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  • Question 1 - Antagonism of which receptor is most likely to cause orthostatic hypotension? ...

    Correct

    • Antagonism of which receptor is most likely to cause orthostatic hypotension?

      Your Answer: Alpha 1

      Explanation:

      Blocking H1 receptors, which respond to histamine, can lead to sedation and weight gain. Cimetidine, an H2 antagonist, is commonly prescribed for peptic ulcer disease. Ondansetron, which blocks the 5HT3 receptor, is effective in reducing nausea.

      Receptors and Side-Effects

      Histamine H1 Blockade:
      – Weight gain
      – Sedation

      Alpha 1 Blockade:
      – Orthostatic hypotension
      – Sedation
      – Sexual dysfunction
      – Priapism

      Muscarinic Central M1 Blockade:
      – Agitation
      – Delirium
      – Memory impairment
      – Confusion
      – Seizures

      Muscarinic Peripheral M1 Blockade:
      – Dry mouth
      – Ataxia
      – Blurred vision
      – Narrow angle glaucoma
      – Constipation
      – Urinary retention
      – Tachycardia

      Each receptor has specific effects on the body, but they can also have side-effects. Histamine H1 blockade can cause weight gain and sedation. Alpha 1 blockade can lead to orthostatic hypotension, sedation, sexual dysfunction, and priapism. Muscarinic central M1 blockade can cause agitation, delirium, memory impairment, confusion, and seizures. Muscarinic peripheral M1 blockade can result in dry mouth, ataxia, blurred vision, narrow angle glaucoma, constipation, urinary retention, and tachycardia. It is important to be aware of these potential side-effects when using medications that affect these receptors.

    • This question is part of the following fields:

      • Psychopharmacology
      3
      Seconds
  • Question 2 - What is a true statement about drugs utilized for treating dementia? ...

    Correct

    • What is a true statement about drugs utilized for treating dementia?

      Your Answer: Rivastigmine inhibits butyrylcholinesterase

      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
      15.6
      Seconds
  • Question 3 - What is the duration of time it takes for half of the olanzapine...

    Correct

    • What is the duration of time it takes for half of the olanzapine to be eliminated from the body?

      Your Answer: 30 hours

      Explanation:

      Given that olanzapine is a once daily medication, it is reasonable to estimate its half-life to fall within the range of 20-30 hours. As it happens, the actual half-life of olanzapine is 30 hours.

      Antipsychotic Half-life and Time to Steady State

      Antipsychotic medications are commonly used to treat various mental health conditions, including schizophrenia and bipolar disorder. Understanding the half-life and time to steady state of these medications is important for determining dosing and monitoring their effectiveness.

      Aripiprazole has a half-life of 75 hours and takes approximately 2 weeks to reach steady state. Olanzapine has a half-life of 30 hours and takes about 1 week to reach steady state. Risperidone has a half-life of 20 hours when taken orally and takes 2-3 days to reach steady state. Clozapine and Amisulpride both have a half-life of 12 hours and take 2-3 days to reach steady state. Ziprasidone has a shorter half-life of 7 hours and takes 2-3 days to reach steady state. Quetiapine has the shortest half-life of 6 hours and also takes 2-3 days to reach steady state.

      Knowing the half-life and time to steady state of antipsychotic medications can help healthcare providers determine the appropriate dosing and frequency of administration. It can also aid in monitoring the effectiveness of the medication and adjusting the treatment plan as needed.

    • This question is part of the following fields:

      • Psychopharmacology
      3.1
      Seconds
  • Question 4 - Which tricyclic antidepressant has been demonstrated to have higher toxicity compared to others?...

    Correct

    • Which tricyclic antidepressant has been demonstrated to have higher toxicity compared to others?

      Your Answer: Dothiepin

      Explanation:

      Tricyclic Antidepressants: Uses, Types, and Side-Effects

      Tricyclic antidepressants (TCAs) are a type of medication used for depression and neuropathic pain. However, due to their side-effects and toxicity in overdose, they are not commonly used for depression anymore. TCAs can be divided into two types: first generation (tertiary amines) and second generation (secondary amines). The secondary amines have a lower side effect profile and act primarily on noradrenaline, while the tertiary amines boost serotonin and noradrenaline.

      Some examples of secondary amines include desipramine, nortriptyline, protriptyline, and amoxapine. Examples of tertiary amines include amitriptyline, lofepramine, imipramine, clomipramine, dosulepin (dothiepin), doxepin, trimipramine, and butriptyline. Common side-effects of TCAs include drowsiness, dry mouth, blurred vision, constipation, and urinary retention.

      Low-dose amitriptyline is commonly used for neuropathic pain and prophylaxis of headache. Lofepramine has a lower incidence of toxicity in overdose. However, amitriptyline and dosulepin (dothiepin) are considered the most dangerous in overdose. It is important to consult with a healthcare provider before taking any medication and to follow their instructions carefully.

    • This question is part of the following fields:

      • Psychopharmacology
      8.5
      Seconds
  • Question 5 - Which statement about Williams syndrome is not true? ...

    Correct

    • Which statement about Williams syndrome is not true?

      Your Answer: It results from a microdeletion in chromosome 8

      Explanation:

      Understanding Williams Syndrome

      Williams syndrome is a rare neurodevelopmental disorder that is characterized by distinct physical and behavioral traits. Individuals with this syndrome have a unique facial appearance, including a low nasal bridge and a cheerful demeanor. They also tend to have mild to moderate mental retardation and are highly sociable and verbal.

      Children with Williams syndrome are particularly sensitive to sound and may overreact to loud of high-pitched noises. The syndrome is caused by a deletion in the q11.23 region of chromosome 7, which codes for more than 20 genes. This deletion typically occurs during the recombination phase of meiosis and can be detected using fluorescent in situ hybridization (FISH).

      Although Williams syndrome is an autosomal dominant condition, most cases are not inherited and occur sporadically in individuals with no family history of the disorder. With a prevalence of around 1 in 20,000, Williams syndrome is a rare condition that requires specialized care and support.

    • This question is part of the following fields:

      • Genetics
      3.3
      Seconds
  • Question 6 - What factor would increase the likelihood of serotonin syndrome in an individual who...

    Correct

    • What factor would increase the likelihood of serotonin syndrome in an individual who is taking an SSRI medication?

      Your Answer: Tramadol

      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
      5
      Seconds
  • Question 7 - Which of the following is not a result of muscarinic blockade? ...

    Correct

    • Which of the following is not a result of muscarinic blockade?

      Your Answer: Miosis

      Explanation:

      Blurred vision occurs as a result of muscarinic blockade, which causes the pupils to dilate (mydriasis).

      Receptors and Side-Effects

      Histamine H1 Blockade:
      – Weight gain
      – Sedation

      Alpha 1 Blockade:
      – Orthostatic hypotension
      – Sedation
      – Sexual dysfunction
      – Priapism

      Muscarinic Central M1 Blockade:
      – Agitation
      – Delirium
      – Memory impairment
      – Confusion
      – Seizures

      Muscarinic Peripheral M1 Blockade:
      – Dry mouth
      – Ataxia
      – Blurred vision
      – Narrow angle glaucoma
      – Constipation
      – Urinary retention
      – Tachycardia

      Each receptor has specific effects on the body, but they can also have side-effects. Histamine H1 blockade can cause weight gain and sedation. Alpha 1 blockade can lead to orthostatic hypotension, sedation, sexual dysfunction, and priapism. Muscarinic central M1 blockade can cause agitation, delirium, memory impairment, confusion, and seizures. Muscarinic peripheral M1 blockade can result in dry mouth, ataxia, blurred vision, narrow angle glaucoma, constipation, urinary retention, and tachycardia. It is important to be aware of these potential side-effects when using medications that affect these receptors.

    • This question is part of the following fields:

      • Psychopharmacology
      6.5
      Seconds
  • Question 8 - Which antipsychotic medication has the strongest binding affinity for D4 receptors? ...

    Correct

    • Which antipsychotic medication has the strongest binding affinity for D4 receptors?

      Your Answer: Clozapine

      Explanation:

      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
      2.6
      Seconds
  • Question 9 - Which type of nerve fiber lacks a myelin sheath? ...

    Correct

    • Which type of nerve fiber lacks a myelin sheath?

      Your Answer: C

      Explanation:

      Primary Afferent Axons: Conveying Information about Touch and Pain

      Primary afferent axons play a crucial role in conveying information about touch and pain from the surface of the body to the spinal cord and brain. These axons can be classified into four types based on their functions: A-alpha (proprioception), A-beta (touch), A-delta (pain and temperature), and C (pain, temperature, and itch). While all A axons are myelinated, C fibers are unmyelinated.

      A-delta fibers are responsible for the sharp initial pain, while C fibers are responsible for the slow, dull, longer-lasting second pain. Understanding the different types of primary afferent axons and their functions is essential in diagnosing and treating various sensory disorders.

    • This question is part of the following fields:

      • Neurosciences
      2.9
      Seconds
  • Question 10 - What are the two purine bases? ...

    Correct

    • What are the two purine bases?

      Your Answer: Adenine and guanine

      Explanation:

      Nucleotides: The Building Blocks of DNA and RNA

      Nucleotides are the fundamental units of DNA (deoxyribonucleic acid) and RNA (ribonucleic acid). Each nucleotide consists of three components: a sugar molecule (deoxyribose in DNA and ribose in RNA), a phosphate group, and a nitrogenous base. The nitrogenous bases can be classified into two categories: purines and pyrimidines. The purine bases include adenine and guanine, while the pyrimidine bases are cytosine, thymine (in DNA), and uracil (in RNA).

      The arrangement of nucleotides in DNA and RNA determines the genetic information that is passed from one generation to the next. The sequence of nitrogenous bases in DNA forms the genetic code that determines the traits of an organism. RNA, on the other hand, plays a crucial role in protein synthesis by carrying the genetic information from DNA to the ribosomes, where proteins are synthesized.

      Understanding the structure and function of nucleotides is essential for understanding the molecular basis of life. The discovery of the structure of DNA and the role of nucleotides in genetic information has revolutionized the field of biology and has led to many breakthroughs in medicine, biotechnology, and genetics.

    • This question is part of the following fields:

      • Genetics
      2.7
      Seconds
  • Question 11 - Ms Y is employed at the Bank. She takes twice as much time...

    Correct

    • Ms Y is employed at the Bank. She takes twice as much time as her colleagues to finish her tasks and always stays late at the office. She is very organized and aims for perfection in every detail. However, her co-workers find her tedious and overly meticulous, and she struggles to build good relationships with many of them. What is being described here?

      Your Answer: Anankastic personality disorder

      Explanation:

      Anankastic personality disorder, previously known as obsessive-compulsive personality disorder in DSM-IV, is a condition where individuals are excessively focused on schedules, rules, and details. Their perfectionism can hinder their ability to meet the criteria outlined in ICD-10, which characterizes the disorder as one marked by doubt, excessive conscientiousness, preoccupation with details, checking, stubbornness, caution, and rigidity. People with this disorder may experience persistent and unwanted thoughts of impulses that do not reach the level of an obsessive-compulsive disorder. They may also struggle to function effectively at work due to difficulty completing tasks.

    • This question is part of the following fields:

      • History And Mental State
      5
      Seconds
  • Question 12 - What physiological factor is the QTc, calculated using Bazett's formula, corrected for? ...

    Correct

    • What physiological factor is the QTc, calculated using Bazett's formula, corrected for?

      Your Answer: RR interval

      Explanation:

      The Bazett formula adjusts the QT interval for heart rate by taking the square root of the R-R interval and dividing the QT interval by it.

      QTc Prolongation: Risks and Identification

      The QT interval is a measure of the time it takes for the ventricles to repolarize and is calculated from the beginning of the QRS complex to the end of the T wave. However, the QT interval varies with the heart rate, making it difficult to use a single number as a cut-off for a prolonged QT. Instead, a corrected QT interval (QTc) is calculated for each heart rate using various formulas. A QTc over the 99th percentile is considered abnormally prolonged, with approximate values of 470 ms for males and 480 ms for females.

      Prolonged QT intervals can lead to torsade de pointes (TdP), a polymorphic ventricular tachycardia that can be fatal if it degenerates into ventricular fibrillation. TdP is characterized by a twisting of the QRS complexes around an isoelectric line and is often asymptomatic but can also be associated with syncope and death. An accurate diagnosis requires an ECG to be recorded during the event. It is important to note that an increase in the QT interval due to a new conduction block should not be considered indicative of acquired LQTS and risk for TdP.

    • This question is part of the following fields:

      • Psychopharmacology
      3.2
      Seconds
  • Question 13 - In comparison to which method of administration, is bioavailability defined as the proportion...

    Correct

    • In comparison to which method of administration, is bioavailability defined as the proportion of a drug that enters the systemic circulation after being administered through a specific route?

      Your Answer: Intravenous

      Explanation:

      Understanding Bioavailability in Drug Trials

      Bioavailability is a crucial factor in drug trials, as it determines the percentage of a drug that reaches the systemic circulation after administration. This can be affected by factors such as absorption and metabolic clearance. For example, if a drug called X is administered orally and only 60% reaches the systemic circulation, its bioavailability is 0.6 of 60%. However, if the same drug is administered intravenously, plasma levels may reach 100%.

      One way to potentially increase bioavailability is through the rectal route, which bypasses around two thirds of the first-pass metabolism. This is because the rectum’s venous drainage is two thirds systemic (middle and inferior rectal vein) and one third portal (superior rectal vein). As a result, drugs administered rectally may reach the circulatory system with less alteration and in greater concentrations. Understanding bioavailability and exploring different administration routes can help optimize drug efficacy in clinical trials.

    • This question is part of the following fields:

      • Psychopharmacology
      1.7
      Seconds
  • Question 14 - What type of personality test is projective in nature? ...

    Correct

    • What type of personality test is projective in nature?

      Your Answer: Thematic Apperception Test

      Explanation:

      Personality Testing

      There are two main types of personality tests: projective and objective. Projective tests aim to assess unconscious material by presenting subjects with ambiguous pictures of phrases to elicit an unconscious response. Examples of projective tests include the Rorschach Inkblot, Thematic Apperception Test, Draw-A-Person test, and sentence completion tests. On the other hand, objective tests have structured and clear questions and aims. Examples of objective tests include the Minnesota Multiphasic Personality Inventory, Sixteen Personality Factor Questionnaire (16PF), NEO Personality Inventory, and Eysenck Personality Test (EPQ).

    • This question is part of the following fields:

      • Social Psychology
      4.2
      Seconds
  • Question 15 - What does Bazett's formula correct for when deriving the corrected QT interval from...

    Correct

    • What does Bazett's formula correct for when deriving the corrected QT interval from the QT interval?

      Your Answer: Heart rate

      Explanation:

      Bazett’s formula adjusts the QT interval to account for variations in heart rate.

      QTc Prolongation: Risks and Identification

      The QT interval is a measure of the time it takes for the ventricles to repolarize and is calculated from the beginning of the QRS complex to the end of the T wave. However, the QT interval varies with the heart rate, making it difficult to use a single number as a cut-off for a prolonged QT. Instead, a corrected QT interval (QTc) is calculated for each heart rate using various formulas. A QTc over the 99th percentile is considered abnormally prolonged, with approximate values of 470 ms for males and 480 ms for females.

      Prolonged QT intervals can lead to torsade de pointes (TdP), a polymorphic ventricular tachycardia that can be fatal if it degenerates into ventricular fibrillation. TdP is characterized by a twisting of the QRS complexes around an isoelectric line and is often asymptomatic but can also be associated with syncope and death. An accurate diagnosis requires an ECG to be recorded during the event. It is important to note that an increase in the QT interval due to a new conduction block should not be considered indicative of acquired LQTS and risk for TdP.

    • This question is part of the following fields:

      • Psychopharmacology
      2.1
      Seconds
  • Question 16 - Which drug experiences the most substantial first-pass metabolism? ...

    Correct

    • Which drug experiences the most substantial first-pass metabolism?

      Your Answer: Imipramine

      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
      4.5
      Seconds
  • Question 17 - Who wrote the first book on medical ethics? ...

    Correct

    • Who wrote the first book on medical ethics?

      Your Answer: Ishaq bin Ali Rahawi

      Explanation:

      Ishaq bin Ali Rahawi tackled ethical concerns in the field of medicine in his work, Adab al-Tabib (Conduct of a Physician), during the 9th century.

      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
      1.9
      Seconds
  • Question 18 - Who coined the term 'punch drunk syndrome'? ...

    Correct

    • Who coined the term 'punch drunk syndrome'?

      Your Answer: Martland

      Explanation:

      Dementia Pugilistica: A Neurodegenerative Condition Resulting from Neurotrauma

      Dementia pugilistica, also known as chronic traumatic encephalopathy (CTE), is a neurodegenerative condition that results from neurotrauma. It is commonly seen in boxers and NFL players, but can also occur in anyone with neurotrauma. The condition is characterized by symptoms such as gait ataxia, slurred speech, impaired hearing, tremors, disequilibrium, neurobehavioral disturbances, and progressive cognitive decline.

      Most cases of dementia pugilistica present with early onset cognitive deficits, and behavioral signs exhibited by patients include aggression, suspiciousness, paranoia, childishness, hypersexuality, depression, and restlessness. The progression of the condition leads to more prominent behavioral symptoms such as difficulty with impulse control, irritability, inappropriateness, and explosive outbursts of aggression.

      Neuropathological abnormalities have been identified in CTE, with the most unique feature being the abnormal accumulation of tau in neurons and glia in an irregular, focal, perivascular distribution and at the depths of cortical sulci. Abnormalities of the septum pellucidum, such as cavum and fenestration, are also a common feature.

      While the condition has become increasingly rare due to the progressive improvement in sports safety, it is important to recognize the potential long-term consequences of repeated head injuries and take steps to prevent them.

    • This question is part of the following fields:

      • Neurosciences
      2.7
      Seconds
  • Question 19 - If a patient suspected of having a stroke presents with a deviation of...

    Correct

    • If a patient suspected of having a stroke presents with a deviation of the tongue towards the right, which nerve is likely to be impacted?

      Your Answer: Right hypoglossal nerve

      Explanation:

      The hypoglossal nerve (nerve XII) is responsible for controlling the motor functions of the tongue and the muscles surrounding the hyoid bone. As a result, when there is a lesion on the right side, the tongue will tend to deviate towards that side. It is important to note that the hypoglossal nerve is purely a motor nerve and does not have any sensory component.

      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
      Seconds
  • Question 20 - What substance of drug directly inhibits the dopamine transporter, resulting in elevated levels...

    Correct

    • What substance of drug directly inhibits the dopamine transporter, resulting in elevated levels of dopamine in the synaptic cleft?

      Your Answer: Cocaine

      Explanation:

      Amphetamine engages in competition with the DAT instead of obstructing it.

      Mechanisms of action for illicit drugs can be classified based on their effects on ionotropic receptors of ion channels, G coupled receptors, of monoamine transporters. Cocaine and amphetamine both increase dopamine levels in the synaptic cleft, but through different mechanisms. Cocaine directly blocks the dopamine transporter, while amphetamine binds to the transporter and increases dopamine efflux through various mechanisms, including inhibition of vesicular monoamine transporter 2 and monoamine oxidase, and stimulation of the intracellular receptor TAAR1. These mechanisms result in increased dopamine levels in the synaptic cleft and reuptake inhibition.

    • This question is part of the following fields:

      • Psychopharmacology
      2.6
      Seconds
  • Question 21 - What is a typical adverse effect associated with the use of carbamazepine? ...

    Correct

    • What is a typical adverse effect associated with the use of carbamazepine?

      Your Answer: Diplopia

      Explanation:

      Diplopia is a frequently occurring side-effect, while the other options are infrequent of extremely infrequent side-effects of carbamazepine.

      Carbamazepine: Uses, Mechanism of Action, Contraindications, Warnings, and Side-Effects

      Carbamazepine, also known as Tegretol, is a medication commonly used in the treatment of epilepsy, particularly partial seizures. It is also used for neuropathic pain, bipolar disorder, and other conditions. The drug works by binding to sodium channels and increasing their refractory period.

      However, carbamazepine has notable contraindications, including a history of bone marrow depression and combination with monoamine oxidase inhibitors (MAOIs). It also carries warnings for serious dermatological reactions such as toxic epidermal necrolysis (TEN) and Stevens Johnson syndrome.

      Common side-effects of carbamazepine include leucopenia, ataxia, dizziness, somnolence, vomiting, nausea, urticaria, and fatigue. Other side-effects include thrombocytopenia, eosinophilia, oedema, fluid retention, weight increase, hyponatraemia, and blood osmolarity decreased due to an antidiuretic hormone (ADH)-like effect, leading in rare cases to water intoxication accompanied by lethargy, vomiting, headache, confusional state, neurological disorders, diplopia, accommodation disorders (e.g. blurred vision), and dry mouth.

      In summary, carbamazepine is a medication with multiple uses, but it also carries significant contraindications, warnings, and side-effects that should be carefully considered before use.

    • This question is part of the following fields:

      • Psychopharmacology
      4.3
      Seconds
  • Question 22 - A concerned parent of a 25-year-old daughter with schizophrenia wants to know what...

    Correct

    • 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: 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
      4
      Seconds
  • Question 23 - What is the maximum duration of a normal QTc interval in a female...

    Correct

    • What is the maximum duration of a normal QTc interval in a female adult?

      Your Answer: 470

      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
      2.7
      Seconds
  • Question 24 - What is the most frequent cause of mortality in individuals with Down syndrome?...

    Correct

    • What is the most frequent cause of mortality in individuals with Down syndrome?

      Your Answer: Heart disease

      Explanation:

      The leading cause of death among individuals with Down’s syndrome is heart disease, despite the condition being linked to higher rates of diabetes, hypothyroidism, and leukemia. Trisomy 21 is the underlying cause of Down’s syndrome.

    • This question is part of the following fields:

      • Genetics
      2.6
      Seconds
  • Question 25 - In what setting is the Clifton Assessment Procedure used as an assessment tool?...

    Correct

    • In what setting is the Clifton Assessment Procedure used as an assessment tool?

      Your Answer: Nursing homes for the elderly

      Explanation:

      Clifton Assessment Procedure (CAPE) is a valuable tool for evaluating the quality of life, cognitive impairments, and physical dependency levels in elderly individuals. It is used to identify areas of unmet needs and can be administered in both hospital and community settings. The assessment takes approximately 15-25 minutes to complete and comprises two scales: the cognitive assessment scale and the behavior rating scale. The cognitive assessment scale evaluates orientation, basic cognition, and psychomotor performance, while the behavior rating scale assesses physical dependency and behavioral problems. The CAPE can differentiate between organic brain disease and functional psychiatric disorders and predict the likelihood of hospital discharge. It is commonly used to determine the most appropriate placement for elderly individuals.

    • This question is part of the following fields:

      • Classification And Assessment
      2.3
      Seconds
  • Question 26 - What is a true statement about failures in memory? ...

    Incorrect

    • What is a true statement about failures in memory?

      Your Answer: Blocking decreases in old age

      Correct Answer: Blocking can occur with both semantic and episodic memory

      Explanation:

      Memory: Encoding, Storage, Retrieval, and Failure

      Memory is a complex process that involves encoding, storage, and retrieval of information. Encoding refers to how information is placed into memory, and it can be improved by organizing data using techniques such as chunking and mnemonics. Storage refers to keeping information in memory, which can be short-term of long-term. Retrieval refers to getting information back from memory when needed, and it can be affected by primacy and recency effects.

      However, memory is not infallible, and there are seven ways in which it tends to fail. Transience refers to the decreasing accessibility of memory over time, while absent-mindedness is characterized by lapses of attention and forgetting to do things. Blocking is the temporary inaccessibility of stored information, while suggestibility involves the incorporation of misinformation into memory due to leading questions of deception.

      Bias refers to retrospective distortions produced by current knowledge and beliefs, while persistence involves unwanted recollections that people cannot forget, such as the intrusive memories of post-traumatic stress disorder. Finally, misattribution refers to the attribution of memories to incorrect sources of believing that one has seen of heard something that they have not, such as in the case of deja vu of cryptomnesia.

      Overall, memory is a complex and active process that can be affected by various factors, leading to failures in encoding, storage, retrieval, and attribution.

    • This question is part of the following fields:

      • Social Psychology
      25.7
      Seconds
  • Question 27 - Which substance is 5-HIAA a metabolite of? ...

    Correct

    • Which substance is 5-HIAA a metabolite of?

      Your Answer: Serotonin

      Explanation:

      The Significance of 5-HIAA in Depression and Aggression

      During the 1980s, there was a brief period of interest in 5-hydroxyindoleacetic acid (5-HIAA), a serotonin metabolite. Studies found that up to a third of people with depression had low concentrations of 5-HIAA in their cerebrospinal fluid (CSF), while very few normal controls did. This suggests that 5-HIAA may play a role in depression.

      Furthermore, individuals with low CSF levels of 5-HIAA have been found to respond less effectively to antidepressants and are more likely to commit suicide. This finding has been replicated in multiple studies, indicating the significance of 5-HIAA in depression.

      Low levels of 5-HIAA are also associated with increased levels of aggression. This suggests that 5-HIAA may play a role in regulating aggressive behavior. Overall, the research on 5-HIAA highlights its potential importance in understanding and treating depression and aggression.

    • This question is part of the following fields:

      • Neurosciences
      3.9
      Seconds
  • Question 28 - What is the accurate statement about the pathology of schizophrenia? ...

    Correct

    • What is the accurate statement about the pathology of schizophrenia?

      Your Answer: Brain volume of affected individuals is often reduced

      Explanation:

      While ventricular enlargement is often observed in individuals with schizophrenia, it is not a definitive indicator of the condition as it can also be present in other disorders.

      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
      4.1
      Seconds
  • Question 29 - A 60 year old man with depression is admitted to hospital for an...

    Correct

    • A 60 year old man with depression is admitted to hospital for an assessment. During the physically examination you notice he has bilaterally small pupils. On further examination you note that they fail to dilate when the lights are turned off and react in a sluggish manner to accommodation. Which of the following do you suspect?

      Your Answer: Senile miosis

      Explanation:

      Senile Pupil: A Common Age-Related Condition

      The senile pupil, also known as senile miosis, is a condition commonly observed in older individuals. It is characterized by a small pupil that does not dilate in the dark, and may also be associated with reduced reaction to light and accommodation. This condition is often a result of age-related changes in the muscles that control the pupil, and can be exacerbated by certain medications of medical conditions. While it may not cause significant vision problems, it is important for individuals with senile pupil to have regular eye exams to monitor any changes in their vision and ensure proper eye health.

    • This question is part of the following fields:

      • Classification And Assessment
      5.5
      Seconds
  • Question 30 - Which option below is not considered a theory of emotion? ...

    Correct

    • Which option below is not considered a theory of emotion?

      Your Answer: Maslow's theory

      Explanation:

      The concept proposed by Maslow is centered around a pyramid of needs.

      Theories of Emotion

      In membership exams, four main theories of emotion are commonly discussed: James-Lange theory, Cannon-Bard theory, Singer-Schachter theory, and Lazarus theory. The key to understanding the differences between these theories is to identify where the stimulus for the emotion arises.

      According to the James-Lange theory, emotions occur as a result of bodily sensations. For instance, if you see a big dog, your heart races, and you feel afraid. This theory proposes that certain external stimuli stimulate specific sensory organs, leading to a particular emotion. The sequence of events suggested by this theory is as follows: event – arousal – interpretation – emotion. In other words, the stimulus for emotion arises from physical sensations.

      The Cannon-Bard theory, also known as the thalami theory, proposes that when an event occurs, one experiences an emotion at the same time as physiological changes. The stimulus for emotion arises simultaneously in the body and the mind.

      The Singer-Schachter theory, also known as the two-factor theory, suggests that emotions result from both physiological changes and the context. For example, if your heart is racing, and you are about to have an exam, you label yourself as afraid. However, if your heart is racing, and you are about to kiss your partner, you label your emotional state as excited. The stimulus for emotion arises via a combination of physical sensations and the mind’s appraisal of them.

      Finally, the Lazarus theory proposes that a thought is required before an emotion occurs. For instance, if you see a big dog, you think it is going to bite you, and you feel afraid. The stimulus for emotion arises from the mind.

      In summary, these theories offer different perspectives on the relationship between physical sensations, cognitive processes, and emotions.

    • This question is part of the following fields:

      • Social Psychology
      4.6
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Psychopharmacology (14/14) 100%
Genetics (3/3) 100%
Neurosciences (5/5) 100%
History And Mental State (1/1) 100%
Social Psychology (3/4) 75%
Stigma And Culture (1/1) 100%
Classification And Assessment (2/2) 100%
Passmed