?

      Your Answer:

      Correct Answer: RNA is typically shorter than DNA

      Explanation:

      Enzymes called RNA polymerases, not transferases, transcribe RNA from DNA.

      Genomics: Understanding DNA, RNA, Transcription, and Translation

      Deoxyribonucleic acid (DNA) is a molecule composed of two chains that coil around each other to form a double helix. DNA is organised into chromosomes, and each chromosome is made up of DNA coiled around proteins called histones. RNA, on the other hand, is made from a long chain of nucleotide units and is usually single-stranded. RNA is transcribed from DNA by enzymes called RNA polymerases and is central to protein synthesis.

      Transcription is the synthesis of RNA from a DNA template, and it consists of three main steps: initiation, elongation, and termination. RNA polymerase binds at a sequence of DNA called the promoter, and the transcriptome is the collection of RNA molecules that results from transcription. Translation, on the other hand, refers to the synthesis of polypeptides (proteins) from mRNA. Translation takes place on ribosomes in the cell cytoplasm, where mRNA is read and translated into the string of amino acid chains that make up the synthesized protein.

      The process of translation involves messenger RNA (mRNA), transfer RNA (tRNA), and ribosomal RNA (rRNA). Transfer RNAs, of tRNAs, connect mRNA codons to the amino acids they encode, while ribosomes are the structures where polypeptides (proteins) are built. Like transcription, translation also consists of three stages: initiation, elongation, and termination. In initiation, the ribosome assembles around the mRNA to be read and the first tRNA carrying the amino acid methionine. In elongation, the amino acid chain gets longer, and in termination, the finished polypeptide chain is released.

    • This question is part of the following fields:

      • Genetics
      0
      Seconds
  • Question 31 - When activated, which type of receptor increases the permeability of a plasma membrane...

    Incorrect

    • When activated, which type of receptor increases the permeability of a plasma membrane to chloride ions?

      Your Answer:

      Correct Answer: GABA-A

      Explanation:

      GABA-A is the sole ionotropic receptor among the options provided. Its function involves the selective conduction of chloride ions across the cell membrane upon activation by GABA, leading to hyperpolarization of the neuron.

      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
      0
      Seconds
  • Question 32 - What is the condition that occurs when there is a deletion of the...

    Incorrect

    • What is the condition that occurs when there is a deletion of the paternal chromosome 15q?

      Your Answer:

      Correct Answer: Prader-Willi syndrome

      Explanation:

      Genetic Conditions and Their Features

      Genetic conditions are disorders caused by abnormalities in an individual’s DNA. These conditions can affect various aspects of a person’s health, including physical and intellectual development. Some of the most common genetic conditions and their features are:

      – Downs (trisomy 21): Short stature, almond-shaped eyes, low muscle tone, and intellectual disability.
      – Angelman syndrome (Happy puppet syndrome): Flapping hand movements, ataxia, severe learning disability, seizures, and sleep problems.
      – Prader-Willi: Hyperphagia, excessive weight gain, short stature, and mild learning disability.
      – Cri du chat: Characteristic cry, hypotonia, down-turned mouth, and microcephaly.
      – Velocardiofacial syndrome (DiGeorge syndrome): Cleft palate, cardiac problems, and learning disabilities.
      – Edwards syndrome (trisomy 18): Severe intellectual disability, kidney malformations, and physical abnormalities.
      – Lesch-Nyhan syndrome: Self-mutilation, dystonia, and writhing movements.
      – Smith-Magenis syndrome: Pronounced self-injurious behavior, self-hugging, and a hoarse voice.
      – Fragile X: Elongated face, large ears, hand flapping, and shyness.
      – Wolf Hirschhorn syndrome: Mild to severe intellectual disability, seizures, and physical abnormalities.
      – Patau syndrome (trisomy 13): Severe intellectual disability, congenital heart malformations, and physical abnormalities.
      – Rett syndrome: Regression and loss of skills, hand-wringing movements, and profound learning disability.
      – Tuberous sclerosis: Hamartomatous tumors, epilepsy, and behavioral issues.
      – Williams syndrome: Elfin-like features, social disinhibition, and advanced verbal skills.
      – Rubinstein-Taybi syndrome: Short stature, friendly disposition, and moderate learning disability.
      – Klinefelter syndrome: Extra X chromosome, low testosterone, and speech and language issues.
      – Jakob’s syndrome: Extra Y chromosome, tall stature, and lower mean intelligence.
      – Coffin-Lowry syndrome: Short stature, slanting eyes, and severe learning difficulty.
      – Turner syndrome: Short stature, webbed neck, and absent periods.
      – Niemann Pick disease (types A and B): Abdominal swelling, cherry red spot, and feeding difficulties.

      It is important to note that these features may vary widely among individuals with the same genetic condition. Early diagnosis and intervention can help individuals with genetic conditions reach their full potential and improve their quality of life.

    • This question is part of the following fields:

      • Genetics
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  • Question 33 - Which type of dementia is characterized by the presence of clumps of aggregated...

    Incorrect

    • Which type of dementia is characterized by the presence of clumps of aggregated alpha synuclein in the cell bodies and axons of neurons?

      Your Answer:

      Correct Answer: Lewy body dementia

      Explanation:

      Alpha-synuclein is the main component of Lewy bodies, which are inclusion bodies found in the cytoplasm of neurons and appear eosinophilic.

      Lewy body dementia is a neurodegenerative disorder that is characterized by both macroscopic and microscopic changes in the brain. Macroscopically, there is cerebral atrophy, but it is less marked than in Alzheimer’s disease, and the brain weight is usually in the normal range. There is also pallor of the substantia nigra and the locus coeruleus, which are regions of the brain that produce dopamine and norepinephrine, respectively.

      Microscopically, Lewy body dementia is characterized by the presence of intracellular protein accumulations called Lewy bodies. The major component of a Lewy body is alpha synuclein, and as they grow, they start to draw in other proteins such as ubiquitin. Lewy bodies are also found in Alzheimer’s disease, but they tend to be in the amygdala. They can also be found in healthy individuals, although it has been suggested that these may be pre-clinical cases of dementia with Lewy bodies. Lewy bodies are also found in other neurodegenerative disorders such as progressive supranuclear palsy, corticobasal degeneration, and multiple system atrophy.

      In Lewy body dementia, Lewy bodies are mainly found within the brainstem, but they are also found in non-brainstem regions such as the amygdaloid nucleus, parahippocampal gyrus, cingulate cortex, and cerebral neocortex. Classic brainstem Lewy bodies are spherical intraneuronal cytoplasmic inclusions, characterized by hyaline eosinophilic cores, concentric lamellar bands, narrow pale halos, and immunoreactivity for alpha synuclein and ubiquitin. In contrast, cortical Lewy bodies typically lack a halo.

      Most brains with Lewy body dementia also show some plaques and tangles, although in most instances, the lesions are not nearly as severe as in Alzheimer’s disease. Neuronal loss and gliosis are usually restricted to brainstem regions, particularly the substantia nigra and locus ceruleus.

    • This question is part of the following fields:

      • Neurosciences
      0
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  • Question 34 - Where was a declaration created that outlines ethical principles for conducting research on...

    Incorrect

    • Where was a declaration created that outlines ethical principles for conducting research on human subjects?

      Your Answer:

      Correct Answer: Helsinki

      Explanation:

      The Significance of the Declaration of Helsinki in Biomedical Research Ethics

      The Declaration of Helsinki, created by the World Medical Association in 1964, outlines the fundamental ethical principles that govern biomedical research involving human subjects. Over the years, it has undergone several revisions and continues to serve as a cornerstone of good medical practice. Its importance lies in its ability to provide a framework for ethical decision-making in research, ensuring that the rights, safety, and well-being of human subjects are protected. The Declaration of Helsinki is a crucial document that guides researchers, clinicians, and policymakers in their efforts to conduct ethical and responsible research.

    • This question is part of the following fields:

      • Social Psychology
      0
      Seconds
  • Question 35 - What is the meaning of the term autochthonous delusion? ...

    Incorrect

    • What is the meaning of the term autochthonous delusion?

      Your Answer:

      Correct Answer: A primary delusion

      Explanation:

      Borderline Learning Disability

      Borderline learning disability is a term used to describe individuals with an IQ between 70-85. This category is not officially recognized as a diagnosis by the ICD-11. It is estimated that approximately 15% of the population falls within this range (Chaplin, 2005). Unlike mild learning disability, borderline learning disability is not typically associated with deficits in adaptive functioning, such as grooming, dressing, safety, of money management.

    • This question is part of the following fields:

      • Classification And Assessment
      0
      Seconds
  • Question 36 - Which individual is linked to the structural approach in family therapy? ...

    Incorrect

    • Which individual is linked to the structural approach in family therapy?

      Your Answer:

      Correct Answer: Minuchin

      Explanation:

      Family therapy has been shaped by various influential figures, each with their own unique approach. Salvador Minuchin is known for his structural model, which emphasizes the importance of family hierarchy, rules, and boundaries. Gregory Bateson, on the other hand, is associated with paradoxical therapy. Murray Bowen is linked to the family systems approach, while Jay Haley is known for his strategic systemic therapy. Finally, the Milan systemic approach is associated with Mara Selvini Palazzoli. Each of these figures has contributed to the development of family therapy, and their approaches continue to be used and adapted by therapists today.

    • This question is part of the following fields:

      • Advanced Psychological Processes And Treatments
      0
      Seconds
  • Question 37 - What is an example of a first generation H1 antihistamine? ...

    Incorrect

    • What is an example of a first generation H1 antihistamine?

      Your Answer:

      Correct Answer: Promethazine

      Explanation:

      Promethazine is utilized for its sedative properties in cases of agitation due to the fact that first generation H1 antihistamines easily penetrate the BBB and induce drowsiness.

      Antihistamines: Types and Uses

      Antihistamines are drugs that block the effects of histamine, a neurotransmitter that regulates physiological function in the gut and potentiates the inflammatory and immune responses of the body. There are two types of antihistamines: H1 receptor blockers and H2 receptor blockers. H1 blockers are mainly used for allergic conditions and sedation, while H2 blockers are used for excess stomach acid.

      There are also first and second generation antihistamines. First generation antihistamines, such as diphenhydramine and promethazine, have uses in psychiatry due to their ability to cross the blood brain barrier and their anticholinergic properties. They tend to be sedating and are useful for managing extrapyramidal side effects. Second generation antihistamines, such as loratadine and cetirizine, show limited penetration of the blood brain barrier and are less sedating.

      It is important to note that there are contraindications to first-generation antihistamines, including benign prostatic hyperplasia, angle-closure glaucoma, and pyloric stenosis in infants. These do not apply to second-generation antihistamines.

    • This question is part of the following fields:

      • Psychopharmacology
      0
      Seconds
  • Question 38 - A 45-year-old man, currently unemployed, has been experiencing frequent panic attacks over the...

    Incorrect

    • 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:

      Correct 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.

    • This question is part of the following fields:

      • Advanced Psychological Processes And Treatments
      0
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  • Question 39 - In which mode of inheritance do typically both parents carry a heterozygous unaffected...

    Incorrect

    • In which mode of inheritance do typically both parents carry a heterozygous unaffected genotype?

      Your Answer:

      Correct Answer: Autosomal recessive

      Explanation:

      Inheritance Patterns:

      Autosomal Dominant Conditions:
      – Can be transmitted from one generation to the next (vertical transmission) through all forms of transmission observed (male to male, male to female, female to female).
      – Males and females are affected in equal proportions.
      – Usually, one parent is an affected heterozygote and the other is an unaffected homozygote.
      – If only one parent is affected, there is a 50% chance that a child will inherit the mutated gene.

      Autosomal Recessive Conditions:
      – Males and females are affected in equal proportions.
      – Two copies of the gene must be mutated for a person to be affected.
      – Both parents are usually unaffected heterozygotes.
      – Two unaffected people who each carry one copy of the mutated gene have a 25% chance with each pregnancy of having a child affected by the disorder.

      X-linked Dominant Conditions:
      – Males and females are both affected, with males typically being more severely affected than females.
      – The sons of a man with an X-linked dominant disorder will all be unaffected.
      – A woman with an X-linked dominant disorder has a 50% chance of having an affected fetus.

      X-linked Recessive Conditions:
      – Males are more frequently affected than females.
      – Transmitted through carrier females to their sons (knights move pattern).
      – Affected males cannot pass the condition onto their sons.
      – A woman who is a carrier of an X-linked recessive disorder has a 50% chance of having sons who are affected and a 50% chance of having daughters who are carriers.

      Y-linked Conditions:
      – Every son of an affected father will be affected.
      – Female offspring of affected fathers are never affected.

      Mitochondrial Inheritance:
      – Mitochondria are inherited only in the maternal ova and not in sperm.
      – Males and females are affected, but always being maternally inherited.
      – An affected male does not pass on his mitochondria to his children, so all his children will be unaffected.

    • This question is part of the following fields:

      • Genetics
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      Seconds
  • Question 40 - In what category of antipsychotics does risperidone fall under? ...

    Incorrect

    • In what category of antipsychotics does risperidone fall under?

      Your Answer:

      Correct Answer: Benzisoxazole

      Explanation:

      Antipsychotics can be classified in various ways, including by chemical structure and generation. The two main generations are typical (first generation) and atypical (second generation) antipsychotics. Risperidone is an atypical antipsychotic and belongs to the benzisoxazole class. It works as an antagonist for dopamine D2, 5-HT 2a, histamine-1 receptor, and alpha 1-adrenoceptor. Other antipsychotics belong to different structural categories, such as butyrophenones (e.g. haloperidol), dibenzodiazapines (e.g. clozapine), dibenzothiazapines (e.g. quetiapine), Thienobenzodiazepine (e.g. olanzapine), phenothiazines (e.g. chlorpromazine, trifluoperazine, thioridazine), thioxanthenes (e.g. flupentixol), diphenylbutylpiperidine (e.g. pimozide), substituted benzamides (e.g. sulpiride), and arylpiperidylindole (quinolone) (e.g. aripiprazole).

    • This question is part of the following fields:

      • Psychopharmacology
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      Seconds
  • Question 41 - What is the term used to describe the process of translating a segment...

    Incorrect

    • What is the term used to describe the process of translating a segment of genetic information from DNA to RNA?

      Your Answer:

      Correct Answer: Transcription

      Explanation:

      Genomics: Understanding DNA, RNA, Transcription, and Translation

      Deoxyribonucleic acid (DNA) is a molecule composed of two chains that coil around each other to form a double helix. DNA is organised into chromosomes, and each chromosome is made up of DNA coiled around proteins called histones. RNA, on the other hand, is made from a long chain of nucleotide units and is usually single-stranded. RNA is transcribed from DNA by enzymes called RNA polymerases and is central to protein synthesis.

      Transcription is the synthesis of RNA from a DNA template, and it consists of three main steps: initiation, elongation, and termination. RNA polymerase binds at a sequence of DNA called the promoter, and the transcriptome is the collection of RNA molecules that results from transcription. Translation, on the other hand, refers to the synthesis of polypeptides (proteins) from mRNA. Translation takes place on ribosomes in the cell cytoplasm, where mRNA is read and translated into the string of amino acid chains that make up the synthesized protein.

      The process of translation involves messenger RNA (mRNA), transfer RNA (tRNA), and ribosomal RNA (rRNA). Transfer RNAs, of tRNAs, connect mRNA codons to the amino acids they encode, while ribosomes are the structures where polypeptides (proteins) are built. Like transcription, translation also consists of three stages: initiation, elongation, and termination. In initiation, the ribosome assembles around the mRNA to be read and the first tRNA carrying the amino acid methionine. In elongation, the amino acid chain gets longer, and in termination, the finished polypeptide chain is released.

    • This question is part of the following fields:

      • Genetics
      0
      Seconds
  • Question 42 - What is another term for wahnstimmung? ...

    Incorrect

    • What is another term for wahnstimmung?

      Your Answer:

      Correct Answer: Delusional mood

      Explanation:

      Unfortunately, the college requires candidates to have some understanding of the German language. It is also important to be familiar with certain German terms such as Gedankenlautwerden (thought echo), Gegenhalten (a condition where a patient resists all passive movements with the same amount of force as applied by the examiner), Schnauzkrampf (a facial expression resembling pouting that is sometimes observed in catatonic patients), and Vorbeigehen/vorbeireden (a symptom seen in Ganser syndrome where patients give approximate answers to questions, such as responding with 14 when asked how many fingers a man has).

      Borderline Learning Disability

      Borderline learning disability is a term used to describe individuals with an IQ between 70-85. This category is not officially recognized as a diagnosis by the ICD-11. It is estimated that approximately 15% of the population falls within this range (Chaplin, 2005). Unlike mild learning disability, borderline learning disability is not typically associated with deficits in adaptive functioning, such as grooming, dressing, safety, of money management.

    • This question is part of the following fields:

      • Classification And Assessment
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      Seconds
  • Question 43 - What gene has been associated with dyslexia? ...

    Incorrect

    • What gene has been associated with dyslexia?

      Your Answer:

      Correct Answer: DCDC2

      Explanation:

      Genetics and Dyslexia: Insights from a Genome-wide Association Study

      Dyslexia is a learning disorder characterized by difficulty in reading despite adequate intelligence and educational opportunities. It is believed to have a genetic component, with heritability estimates ranging from 40-60%. Recent research has identified several candidate genes associated with dyslexia, including DCDC2, DYX1C1, KIAA0319, GCFC2, MRPL19, and ROBO1.

      A genome-wide association study conducted by Gialluisi (2020) sheds new light on the genetic correlates of dyslexia. The study identified several genetic variants associated with dyslexia, including those located in of near the candidate genes mentioned above. These findings provide further evidence for the genetic basis of dyslexia and may help to improve our understanding of the underlying biological mechanisms involved in the disorder.

      Overall, the study highlights the importance of genetics in dyslexia and underscores the need for continued research in this area. By identifying specific genetic variants associated with dyslexia, researchers may be able to develop more targeted interventions and treatments for individuals with this disorder.

    • This question is part of the following fields:

      • Genetics
      0
      Seconds
  • Question 44 - In what processes is the enzyme RNA polymerase involved? ...

    Incorrect

    • In what processes is the enzyme RNA polymerase involved?

      Your Answer:

      Correct Answer: Transcription

      Explanation:

      Genomics: Understanding DNA, RNA, Transcription, and Translation

      Deoxyribonucleic acid (DNA) is a molecule composed of two chains that coil around each other to form a double helix. DNA is organised into chromosomes, and each chromosome is made up of DNA coiled around proteins called histones. RNA, on the other hand, is made from a long chain of nucleotide units and is usually single-stranded. RNA is transcribed from DNA by enzymes called RNA polymerases and is central to protein synthesis.

      Transcription is the synthesis of RNA from a DNA template, and it consists of three main steps: initiation, elongation, and termination. RNA polymerase binds at a sequence of DNA called the promoter, and the transcriptome is the collection of RNA molecules that results from transcription. Translation, on the other hand, refers to the synthesis of polypeptides (proteins) from mRNA. Translation takes place on ribosomes in the cell cytoplasm, where mRNA is read and translated into the string of amino acid chains that make up the synthesized protein.

      The process of translation involves messenger RNA (mRNA), transfer RNA (tRNA), and ribosomal RNA (rRNA). Transfer RNAs, of tRNAs, connect mRNA codons to the amino acids they encode, while ribosomes are the structures where polypeptides (proteins) are built. Like transcription, translation also consists of three stages: initiation, elongation, and termination. In initiation, the ribosome assembles around the mRNA to be read and the first tRNA carrying the amino acid methionine. In elongation, the amino acid chain gets longer, and in termination, the finished polypeptide chain is released.

    • This question is part of the following fields:

      • Genetics
      0
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  • Question 45 - Which psychological concept is primarily characterized by the defence mechanism of splitting? ...

    Incorrect

    • Which psychological concept is primarily characterized by the defence mechanism of splitting?

      Your Answer:

      Correct Answer: Paranoid-schizoid position

      Explanation:

      Melanie Klein, a prominent psychoanalyst, introduced two significant concepts in her work: the paranoid-schizoid position and the depressive position. The paranoid-schizoid position is a state of mind where the individual perceives the world as fragmented, dividing it into good and bad. This position is characterized by the defense mechanism of splitting, where the individual separates the good and bad aspects of themselves and others.

      On the other hand, the depressive position follows the paranoid-schizoid position and is characterized by the ability to accept ambivalence, where something can be both good and bad. This position represents a more integrated state of mind, where the individual can hold conflicting emotions and thoughts simultaneously. These concepts have been influential in psychoanalytic theory and have contributed to our understanding of the human psyche.

    • This question is part of the following fields:

      • Social Psychology
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  • Question 46 - A teacher is eager to teach her middle school student better study habits....

    Incorrect

    • A teacher is eager to teach her middle school student better study habits. She starts by praising the student for simply sitting down at their desk to do homework. She then gives praise when the student opens their textbook and begins reading. She waits until the student has read a few pages and takes notes before issuing more praise. How would you describe the teacher's approach?

      Your Answer:

      Correct Answer: Shaping

      Explanation:

      Operant Conditioning: Reinforcement, Punishment, and More

      Operant conditioning, also known as instrumental learning, is a theory of learning developed by B.F. Skinner. It suggests that people learn by interacting with their environment. Reinforcement and punishment are key concepts in operant conditioning. A reinforcer is a stimulus of event that increases the likelihood of a behavior being repeated. Reinforcement can be positive of negative. Positive reinforcement occurs when a behavior is strengthened by adding a rewarding stimulus, while negative reinforcement occurs when a behavior is strengthened by removing an unpleasant stimulus. A punisher is a stimulus that decreases the likelihood of a behavior being repeated. Positive punishment occurs when a behavior is reduced in frequency by adding an unpleasant stimulus, while negative punishment occurs when a behavior is reduced in frequency by removing a pleasant stimulus.

      Primary reinforcers are instinctual desires such as food, water, social approval, and sex. Secondary reinforcers, also known as conditioned reinforcers, are not innately appreciated and people have to learn to like them through classical conditioning of other methods. Secondary reinforcers include things such as money. Different patterns of reinforcement have different influences on the response. There are five main reinforcement schedules: fixed interval, variable interval, fixed ratio, variable ratio, and random. Variable ratio schedules are most resistant to extinction.

      Shaping and chaining are techniques used when an exact behavior cannot be performed and so cannot be rewarded. Shaping involves rewarding successive, increasingly accurate approximations to the behavior, while chaining involves breaking a complex task into smaller, more manageable sections. Escape conditioning refers to a situation whereby an aversive situation is removed after a response. It is a form of negative reinforcement. Habituation refers to the phenomenon whereby there is a decrease in response to a stimulus over time. Covert sensitization is a technique used whereby someone learns to use mental imagery to associate a behavior with a negative consequence.

    • This question is part of the following fields:

      • Social Psychology
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  • Question 47 - What is the primary neurotransmitter responsible for excitatory signals in the brain? ...

    Incorrect

    • What is the primary neurotransmitter responsible for excitatory signals in the brain?

      Your Answer:

      Correct Answer: Glutamate

      Explanation:

      Glutamate is the primary neurotransmitter responsible for excitatory signaling in the brain.

      Glutamate: The Most Abundant Neurotransmitter in the Brain

      Glutamate is a neurotransmitter that is found in abundance in the brain. It is always excitatory and can act through both ionotropic and metabotropic receptors. This neurotransmitter is believed to play a crucial role in learning and memory processes. Its ability to stimulate neurons and enhance synaptic plasticity is thought to be responsible for its role in memory formation. Glutamate is also involved in various other brain functions, including motor control, sensory perception, and emotional regulation. Its importance in the brain makes it a target for various neurological disorders, including Alzheimer’s disease, Parkinson’s disease, and epilepsy.

    • This question is part of the following fields:

      • Neurosciences
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  • Question 48 - A 65-year-old patient with first onset psychosis is prescribed olanzapine and shows a...

    Incorrect

    • A 65-year-old patient with first onset psychosis is prescribed olanzapine and shows a good response. After twelve months of therapy, their BMI has increased from 25 to 35. An attempt to reduce the dose precipitates a relapse in their illness, lifestyle interventions are also unsuccessful. A trial of a switch to which of the following antipsychotics would be indicated in order to attempt to reduce their weight whilst also addressing the psychosis?

      Your Answer:

      Correct Answer: Aripiprazole

      Explanation:

      Antipsychotic drugs are known to cause weight gain, but some more than others. The reason for this is not due to a direct metabolic effect, but rather an increase in appetite and a decrease in activity levels. The risk of weight gain appears to be linked to clinical response. There are several suggested mechanisms for this, including antagonism of certain receptors and hormones that stimulate appetite. The risk of weight gain varies among different antipsychotics, with clozapine and olanzapine having the highest risk. Management strategies for antipsychotic-induced weight gain include calorie restriction, low glycemic index diet, exercise, and switching to an alternative antipsychotic. Aripiprazole, ziprasidone, and lurasidone are recommended as alternative options. Other options include aripiprazole augmentation, metformin, orlistat, liraglutide, and topiramate.

    • This question is part of the following fields:

      • Psychopharmacology
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  • Question 49 - Which medications have the potential to reduce the contraceptive effect of oral contraceptives?...

    Incorrect

    • Which medications have the potential to reduce the contraceptive effect of oral contraceptives?

      Your Answer:

      Correct Answer: St John's Wort

      Explanation:

      Out of the given options, only St John’s Wort is explicitly stated in the interactions section of the BNF as causing a decrease in contraceptive effectiveness. While tricyclic antidepressants are also mentioned, the BNF notes that their impact may be on the effectiveness of the antidepressant rather than the contraceptive.

      Interactions with Oral Contraceptives

      Psychiatric drugs such as St John’s Wort, Carbamazepine, Phenytoin, Topiramate, and Barbiturates can interact with oral contraceptives and lead to a reduced contraceptive effect. It is important to be aware of these potential interactions to ensure the effectiveness of oral contraceptives.

    • This question is part of the following fields:

      • Psychopharmacology
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  • Question 50 - A child undergoes a lower limb amputation. She comes to clinic, talks about...

    Incorrect

    • A child undergoes a lower limb amputation. She comes to clinic, talks about her favorite toys and resists your attempts to discuss her operation. When you ask her how her leg is feeling, she replies by saying that she has no pain and that there is nothing wrong with her leg. She says that she used a wheelchair to get to clinic as she wanted to try it out.
      Which defense mechanism is being used?

      Your Answer:

      Correct Answer: Denial

      Explanation:

      The man’s denial was evident as he refused to acknowledge the external reality that his legs had been amputated. On the other hand, if he tried to change the subject and only reluctantly accepted the truth when pressed, it would suggest that he was suppressing his emotions and thoughts about the amputation.

      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
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  • Question 51 - Which of the following is classified as a primary delusion? ...

    Incorrect

    • Which of the following is classified as a primary delusion?

      Your Answer:

      Correct Answer: Delusional atmosphere

      Explanation:

      The only primary delusion listed is delusional atmosphere, as it pertains to the form of the delusion. The other delusions mentioned are related to the content of the delusion and therefore cannot be classified as primary delusions.

      Borderline Learning Disability

      Borderline learning disability is a term used to describe individuals with an IQ between 70-85. This category is not officially recognized as a diagnosis by the ICD-11. It is estimated that approximately 15% of the population falls within this range (Chaplin, 2005). Unlike mild learning disability, borderline learning disability is not typically associated with deficits in adaptive functioning, such as grooming, dressing, safety, of money management.

    • This question is part of the following fields:

      • Classification And Assessment
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  • Question 52 - Which route of administration is known to have the highest degree of first...

    Incorrect

    • Which route of administration is known to have the highest degree of first pass effect?

      Your Answer:

      Correct Answer: Oral

      Explanation:

      The First Pass Effect in Psychiatric Drugs

      The first-pass effect is a process in drug metabolism that significantly reduces the concentration of a drug before it reaches the systemic circulation. This phenomenon is related to the liver and gut wall, which absorb and metabolize the drug before it can enter the bloodstream. Psychiatric drugs are not exempt from this effect, and some undergo a significant reduction in concentration before reaching their target site. Examples of psychiatric drugs that undergo a significant first-pass effect include imipramine, fluphenazine, morphine, diazepam, and buprenorphine. On the other hand, some drugs undergo little to no first-pass effect, such as lithium and pregabalin.

      Orally administered drugs are the most affected by the first-pass effect. However, there are other routes of administration that can avoid of partly avoid this effect. These include sublingual, rectal (partly avoids first pass), intravenous, intramuscular, transdermal, and inhalation. Understanding the first-pass effect is crucial in drug development and administration, especially in psychiatric drugs, where the concentration of the drug can significantly affect its efficacy and safety.

    • This question is part of the following fields:

      • Psychopharmacology
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  • Question 53 - What is the term used to describe a medication that has its own...

    Incorrect

    • What is the term used to describe a medication that has its own distinct effects but does not provide any benefits for the intended condition?

      Your Answer:

      Correct Answer: An active placebo

      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
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  • Question 54 - What sign is exhibited by a patient with catatonia who moves their arm...

    Incorrect

    • What sign is exhibited by a patient with catatonia who moves their arm in the direction of minimal force applied by a psychiatrist and returns it to its original position after the force is removed?

      Your Answer:

      Correct Answer: Mitgehen

      Explanation:

      The terms mitmachen and mitgehen are often used interchangeably in the literature, leading to confusion. However, it is important to note that mitgehen is a more severe manifestation of mitmachen, as it involves the examiner being able to move the patient’s body with minimal pressure, as seen in the anglepoise lamp sign.

      – Catatonia is a psychiatric syndrome characterized by disturbed motor functions, mood, and thought.
      – Key behaviors associated with catatonia include stupor, posturing, waxy flexibility, negativism, automatic obedience, mitmachen, mitgehen, ambitendency, psychological pillow, forced grasping, obstruction, echopraxia, aversion, mannerisms, stereotypies, motor perseveration, echolalia, and logorrhoea.
      – These behaviors are often tested in exam questions.
      – Karl Ludwig Kahlbaum is credited with the original clinical description of catatonia.

    • This question is part of the following fields:

      • Classification And Assessment
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  • Question 55 - What is the term used by Freud to describe the process through which...

    Incorrect

    • What is the term used by Freud to describe the process through which people release their aggressive impulses?

      Your Answer:

      Correct Answer: Catharsis

      Explanation:

      Theories of aggression can be categorized into three main perspectives: psychodynamic, sociological/drive, and cognitive and learning. Psychodynamic theory, proposed by Freud, suggests that aggression arises from a primary instinct called thanatos, which aims for destruction and death. Sociobiological/drive theory, proposed by Lorenz, suggests that aggression is instinctual and necessary for survival, and that stronger genes are selected through aggression. Cognitive and learning theory, proposed by Berkowitz, Rotter, Bandura, and Anderson, suggests that aggression can be learned through observational learning and is influenced by environmental factors. Bandura’s work introduced the concept of reciprocal determinism, which suggests that behavior is influenced by both the environment and the individual’s behavior. Rotter’s social learning theory emphasizes the interaction between the individual and their environment, while Anderson and Bushman’s general aggression model considers the role of social, cognitive, developmental, and biological factors on aggression.

    • This question is part of the following fields:

      • Social Psychology
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  • Question 56 - What condition of situation would make the use of lithium inappropriate of unsafe?...

    Incorrect

    • What condition of situation would make the use of lithium inappropriate of unsafe?

      Your Answer:

      Correct Answer: Brugada syndrome

      Explanation:

      Brugada syndrome typically appears in males during adulthood, usually around age 40, and sudden death may be the initial symptom. This genetic disorder is inherited in an autosomal dominant pattern. This information is sourced from the National Organization for Rare Disorders (NORD).

      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
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  • Question 57 - What is a true statement about serotonin syndrome? ...

    Incorrect

    • What is a true statement about serotonin syndrome?

      Your Answer:

      Correct Answer: Hypertonia is a characteristic finding

      Explanation:

      Serotonin Syndrome and Neuroleptic Malignant Syndrome are two conditions that can be difficult to differentiate. Serotonin Syndrome is caused by excess serotonergic activity in the CNS and is characterized by neuromuscular abnormalities, altered mental state, and autonomic dysfunction. On the other hand, Neuroleptic Malignant Syndrome is a rare acute disorder of thermoregulation and neuromotor control that is almost exclusively caused by antipsychotics. The symptoms of both syndromes can overlap, but there are some distinguishing clinical features. Hyper-reflexia, ocular clonus, and tremors are more prominent in Serotonin Syndrome, while Neuroleptic Malignant Syndrome is characterized by uniform ‘lead-pipe’ rigidity and hyporeflexia. Symptoms of Serotonin Syndrome usually resolve within a few days of stopping the medication, while Neuroleptic Malignant Syndrome can take up to 14 days to remit with appropriate treatment. The following table provides a useful guide to the main differentials of Serotonin Syndrome and Neuroleptic Malignant Syndrome.

    • This question is part of the following fields:

      • Psychopharmacology
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  • Question 58 - What is the correct diagnosis for autism spectrum disorder in the most recent...

    Incorrect

    • What is the correct diagnosis for autism spectrum disorder in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)?

      Your Answer:

      Correct Answer: There are no subtypes in schizophrenia

      Explanation:

      The fifth edition of the DSM-5 no longer includes subtypes of schizophrenia due to their lack of usefulness to clinicians. The previous subtypes were based on the predominant symptom at the time of evaluation, but patients often exhibited overlapping symptoms that made it difficult to distinguish between subtypes. The DSM-5 now requires individuals to exhibit at least two specified symptoms, compared to the previous threshold of one, and symptoms must have been present for six months with at least one month of active symptoms for a diagnosis to be made.

    • This question is part of the following fields:

      • Description And Measurement
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  • Question 59 - What is the meaning of animus in the context of Jungian therapy? ...

    Incorrect

    • What is the meaning of animus in the context of Jungian therapy?

      Your Answer:

      Correct Answer: The unconscious male aspect present in every female

      Explanation:

      According to Jung, every individual possesses a concealed bisexuality. He referred to the feminine traits within a man as anima and the masculine traits within a woman as animus. The shadow represents the embodiment of our undesirable characteristics, while the persona is the facade we present to society.

    • This question is part of the following fields:

      • Dynamic Psychopathology
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  • Question 60 - Which of the following is not a factor that increases the risk of...

    Incorrect

    • Which of the following is not a factor that increases the risk of developing neuroleptic malignant syndrome when administering antipsychotics?

      Your Answer:

      Correct Answer: Being female

      Explanation:

      Serotonin Syndrome and Neuroleptic Malignant Syndrome are two conditions that can be difficult to differentiate. Serotonin Syndrome is caused by excess serotonergic activity in the CNS and is characterized by neuromuscular abnormalities, altered mental state, and autonomic dysfunction. On the other hand, Neuroleptic Malignant Syndrome is a rare acute disorder of thermoregulation and neuromotor control that is almost exclusively caused by antipsychotics. The symptoms of both syndromes can overlap, but there are some distinguishing clinical features. Hyper-reflexia, ocular clonus, and tremors are more prominent in Serotonin Syndrome, while Neuroleptic Malignant Syndrome is characterized by uniform ‘lead-pipe’ rigidity and hyporeflexia. Symptoms of Serotonin Syndrome usually resolve within a few days of stopping the medication, while Neuroleptic Malignant Syndrome can take up to 14 days to remit with appropriate treatment. The following table provides a useful guide to the main differentials of Serotonin Syndrome and Neuroleptic Malignant Syndrome.

    • This question is part of the following fields:

      • Psychopharmacology
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  • Question 61 - What is a true statement about Turner syndrome? ...

    Incorrect

    • What is a true statement about Turner syndrome?

      Your Answer:

      Correct Answer: It only affects females

      Explanation:

      The majority of Turner syndrome cases are not inherited and occur due to a failure in the separation of chromosomes during cell division, known as nondisjunction.

      Understanding Turner Syndrome

      Turner syndrome is a genetic disorder that affects only females. It occurs when one of the two X chromosomes is missing of partially missing. This happens randomly and does not increase the risk of the condition in future siblings. Although X-inactivation occurs in females, having only one X chromosome can cause issues as not all genes are inactivated in the inactivated X chromosome.

      The features of Turner syndrome include short stature, a webbed neck, a broad chest with widely spaced nipples, gonadal dysfunction leading to amenorrhea and infertility, congenital heart disease, and hypothyroidism. Despite these physical characteristics, girls with Turner syndrome typically have normal intelligence, with a mean full-scale IQ of 90. However, they may struggle with nonverbal, social, and psychomotor skills. It is important to understand the symptoms and effects of Turner syndrome to provide appropriate care and support for affected individuals.

    • This question is part of the following fields:

      • Psychological Development
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  • Question 62 - A child complains that people's heads seem to appear larger than they should...

    Incorrect

    • A child complains that people's heads seem to appear larger than they should in relation to their bodies.

      Which of the following best describes their experience?

      Your Answer:

      Correct Answer: Dysmegalopsia

      Explanation:

      Dysmegalopsia: Difficulty in Perceiving Object Size

      Dysmegalopsia is a condition characterized by a reduced ability to accurately perceive the size of objects. This can manifest as either micropsia, where objects appear smaller than they actually are, of macropsia, where objects appear larger than they actually are. Dysmegalopsia can occur as a standalone symptom of as part of a group of symptoms known as the Alice in Wonderland Syndrome. In this syndrome, individuals may experience distortions in their perception of size, shape, and distance, as well as other sensory disturbances. Dysmegalopsia can be caused by various factors, including neurological conditions, migraines, and the use of certain medications.

    • This question is part of the following fields:

      • Classification And Assessment
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  • Question 63 - Which ability is not included in Thurstone's list of primary abilities? ...

    Incorrect

    • Which ability is not included in Thurstone's list of primary abilities?

      Your Answer:

      Correct Answer: Working memory

      Explanation:

      The WAIS includes working memory as a component, but it is not considered a fundamental skill.

      Thurstone’s Theory of Intelligence

      Louis Leon Thurstone believed that intelligence could not be reduced to a single factor. Instead, he proposed that intelligence is composed of seven distinct abilities, which he called the primary abilities. These abilities include word fluency, verbal comprehension, spatial visualization, number facility, associative memory, reasoning, and perceptual speed. According to Thurstone, each of these abilities is independent of the others and contributes to an individual’s overall intelligence. This theory challenged the prevailing view of intelligence at the time, which held that intelligence could be measured by a single factor known as the g factor. Thurstone’s theory has had a lasting impact on the field of psychology and has influenced the development of modern intelligence tests.

    • This question is part of the following fields:

      • Social Psychology
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  • Question 64 - A 62-year-old male with a prolonged history of alcohol abuse arrives at the...

    Incorrect

    • A 62-year-old male with a prolonged history of alcohol abuse arrives at the Emergency department displaying evident disorientation, a lateral gaze palsy, and lack of coordination. His blood alcohol concentration measures at 68 mg per 100 mls blood, while his electrolytes, complete blood count, and liver function tests appear normal. What is the most probable diagnosis?

      Your Answer:

      Correct Answer: Wernicke's encephalopathy

      Explanation:

      If a patient presents with confusion, eye signs (ophthalmoplegia of nystagmus), and an ataxic gait, Wernicke’s encephalopathy should be suspected. This serious, but reversible, condition is most commonly caused by alcohol dependence and is due to a lack of Vitamin B1 (thiamine). Acute alcohol intoxication is unlikely as the patient’s blood alcohol level is below the legal limit for driving. Amnesic syndrome is not the correct diagnosis as it is characterized by impairment of new learning without obvious confusion. Normal pressure hydrocephalus is characterized by urinary incontinence, gait disturbance, and cognitive decline. Subdural hematoma is not a likely diagnosis as there is no history of head injury.

    • This question is part of the following fields:

      • Diagnosis
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  • Question 65 - What is the accurate statement about night terrors in children? ...

    Incorrect

    • What is the accurate statement about night terrors in children?

      Your Answer:

      Correct Answer: Violent behaviour has been reported

      Explanation:

      Night terrors typically occur during deep sleep in stage 4. Upon waking, there is no memory of the experience. These episodes can be considered a dissociative state and may involve automatic behaviors. In some cases, violent behavior may occur during night terrors, but the individual cannot be held accountable for their actions. Family history is not a common factor in the occurrence of night terrors.

    • This question is part of the following fields:

      • Neurosciences
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  • Question 66 - What is the term used to describe an agonist that elicits the maximum...

    Incorrect

    • What is the term used to describe an agonist that elicits the maximum effect at a receptor?

      Your Answer:

      Correct Answer: A full agonist

      Explanation:

      Agonists and Antagonists in Pharmacology

      In pharmacology, an agonist is a substance that binds to a receptor and triggers a biological response. On the other hand, an antagonist is a substance that blocks the effects of an agonist. A partial agonist produces a response but cannot produce the maximum response even at high doses.

      Competitive antagonists bind to the receptor in a reversible way without affecting the biological response. They make the agonist appear less potent. Inverse agonists, on the other hand, have opposite effects from those of full agonists. They are not the same as antagonists, which block the effect of both agonists and inverse agonists.

      Full agonists display full efficacy at a receptor. Some substances can act as an agonist at certain receptors and as an antagonist at others. Such a substance is called an agonist-antagonist. Understanding the differences between agonists and antagonists is crucial in drug development and treatment.

    • This question is part of the following fields:

      • Psychopharmacology
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  • Question 67 - What precautions should be taken for a patient with pseudocholinesterase deficiency to avoid...

    Incorrect

    • What precautions should be taken for a patient with pseudocholinesterase deficiency to avoid potential complications?

      Your Answer:

      Correct Answer: Donepezil

      Explanation:

      Pseudocholinesterase Deficiency

      Pseudocholinesterase deficiency, also known as butyrylcholinesterase deficiency, is a medical condition that can lead to increased sensitivity to certain drugs. This condition affects approximately 1 in 3200 to 1 in 5000 people, with higher prevalence in certain populations such as the Persian Jewish community and Alaska Natives. Interestingly, this condition does not cause any noticeable symptoms until an abnormal drug reaction occurs.

      It is important for individuals with pseudocholinesterase deficiency to avoid certain drugs, including donepezil, galantamine, procaine, succinylcholine, and pilocarpine. By avoiding these drugs, individuals with this condition can reduce their risk of experiencing adverse reactions.

    • This question is part of the following fields:

      • Psychopharmacology
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  • Question 68 - What is a true statement about the symptoms that occur when discontinuing SSRI...

    Incorrect

    • What is a true statement about the symptoms that occur when discontinuing SSRI medication?

      Your Answer:

      Correct Answer: They are more common with antidepressants with shorter half-lives

      Explanation:

      Antidepressants can cause discontinuation symptoms when patients stop taking them, regardless of the type of antidepressant. These symptoms usually occur within 5 days of stopping the medication and can last up to 3 weeks. Symptoms include flu-like symptoms, dizziness, insomnia, vivid dreams, irritability, crying spells, and sensory symptoms. SSRIs and related drugs with short half-lives, such as paroxetine and venlafaxine, are particularly associated with discontinuation symptoms. Tapering antidepressants at the end of treatment is recommended to prevent these symptoms. TCAs and MAOIs are also associated with discontinuation symptoms, with amitriptyline and imipramine being the most common TCAs and all MAOIs being associated with prominent discontinuation symptoms. Patients at highest risk for discontinuation symptoms include those on antidepressants with shorter half-lives, those who have been taking antidepressants for 8 weeks of longer, those using higher doses, younger people, and those who have experienced discontinuation symptoms before. Agomelatine is not associated with any discontinuation syndrome. If a discontinuation reaction occurs, restarting the antidepressant of switching to an alternative with a longer half-life and tapering more slowly may be necessary. Explanation and reassurance are often sufficient for mild symptoms. These guidelines are based on the Maudsley Guidelines 14th Edition and a study by Tint (2008).

    • This question is part of the following fields:

      • Psychopharmacology
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  • Question 69 - What is the term used to describe the automatic obedience observed in catatonia?...

    Incorrect

    • What is the term used to describe the automatic obedience observed in catatonia?

      Your Answer:

      Correct Answer: Mitgehen

      Explanation:

      Mitmachen and Mitgehen are two types of reflexive compliance. Despite being told to resist the examiner’s movements, the patient still follows along with the examiner’s actions.

      – Catatonia is a psychiatric syndrome characterized by disturbed motor functions, mood, and thought.
      – Key behaviors associated with catatonia include stupor, posturing, waxy flexibility, negativism, automatic obedience, mitmachen, mitgehen, ambitendency, psychological pillow, forced grasping, obstruction, echopraxia, aversion, mannerisms, stereotypies, motor perseveration, echolalia, and logorrhoea.
      – These behaviors are often tested in exam questions.
      – Karl Ludwig Kahlbaum is credited with the original clinical description of catatonia.

    • This question is part of the following fields:

      • Classification And Assessment
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  • Question 70 - Which ethical theory is attributed to Bentham and Mill as its main founders?...

    Incorrect

    • Which ethical theory is attributed to Bentham and Mill as its main founders?

      Your Answer:

      Correct Answer: Utilitarianism

      Explanation:

      Ethical theory and principles are important in medical ethics. There are three key ethical theories that have dominated medical ethics: utilitarianism, deontological, and virtue-based. Utilitarianism is based on the greatest good for the greatest number and is a consequentialist theory. Deontological ethics emphasize moral duties and rules, rather than consequences. Virtue ethics is based on the ethical characteristics of a person and is associated with the concept of a good, happy, flourishing life.

      More recent frameworks have attempted to reconcile different theories and values. The ‘four principles’ of ‘principlism’ approach, developed in the United States, is based on four common, basic prima facie moral commitments: autonomy, beneficence, non-maleficence, and justice. Autonomy refers to a patient’s right to make their own decisions, beneficence refers to the expectation that a doctor will act in a way that will be helpful to the patient, non-maleficence refers to the fact that doctors should avoid harming their patients, and justice refers to the expectation that all people should be treated fairly and equally.

    • This question is part of the following fields:

      • Social Psychology
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  • Question 71 - What condition is the result of a mutation in the MECP2 gene? ...

    Incorrect

    • What condition is the result of a mutation in the MECP2 gene?

      Your Answer:

      Correct Answer: Rett syndrome

      Explanation:

      Rett Syndrome: A Rare Neurodevelopmental Disorder

      Rett syndrome is a neurodevelopmental disorder that is rare, affecting approximately 1 in 10,000 female births. Although it mostly affects females, there have been cases of males with the disorder. While the exact cause of the disorder is not known, it is believed to have a genetic basis, with mutations in the MECP2 gene (Xq28) being associated with the disorder. Monozygotic twins have been found to have complete concordance in cases of Rett syndrome.

      The disorder has a unique presentation, with affected children experiencing a normal period of development until 6-18 months. After this period, they begin to develop problems with language, losing previously acquired speech. Purposeful hand movements are replaced with stereotypic movements, such as hand wringing, and ataxia and psychomotor retardation may occur. Other stereotypical movements, such as finger licking of biting and tapping of slapping, may also be seen. Head circumference is normal at birth, but growth begins to decelerate between 6-12 months, resulting in microcephaly. All language skills are lost, both receptive and expressive, and social skills plateau at developmental levels between 6-12 months.

      Seizures are associated with Rett syndrome in 75% of those affected, and almost all affected children have abnormal EEG findings. Breathing problems, such as hyperventilation, apnea, and breath holding, are also seen. Children with Rett syndrome may live for well over a decade after the onset of the disorder, but after 10 years, many patients are wheelchair-bound with virtually no language ability. Additional features of the disorder include seizures, breath holding and hyperventilation, sleep difficulties, and issues with locomotion.

    • This question is part of the following fields:

      • Psychological Development
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  • Question 72 - A 45-year-old man presents with a persistent abnormal movement of his neck. He...

    Incorrect

    • A 45-year-old man presents with a persistent abnormal movement of his neck. He experiences opisthotonos, retrocollis and mild blepharospasm, which worsen when walking of stressed and are not alleviated by alcohol. He has a history of paranoid schizophrenia for the past eight years and has been treated with various antipsychotics. Currently, he is stable on clozapine. What is the most probable diagnosis?

      Your Answer:

      Correct Answer: Tardive dystonia

      Explanation:

      The symptoms described are consistent with tardive dystonia, which is commonly observed in younger patients who have been exposed to neuroleptic medication. Orofacial dyskinesia is more frequently seen in older patients. The symptoms do not suggest Huntington’s chorea of non-epileptic seizures, as the latter typically do not persist. Friedreich’s ataxia typically presents with muscle weakness and lack of coordination. Tourette’s syndrome is unlikely to cause such severe motor neurological symptoms.

    • This question is part of the following fields:

      • Diagnosis
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  • Question 73 - What substances are found at higher levels in individuals with depression and bipolar...

    Incorrect

    • What substances are found at higher levels in individuals with depression and bipolar affective disorder?

      Your Answer:

      Correct Answer: Cortisol

      Explanation:

      HPA Axis Dysfunction in Mood Disorders

      The HPA axis, which includes regulatory neural inputs and a feedback loop involving the hypothalamus, pituitary, and adrenal glands, plays a central role in the stress response. Excessive secretion of cortisol, a glucocorticoid hormone, can lead to disruptions in cellular functioning and widespread physiologic dysfunction. Dysregulation of the HPA axis is implicated in mood disorders such as depression and bipolar affective disorder.

      In depressed patients, cortisol levels often do not decrease as expected in response to the administration of dexamethasone, a synthetic corticosteroid. This abnormality in the dexamethasone suppression test is thought to be linked to genetic of acquired defects of glucocorticoid receptors. Tricyclic antidepressants have been shown to increase expression of glucocorticoid receptors, whereas this is not the case for SSRIs.

      Early adverse experiences can produce long standing changes in HPA axis regulation, indicating a possible neurobiological mechanism whereby childhood trauma could be translated into increased vulnerability to mood disorder. In major depression, there is hypersecretion of cortisol, corticotropin-releasing factor (CRF), and ACTH, and associated adrenocortical enlargement. HPA abnormalities have also been found in other psychiatric disorders including Alzheimer’s and PTSD.

      In bipolar disorder, dysregulation of ACTH and cortisol response after CRH stimulation have been reported. Abnormal DST results are found more often during depressive episodes in the course of bipolar disorder than in unipolar disorder. Reduced pituitary volume secondary to LHPA stimulation, resulting in pituitary hypoactivity, has been observed in bipolar patients.

      Overall, HPA axis dysfunction is implicated in mood disorders, and understanding the underlying mechanisms may lead to new opportunities for treatments.

    • This question is part of the following fields:

      • Neurosciences
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  • Question 74 - What is the most effective way to distinguish between hypothyroidism and hyperthyroidism? ...

    Incorrect

    • What is the most effective way to distinguish between hypothyroidism and hyperthyroidism?

      Your Answer:

      Correct Answer: Brisk reflexes

      Explanation:

      Hyperthyroidism is typically associated with brisk reflexes, while hypothyroidism is associated with reduced reflexes. However, the other symptoms and signs can be present in both hyperthyroidism and hypothyroidism.

      Thyroid Examination Findings

      Hypothyroidism:

      – Weight gain (with decreased appetite)
      – Intolerance to cold
      – Lethargy
      – Constipation
      – Menstrual disturbances
      – Decreased perspiration

      Exam findings:

      – Hair loss
      – Bradycardia
      – Periorbital puffiness and dry skin
      – Coarse, brittle, straw-like hair
      – Myxoedema
      – Hyporeflexia

      Hyperthyroidism:

      – Weight loss (with increased appetite)
      – Intolerance to heat
      – Palpitations
      – Menstrual disturbances

      Exam findings:

      – Hair loss
      – Tachycardia
      – Warm, moist, and smooth skin
      – Tremor
      – Brisk reflexes

    • This question is part of the following fields:

      • Classification And Assessment
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  • Question 75 - What is the culture bound syndrome observed in Eskimos? ...

    Incorrect

    • What is the culture bound syndrome observed in Eskimos?

      Your Answer:

      Correct Answer: Piblokto

      Explanation:

      Culture bound illnesses are psychiatric conditions that are specific to one particular culture. There are many different types of culture bound illnesses, including Amok, Shenjing shuairuo, Ataque de nervios, Bilis, colera, Bouffee delirante, Brain fag, Dhat, Falling-out, blacking out, Ghost sickness, Hwa-byung, wool-hwa-byung, Koro, Latah, Locura, Mal de ojo, Nervios, Rootwork, Pibloktoq, Qi-gong psychotic reaction, Sangue dormido, Shen-k’uei, shenkui, Shin-byung, Taijin kyofusho, Spell, Susto, Zar, and Wendigo.

      Some of the most commonly discussed culture bound illnesses include Amok, which is confined to males in the Philippines and Malaysia who experience blind, murderous violence after a real of imagined insult. Ataque de nervios is a condition that occurs in those of Latino descent and is characterized by intense emotional upset, shouting uncontrollably, aggression, dissociation, seizure-like episodes, and suicidal gestures. Brain fag is a form of psychological distress first identified in Nigerian students in the 1960s but reported more generally in the African diaspora. It consists of a variety of cognitive and sensory disturbances that occur during periods of intense intellectual activity. Koro is a condition that affects Chinese patients who believe that their penis is withdrawing inside their abdomen, resulting in panic and the belief that they will die. Taijin kyofusho is a Japanese culture bound illness characterized by anxiety about and avoidance of interpersonal situations due to the thought, feeling, of conviction that one’s appearance and actions in social interactions are inadequate of offensive to others. Finally, Wendigo is a culture bound illness that occurs in Native American tribes during severe winters and scarcity of food, characterized by a distaste for food that leads to anxiety and the belief that one is turning into a cannibalistic ice spirit.

    • This question is part of the following fields:

      • Classification And Assessment
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  • Question 76 - A 35-year-old individual presents with symptoms consistent with social anxiety disorder. To further...

    Incorrect

    • A 35-year-old individual presents with symptoms consistent with social anxiety disorder. To further assess their condition, you inquire about their seating preference when dining out.

      Which of the following responses would best support your suspicion?

      Your Answer:

      Correct Answer: In a quiet corner

      Explanation:

      Individuals with social phobia experience anxiety and apprehension regarding the possibility of receiving unfavorable attention from others, leading them to avoid eating in public.

    • This question is part of the following fields:

      • Diagnosis
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  • Question 77 - Which one of the following is a 10 item scale used as a...

    Incorrect

    • Which one of the following is a 10 item scale used as a screening tool for problematic alcohol consumption?

      Your Answer:

      Correct Answer: AUDIT

      Explanation:

      The AUDIT is a screening tool consisting of 10 items that can quickly identify potential alcohol problems. Similarly, the AQ-10 is a 10 item scale used to measure autism quotient. The CAGE is a four item screening tool for alcohol problems, while the CIWA is a scale used to assess alcohol withdrawal. The PHQ-9, commonly used in general practice, is the personal health questionnaire.

    • This question is part of the following fields:

      • Description And Measurement
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  • Question 78 - Who were the pioneers in publishing clinical reports that showcased the efficacy of...

    Incorrect

    • Who were the pioneers in publishing clinical reports that showcased the efficacy of chlorpromazine as a valuable medication for psychiatric treatment?

      Your Answer:

      Correct Answer: Delay and Deniker

      Explanation:

      A Historical Note on the Development of Zimelidine, the First Selective Serotonin Reuptake Inhibitor

      In 1960s, evidence began to emerge suggesting a significant role of serotonin in depression. This led to the development of zimelidine, the first selective serotonin reuptake inhibitor (SSRI). Zimelidine was derived from pheniramine and was marketed in Europe in 1982. However, it was removed from the market in 1983 due to severe side effects such as hypersensitivity reactions and Guillain-Barre syndrome.

      Despite its short-lived availability, zimelidine paved the way for the development of other SSRIs such as fluoxetine, which was approved by the FDA in 1987 and launched in the US market in 1988 under the trade name Prozac. The development of SSRIs revolutionized the treatment of depression and other mood disorders, providing a safer and more effective alternative to earlier antidepressants such as the tricyclics and MAO inhibitors.

    • This question is part of the following fields:

      • Psychopharmacology
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  • Question 79 - In child psychology, what is the term used to describe the symptom where...

    Incorrect

    • In child psychology, what is the term used to describe the symptom where a child's speech is reduced to meaningless repetition of sounds, words, of phrases?

      Your Answer:

      Correct Answer: Verbigeration

      Explanation:

      When a patient exhibits verbigeration, it can be a sign of loosening of association, which can also be seen in severe expressive aphasia and sometimes in schizophrenia. Knight’s move thinking is another example of loosening of associations, where the patient transitions from one topic to another without any logical connection. Neologisms are words of phrases created by the patient to describe their experiences, often related to their illness. Overinclusion is when the patient expands the boundaries of concepts, grouping things together that are not normally associated. Talking past the point, of vorbeireden, is when the patient seems to be approaching the end of a topic but never actually reaches it.

    • This question is part of the following fields:

      • Descriptive Psychopathology
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  • Question 80 - What is the most frequently occurring genetic mutation in individuals with early onset...

    Incorrect

    • What is the most frequently occurring genetic mutation in individuals with early onset familial Alzheimer's disease?

      Your Answer:

      Correct Answer: PSEN1

      Explanation:

      Genetics plays a role in the development of Alzheimer’s disease, with different genes being associated with early onset and late onset cases. Early onset Alzheimer’s, which is rare, is linked to three genes: amyloid precursor protein (APP), presenilin one (PSEN-1), and presenilin two (PSEN-2). The APP gene, located on chromosome 21, produces a protein that is a precursor to amyloid. The presenilins are enzymes that cleave APP to produce amyloid beta fragments, and alterations in the ratios of these fragments can lead to plaque formation. Late onset Alzheimer’s is associated with the apolipoprotein E (APOE) gene on chromosome 19, with the E4 variant increasing the risk of developing the disease. People with Down’s syndrome are also at high risk of developing Alzheimer’s due to inheriting an extra copy of the APP gene.

    • This question is part of the following fields:

      • Genetics
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  • Question 81 - What is the truth about hyperprolactinemia that is linked to the use of...

    Incorrect

    • What is the truth about hyperprolactinemia that is linked to the use of antipsychotic medication?

      Your Answer:

      Correct Answer: It is often asymptomatic

      Explanation:

      Hyperprolactinemia is frequently without symptoms, and determining whether treatment is necessary involves weighing the present symptoms, potential long-term risks, and perceived advantages of maintaining the antipsychotic. It is frequently discovered by chance and does not typically necessitate altering the medication regimen.

      Hyperprolactinemia is a potential side effect of antipsychotic medication, but it is rare with antidepressants. Dopamine inhibits prolactin, so dopamine antagonists, such as antipsychotics, can increase prolactin levels. The degree of prolactin elevation is dose-related, and some antipsychotics cause more significant increases than others. Hyperprolactinemia can cause symptoms such as galactorrhea, menstrual difficulties, gynecomastia, hypogonadism, and sexual dysfunction. Long-standing hyperprolactinemia in psychiatric patients can increase the risk of osteoporosis and breast cancer, although there is no conclusive evidence that antipsychotic medication increases the risk of breast malignancy and mortality. Some antipsychotics, such as clozapine and aripiprazole, have a low risk of causing hyperprolactinemia, while typical antipsychotics and risperidone have a high risk. Monitoring of prolactin levels is recommended before starting antipsychotic therapy and at three months and annually thereafter. Antidepressants rarely cause hyperprolactinemia, and routine monitoring is not recommended. Symptomatic hyperprolactinemia has been reported with most antidepressants, except for a few, such as mirtazapine, agomelatine, bupropion, and vortioxetine.

    • This question is part of the following fields:

      • Psychopharmacology
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  • Question 82 - Which of the following is not a known trigger for migraines? ...

    Incorrect

    • Which of the following is not a known trigger for migraines?

      Your Answer:

      Correct Answer: Vinegar

      Explanation:

      Migraine

      Migraine is a common condition that affects 5-10% of the population, with a higher prevalence in women than men (2-3:1). It typically starts in childhood of adolescence and has a strong familial association, with 2/3 of cases reporting a family history of migraine.

      The most prominent symptom of migraine is headache, which is usually unilateral but can occur on both sides. Other symptoms include anorexia, nausea and vomiting, photophobia, and intolerance of noise.

      In about 1/3 of cases, migraines are preceded by a visual aura (known as classic migraine). The most common form of visual aura is the ‘fortification spectra’ (semicircle of zigzag lights), but other disturbances such as micropsia, macropsia, zoom vision, mosaic vision, scotomas, and even hallucinations can occur.

      Basilar migraines are a subtype of migraine where headache and aura are accompanied by difficulty speaking, vertigo, ringing in ears, of other brainstem-related symptoms, but not motor weakness.

      Migraine can be triggered by various factors, including alcohol, cheese, chocolate, skipping meals, missing sleep, and oral contraceptives. Stress is also a common precipitant of migraine.

    • This question is part of the following fields:

      • Classification And Assessment
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  • Question 83 - Which artery blockage is most likely to cause Broca's aphasia? ...

    Incorrect

    • Which artery blockage is most likely to cause Broca's aphasia?

      Your Answer:

      Correct Answer: Middle cerebral

      Explanation:

      Brain Blood Supply and Consequences of Occlusion

      The brain receives blood supply from the internal carotid and vertebral arteries, which form the circle of Willis. The circle of Willis acts as a shunt system in case of vessel damage. The three main vessels arising from the circle are the anterior cerebral artery (ACA), middle cerebral artery (MCA), and posterior cerebral artery (PCA). Occlusion of these vessels can result in various neurological deficits. ACA occlusion may cause hemiparesis of the contralateral foot and leg, sensory loss, and frontal signs. MCA occlusion is the most common and can lead to hemiparesis, dysphasia/aphasia, neglect, and visual field defects. PCA occlusion may cause alexia, loss of sensation, hemianopia, prosopagnosia, and cranial nerve defects. It is important to recognize these consequences to provide appropriate treatment.

    • This question is part of the following fields:

      • Neurosciences
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  • Question 84 - A 70-year-old man, who is being treated for psychotic depression, arrives at the...

    Incorrect

    • A 70-year-old man, who is being treated for psychotic depression, arrives at the emergency department in a state of confusion. He has a fever and is tachycardic. During the examination, it is observed that he has generalised muscular rigidity in his extremities, which is present throughout all ranges of movement. Additionally, he displays signs of tremors. What medication is the most probable cause of this presentation?

      Your Answer:

      Correct Answer: Haloperidol

      Explanation:

      This is a case of neuroleptic malignant syndrome, which is primarily associated with the use of antipsychotic medications. The key features of NMS include mental status changes, muscular rigidity, hyperthermia, and autonomic instability, typically presenting as tachycardia. Mental state changes are often the first symptom to appear.

      Serotonin Syndrome and Neuroleptic Malignant Syndrome are two conditions that can be difficult to differentiate. Serotonin Syndrome is caused by excess serotonergic activity in the CNS and is characterized by neuromuscular abnormalities, altered mental state, and autonomic dysfunction. On the other hand, Neuroleptic Malignant Syndrome is a rare acute disorder of thermoregulation and neuromotor control that is almost exclusively caused by antipsychotics. The symptoms of both syndromes can overlap, but there are some distinguishing clinical features. Hyper-reflexia, ocular clonus, and tremors are more prominent in Serotonin Syndrome, while Neuroleptic Malignant Syndrome is characterized by uniform ‘lead-pipe’ rigidity and hyporeflexia. Symptoms of Serotonin Syndrome usually resolve within a few days of stopping the medication, while Neuroleptic Malignant Syndrome can take up to 14 days to remit with appropriate treatment. The following table provides a useful guide to the main differentials of Serotonin Syndrome and Neuroleptic Malignant Syndrome.

    • This question is part of the following fields:

      • Psychopharmacology
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  • Question 85 - Which area is Kohlberg recognized for introducing a developmental framework? ...

    Incorrect

    • Which area is Kohlberg recognized for introducing a developmental framework?

      Your Answer:

      Correct Answer: Morality

      Explanation:

      Kohlberg’s Six Stages of Moral Development

      Kohlberg’s theory of moral development consists of six stages that can be categorized into three levels. The first level is the preconventional stage, which is characterized by obedience and punishment orientation, where the focus is on the direct consequences of actions and unquestioning deference to power. The second stage is the self-interest orientation, where right behavior is defined purely by what is in the individual’s own interest.

      The second level is the conventional stage, which is characterized by interpersonal accord and conformity, where the focus is on how the individual will appear to others. The behavior should accord with a consensus view on what is good. The second stage is the authority and social order obedience driven, where what is lawful is judged to be morally right. Right behavior is dictated by societal rules, and there is a greater respect for social order and the need for laws.

      The third level is the postconventional stage, which is characterized by the social contract orientation, where individual rights determine behavior. The individual views laws and rules as flexible tools for improving human purposes. The fourth stage is the universal ethical principles orientation, where the right action is the one that is consistent with abstract reasoning using universal ethical principles.

      It is important to note that the age ranges for Kohlberg’s developmental stages are rough guides, and sources vary widely. Kohlberg developed his stage theory following an experiment he conducted on 72 boys aged 10-16. However, the theory is criticized as sexist as it only included boys.

    • This question is part of the following fields:

      • Psychological Development
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  • Question 86 - Acamprosate is believed to produce its positive effects in the treatment of alcohol...

    Incorrect

    • Acamprosate is believed to produce its positive effects in the treatment of alcohol dependence by targeting which type of receptors?

      Your Answer:

      Correct Answer: Metabotropic glutamate receptors

      Explanation:

      The exact way in which acamprosate helps maintain alcohol abstinence is not fully understood. However, it is believed that chronic alcohol exposure disrupts the balance between neuronal excitation and inhibition. Studies conducted on animals suggest that acamprosate may interact with the glutamate and GABA neurotransmitter systems in the brain, which may help restore this balance. Acamprosate is thought to inhibit glutamate receptors while activating GABA receptors, specifically GABA-A and metabotropic glutamate receptors. It should be noted that some sources suggest that acamprosate affects NMDA receptors, which are a type of ionotropic glutamate receptor. However, this is not entirely accurate and may not be reflected in exam questions.

      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.

    • This question is part of the following fields:

      • Psychopharmacology
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  • Question 87 - A sequence of three nucleotides is referred to as: ...

    Incorrect

    • A sequence of three nucleotides is referred to as:

      Your Answer:

      Correct Answer: Codon

      Explanation:

      Codons and Amino Acids

      Codons are made up of three bases and each codon codes for an amino acid. There are 64 different triplet sequences, with three of them indicating the end of the polypeptide chain. The start codon always has the code AUG in mRNA and codes for the amino acid methionine. This leaves 61 codons that code for a total of 20 different amino acids. As a result, most of the amino acids are represented by more than one codon. Amino acids are the building blocks of proteins, which can form short polymer chains called peptides of longer chains called polypeptides of proteins.

    • This question is part of the following fields:

      • Genetics
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  • Question 88 - Whenever a certain student receives a good grade from a teacher, they believe...

    Incorrect

    • Whenever a certain student receives a good grade from a teacher, they believe it is because they did well and met high standards. But when the same student receives a bad grade, they assume the teacher must be in a bad mood of doesn't like them. What is this reaction an example of?

      Your Answer:

      Correct Answer: Self-serving bias

      Explanation:

      A fundamental attribution error refers to the tendency to overemphasize dispositional factors and underestimate situational factors when explaining other people’s behavior. The correct term for making false assumptions about other people’s behavior is actually the fundamental attribution error.

      Attribution Theory: Understanding How We Explain Events

      Attribution theory provides a framework for understanding how individuals explain events in their environment. It examines how people use information to arrive at causal explanations for events and what factors influence their judgments. Fritz Heider first proposed a theory of attribution in 1958.

      However, attribution is prone to biases such as the Fundamental Attribution Error (FAE), which overemphasizes dispositional factors over situational causes when making attributions about others’ behavior. The Actor-Observer Bias, on the other hand, undervalues dispositional explanations and overvalued situational explanations of our own behavior. Correspondence bias is the tendency to draw inferences about a person’s unique and enduring dispositions from behaviors that can be entirely explained by the situations in which they occur. Self-serving bias refers to people’s tendency to attribute their successes to internal factors but attribute their failures to external factors. Hostile Attribution Bias (HAB) is an interpretive bias where individuals interpret ambiguous behavior as hostile, leading to aggression. Finally, the False Consensus Effect is the tendency for people to project their way of thinking onto others, assuming that everyone else thinks the same way they do.

      Overall, attribution theory helps us understand how people make sense of events in their environment, but it is important to be aware of the biases that can influence our judgments.

    • This question is part of the following fields:

      • Social Psychology
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  • Question 89 - What structure's reduced asymmetry has been linked to schizophrenia? ...

    Incorrect

    • What structure's reduced asymmetry has been linked to schizophrenia?

      Your Answer:

      Correct Answer: Planum temporale

      Explanation:

      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
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  • Question 90 - Is the following estimate of heritability accurate? ...

    Incorrect

    • Is the following estimate of heritability accurate?

      Your Answer:

      Correct Answer: Major depression = 30%

      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.

    • This question is part of the following fields:

      • Genetics
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  • Question 91 - What is a characteristic of consequentialist theories? ...

    Incorrect

    • What is a characteristic of consequentialist theories?

      Your Answer:

      Correct Answer: The moral status of an act is determined by its outcomes

      Explanation:

      The exam will require you to differentiate between the three main ethical principles: consequentialism, virtue theory, and deontology. Consequentialism prioritizes outcomes over intentions, while virtue theory emphasizes character, and deontology focuses on motives. A deep understanding of ethics is not necessary, but a basic comprehension of these principles is required.

      Ethical theory and principles are important in medical ethics. There are three key ethical theories that have dominated medical ethics: utilitarianism, deontological, and virtue-based. Utilitarianism is based on the greatest good for the greatest number and is a consequentialist theory. Deontological ethics emphasize moral duties and rules, rather than consequences. Virtue ethics is based on the ethical characteristics of a person and is associated with the concept of a good, happy, flourishing life.

      More recent frameworks have attempted to reconcile different theories and values. The ‘four principles’ of ‘principlism’ approach, developed in the United States, is based on four common, basic prima facie moral commitments: autonomy, beneficence, non-maleficence, and justice. Autonomy refers to a patient’s right to make their own decisions, beneficence refers to the expectation that a doctor will act in a way that will be helpful to the patient, non-maleficence refers to the fact that doctors should avoid harming their patients, and justice refers to the expectation that all people should be treated fairly and equally.

    • This question is part of the following fields:

      • Social Psychology
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  • Question 92 - How can the inheritance pattern be described as horizontal? ...

    Incorrect

    • How can the inheritance pattern be described as horizontal?

      Your Answer:

      Correct Answer: Autosomal recessive

      Explanation:

      On a genogram, autosomal recessive conditions are represented by a horizontal inheritance pattern.

      Modes of Inheritance

      Genetic disorders can be passed down from one generation to the next in various ways. There are four main modes of inheritance: autosomal dominant, autosomal recessive, X-linked (sex-linked), and multifactorial.

      Autosomal Dominant Inheritance

      Autosomal dominant inheritance occurs when one faulty gene causes a problem despite the presence of a normal one. This type of inheritance shows vertical transmission, meaning it is based on the appearance of the family pedigree. If only one parent is affected, there is a 50% chance of each child expressing the condition. Autosomal dominant conditions often show pleiotropy, where a single gene influences several characteristics.

      Autosomal Recessive Inheritance

      In autosomal recessive conditions, a person requires two faulty copies of a gene to manifest a disease. A person with one healthy and one faulty gene will generally not manifest a disease and is labelled a carrier. Autosomal recessive conditions demonstrate horizontal transmission.

      X-linked (Sex-linked) Inheritance

      In X-linked conditions, the problem gene lies on the X chromosome. This means that all males are affected. Like autosomal conditions, they can be dominant of recessive. Affected males are unable to pass the condition on to their sons. In X-linked recessive conditions, the inheritance pattern is characterised by transmission from affected males to male grandchildren via affected carrier daughters.

      Multifactorial Inheritance

      Multifactorial conditions result from the interaction between genes from both parents and the environment.

    • This question is part of the following fields:

      • Genetics
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  • Question 93 - A 28 year old man with anxiety is referred to clinic by his...

    Incorrect

    • A 28 year old man with anxiety is referred to clinic by his GP. On examination you find an elevated blood pressure and notice his lower legs appear mottled. His pulse is 140 bpm. Testing of his urine would most likely demonstrate raised levels of which of the following metabolites?:

      Your Answer:

      Correct Answer: Vanillylmandelic acid

      Explanation:

      Based on the patient’s characteristics, it is possible that he has a pheochromocytoma.

      Pheochromocytoma: Symptoms and Diagnosis

      A pheochromocytoma is a tumor that secretes catecholamines and is usually found in the adrenal glands. Symptoms of this condition include hypertension, tachycardia, diaphoresis, livedo reticularis (mottled skin), postural hypotension, tachypnea, cold and clammy skin, severe headache, angina, palpitations, nausea, and vomiting.

      To diagnose pheochromocytoma, doctors measure the levels of catecholamine products in the blood of urine. The metanephrines vanillylmandelic acid (VMA) and homovanillic acid (HVA) are the principal urinary metabolic products of epinephrine and norepinephrine. Healthy individuals excrete only small amounts of these substances.

    • This question is part of the following fields:

      • Classification And Assessment
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  • Question 94 - What is accurate about the historical categorization of autism? ...

    Incorrect

    • What is accurate about the historical categorization of autism?

      Your Answer:

      Correct Answer: The diagnosis of Asperger disorder first appeared in the DSM-IV

      Explanation:

      Autism: A Brief History

      The term autism was first coined in 1911 by Eugen Bleuler to describe individuals with schizophrenia who had cut themselves off as much as possible from any contact with the external world. In 1926, Grunya Sukhareva attempted to delineate autism spectrum disorders as distinct diagnostic entities, referring to them as schizoid personality disorder. However, her work remained largely unknown until 1996.

      The first widely publicized use of the term autism to describe a distinct condition was in 1943 by Leo Kanner, who referred to it as autistic disturbance of affective contact. Kanner suggested that autism may be a manifestation of childhood schizophrenia and that it was characterized by an inability to related to themselves in the ordinary way to people and situations from the beginning of life. In 1944, Hans Asperger published descriptions of four cases of a condition he termed der autistichen psychopathie, which he regarded as a limitation of social relationships.

      In 1980, infantile autism was included in the DSM-III under a new category of pervasive developmental disorders. Lorna Wing redefined Asperger Syndrome in 1981, proposing a triad of impairments in social interaction, communication, and imaginative activities. In 2000, the DSM-IV utilized the umbrella category of pervasive developmental disorders, with five main subcategories. Finally, in 2013, the DSM-5 combined the subcategories into a single label of autism spectrum disorder, asserting that autism is a single disorder on a wide spectrum.

    • This question is part of the following fields:

      • Classification And Assessment
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  • Question 95 - What is a true statement about the falx cerebri? ...

    Incorrect

    • What is a true statement about the falx cerebri?

      Your Answer:

      Correct Answer: It is a layer of dura mater which separates the two cerebral hemispheres

      Explanation:

      Dura Mater

      The dura mater is one of the three membranes, known as meninges, that cover the brain and spinal cord. It is the outermost and most fibrous layer, with the pia mater and arachnoid mater making up the remaining layers. The pia mater is the innermost layer.

      The dura mater is folded at certain points, including the falx cerebri, which separates the two cerebral hemispheres of the brain, the tentorium cerebelli, which separates the cerebellum from the cerebrum, the falx cerebelli, which separates the cerebellar hemispheres, and the sellar diaphragm, which covers the pituitary gland and forms a roof over the hypophyseal fossa.

    • This question is part of the following fields:

      • Neurosciences
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  • Question 96 - A mutation affecting the transcriptional activity of a new gene associated with Alzheimer's...

    Incorrect

    • A mutation affecting the transcriptional activity of a new gene associated with Alzheimer's disease is reported. The mutation is most likely to be in which of the following?

      Your Answer:

      Correct Answer: Promoter region

      Explanation:

      Genomics: Understanding DNA, RNA, Transcription, and Translation

      Deoxyribonucleic acid (DNA) is a molecule composed of two chains that coil around each other to form a double helix. DNA is organised into chromosomes, and each chromosome is made up of DNA coiled around proteins called histones. RNA, on the other hand, is made from a long chain of nucleotide units and is usually single-stranded. RNA is transcribed from DNA by enzymes called RNA polymerases and is central to protein synthesis.

      Transcription is the synthesis of RNA from a DNA template, and it consists of three main steps: initiation, elongation, and termination. RNA polymerase binds at a sequence of DNA called the promoter, and the transcriptome is the collection of RNA molecules that results from transcription. Translation, on the other hand, refers to the synthesis of polypeptides (proteins) from mRNA. Translation takes place on ribosomes in the cell cytoplasm, where mRNA is read and translated into the string of amino acid chains that make up the synthesized protein.

      The process of translation involves messenger RNA (mRNA), transfer RNA (tRNA), and ribosomal RNA (rRNA). Transfer RNAs, of tRNAs, connect mRNA codons to the amino acids they encode, while ribosomes are the structures where polypeptides (proteins) are built. Like transcription, translation also consists of three stages: initiation, elongation, and termination. In initiation, the ribosome assembles around the mRNA to be read and the first tRNA carrying the amino acid methionine. In elongation, the amino acid chain gets longer, and in termination, the finished polypeptide chain is released.

    • This question is part of the following fields:

      • Genetics
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  • Question 97 - The histopathological findings from a post-mortem of an older man with long standing...

    Incorrect

    • 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:

      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.

    • This question is part of the following fields:

      • Neurosciences
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  • Question 98 - What is true about hyponatremia caused by antidepressants? ...

    Incorrect

    • What is true about hyponatremia caused by antidepressants?

      Your Answer:

      Correct Answer: Onset is usually within 30 days of starting treatment

      Explanation:

      Hyponatremia is commonly linked to the use of SSRIs (antidepressants) and typical antipsychotics.

      Hyponatremia in Psychiatric Patients

      Hyponatremia, of low serum sodium, can occur in psychiatric patients due to the disorder itself, its treatment, of other medical conditions. Symptoms include nausea, confusion, seizures, and muscular cramps. Drug-induced hyponatremia is known as the syndrome of inappropriate antidiuretic hormone hypersecretion (SIADH), which results from excessive secretion of ADH and fluid overload. Diagnosis is based on clinically euvolemic state with low serum sodium and osmolality, raised urine sodium and osmolality. SSRIs, SNRIs, and tricyclics are the most common drugs that can cause SIADH. Risk factors for SIADH include starting a new drug, and treatment usually involves fluid restriction and sometimes demeclocycline.

    • This question is part of the following fields:

      • Psychopharmacology
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  • Question 99 - A forensic psychiatrist evaluates a woman in custody who is accused of murdering...

    Incorrect

    • A forensic psychiatrist evaluates a woman in custody who is accused of murdering her 4 year old daughter. The woman has a background of schizophrenia. She confesses to the psychiatrist that she committed the crime and provides a detailed description of the event. The psychiatrist observes that although she appeared somewhat disturbed by her recollection of the incident, her level of disturbance was significantly lower than anticipated. What does this imply?

      Your Answer:

      Correct Answer: Blunt affect

      Explanation:

      The women’s affect is not flat as she displays some emotions, but they seem to be blunted and less intense than anticipated. However, her emotions are appropriate and in line with the situation, indicating that they are not incongruous.

      Mental State Exam – Mood and Affect

      Affect is a term used to describe a patient’s present emotional responsiveness, which is indicated by their facial expression and tone of voice. It can be described as being within normal range, constricted (where the affect is restricted in range and intensity), blunted (similar to constricted but a bit more so), of flat (where there are virtually no signs of affective expression). Mood, on the other hand, is a more prolonged prevailing state of disposition. A feeling is an active experience of somatic sensation of a passive subjective experience of an emotion, while an emotion is best thought of as a feeling and memory intertwined. Apathy is the absence of feeling. It is important to distinguish between affect and mood, as affect is momentary and mood is more prolonged.

    • This question is part of the following fields:

      • Classification And Assessment
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  • Question 100 - Which statement accurately describes the half-life of a drug? ...

    Incorrect

    • Which statement accurately describes the half-life of a drug?

      Your Answer:

      Correct Answer: In Zero order reactions the half-life decreases as the concentration falls

      Explanation:

      In contrast to first order reactions, drugs that exhibit zero order kinetics do not have a fixed half-life, as the rate of drug elimination remains constant regardless of the drug concentration in the plasma. The relationship between time and plasma concentration in zero order kinetics is linear, whereas in first order reactions, the half-life remains constant.

      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.

    • This question is part of the following fields:

      • Psychopharmacology
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SESSION STATS - PERFORMANCE PER SPECIALTY

Dynamic Psychopathology (1/2) 50%
Neurosciences (3/6) 50%
Psychological Development (1/1) 100%
Social Psychology (0/3) 0%
Psychopharmacology (4/6) 67%
Genetics (2/2) 100%
Stigma And Culture (1/1) 100%
History Of Psychiatry (0/1) 0%
Assessment (0/1) 0%
Description And Measurement (1/1) 100%
Classification And Assessment (1/4) 25%
Advanced Psychological Processes And Treatments (0/1) 0%
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