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  • Question 1 - Which drug was introduced into clinical practice by Kane? ...

    Incorrect

    • Which drug was introduced into clinical practice by Kane?

      Your Answer: Lithium

      Correct Answer: Clozapine

      Explanation:

      Clozapine has a unique past, having been initially utilized in Europe during the early 1970s. Its effectiveness was notable, particularly due to its lack of causing EPSE’s. However, its popularity declined after several instances of agranulocytosis. In 1988, Kane conducted a study that demonstrated its safe use with proper blood monitoring, leading to its introduction in both the UK and the US.

      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
      9.2
      Seconds
  • Question 2 - What is the primary neurotransmitter responsible for excitatory signals in the brain? ...

    Correct

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

      Your 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
      8.7
      Seconds
  • Question 3 - Which of the following experiences is usually considered normal and not a sign...

    Correct

    • Which of the following experiences is usually considered normal and not a sign of illness?

      Your Answer: Hypnagogic hallucination

      Explanation:

      Mitmachen involves manipulating a patient’s body into a specific posture, even if they resist. Mitgehen is a more severe form of mitmachen, where even slight pressure can cause the patient to move in any direction, similar to an anglepoise effect. Hypnagogic hallucinations are a common occurrence when falling asleep, while chorea is characterized by sudden and jerky movements that resemble purposeful actions. Echopraxia refers to the imitation of another person’s movements.

    • This question is part of the following fields:

      • Descriptive Psychopathology
      5.9
      Seconds
  • Question 4 - Who is credited with creating the term 'catatonia'? ...

    Incorrect

    • Who is credited with creating the term 'catatonia'?

      Your Answer: Kraepelin

      Correct Answer: Kahlbaum

      Explanation:

      – 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
      9
      Seconds
  • Question 5 - What is the genetic condition that occurs due to the removal of genetic...

    Correct

    • What is the genetic condition that occurs due to the removal of genetic material from chromosome 22?

      Your Answer: DiGeorge syndrome

      Explanation:

      DiGeorge syndrome is primarily caused by a deletion on chromosome 22 and presents with a range of symptoms. To aid in remembering the chromosome involved and some of the signs and symptoms, a mnemonic is used. These include cardiac abnormalities such as tetralogy of Fallot, abnormal facies with almond-shaped eyes and low-set ears, thymic aplasia leading to recurrent infections, cleft palate, and hypocalcemia/hypoparathyroidism causing short stature and seizures. Additionally, individuals with DiGeorge syndrome often have a degree of learning disability and are at an increased risk for psychiatric conditions such as depression, ADHD, and schizophrenia.

      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
      5.8
      Seconds
  • Question 6 - The Maudsley guidelines suggest a particular approach for managing restlessness resulting from the...

    Correct

    • The Maudsley guidelines suggest a particular approach for managing restlessness resulting from the use of antipsychotics.

      Your Answer: Clonazepam

      Explanation:

      The Maudsley Guidelines recommend the use of diazepam and clonazepam in their treatment plan for antipsychotic induced akathisia, likely because of their extended duration of action.

      Benzodiazepines are a class of drugs commonly used to treat anxiety and sleep disorders. It is important to have a working knowledge of the more common benzodiazepines and their half-life. Half-life refers to the amount of time it takes for half of the drug to be eliminated from the body.

      Some of the more common benzodiazepines and their half-life include diazepam with a half-life of 20-100 hours, clonazepam with a half-life of 18-50 hours, chlordiazepoxide with a half-life of 5-30 hours, nitrazepam with a half-life of 15-38 hours, temazepam with a half-life of 8-22 hours, lorazepam with a half-life of 10-20 hours, alprazolam with a half-life of 10-15 hours, oxazepam with a half-life of 6-10 hours, zopiclone with a half-life of 5-6 hours, zolpidem with a half-life of 2 hours, and zaleplon with a half-life of 2 hours. Understanding the half-life of these drugs is important for determining dosages and timing of administration.

    • This question is part of the following fields:

      • Psychopharmacology
      10.5
      Seconds
  • Question 7 - A senior citizen started on an antidepressant develops hyponatremia. Which of the following...

    Correct

    • A senior citizen started on an antidepressant develops hyponatremia. Which of the following in their history was most likely to contribute to this?

      Your Answer: Having a low baseline sodium concentration

      Explanation:

      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 euvolaemic 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
      7.5
      Seconds
  • Question 8 - What is an example of a type of passive thinking? ...

    Correct

    • What is an example of a type of passive thinking?

      Your Answer: Thought broadcast

      Explanation:

      Patients may feel that they have lost control over their thoughts, which can manifest as passivity of thought. This refers to the belief that an external agency is controlling one’s thoughts. Passivity can take different forms, such as thought withdrawal, thought insertion, and thought broadcasting.

      Ego (Boundary) Disturbances

      Ego (boundary) disturbances refer to experiences where there is a disturbance in the perception of self as distinct from the environment of the integrity of self. It also includes instances where bodily processes, personal thought processes, feelings, and actions are experienced as being externally directed. These phenomena are referred to as passivity phenomena, and some of the symptom characteristics are classified as bizarre delusional phenomena in the DSM.

      Derealization is when a patient experiences their surroundings of time as if they are unreal and changed, losing all feelings of familiarity and trust in the environment. People, objects, and surroundings appear unreal, unfamiliar, of spatially altered. The sensations may be intense of weak in nature.

      Depersonalization is when a patient perceives themselves as alien, unreal, changed, of as a stranger. The disturbances of depersonalization may be of a transient nature only of become more persistent over a longer period of time. It is generally felt to be both strange and unpleasant.

      Thought broadcasting is when a patient’s personal thoughts are experienced as no longer belonging to the patient alone but accessible by others who will know what the patient is thinking (mind reading). Thought withdrawal is when a patient’s thoughts are being removed of stripped from them. Thought insertion is when patients experience their thoughts and ideas as being externally influenced, made externally, controlled, directed, entered/ of externally imposed.

      Other feelings of alien influence refer to feelings, intentions, behavior, of bodily functions that are experienced as externally controlled of made by others (passivity phenomena). The patient feels externally compelled to say something specific, to scream, to act of behave in a particular way, to attack someone, to throw a tantrum, etc.

    • This question is part of the following fields:

      • Classification And Assessment
      5.6
      Seconds
  • Question 9 - Which ethical theory is attributed to Bentham and Mill as its main founders?...

    Correct

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

      Your 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
      7.4
      Seconds
  • Question 10 - A 65-year-old patient with schizophrenia reports experiencing sluggish thinking and difficulty initiating thoughts....

    Correct

    • A 65-year-old patient with schizophrenia reports experiencing sluggish thinking and difficulty initiating thoughts. However, no apparent issues with the patient's thoughts are observed during conversation. What would you document in your mental state examination?

      Your Answer: Inhibited Thinking

      Explanation:

      Formal Thought Disorders

      In formal thought disorders, changes in the speed, coherence, and cogency of thought can be observed from a patient’s speech. These disorders can also be self-reported and may be accompanied by enhanced use of nonverbal language. One possible indication is a lack of an adequate connection between two consecutive thoughts, which is called ‘asyndesis’.

      There are several types of formal thought disorders, including inhibited thinking, retarded thinking, circumstantial thinking, restricted thinking, perseverative thinking, rumination, pressured thinking, flight of ideas, tangential thinking, thought blocking, disruption of thought, incoherence/derailment, and neologisms.

      Inhibited thinking is about the subjective experience of the patient, who may feel that their thinking process is slowed down of blocked by an inner wall of resistance. Retarded thinking, on the other hand, is about the observed quality of thought as inferred through speech, where the flow of thought processes is slowed down and sluggish.

      Circumstantial thinking refers to an inability to separate the essential from the unessential during a conversation without rendering the conversation incoherent. Restricted thinking involves a limited range of thought content, fixation on one particular topic of a small number of topics only, and a stereotyped pattern of thinking.

      Perseverative thinking is characterized by the persistent repetition of previously used words, phrases, of details to the point where they become meaningless in the context of the current stage of the interview. Rumination is the endless mental preoccupation with, of excessive concern over, mostly unpleasant thoughts.

      Pressured thinking, also known as crowding of thought, is when the patient feels helplessly exposed to the pressures of floods of different ideas of thoughts. Flight of ideas involves an increasing multitude of thoughts and ideas which are no longer firmly guided by clear goal-directed thinking.

      Tangential thinking occurs when the patient appears to understand the contents of the questions addressed to them but provides answers which are completely out of context. Thought blocking of disruption of thought refers to sudden disruption of an otherwise normal flow of thought of speech for no obvious reason.

      Incoherence of derailment is when the interviewer is unable to establish sensible connections between the patient’s thinking and verbal output, which is sometimes also called derailment. Neologisms involve the formation of new words of usage of words which disregard normal conventions and are generally not easily understandable.

    • This question is part of the following fields:

      • Classification And Assessment
      12.5
      Seconds
  • Question 11 - A young adult develops nephrolithiasis after initiating a mood stabiliser. What has been...

    Incorrect

    • A young adult develops nephrolithiasis after initiating a mood stabiliser. What has been demonstrated to cause this side effect?

      Your Answer: Sodium valproate

      Correct Answer: Topiramate

      Explanation:

      The use of topiramate can result in metabolic acidosis due to its ability to block carbonic anhydrase. This can increase the risk of developing calcium phosphate nephrolithiasis, commonly known as kidney stones.

      Topiramate is a medication used for epilepsy and bipolar affective disorder. It works by inhibiting voltage gated sodium channels and increasing GABA levels. Unlike most psychotropic drugs, it is associated with weight loss.

    • This question is part of the following fields:

      • Psychopharmacology
      10.4
      Seconds
  • Question 12 - What type of attachment is demonstrated by a child who is equally comforted...

    Incorrect

    • What type of attachment is demonstrated by a child who is equally comforted by a parent and a stranger?

      Your Answer: Resistant

      Correct Answer: Avoidant

      Explanation:

      Attachment (Ainsworth)

      Psychologist Mary Ainsworth developed the ‘Strange Situation procedure’ to study and categorize attachment in children aged 12 to 18 months. The procedure involves seven steps, including two separations and two reunions, and takes place in one room. The child’s attachment is classified into one of three styles: secure, anxious-resistant, and anxious-avoidant. A fourth category, disorganized, is sometimes observed. Ainsworth suggested that the child’s attachment style is determined by the primary caregiver’s behavior.

      Mary Main later developed the Adult Attachment Interview and identified four categories of attachment in adults that correspond to those observed in the strange situation. The distribution of adult attachment styles correlates with those of the strange situation, with 70% of children and adults having secure attachment. Attachment styles also seem to be passed on to subsequent generations.

    • This question is part of the following fields:

      • Psychological Development
      7.7
      Seconds
  • Question 13 - What is the extracellular ion that contributes to the resting membrane potential of...

    Correct

    • What is the extracellular ion that contributes to the resting membrane potential of a neuron due to its high concentration?

      Your Answer: Na

      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
      5.7
      Seconds
  • Question 14 - Which enzyme is responsible for adding amino acids to RNA molecules to create...

    Correct

    • Which enzyme is responsible for adding amino acids to RNA molecules to create transfer RNA?

      Your Answer: Aminoacyl tRNA synthetase

      Explanation:

      The Aminoacyl tRNA Synthetases (AARSs) are a group of enzymes that attach a specific amino acid to its corresponding tRNA molecule. There are 21 different AARS enzymes, each responsible for a different amino acid, except for lysine, which has two AARSs.

      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
      13.6
      Seconds
  • Question 15 - What was the first SSRI to receive approval and be introduced to the...

    Correct

    • What was the first SSRI to receive approval and be introduced to the market in the United States?

      Your Answer: Fluoxetine

      Explanation:

      The initial SSRI to be developed was fluoxetine.

      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
      5.2
      Seconds
  • Question 16 - Which wave pattern is considered the most abnormal during a state of wakefulness?...

    Incorrect

    • Which wave pattern is considered the most abnormal during a state of wakefulness?

      Your Answer: Beta

      Correct Answer: Delta

      Explanation:

      Electroencephalography

      Electroencephalography (EEG) is a clinical test that records the brain’s spontaneous electrical activity over a short period of time using multiple electrodes placed on the scalp. It is mainly used to rule out organic conditions and can help differentiate dementia from other disorders such as metabolic encephalopathies, CJD, herpes encephalitis, and non-convulsive status epilepticus. EEG can also distinguish possible psychotic episodes and acute confusional states from non-convulsive status epilepticus.

      Not all abnormal EEGs represent an underlying condition, and psychotropic medications can affect EEG findings. EEG abnormalities can also be triggered purposely by activation procedures such as hyperventilation, photic stimulation, certain drugs, and sleep deprivation.

      Specific waveforms are seen in an EEG, including delta, theta, alpha, sigma, beta, and gamma waves. Delta waves are found frontally in adults and posteriorly in children during slow wave sleep, and excessive amounts when awake may indicate pathology. Theta waves are generally seen in young children, drowsy and sleeping adults, and during meditation. Alpha waves are seen posteriorly when relaxed and when the eyes are closed, and are also seen in meditation. Sigma waves are bursts of oscillatory activity that occur in stage 2 sleep. Beta waves are seen frontally when busy of concentrating, and gamma waves are seen in advanced/very experienced meditators.

      Certain conditions are associated with specific EEG changes, such as nonspecific slowing in early CJD, low voltage EEG in Huntington’s, diffuse slowing in encephalopathy, and reduced alpha and beta with increased delta and theta in Alzheimer’s.

      Common epileptiform patterns include spikes, spike/sharp waves, and spike-waves. Medications can have important effects on EEG findings, with clozapine decreasing alpha and increasing delta and theta, lithium increasing all waveforms, lamotrigine decreasing all waveforms, and valproate having inconclusive effects on delta and theta and increasing beta.

      Overall, EEG is a useful tool in clinical contexts for ruling out organic conditions and differentiating between various disorders.

    • This question is part of the following fields:

      • Neurosciences
      4.3
      Seconds
  • Question 17 - In what region of the brain is the dentate gyrus located? ...

    Correct

    • In what region of the brain is the dentate gyrus located?

      Your Answer: Temporal lobe

      Explanation:

      The hippocampal formation includes the dentate gyrus, which is located in the medial temporal lobe. The cerebrum, which is the largest part of the brain, is divided into four lobes: frontal, temporal, parietal, and occipital. The frontal lobe is situated at the front of the cerebrum, while the temporal lobes are on the sides, the parietal lobe is on the top, and the occipital lobe is at the back.

    • This question is part of the following fields:

      • Neurological Examination
      7.6
      Seconds
  • Question 18 - Based on the information provided, it is most likely that the 25-year-old male...

    Incorrect

    • Based on the information provided, it is most likely that the 25-year-old male with schizophrenia, who has no significant medical history, is experiencing symptoms of dehydration and hypoglycemia due to excessive fluid intake and lack of food intake. He has become lethargic and is vomiting, which are common symptoms of dehydration. His low blood glucose level of 4.3 mmol/L indicates that he has not eaten in a while and is experiencing hypoglycemia. It is important to address his dehydration and hypoglycemia promptly to prevent further complications.

      Your Answer: Diabetes mellitus

      Correct Answer: Psychogenic polydipsia

      Explanation:

      It is probable that the patient is experiencing hyponatremia due to psychogenic polydipsia, while diabetes mellitus can be ruled out as their blood glucose level is normal. Additionally, lithium toxicity is an unlikely cause as lithium is not typically prescribed for schizophrenia treatment.

      Psychogenic polydipsia is a condition where there is excessive consumption of fluids leading to polyuria, and it is commonly seen in psychiatric conditions such as schizophrenia and developmental disorders. The exact mechanism is unknown, but it is thought to be due to a defect in thirst and a dysfunction in AVP regulation. Patients with psychogenic polydipsia rarely complain of thirst but instead provide delusional explanations for their excessive drinking of state that drinking reduces their anxiety and makes them feel better. If fluid intake exceeds the capacity for excretion, then the resultant hyponatremia may produce signs of water intoxication. It is best managed by fluid restriction. Differential diagnosis should be done to rule out other causes of polyuria and polydipsia. Investigations such as fluid balance charts, urine dipstick, serum U&E and calcium, and urine and plasma osmolality should be arranged. Primary polydipsia can be subclassified into psychogenic and dipsogenic types.

    • This question is part of the following fields:

      • Classification And Assessment
      14
      Seconds
  • Question 19 - What is the maximum duration of a normal QTc interval in an adult...

    Correct

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

      Your Answer: 440

      Explanation:

      While the upper limit technically reaches 439, it is evident that 440 is the optimal choice among the options provided.

      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
      8.4
      Seconds
  • Question 20 - What is a framework that can be used for ethical discussions, regardless of...

    Correct

    • What is a framework that can be used for ethical discussions, regardless of the ethical theory held by the participants?

      Your Answer: The four principles

      Explanation:

      The four principles serve as a framework for ethical discussions, rather than being an ethical theory themselves. They provide guidelines that can be used regardless of the ethical theory that the participants may hold.

      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
      10.9
      Seconds
  • Question 21 - What is located within Brodmann area 22? ...

    Correct

    • What is located within Brodmann area 22?

      Your Answer: Wernicke's area

      Explanation:

      Broca’s and Wernicke’s are two types of expressive dysphasia, which is characterized by difficulty producing speech despite intact comprehension. Dysarthria is a type of expressive dysphasia caused by damage to the speech production apparatus, while Broca’s aphasia is caused by damage to the area of the brain responsible for speech production, specifically Broca’s area located in Brodmann areas 44 and 45. On the other hand, Wernicke’s aphasia is a type of receptive of fluent aphasia caused by damage to the comprehension of speech, while the actual production of speech remains normal. Wernicke’s area is located in the posterior part of the superior temporal gyrus in the dominant hemisphere, within Brodmann area 22.

    • This question is part of the following fields:

      • Neurosciences
      2.3
      Seconds
  • Question 22 - What combination of substances is included in Suboxone? ...

    Correct

    • What combination of substances is included in Suboxone?

      Your Answer: Naloxone and buprenorphine

      Explanation:

      Suboxone vs. Subutex: What’s the Difference?

      Suboxone and Subutex are both medications used to treat opioid addiction. However, there are some key differences between the two.

      Suboxone is a combination of buprenorphine and naloxone. The naloxone is added to prevent people from injecting the medication, as this was a common problem with pure buprenorphine tablets. If someone tries to inject Suboxone, the naloxone will cause intense withdrawal symptoms. However, if the tablet is swallowed as directed, the naloxone is not absorbed by the gut and does not cause any problems.

      Subutex, on the other hand, contains only buprenorphine and does not include naloxone. This means that it may be more likely to be abused by injection, as there is no deterrent to prevent people from doing so.

      Overall, both Suboxone and Subutex can be effective treatments for opioid addiction, but Suboxone may be a safer choice due to the addition of naloxone.

    • This question is part of the following fields:

      • Psychopharmacology
      9.6
      Seconds
  • Question 23 - Which of the following is a cognitive condition affecting the content of one's...

    Incorrect

    • Which of the following is a cognitive condition affecting the content of one's thoughts?

      Your Answer: Flight of ideas

      Correct Answer: Delusional perception

      Explanation:

      A delusional perception is when a normal percept is interpreted in a delusional way, rather than simply fitting into an existing delusional belief system. This is different from disorders of form of thought, such as circumstantiality (slow thinking with inclusion of trivial details), thought block (sudden interruption of thought), derailment (breakdown of association between thoughts), and flight of ideas (increase in flow of thinking with frequent changes in goal and tangents).

    • This question is part of the following fields:

      • Descriptive Psychopathology
      17
      Seconds
  • Question 24 - Which of the options below is not classified as a type of motor...

    Incorrect

    • Which of the options below is not classified as a type of motor neuron disease?

      Your Answer: Amyotrophic lateral sclerosis

      Correct Answer: Multisystem atrophy

      Explanation:

      Motor neuron Disease: A Progressive Neurodegenerative Condition

      Motor neuron Disease (MND) is a condition that progressively damages the upper and lower motor neurons. This damage leads to muscle weakness and wasting, resulting in a loss of mobility in the limbs, as well as difficulties with speech, swallowing, and breathing. MND can be classified into four main types, including Amyotrophic lateral sclerosis, Progressive bulbar palsy, Progressive muscular atrophy, and Primary lateral sclerosis.

      Macroscopic pathological features of MND include atrophy of the precentral gyrus and frontotemporal regions, thinning of the spinal cord, and atrophic anterior nerve roots. Microscopic changes involve the loss of motor neurons from the ventral horn of the spinal cord and lower brainstem. MND is a devastating condition that currently has no cure, and treatment is focused on managing symptoms and improving quality of life for those affected.

    • This question is part of the following fields:

      • Neurosciences
      11.8
      Seconds
  • Question 25 - What is the average number of digits that individuals can remember in the...

    Correct

    • What is the average number of digits that individuals can remember in the digit span forwards test?

      Your Answer: 7 +/- 2

      Explanation:

      The Magical Number Seven, Plus of Minus Two: Some Limits on Our Capacity for Processing Information

      Miller’s (1956) study focused on the limits of our short-term memory capacity, specifically in regards to our ability to recall sequences of numbers. The digit span test, which involves repeating back increasingly longer sequences of numbers both forwards and backwards, is used to measure this capacity. Miller found that the normal range for Digit Span forward was a maximum span of 7±2 digits. This study highlights the limitations of our short-term memory and the importance of understanding these limitations in various contexts, such as education and cognitive psychology.

    • This question is part of the following fields:

      • Classification And Assessment
      2.9
      Seconds
  • Question 26 - Which neo-Freudian theorists are linked to the concepts of anima and animus? ...

    Correct

    • Which neo-Freudian theorists are linked to the concepts of anima and animus?

      Your Answer: Carl Jung

      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
      3.7
      Seconds
  • Question 27 - What is one assumption of the Hardy-Weinberg equilibrium? ...

    Correct

    • What is one assumption of the Hardy-Weinberg equilibrium?

      Your Answer: Mating between individuals is random

      Explanation:

      Hardy-Weinberg Principle and Allele Frequency

      Allele frequency refers to the proportion of a population that carries a specific variant at a particular gene locus. It can be calculated by dividing the number of individual alleles of a certain type by the total number of alleles in a population. The Hardy-Weinberg Principle states that both allele and genotype frequencies in a population remain constant from generation to generation unless specific disturbing influences are introduced. To remain in equilibrium, five conditions must be met, including no mutations, no gene flow, random mating, a sufficiently large population, and no natural selection. The Hardy-Weinberg Equation is used to predict the frequency of alleles in a population, and it can be used to estimate the carrier frequency of genetic diseases. For example, if the incidence of PKU is one in 10,000 babies, then the carrier frequency in the general population is 1/50. Couples with a previous child with PKU have a 25% chance of having another affected child.

    • This question is part of the following fields:

      • Genetics
      6.2
      Seconds
  • Question 28 - What information is necessary to determine the volume of distribution? ...

    Correct

    • What information is necessary to determine the volume of distribution?

      Your Answer: The concentration of the drug in the plasma

      Explanation:

      Understanding the Volume of Distribution in Pharmacology

      The volume of distribution (Vd) is a crucial concept in pharmacology that helps determine how a drug distributes in the body. It is also known as the apparent volume of distribution, as it is an abstract volume. The Vd indicates whether a drug concentrates in the plasma of spreads out in the body. Drugs that are highly polar tend to stay in central compartments such as the plasma, resulting in a low Vd. Conversely, drugs that are more lipid-soluble are distributed widely, such as in fat, resulting in a high Vd.

      The Vd is calculated by dividing the amount of drug in the body by the concentration in the plasma. Clinically, the Vd is used to determine the loading dose of a drug required for a desired blood concentration and to estimate blood concentration in the treatment of overdose. The units of Vd are in volume.

      The apparent volume of distribution is dependent on the drug’s lipid of water solubility, plasma protein binding, and tissue binding. Plasma protein binding affects the Vd, as drugs that bind to plasma proteins like albumin have a smaller apparent volume of distribution. This is because they are extracted from plasma and included in drug concentration measurements, which can give a misleading impression of their volume of distribution. Understanding the Vd is essential in pharmacology to ensure the safe and effective use of drugs.

    • This question is part of the following fields:

      • Psychopharmacology
      8.9
      Seconds
  • Question 29 - You diagnose a mild depressive episode in a male patient undergoing lithium treatment...

    Correct

    • You diagnose a mild depressive episode in a male patient undergoing lithium treatment for bipolar disorder.
      Which of the following mood stabilizers should be avoided?

      Your Answer: Fluoxetine

      Explanation:

      Tamoxifen metabolism to its active metabolite may be inhibited by the use of fluoxetine and paroxetine, therefore, these medications should be avoided in patients receiving tamoxifen. Venlafaxine is considered the safest choice of antidepressant as it has little to no effect on tamoxifen metabolism. Mirtazapine has been found to have minimal effect on CYP2D6, while the other commonly prescribed antidepressants have mild to moderate degrees of CYP2D6 inhibition.

    • This question is part of the following fields:

      • Psychopharmacology
      17.1
      Seconds
  • Question 30 - Which of the following is an example of a compound question? ...

    Correct

    • Which of the following is an example of a compound question?

      Your Answer: Do you limit what you eat and exercise to keep thin?

      Explanation:

      Understanding Compound Questions in Interview Techniques

      When conducting interviews, it is important to be aware of compound questions. These are questions that combine multiple inquiries into what appears to be a single question. Compound questions can be confusing for the interviewee and may lead to inaccurate of incomplete responses.

      To avoid compound questions, it is important to break down inquiries into separate, clear questions. This allows the interviewee to fully understand what is being asked and provide a thoughtful response. Additionally, it is important to avoid using conjunctions such as and of of when asking questions, as this can create compound questions.

      By using clear and concise language and avoiding compound questions, interviewers can ensure that they are receiving accurate and complete responses from their interviewees. This can lead to a more successful and informative interview process.

    • This question is part of the following fields:

      • Classification And Assessment
      9.5
      Seconds
  • Question 31 - Freud believed that the conscience is located in which of the following? ...

    Correct

    • Freud believed that the conscience is located in which of the following?

      Your Answer: Superego

      Explanation:

      Freud’s Structural Theory: Understanding the Three Areas of the Mind

      According to Freud’s structural model, the human mind is divided into three distinct areas: the Id, the Ego, and the Superego. The Id is the part of the mind that contains instinctive drives and operates on the ‘pleasure principle’. It functions without a sense of time and is governed by ‘primary process thinking’. The Ego, on the other hand, attempts to modify the drives from the Id with external reality. It operates on the ‘reality principle’ and has conscious, preconscious, and unconscious aspects. It is also home to the defense mechanisms. Finally, the Superego acts as a critical agency, constantly observing a person’s behavior. Freud believed that it developed from the internalized values of a child’s main caregivers. The Superego contains the ‘ego ideal’, which represents ideal attitudes and behavior. It is often referred to as the conscience. Understanding these three areas of the mind is crucial to understanding Freud’s structural theory.

    • This question is part of the following fields:

      • Social Psychology
      3.7
      Seconds
  • Question 32 - What is a true statement about interactions involving lithium? ...

    Incorrect

    • What is a true statement about interactions involving lithium?

      Your Answer: ACE inhibitors can reduce lithium levels

      Correct Answer: NSAIDS can increase lithium levels

      Explanation:

      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
      10.7
      Seconds
  • Question 33 - How can the effectiveness of executive function be tested, and which test is...

    Incorrect

    • How can the effectiveness of executive function be tested, and which test is the least effective?

      Your Answer: Cognitive estimates

      Correct Answer: Digit span

      Explanation:

      While digit span is primarily used to assess working memory, it also involves executive attention, which is a component shared by tests of working memory capacity and executive function. Therefore, digit span cannot be considered solely a test of working memory.

      The mental state exam assesses various areas of cognition, including orientation, attention/concentration, short term memory, long term memory, and executive function. Standard tests for each area include asking about time, place, and person for orientation, serial 7’s for attention/concentration, digit span for short term memory, delayed recall of name and address for long term memory, and various tasks such as proverbs, similarities, differences, verbal fluency, and cognitive estimates for executive function.

    • This question is part of the following fields:

      • Classification And Assessment
      11.1
      Seconds
  • Question 34 - What is a true statement about olanzapine pamoate / embonate? ...

    Correct

    • What is a true statement about olanzapine pamoate / embonate?

      Your Answer: It is licenced only for gluteal administration

      Explanation:

      Although only gluteal injection is approved for olanzapine, deltoid injection is not as effective. Smoking and carbamazepine can induce the metabolism of olanzapine, resulting in lower concentrations. However, the increase in olanzapine clearance is only slight to moderate, and the clinical implications are likely limited. Clinical monitoring is recommended, and an increase in olanzapine dosage may be necessary. While test doses are not required for olanzapine embonate, the Summary of Product Characteristics (SPC) recommends treating patients with oral olanzapine before administering ZYPADHERA to establish tolerability and response.

      , coma, respiratory depression (rare)

    • This question is part of the following fields:

      • Psychopharmacology
      11.9
      Seconds
  • Question 35 - What is the estimated rate of adherence to prescribed medications across all age...

    Correct

    • What is the estimated rate of adherence to prescribed medications across all age groups and medication types?

      Your Answer: 50%

      Explanation:

      Across all medical specialties, it is typical for patients to take less than half of their prescribed doses of self-administered medications, indicating low adherence rates that have been shown to be around 50%.

    • This question is part of the following fields:

      • Advanced Psychological Processes And Treatments
      9.5
      Seconds
  • Question 36 - A 30-year-old smoker successfully quit smoking by acknowledging the harm it was causing...

    Correct

    • A 30-year-old smoker successfully quit smoking by acknowledging the harm it was causing to their health, considering the benefits of quitting, setting a quit date, and gradually reducing their nicotine intake until they were able to quit completely. This behaviour change is an example of which of the following theories?

      Your Answer: Stage model

      Explanation:

      Behaviour change theories can be categorized into two main groups: social cognition models and stage models. Stage models involve progression through specific stages, while social cognition models focus on beliefs and attitudes as drivers of behaviour change. Examples of social cognition models include the health belief model, protection motivation theory, and self-efficacy theory.

    • This question is part of the following fields:

      • Advanced Psychological Processes And Treatments
      8.3
      Seconds
  • Question 37 - Which model of the mind is composed of the fundamental elements of the...

    Correct

    • Which model of the mind is composed of the fundamental elements of the Id, ego, and Superego?

      Your Answer: Structural

      Explanation:

      Freud’s Structural Theory: Understanding the Three Areas of the Mind

      According to Freud’s structural model, the human mind is divided into three distinct areas: the Id, the Ego, and the Superego. The Id is the part of the mind that contains instinctive drives and operates on the ‘pleasure principle’. It functions without a sense of time and is governed by ‘primary process thinking’. The Ego, on the other hand, attempts to modify the drives from the Id with external reality. It operates on the ‘reality principle’ and has conscious, preconscious, and unconscious aspects. It is also home to the defense mechanisms. Finally, the Superego acts as a critical agency, constantly observing a person’s behavior. Freud believed that it developed from the internalized values of a child’s main caregivers. The Superego contains the ‘ego ideal’, which represents ideal attitudes and behavior. It is often referred to as the conscience. Understanding these three areas of the mind is crucial to understanding Freud’s structural theory.

    • This question is part of the following fields:

      • Social Psychology
      6.9
      Seconds
  • Question 38 - In what stage of the cell cycle does the process of DNA replication...

    Correct

    • In what stage of the cell cycle does the process of DNA replication occur?

      Your Answer: S phase

      Explanation:

      Cytokinesis: The Final Stage of Cell Division

      Cytokinesis is the final stage of cell division, where the cell splits into two daughter cells, each with a nucleus. This process is essential for the growth and repair of tissues in multicellular organisms. In mitosis, cytokinesis occurs after telophase, while in meiosis, it occurs after telophase I and telophase II.

      During cytokinesis, a contractile ring made of actin and myosin filaments forms around the cell’s equator, constricting it like a belt. This ring gradually tightens, pulling the cell membrane inward and creating a furrow that deepens until it reaches the center of the cell. Eventually, the furrow meets in the middle, dividing the cell into two daughter cells.

      In animal cells, cytokinesis is achieved by the formation of a cleavage furrow, while in plant cells, a cell plate forms between the two daughter nuclei, which eventually develops into a new cell wall. The timing and mechanism of cytokinesis are tightly regulated by a complex network of proteins and signaling pathways, ensuring that each daughter cell receives the correct amount of cytoplasm and organelles.

      Overall, cytokinesis is a crucial step in the cell cycle, ensuring that genetic material is equally distributed between daughter cells and allowing for the growth and development of multicellular organisms.

    • This question is part of the following fields:

      • Genetics
      7.2
      Seconds
  • Question 39 - Who was the first psychiatrist to utilize electroconvulsive therapy as a treatment method?...

    Correct

    • Who was the first psychiatrist to utilize electroconvulsive therapy as a treatment method?

      Your Answer: Ugo Cerletti

      Explanation:

      Ugo Cerletti was a neurologist from Italy who is known for his work in developing electroconvulsive therapy (ECT). Emil Kraepelin, considered the founder of modern scientific psychiatry, coined the term dementia praecox. Eugen Bleuler, on the other hand, replaced the term with schizophrenia. Karl Jaspers, a psychiatrist and existential philosopher, made significant contributions to the field. Lastly, Carl Jung founded analytical psychology.

    • This question is part of the following fields:

      • History Of Psychiatry
      3.2
      Seconds
  • Question 40 - What is an example of a common antipsychotic medication? ...

    Correct

    • What is an example of a common antipsychotic medication?

      Your Answer: Sulpiride

      Explanation:

      Antipsychotics can be classified in different ways, with the most common being typical (first generation) and atypical (second generation) types. Typical antipsychotics block dopamine (D2) receptors and have varying degrees of M1, Alpha-1, and H1 receptor blockade. Atypical antipsychotics have a lower propensity for extrapyramidal side-effects and are attributed to the combination of relatively lower D2 antagonism with 5HT2A antagonism. They are also classified by structure, with examples including phenothiazines, butyrophenones, thioxanthenes, diphenylbutylpiperidine, dibenzodiazepines, benzoxazoles, thienobenzodiazepine, substituted benzamides, and arylpiperidylindole (quinolone). Studies have found little evidence to support the superiority of atypicals over typicals in terms of efficacy, discontinuation rates, of adherence, with the main difference being the side-effect profile. The Royal College also favors classification by structure.

    • This question is part of the following fields:

      • Psychopharmacology
      16.4
      Seconds
  • Question 41 - What is one of the fundamental symptoms of schizophrenia according to Bleuler? ...

    Correct

    • What is one of the fundamental symptoms of schizophrenia according to Bleuler?

      Your Answer: Autism

      Explanation:

      Bleuler identified autism as a key symptom of schizophrenia.

      Historical Classification of Schizophrenia

      The classification of schizophrenia has evolved over time, with various individuals contributing to its development. In 1801, Philippe Pinel used the term ‘demencé’ to describe the loss of mental abilities in chronically ill patients. Benedict Morel coined the term ‘demencé precocé’ in 1852 to describe young patients with premature dementia. Kahlbaum was the first to describe ‘paraphrenia hebetica’ in the 1860s, which was later elaborated as ‘hebephrenia’ by Hecker in 1871.

      In 1893, Emil Kraepelin used the term dementia praecox to describe the condition, emphasizing the importance of delusions, hallucinations, impaired attention, thought incoherence, stereotyped movements and expressions, deterioration of emotional life, and a loss of drive as key symptoms. In 1908, Eugen Bleuler coined the term ‘schizophrenia’ to replace dementia praecox, denoting ‘a splitting of the psychic functions.’ Bleuler expanded the concept to include presentations that did not include a ‘terminal state.’

      Bleuler introduced a distinction between basic and accessory symptoms and primary and secondary symptoms. Basic symptoms are necessarily present in any case of schizophrenia, while accessory symptoms may of may not occur. The fundamental features of schizophrenia were loosening of associations, disturbances of affectivity, ambivalence, and autism. The alteration of associations is the only symptom that Bleuler regarded as both basic and primary, and can thus be described as the core disturbance in the Bleulerian conception of schizophrenia.

      In 1939, Langfeldt introduced the term ‘schizophreniform psychosis’ to describe patients with Bleulerian schizophrenia who did not follow a progressively deteriorating course. In the 1960s, Rado/Meehl introduced the term ‘schizotypy’ to recognize the concept of a continuum of spectrum of schizophrenia-related phenotypes. In the 1980s, Crow proposed a subclassification of schizophrenia, dividing patients into types I and II. Type I patients present with positive symptoms such as delusions and hallucinations, while type II patients present with negative symptoms such as affective flattening and poverty of speech.

    • This question is part of the following fields:

      • Classification And Assessment
      4.9
      Seconds
  • Question 42 - What was the amount of drug X ingested by a patient who has...

    Incorrect

    • What was the amount of drug X ingested by a patient who has overdosed, given that the drug has a volume of distribution of 4L and their blood concentration of X is 10 mg/L, assuming 100% bioavailability via the route of administration?

      Your Answer: 2.5mg

      Correct Answer: 40mg

      Explanation:

      Understanding the Volume of Distribution in Pharmacology

      The volume of distribution (Vd) is a crucial concept in pharmacology that helps determine how a drug distributes in the body. It is also known as the apparent volume of distribution, as it is an abstract volume. The Vd indicates whether a drug concentrates in the plasma of spreads out in the body. Drugs that are highly polar tend to stay in central compartments such as the plasma, resulting in a low Vd. Conversely, drugs that are more lipid-soluble are distributed widely, such as in fat, resulting in a high Vd.

      The Vd is calculated by dividing the amount of drug in the body by the concentration in the plasma. Clinically, the Vd is used to determine the loading dose of a drug required for a desired blood concentration and to estimate blood concentration in the treatment of overdose. The units of Vd are in volume.

      The apparent volume of distribution is dependent on the drug’s lipid of water solubility, plasma protein binding, and tissue binding. Plasma protein binding affects the Vd, as drugs that bind to plasma proteins like albumin have a smaller apparent volume of distribution. This is because they are extracted from plasma and included in drug concentration measurements, which can give a misleading impression of their volume of distribution. Understanding the Vd is essential in pharmacology to ensure the safe and effective use of drugs.

    • This question is part of the following fields:

      • Psychopharmacology
      24.1
      Seconds
  • Question 43 - A 17-year-old girl is involved in a car crash and is experiencing internal...

    Correct

    • A 17-year-old girl is involved in a car crash and is experiencing internal bleeding. She has no identified emergency contact and is declining medical intervention. As she is unable to provide consent, what options are available for her treatment?

      Your Answer: Common law

      Explanation:

      Legal Principles and Acts Related to Mental Capacity and Treatment

      A common law principle is a legal concept that is recognized and enforced by courts based on societal customs. The doctrine of necessity allows for the use of reasonable force and necessary treatment for individuals who lack capacity and are in their best interests.

      The Mental Capacity Act Deprivation of Liberty Safeguards (DoLS) provides protection for vulnerable individuals who lack capacity and are in hospitals of care homes. It applies to those who are 18 and over, have a mental disorder of disability of the mind, and cannot give informed consent for their care of treatment.

      The Mental Capacity Act 2005 governs decision-making for individuals who may lose capacity of have an incapacitating condition. It applies to those aged 16 and over who cannot make some of all decisions for themselves.

      Children who understand proposed treatments are considered competent to give consent (Gillick competent). The Mental Health Act 1983 covers the compulsory assessment and treatment of individuals with mental disorders.

    • This question is part of the following fields:

      • Basic Ethics And Philosophy Of Psychiatry
      19.2
      Seconds
  • Question 44 - Which processes involve the activation of incentive salience? ...

    Correct

    • Which processes involve the activation of incentive salience?

      Your Answer: Grief

      Explanation:

      Understanding Incentive Salience and its Role in Addiction and Grief

      Incentive salience is a process that drives the brain to desire certain things, such as drugs, and is mediated by mesolimbic dopamine systems. This process is separate from the experience of pleasure, and a person can want something they don’t necessarily like. Desire is amplified by brain states that heighten dopamine reactivity, such as stress, emotional excitement, relevant appetites, of intoxication. This state-dependent amplification of incentive salience is one reason why many addicts find it difficult to stop at just one hit.

      Interestingly, grief has been hypothesized to be underpinned by a very similar process as drug addiction, referred to as the ‘incentive salience theory of grief’. Understanding the distinction between liking and wanting can help us better understand addiction and grief, and how the brain processes these experiences.

    • This question is part of the following fields:

      • Social Psychology
      5.9
      Seconds
  • Question 45 - On which of the following does CYP2D6 have a notable impact in terms...

    Incorrect

    • On which of the following does CYP2D6 have a notable impact in terms of metabolism?

      Your Answer: Clozapine

      Correct Answer: Olanzapine

      Explanation:

      The Cytochrome P450 system is a group of enzymes that metabolize drugs by altering their functional groups. The system is located in the liver and small intestine and is involved in drug interactions through enzyme induction of inhibition. Notable inducers include smoking, alcohol, and St John’s Wort, while notable inhibitors include grapefruit juice and some SSRIs. CYP2D6 is important due to genetic polymorphism, and CYP3A4 is the most abundant subfamily and is commonly involved in interactions. Grapefruit juice inhibits both CYP1A2 and CYP3A4, while tobacco smoking induces CYP1A2. The table summarizes the main substrates, inhibitors, and inducers for each CYP enzyme.

    • This question is part of the following fields:

      • Psychopharmacology
      7.6
      Seconds
  • Question 46 - 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
      2.5
      Seconds
  • Question 47 - A middle-aged woman with a long history of temporal lobe epilepsy enters a...

    Correct

    • A middle-aged woman with a long history of temporal lobe epilepsy enters a museum and is perplexed by the sensation of having previously visited the museum. She is on vacation and has never been to this city before.
      What could account for her encounter?

      Your Answer: Déjà vu

      Explanation:

      Different Types of Memory-Related Experiences

      There are various types of experiences related to memory, including déjà vu, jamais vu, confabulation, dissociative fugue state, and recognition. Déjà vu is when a person feels a sense of familiarity with an event that they are experiencing for the first time. This can occur in normal individuals, but it can also be a symptom of temporal lobe epilepsy of cerebrovascular disorder.

      Confabulation is when a person falsifies their memory while being fully conscious. They may try to cover up memory gaps with excuses related to their recent behavior. Dissociative fugue state is when a person wanders away from their normal surroundings, experiences amnesia, and appears to be in good contact with their environment while maintaining basic self-care.

      In contrast, jamais vu is when a person does not feel familiar with an experience that they have had before. Recognition is the sense of familiarity that accompanies the return of stored material to consciousness. While it is not strictly part of the memory process, it is connected to it. It is important to note that these experiences can occur in both neurotic patients and normal individuals, and should not be solely relied upon as evidence of temporal lobe epilepsy.

    • This question is part of the following fields:

      • Descriptive Psychopathology
      7.3
      Seconds
  • Question 48 - What is the most sleep-inducing SSRI for older adults? ...

    Correct

    • What is the most sleep-inducing SSRI for older adults?

      Your Answer: Paroxetine

      Explanation:

      Compared to other SSRIs, paroxetine has a higher affinity for muscarinic acetylcholine receptors, resulting in greater sedation. Conversely, citalopram and escitalopram have a low likelihood of causing sedation. Fluoxetine and sertraline do not typically induce sedation.

    • This question is part of the following fields:

      • Psychopharmacology
      4.5
      Seconds
  • Question 49 - What is the likely diagnosis when a patient exhibits a normal accommodation reflex...

    Correct

    • What is the likely diagnosis when a patient exhibits a normal accommodation reflex but an absent light reflex during a pupil examination?

      Your Answer: Argyll Robertson pupil

      Explanation:

      Argyll Robertson Pupil: Accommodation Retained

      The Argyll Robertson pupil is a notable topic in medical exams, as it is associated with tertiary syphilis, which is a crucial differential diagnosis for various psychiatric conditions like mood disorders, dementia, and psychosis. This type of pupil reacts poorly to light but normally to near stimuli, such as accommodation and convergence. They are typically small and irregular in shape, but they do not usually affect visual acuity. Mydriatic agents are not effective in dilating the Argyll Robertson pupil. Although this type of pupil is often considered pathognomonic of tertiary syphilis, it has also been observed in diabetes.

    • This question is part of the following fields:

      • Classification And Assessment
      5.1
      Seconds
  • Question 50 - Which of the following is an uncommon feature of discontinuing SSRI medication? ...

    Correct

    • Which of the following is an uncommon feature of discontinuing SSRI medication?

      Your Answer: Palpitations

      Explanation:

      The symptoms experienced during discontinuation can be similar to those of anxiety and depression, leading to the possibility of misinterpreting them as a relapse.

      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 51 - Which of the following is believed to be the least mature at the...

    Correct

    • Which of the following is believed to be the least mature at the time of birth?

      Your Answer: Sense of vision

      Explanation:

      The human visual system is incredibly intricate, but it is not fully developed when a baby is born. Although newborns can perceive shapes by tracking the intersections of light and dark lines, their vision is limited to distinguishing shades of grey. Additionally, their ability to focus is restricted to a range of 8 to 12 inches (20 to 30 cm), resulting in blurry vision. However, within a week of birth, babies born at full term should be able to recognize their mother’s facial expressions.

      The Emergence of Social Smiling in Infants

      Wormann (2014) discusses the emergence of social smiling in infants, which is usually interpreted as the first positive expression directed towards a cause. This occurs when an infant with an initially expressionless face examines the face of another person, and their face and eyes light up while the corners of their mouth pull upward. The age of the first appearance of the social smile varies across cultures, ranging from the fifth to seventh week. Additionally, there are differences in its duration and frequency between the second and seventh month of life. Understanding these milestones is important for a basic understanding of normal child development.

      Child Development Milestones:
      4 weeks Responds to noise (either by crying, of quieting), follows an object moved in front of eyes
      6 weeks Begins social smiling*
      3 months Holds head steady on sitting
      6 months Rolls from stomach to back, starts babbling
      7 months Transfers objects from hand to hand, looks for dropped object
      9 months Sits unsupported, begins to crawl
      12 months Cruising (walking by holding furniture)
      18 months Walks without assistance, speaks about 10-20 words
      2 years Runs, climbs up and down stairs alone, makes 2-3 word sentences
      3 years Dresses self except for buttons and laces, counts to 10, feeds themself well
      4 years Hops on one foot, copies a cross
      5 years Copies a triangle, skips

    • This question is part of the following fields:

      • Psychological Development
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  • Question 52 - Which of the following is classified as a mature defence? ...

    Correct

    • Which of the following is classified as a mature defence?

      Your Answer: Suppression

      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
      20
      Seconds
  • Question 53 - What is the likelihood of a child developing schizophrenia if their father has...

    Correct

    • What is the likelihood of a child developing schizophrenia if their father has the condition, based on the Gottesman data?

      Your Answer: 13%

      Explanation:

      Schizophrenia Risk According to Gottesman

      Irving I. Gottesman conducted family and twin studies in European populations between 1920 and 1987 to determine the risk of developing schizophrenia for relatives of those with the disorder. The following table displays Gottesman’s findings, which show the average lifetime risk for each relationship:

      General population: 1%
      First cousin: 2%
      Uncle/aunt: 2%
      Nephew/niece: 4%
      Grandchildren: 5%
      Parents: 6%
      Half sibling: 6%
      Full sibling: 9%
      Children: 13%
      Fraternal twins: 17%
      Offspring of dual matings (both parents had schizophrenia): 46%
      Identical twins: 48%

    • This question is part of the following fields:

      • Genetics
      7
      Seconds
  • Question 54 - Which base pairs are found within DNA? ...

    Correct

    • Which base pairs are found within DNA?

      Your Answer: Guanine and cytosine

      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
      5.6
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  • Question 55 - What is the accurate statement regarding culture-specific disorders? ...

    Incorrect

    • What is the accurate statement regarding culture-specific disorders?

      Your Answer: Afro-Caribbean men when depressed will complain of psychological symptoms instead of somatic symptoms

      Correct Answer: South Asians rarely complain about mental health problems

      Explanation:

      Depression can be presented differently across cultures. For example, Afro-Caribbean men may report erectile dysfunction and other physical symptoms when experiencing depression. South Asians may also experience mental health problems, but are more likely to report physical symptoms rather than psychological distress. In the United Kingdom, there is a higher prevalence of schizophrenia among black immigrants. In Siberia, there is a type of jumping disease called Myriachit, which may be similar to latah, a culture-bound syndrome seen in Southeast Asia characterized by hyper-suggestibility, echolalia, echopraxia, coprolalia, disorganization, and automatic obedience. Amok is another culture-bound syndrome that typically occurs in men and involves a period of withdrawal followed by sudden outbursts of homicidal aggression. Susto is a culture-bound syndrome seen in Latin America that is attributed to severe fright causing the soul to leave the body and is characterized by anxiety, sadness, altered sleep and eating habits, and physical symptoms such as headache, stomach-ache, muscle aches, and diarrhea.

    • This question is part of the following fields:

      • Stigma And Culture
      18.7
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  • Question 56 - Which aspect is often overlooked of not given enough importance in utilitarianism? ...

    Correct

    • Which aspect is often overlooked of not given enough importance in utilitarianism?

      Your Answer: Individual rights

      Explanation:

      According to utilitarianism, the morally right action is one that results in the most happiness for the largest number of people. This ethical theory was first introduced by Jeremy Bentham in the early 1800s and later refined by John Stuart Mill. The ultimate goal is to maximize utility, which is the overall amount of pleasure of happiness in the world. In order to achieve this, the consequences of an action on all those affected must be considered. However, a utilitarian may have to acknowledge that sometimes the greatest happiness for the greatest number can only be achieved by violating certain rights, such as the right to not be punished if innocent.

      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 57 - 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
      3.4
      Seconds
  • Question 58 - What is the pathway that links the lateral geniculate nucleus to the primary...

    Correct

    • What is the pathway that links the lateral geniculate nucleus to the primary visual cortex in the occipital lobe?

      Your Answer: Geniculocalcarine tract

      Explanation:

      White matter is the cabling that links different parts of the CNS together. There are three types of white matter cables: projection tracts, commissural tracts, and association tracts. Projection tracts connect higher centers of the brain with lower centers, commissural tracts connect the two hemispheres together, and association tracts connect regions of the same hemisphere. Some common tracts include the corticospinal tract, which connects the motor cortex to the brainstem and spinal cord, and the corpus callosum, which is the largest white matter fiber bundle connecting corresponding areas of cortex between the hemispheres. Other tracts include the cingulum, superior and inferior occipitofrontal fasciculi, and the superior and inferior longitudinal fasciculi.

    • This question is part of the following fields:

      • Neurosciences
      15.2
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  • Question 59 - A 16-year-old girl is 5 weeks pregnant. She wants to discuss her options....

    Correct

    • A 16-year-old girl is 5 weeks pregnant. She wants to discuss her options. The GP provides the girl with a balanced overview of the risks of termination and establishes that she is not in a relationship, has little social support, and would struggle to raise a child.

      The girl talks about his thoughts and feelings with the GP and is clearly uncertain about what to do. Eventually, the GP expresses their own opinion that a termination would be the best option and encourages the girl to consider this route.

      The GP advises the girl to take time to consider all the information, to talk to friends, and then to return once she has made a decision.

      What type of approach to doctor-patient relationships does this GP exhibit?

      Your Answer: Deliberative

      Explanation:

      The GP’s approach can be classified as deliberative as they allow the patient to make the final decision while also sharing their own perspective. However, distinguishing between deliberative and paternalistic approaches can be challenging. If the GP had imposed their decision on the patient, such as insisting on an abortion, it would be considered paternalistic. Similarly, if the GP had presented biased information to influence the patient’s decision, it would also be considered paternalistic.

      Models of Doctor-Patient Relationship

      There are four distinct models of doctor-patient relationship that have been identified. The first is the paternalistic of autocratic model, which assumes that the doctor knows best and makes all decisions regarding treatment. The patient is expected to simply comply with the doctor’s orders. The second model is the informative model, where the doctor provides information to the patient and leaves the decision-making process entirely up to them. The third model is the interpretive model, where the doctor takes the time to understand the patient’s circumstances and helps them make a decision based on their unique situation. This model involves shared decision-making and active participation from the patient. Finally, the deliberative model involves the doctor acting as a friend to the patient and attempting to steer them in a particular course of action that they believe is in the patient’s best interest. However, ultimately, the choice is left up to the patient. Understanding these different models can help doctors and patients work together more effectively to achieve the best possible outcomes.

    • This question is part of the following fields:

      • Classification And Assessment
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  • Question 60 - What statement accurately describes Maslow's hierarchy of needs model? ...

    Correct

    • What statement accurately describes Maslow's hierarchy of needs model?

      Your Answer: B needs can only be met once D needs are satisfied

      Explanation:

      Maslow differentiated between two types of needs: deficiency needs (D-needs) and being needs (B-needs). While B-needs enable us to achieve our highest potential, they can only be met once the D-needs have been fulfilled. The lower four levels of Maslow’s hierarchy of needs correspond to D-needs.

      Maslow’s Hierarchy of Needs is a theory of motivation introduced by Abraham Maslow. The hierarchy consists of five levels, with the most basic needs at the bottom and the most advanced needs at the top. Maslow proposed that a person would only become concerned with the needs of a particular level when all the needs of the lower levels had been satisfied. The levels include physiological needs, safety needs, social needs, esteem needs, and self-actualization needs. Maslow also made a distinction between D-needs (deficiency needs) and B-needs (being needs), with B-needs allowing us to reach our full potential but only after D-needs have been satisfied. Later in life, Maslow expanded upon the model and included cognitive, aesthetic, and transcendence needs, resulting in an eight-staged model. The cognitive needs include knowledge and understanding, while aesthetic needs involve appreciation and search for beauty. Transcendence needs are motivated by values that transcend beyond the personal self.

    • This question is part of the following fields:

      • Social Psychology
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      Seconds
  • Question 61 - What is the heuristic that best explains a junior psychiatrist's misdiagnosis of a...

    Correct

    • What is the heuristic that best explains a junior psychiatrist's misdiagnosis of a simple case of depression as a rare mental health condition they recently read about?

      Your Answer: Availability

      Explanation:

      Heuristics: Cognitive Shortcuts that can Lead to Diagnostic Errors

      In the 1970s, Tversky and Kahneman proposed that humans use cognitive heuristics, of mental shortcuts, to simplify complex decision-making processes. However, these heuristics can also lead to systematic errors. One such heuristic is the representativeness bias, where individuals judge the likelihood of an event based on how closely it resembles a stereotype. For example, a person described as shy and detail-oriented may be more likely to be perceived as a librarian than a farmer.

      Another heuristic is the availability bias, where individuals favor recent and readily available information over more accurate but less accessible information. This can lead to overestimating the frequency of certain events, such as violent crime. The anchoring-and-adjustment bias occurs when individuals lock onto salient features in a patient’s initial presentation and fail to adjust their impression in light of new information.

      The framing effect is another bias where individuals react differently to a choice depending on how the information is presented. For example, a pharmaceutical company may present a drug as having a 95% cure rate, making it seem superior to a drug with a 2.5% failure rate. Base rate neglect occurs when individuals ignore underlying incident rates of population-based knowledge, leading to unnecessary testing of treatment.

      Confirmation bias is a tendency to interpret information to fit preconceived diagnoses, rather than considering alternative explanations. The conjunction rule is the incorrect belief that the probability of multiple events being true is greater than a single event. Finally, diagnostic momentum occurs when clinicians continue a course of action initiated by previous clinicians without considering new information.

      Overall, while heuristics can be useful in simplifying complex decision-making processes, they can also lead to diagnostic errors if not used appropriately. It is important for clinicians to be aware of these biases and actively work to avoid them in their practice.

    • This question is part of the following fields:

      • Social Psychology
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  • Question 62 - Which of the following is not a licensed treatment for obsessive compulsive disorder?...

    Correct

    • Which of the following is not a licensed treatment for obsessive compulsive disorder?

      Your Answer: Citalopram

      Explanation:

      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
      5.2
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  • Question 63 - Which receptor's agonist effect is most likely responsible for anorgasmia caused by SSRIs?...

    Incorrect

    • Which receptor's agonist effect is most likely responsible for anorgasmia caused by SSRIs?

      Your Answer: 5HT-1A

      Correct Answer: 5HT2C

      Explanation:

      As an AI language model, I cannot provide a response without knowing the context of the rewrite you are referring to. Please provide more information of context so that I can assist you better.

      Serotonin (5-hydroxytryptamine, 5-HT) receptors are primarily G protein receptors, except for 5-HT3, which is a ligand-gated receptor. It is important to remember that 5-HT3 is most commonly associated with nausea. Additionally, 5-HT7 is linked to circadian rhythms. The stimulation of 5-HT2 receptors is believed to be responsible for the side effects of insomnia, agitation, and sexual dysfunction that are associated with the use of selective serotonin reuptake inhibitors (SSRIs).

    • This question is part of the following fields:

      • Neurosciences
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  • Question 64 - Which of the following refers to a continuous stream of slow, flowing, writhing...

    Incorrect

    • Which of the following refers to a continuous stream of slow, flowing, writhing involuntary movements?

      Your Answer: Chorea

      Correct Answer: Athetosis

      Explanation:

      Movement Disorders: Key Features

      Movement disorders refer to a range of conditions that affect voluntary muscle movements. These disorders can be caused by various factors, including neurological conditions, medication side effects, and metabolic imbalances. The following table outlines some of the key features of common movement disorders:

      Akinesia: Absence of loss of control of voluntary muscle movements, often seen in severe Parkinson’s disease.

      Bradykinesia: Slowness of voluntary movement, a core symptom of Parkinson’s disease.

      Akathisia: Subjective feeling of inner restlessness, often caused by antipsychotic medication use.

      Athetosis: Continuous stream of slow, flowing, writhing involuntary movements, often seen in cerebral palsy, stroke, and Huntington’s disease.

      Chorea: Brief, quasi-purposeful, irregular contractions that appear to flow from one muscle to the next, often seen in Huntington’s disease and Wilson’s disease.

      Dystonia: Involuntary sustained of intermittent muscle contractions that cause twisting and repetitive movements, abnormal postures, of both.

      Dyskinesia: General term referring to problems with voluntary movements and the presence of involuntary movements, often drug-induced.

      Myoclonus: A sequence of repeated, often non-rhythmic, brief shock-like jerks due to sudden involuntary contraction of relaxation of one of more muscles.

      Parkinsonism: Syndrome characterized by tremor, rigidity, and bradykinesia.

      Tic: Sudden, repetitive, non-rhythmic, stereotyped motor movement of vocalization involving discrete muscle groups, often seen in Tourette’s syndrome.

      Tremor: Involuntary, rhythmic, alternating movement of one of more body parts, often seen in essential tremor, Parkinson’s disease, and alcohol withdrawal.

      Hemiballismus: Repetitive, but constantly varying, large amplitude involuntary movements of the proximal parts of the limbs, often seen in stroke and traumatic brain injury.

      Stereotypies: Repetitive, simple movements that can be voluntarily suppressed, often seen in autism and intellectual disability.

      It is important to consider the underlying conditions and factors that may contribute to movement disorders in order to properly diagnose and treat these conditions.

    • This question is part of the following fields:

      • Classification And Assessment
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  • Question 65 - What is the condition being described by a woman who experiences sudden falls...

    Correct

    • What is the condition being described by a woman who experiences sudden falls upon hearing a loud noise?

      Your Answer: Cataplexy

      Explanation:

      Narcolepsy is identified by a set of four symptoms, including excessive sleepiness, hypnagogic hallucinations, sleep paralysis, and cataplexy. Cataplexy is a brief and sudden weakening of muscle control, typically brought on by emotional triggers, and is frequently observed in individuals with narcolepsy.

      Sleep Disorders

      The International Classification of Sleep Disorders (ISCD) categorizes sleep disorders into several main categories and subclasses. Dyssomnias are intrinsic sleep disorders that include narcolepsy, psychopsychologic insomnia, idiopathic hypersomnia, restless leg syndrome, periodic limb movement disorder, and obstructive sleep apnea. Extrinsic sleep disorders include inadequate sleep hygiene and alcohol-dependent sleep disorder. Circadian rhythm disorders consist of jet lag syndrome, shift work sleep disorder, irregular sleep-wake pattern, delayed sleep phase syndrome, and advanced sleep phase disorder. Parasomnias include arousal disorders such as sleepwalking and sleep terrors, sleep-wake transition disorders such as rhythmic movement disorder, sleep talking, and nocturnal leg cramps, and parasomnias associated with REM sleep such as nightmares and sleep paralysis. Sleep disorders associated with medical/psychiatric disorders and proposed sleep disorders are also included in the classification.

      Narcolepsy is a disorder of unknown cause that is characterized by excessive sleepiness, cataplexy, and other REM sleep phenomena such as sleep paralysis and hypnagogic hallucinations. Periodic limb movement disorder is characterized by periodic episodes of repetitive and highly stereotyped limb movements that occur during sleep. Restless legs syndrome is a disorder characterized by disagreeable leg sensations that usually occur prior to sleep onset and that cause an almost irresistible urge to move the legs. Jet lag syndrome consists of varying degrees of difficulties in initiating or maintaining sleep, excessive sleepiness, decrements in subjective daytime alertness and performance, and somatic symptoms following rapid travel across multiple time zones. Shift work sleep disorder consists of symptoms of insomnia of excessive sleepiness that occur as transient phenomena in relation to work schedules. Non 24 hour sleep wake syndrome consists of a chronic steady pattern comprising one to two hour daily delays in sleep onset and wake times in an individual living in society. Sleepwalking consists of a series of complex behaviors that are initiated during slow-wave sleep and result in walking during sleep. Sleep terrors are characterized by a sudden arousal from slow wave sleep with a piercing scream of cry, accompanied by autonomic and behavioral manifestations of intense fear. Rhythmic movement disorder comprises a group of stereotyped, repetitive movements involving large muscles, usually of the head and neck. Sleep starts are sudden, brief contractions of the legs, sometimes also involving the arms and head, that occur at sleep onset. Nocturnal leg cramps are painful sensations of muscular tightness of tension, usually in the calf but occasionally in the foot, that occur during the sleep episode. Nightmares are frightening dreams that usually awaken the sleeper from REM sleep. Sleep paralysis is a common condition characterized by transient paralysis of skeletal muscles which occurs when awakening from sleep of less often while falling asleep.

    • This question is part of the following fields:

      • Social Psychology
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  • Question 66 - A suspect awaiting trial provides vague responses to the inquiries posed by the...

    Correct

    • A suspect awaiting trial provides vague responses to the inquiries posed by the investigators. He has a past of participating in a brawl and experiencing a head trauma. During his confinement, he has reported hearing voices that seem to originate from inside his mind.
      What is the most probable scenario?

      Your Answer: Ganser syndrome

      Explanation:

      Ganser syndrome is characterized by approximate answers, clouding of consciousness, somatic conversion features, and pseudohallucinations. It is controversially classified as a reactive psychosis, with stressful life events as a possible trigger. Pseudologia fantastica, of pathological lying, involves grandiose and extreme untruthful statements that may be believed by the individual, often associated with personality disorders such as histrionic of dissocial and precipitated by major life crises. Cryptomnesia involves falsely recalling an idea, thought, of song as new and original. Confabulation is the falsification of memory in clear consciousness, often used to cover up memory gaps. Dissociative fugue state involves narrowing of consciousness, wandering away from normal surroundings, and subsequent amnesia, with the individual appearing to be in good contact with their environment and maintaining basic self-care.

    • This question is part of the following fields:

      • Descriptive Psychopathology
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  • Question 67 - You are requested to conduct a home visit for a 35-year-old male patient...

    Correct

    • You are requested to conduct a home visit for a 35-year-old male patient who is experiencing depression. He also complains of poor coordination and you observe that he has an unsteady gait. During the consultation, you learn that his father passed away at the age of 55 due to a degenerative disease and had exhibited abnormal jerky movements for a few years. Based on this information, which of the following trinucleotide repeat disorders would you suspect the most?

      Your Answer: CAG

      Explanation:

      The historical evidence indicates that the individual may be affected by Huntington’s disease, which is a genetic disorder caused by the expansion of a trinucleotide repeat in the huntingtin gene.

      Trinucleotide Repeat Disorders: Understanding the Genetic Basis

      Trinucleotide repeat disorders are genetic conditions that arise due to the abnormal presence of an expanded sequence of trinucleotide repeats. These disorders are characterized by the phenomenon of anticipation, which refers to the amplification of the number of repeats over successive generations. This leads to an earlier onset and often a more severe form of the disease.

      The table below lists the trinucleotide repeat disorders and the specific repeat sequences involved in each condition:

      Condition Repeat Sequence Involved
      Fragile X Syndrome CGG
      Myotonic Dystrophy CTG
      Huntington’s Disease CAG
      Friedreich’s Ataxia GAA
      Spinocerebellar Ataxia CAG

      The mutations responsible for trinucleotide repeat disorders are referred to as ‘dynamic’ mutations. This is because the number of repeats can change over time, leading to a range of clinical presentations. Understanding the genetic basis of these disorders is crucial for accurate diagnosis, genetic counseling, and the development of effective treatments.

    • This question is part of the following fields:

      • Genetics
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  • Question 68 - What condition of situation would make the use of lithium inappropriate of unsafe?...

    Correct

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

      Your 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 69 - A teenage girl is brought to the emergency room with deep cuts on...

    Correct

    • A teenage girl is brought to the emergency room with deep cuts on her arm. She tells the doctor that she has been trying to extract the worms that are reproducing under her skin. However, the doctor finds no signs of infestation. What type of delusional disorder is she experiencing?

      Your Answer: Ekbom's

      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 70 - A 16 year old boy is brought to clinic by his parents who...

    Correct

    • A 16 year old boy is brought to clinic by his parents who are worried about his recent behavior of talking to imaginary people and exhibiting unusual behavior. Upon further inquiry, it is discovered that he has a history of learning disability and was born with a cleft palate and a heart defect. The parents also report that he has had frequent bouts of pneumonia. Based on this information, what is the most likely diagnosis?

      Your Answer: DiGeorge syndrome

      Explanation:

      DiGeorge syndrome is primarily caused by a deletion on chromosome 22 and presents with a range of symptoms. To aid in remembering the chromosome involved and some of the signs and symptoms, a mnemonic is used. These include cardiac abnormalities such as tetralogy of Fallot, abnormal facies with almond-shaped eyes and low-set ears, thymic aplasia leading to recurrent infections, cleft palate, and hypocalcemia/hypoparathyroidism causing short stature and seizures. Additionally, individuals with DiGeorge syndrome often have a degree of learning disability and are at an increased risk for psychiatric conditions such as depression, ADHD, and schizophrenia.

      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 71 - What is a true statement about priapism? ...

    Correct

    • What is a true statement about priapism?

      Your Answer: It is associated with chlorpromazine use

      Explanation:

      Females can experience priapism of the clitoris.

      Priapism: A Painful and Persistent Erection

      Priapism is a condition characterized by a prolonged and painful erection, which can occur in males and even in the clitoris. Although rare, certain medications such as antipsychotics and antidepressants have been known to cause priapism. The primary mechanism behind this condition is alpha blockade, although other mechanisms such as serotonin-mediated pathways have also been suggested. Some of the drugs most commonly associated with priapism include Trazodone, Chlorpromazine, and Thioridazine. Treatment involves the use of alpha-adrenergic agonists, which can be administered orally of injected directly into the penis. Priapism is a serious condition that can lead to complications such as penile amputation, although such cases are extremely rare.

    • This question is part of the following fields:

      • Psychopharmacology
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  • Question 72 - Which of the following symptoms is not classified as a first rank symptom?...

    Correct

    • Which of the following symptoms is not classified as a first rank symptom?

      Your Answer: Gustatory hallucinations

      Explanation:

      First Rank Symptoms: Their Significance in Identifying Schizophrenia

      First rank symptoms were introduced by Kurt Schneider in 1938 as a practical tool for non-psychiatrists to identify schizophrenia. While they are highly suggestive of schizophrenia, they are not pathognomonic and can also be seen in affective and personality disorders. Additionally, there is no evidence to support their prognostic significance.

      A systematic review in 2015 found that first rank symptoms differentiated schizophrenia from nonpsychotic mental health disorders with a sensitivity of 61.8% and a specificity of 94.1%. They also differentiated schizophrenia from other types of psychosis with a sensitivity of 58% and a specificity of 74.7%.

      The first rank symptoms include running commentary, thought echo, voices heard arguing, thought insertion, thought withdrawal, thought broadcast, delusional perception, somatic passivity, made affect, and made volition. While they can be helpful in identifying schizophrenia, they should not be relied upon as the sole diagnostic criteria.

    • This question is part of the following fields:

      • Classification And Assessment
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  • Question 73 - What is a true statement about epilepsy? ...

    Correct

    • What is a true statement about epilepsy?

      Your Answer: Lamotrigine is considered a first-line option for the treatment of focal epilepsy

      Explanation:

      Epilepsy: An Overview

      Epilepsy is a condition that is diagnosed when a person experiences at least two unprovoked seizures that occur more than 24 hours apart. In the UK, the prevalence of epilepsy is 5-10 cases per 1000. Seizure types are categorized as focal onset of generalized onset. Focal seizures only involve a localized part of the brain, while generalized seizures involve the whole of both hemispheres. Temporal lobe epilepsy is the most common type of focal epilepsy, accounting for 60-70% of cases.

      In 60% of people with epilepsy, there is no identifiable cause. Approximately 70% of people with epilepsy achieve remission, meaning they have no seizures for 5 years on of off treatment. of those with convulsive seizures, 2/3 have focal epilepsies and secondary generalized seizures, while the other 1/3 have generalized tonic-clonic seizures.

      The National Institute for Health and Care Excellence (NICE) recommends treatment with antiepileptic drugs (AEDs) after a second epileptic seizure. For newly diagnosed focal seizures, carbamazepine of lamotrigine are recommended as first-line treatment. Levetiracetam, oxcarbazepine, of sodium valproate may be offered if carbamazepine and lamotrigine are unsuitable of not tolerated. For newly diagnosed generalized tonic-clonic seizures, sodium valproate is recommended as first-line treatment, with lamotrigine as an alternative if sodium valproate is unsuitable. For absence seizures, ethosuximide of sodium valproate are recommended as first-line treatment. For myoclonic seizures, sodium valproate is recommended as first-line treatment, and for tonic of atonic seizures, sodium valproate is also recommended as first-line treatment.

    • This question is part of the following fields:

      • Classification And Assessment
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  • Question 74 - What is considered a 'neurological soft sign' in children? ...

    Correct

    • What is considered a 'neurological soft sign' in children?

      Your Answer: Impaired fist-edge-palm test

      Explanation:

      Subtle impairments of motor or sensory function that are not specific to a particular neurological condition and are referred to as neurological ‘soft’ signs. These signs are prevalent in individuals with schizophrenia and may serve as a potential endophenotype.

    • This question is part of the following fields:

      • Description And Measurement
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  • Question 75 - Which of the following statements is not a requirement for the Hardy-Weinberg equilibrium?...

    Correct

    • Which of the following statements is not a requirement for the Hardy-Weinberg equilibrium?

      Your Answer: Natural selection occurs

      Explanation:

      Hardy-Weinberg Principle and Allele Frequency

      Allele frequency refers to the proportion of a population that carries a specific variant at a particular gene locus. It can be calculated by dividing the number of individual alleles of a certain type by the total number of alleles in a population. The Hardy-Weinberg Principle states that both allele and genotype frequencies in a population remain constant from generation to generation unless specific disturbing influences are introduced. To remain in equilibrium, five conditions must be met, including no mutations, no gene flow, random mating, a sufficiently large population, and no natural selection. The Hardy-Weinberg Equation is used to predict the frequency of alleles in a population, and it can be used to estimate the carrier frequency of genetic diseases. For example, if the incidence of PKU is one in 10,000 babies, then the carrier frequency in the general population is 1/50. Couples with a previous child with PKU have a 25% chance of having another affected child.

    • This question is part of the following fields:

      • Genetics
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  • Question 76 - What is the most prevalent type of mental illness among male inmates in...

    Correct

    • What is the most prevalent type of mental illness among male inmates in the United Kingdom?

      Your Answer: Personality disorder in remanded prisoners

      Explanation:

      Mental health problems are prevalent among prisoners, with approximately 75% of them experiencing a mental disorder. Personality disorder is the most frequent type of mental disorder among prisoners, and those who are on remand have a higher likelihood of being diagnosed with a mental disorder compared to those who have been sentenced. The diagnosis rates for psychotic disorder, neurotic disorder, and drug dependence are 7 and 10, 40 and 59, and 43 and 51, respectively, for sentenced and remand prisoners.

    • This question is part of the following fields:

      • Epidemiology
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  • Question 77 - Which of the following is an amino acid neurotransmitter? ...

    Correct

    • Which of the following is an amino acid neurotransmitter?

      Your Answer: Gamma-aminobutyric acid (GABA)

      Explanation:

      Neurotransmitters are substances used by neurons to communicate with each other and with target tissues. They are synthesized and released from nerve endings into the synaptic cleft, where they bind to receptor proteins in the cellular membrane of the target tissue. Neurotransmitters can be classified into different types, including small molecules (such as acetylcholine, dopamine, norepinephrine, serotonin, and GABA) and large molecules (such as neuropeptides). They can also be classified as excitatory or inhibitory. Receptors can be ionotropic or metabotropic, and the effects of neurotransmitters can be fast of slow. Some important neurotransmitters include acetylcholine, dopamine, GABA, norepinephrine, and serotonin. Each neurotransmitter has a specific synthesis, breakdown, and receptor type. Understanding neurotransmitters is important for understanding the function of the nervous system and for developing treatments for neurological and psychiatric disorders.

    • This question is part of the following fields:

      • Neurosciences
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  • Question 78 - What type of apraxia is indicated when a patient is given a pencil...

    Incorrect

    • What type of apraxia is indicated when a patient is given a pencil during a neurological examination and they attempt to use it to brush their teeth after looking at it for a minute?

      Your Answer: Ideational

      Correct Answer: Ideomotor

      Explanation:

      The inability to carry out complex instructions is referred to as Ideational Apraxia, while the inability to perform previously learned actions with the appropriate tools is known as Ideomotor Apraxia.

      Apraxia: Understanding the Inability to Carry Out Learned Voluntary Movements

      Apraxia is a neurological condition that affects a person’s ability to carry out learned voluntary movements. It is important to note that this condition assumes that everything works and the person is not paralyzed. There are different types of apraxia, each with its own set of symptoms and characteristics.

      Limb kinetic apraxia is a type of apraxia that affects a person’s ability to make fine of delicate movements. This can include tasks such as buttoning a shirt of tying shoelaces.

      Ideomotor apraxia, on the other hand, is an inability to carry out learned tasks when given the necessary objects. For example, a person with ideomotor apraxia may try to write with a hairbrush instead of using it to brush their hair.

      Constructional apraxia affects a person’s ability to copy a picture of combine parts of something to form a whole. This can include tasks such as building a puzzle of drawing a picture.

      Ideational apraxia is an inability to follow a sequence of actions in the correct order. For example, a person with ideational apraxia may struggle to take a match out of a box and strike it with their left hand.

      Finally, oculomotor apraxia affects a person’s ability to control eye movements. This can make it difficult for them to track moving objects of read smoothly.

      Overall, apraxia can have a significant impact on a person’s ability to carry out everyday tasks. However, with the right support and treatment, many people with apraxia are able to improve their abilities and maintain their independence.

    • This question is part of the following fields:

      • Neurosciences
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  • Question 79 - What is the cause of the formation of the 'Barr body'? ...

    Correct

    • What is the cause of the formation of the 'Barr body'?

      Your Answer: Lyonization

      Explanation:

      Lyonization: The Process of X-Inactivation

      The X chromosome is crucial for proper development and cell viability, containing over 1,000 essential genes. However, females carry two copies of the X chromosome, which can result in a potentially toxic double dose of X-linked genes. To address this imbalance, females undergo a process called Lyonization, of X-inactivation, where one of their two X chromosomes is transcriptionally silenced. The silenced X chromosome then condenses into a compact structure known as a Barr body, which remains in a silent state.

      X-inactivation occurs randomly, with no preference for the paternal or maternal X chromosome. It takes place early in embryogenesis, soon after fertilization when the dividing conceptus is about 16-32 cells big. This process occurs in all somatic cells of women, but not in germ cells involved in forming gametes. X-inactivation affects most, but not all, genes on the X chromosome. If a cell has more than two X chromosomes, the extra Xs are also inactivated.

    • This question is part of the following fields:

      • Genetics
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  • Question 80 - Which statement about Rett syndrome is accurate? ...

    Correct

    • Which statement about Rett syndrome is accurate?

      Your Answer: It almost exclusively occurs in females

      Explanation:

      While Rett syndrome is predominantly found in females, there have been studies conducted on boys who have either Rett syndrome of the MECP2 gene defect commonly associated with the syndrome. These studies have shown that boys with the MECP2 gene defect may exhibit symptoms that differ from those typically seen in classic Rett syndrome.

      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 81 - What should be avoided for a patient who has a high level of...

    Correct

    • What should be avoided for a patient who has a high level of concern about gaining weight?

      Your Answer: Mirtazapine

      Explanation:

      Non-compliance is often caused by weight gain.

      Antidepressants and Weight Gain

      Studies suggest that certain types of antidepressants, such as tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs), may be more likely to cause weight gain than newer antidepressants like selective serotonin reuptake inhibitors (SSRIs). However, mirtazapine, a newer antidepressant, may have a similar risk for weight gain as TCAs. Among SSRIs, paroxetine may have a higher risk for weight gain during long-term treatment compared to other SSRIs. On the other hand, bupropion and nefazodone may have a lower risk for weight gain than SSRIs in the long term.

    • This question is part of the following fields:

      • Psychopharmacology
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  • Question 82 - What is a true statement about Prader-Willi syndrome? ...

    Correct

    • What is a true statement about Prader-Willi syndrome?

      Your Answer: Short stature is characteristic

      Explanation:

      Prader-Willi Syndrome: A Genetic Disorder with Unique Characteristics

      Prader-Willi Syndrome is a genetic disorder that occurs when there is a deletion of genetic material from the paternal chromosome 15. This condition is a classic example of imprinting, where the expression of certain genes is dependent on whether they are inherited from the mother of father. The syndrome is characterized by several unique features, including hyperphagia (excessive eating) and obesity, short stature, delayed puberty, hypogonadism, infertility, learning difficulties, and compulsive behavior such as skin picking.

    • This question is part of the following fields:

      • Genetics
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  • Question 83 - In which type of storage is factual information and general knowledge about the...

    Correct

    • In which type of storage is factual information and general knowledge about the world kept?

      Your Answer: Semantic memory

      Explanation:

      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
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  • Question 84 - What substance do bodybuilders misuse in order to increase their overall body mass?...

    Correct

    • What substance do bodybuilders misuse in order to increase their overall body mass?

      Your Answer: Insulin

      Explanation:

      Anabolic Steroids: Uses, Misuse, and Complications

      Anabolic steroids are synthetic derivatives of testosterone that have both anabolic and androgenic properties. They are commonly used by athletes to enhance performance and by individuals to improve physical appearance. However, their misuse is not uncommon, with nearly half of users of dedicated bodybuilding gyms admitting to taking anabolic agents. Misuse can lead to dependence, tolerance, and the development of psychiatric disorders such as aggression, psychosis, mania, and depression/anxiety.

      There are three common regimes practised by steroid misusers: ‘cycling’, ‘stacking’ and ‘pyramiding’. Anabolic steroids can be taken orally, injected intramuscularly, and applied topically in the form of creams and gels. Other drugs are also used by athletes, such as clenbuterol, ephedrine, thyroxine, insulin, tamoxifen, human chorionic Gonadotropin, diuretics, and growth hormone.

      Medical complications are common and can affect various systems, such as the musculoskeletal, cardiovascular, hepatic, reproductive (males and females), dermatological, and other systems. Complications include muscular hypertrophy, increased blood pressure, decreased high-density lipoprotein cholesterol and increased low-density lipoprotein cholesterol, cholestatic jaundice, benign and malignant liver tumours, testicular atrophy, sterility, gynaecomastia, breast tissue shrinkage, menstrual abnormalities, masculinisation, male-pattern baldness, acne, sleep apnoea, exacerbation of tic disorders, polycythaemia, altered immunity, and glucose intolerance.

      Anabolic steroids are a class C controlled drug and can only be obtained legally through a medical prescription. It is important to educate individuals about the risks and complications associated with their misuse and to promote safe and legal use.

    • This question is part of the following fields:

      • Psychopharmacology
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  • Question 85 - What is the meaning of 'placebo sag'? ...

    Correct

    • What is the meaning of 'placebo sag'?

      Your Answer: Where a patient's response to the placebo effect is diminished as an increasing number of treatments fail

      Explanation:

      The phenomenon known as placebo sag occurs when individuals who have undergone multiple treatment failures experience a decrease in the placebo effect. This is particularly common in chronically ill patients who may feel hopeless and discouraged. However, it is important to note that the extent to which the placebo effect diminishes over time varies depending on the individual’s experiences.

      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 86 - What intervention has been demonstrated, through systematic review, to decrease the likelihood of...

    Correct

    • What intervention has been demonstrated, through systematic review, to decrease the likelihood of sudden, unforeseen death in individuals with epilepsy?

      Your Answer: Nocturnal supervision

      Explanation:

      SUDEP, of sudden unexpected death in epilepsy, is a condition where patients with epilepsy die suddenly and unexpectedly without any apparent cause. It is estimated to be responsible for 20-30% of deaths in epilepsy patients. The condition is more common in adults than in children, affecting 1 in 1,000 adults with epilepsy per year. The main risk factor for SUDEP is having active generalised tonic clonic seizures (GTCS), and better control of these seizures through improved compliance can reduce the risk of SUDEP. Other risk factors include nocturnal seizures, lamotrigine, never having been treated with an antiepileptic drug, intellectual disability, and male sex. However, the evidence for these factors is considered low. Autopsy findings in SUDEP cases do not reveal any specific cause of death, but obstruction of the airways and cardiorespiratory events such as arrhythmia are thought to be possible mechanisms.

    • This question is part of the following fields:

      • Classification And Assessment
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  • Question 87 - What is the most frequently occurring side effect of rivastigmine? ...

    Correct

    • What is the most frequently occurring side effect of rivastigmine?

      Your Answer: Nausea

      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
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  • Question 88 - This is an example of automatic obedience. We can provide more details as...

    Correct

    • This is an example of automatic obedience. We can provide more details as the psychiatrist uses only a minimal amount of force to move the patient's arm, which is an instance of mitgehen. Mitgehen is an extreme form of automatic obedience.

      Your Answer: Mitgehen

      Explanation:

      The examiner’s use of minimal force to move the patient’s arm is an instance of automatic obedience, but it can be categorized more precisely as mitgehen, which represents a heightened form of automatic obedience.

      – 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 89 - Which adverse drug reaction is correctly paired with its corresponding Gell and Coombs...

    Correct

    • Which adverse drug reaction is correctly paired with its corresponding Gell and Coombs classification system?

      Your Answer: Type II - cytotoxic

      Explanation:

      Adverse Drug Reactions (ADRs) refer to the harmful effects associated with the use of a medication at a normal dose. These reactions are classified into two types: Type A and Type B. Type A reactions can be predicted from the pharmacology of the drug and are dose-dependent, meaning they can be reversed by withdrawing the drug. On the other hand, Type B reactions cannot be predicted from the known pharmacology of the drug and include allergic reactions.

      Type A reactions account for up to 80% of all ADRs, while Type B reactions are less common. Allergic reactions are a type of Type B reaction and are further subdivided by Gell and Coombs into four types: Type I (IgE-mediated) reactions, Type II (cytotoxic) reactions, Type III (immune complex) reactions, and Type IV (cell-mediated) reactions. Proper identification and management of ADRs are crucial in ensuring patient safety and optimizing treatment outcomes.

    • This question is part of the following fields:

      • Psychopharmacology
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  • Question 90 - Which symptom is the strongest indicator of neuroleptic malignant syndrome? ...

    Incorrect

    • Which symptom is the strongest indicator of neuroleptic malignant syndrome?

      Your Answer: Seizures

      Correct Answer: Increased muscle tone

      Explanation:

      NMS can be identified by three primary symptoms: hyperthermia, rigidity, and elevated creatine phosphokinase concentration. If these symptoms are not present, the diagnosis of NMS should be reconsidered as other symptoms may be present in patients taking neuroleptics without having NMS. This information was reported by P Adnet in the British Journal of Anaesthesia in 2000.

      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
      6.8
      Seconds
  • Question 91 - Which statement accurately describes Parkinson's disease? ...

    Incorrect

    • Which statement accurately describes Parkinson's disease?

      Your Answer: There is degeneration of dopaminergic cells in the mesocortical pathway

      Correct Answer: Mutations in the gene that produces alpha-synuclein have been linked to early-onset Parkinson's disease

      Explanation:

      Lewy bodies, which are present in Parkinson’s disease, are composed of alpha-synuclein.

      Genetic Contributors to Parkinson’s Disease

      Genetic contributors to Parkinson’s disease can range from highly penetrant DNA variants to variants that individually increase the lifetime risk of the disease. These genetic risks are often divided into rare DNA variants with high effect sizes, typically associated with familial Parkinson’s disease, and more common, smaller effect variants, usually identified in sporadic cases. While rare variants in over 20 genes have been reported to cause Parkinson’s disease, most cases are idiopathic.

      One gene implicated in Parkinson’s disease is SNCA, which codes for alpha-synuclein. Autosomal dominant mutations of SNCA have been identified in several families with inherited Parkinson’s disease. Mutant forms of alpha-synuclein aggregate and induce other proteins to incorporate into the aggregate, forming Lewy bodies, which are similar to the beta-amyloid plaques found in Alzheimer’s patients. Another gene implicated in Parkinson’s disease is the Parkin gene.

      It is important to note that the known genes responsible for Parkinson’s disease are responsible for a minority of cases, with the majority being sporadic.

    • This question is part of the following fields:

      • Genetics
      20.5
      Seconds
  • Question 92 - What is the breakdown product of serotonin? ...

    Correct

    • What is the breakdown product of serotonin?

      Your Answer: 5-Hydroxyindoleacetic acid

      Explanation:

      Serotonin: Synthesis and Breakdown

      Serotonin, also known as 5-Hydroxytryptamine (5-HT), is synthesized in the central nervous system (CNS) in the raphe nuclei located in the brainstem, as well as in the gastrointestinal (GI) tract in enterochromaffin cells. The amino acid L-tryptophan, obtained from the diet, is used to synthesize serotonin. L-tryptophan can cross the blood-brain barrier, but serotonin cannot.

      The transformation of L-tryptophan into serotonin involves two steps. First, hydroxylation to 5-hydroxytryptophan is catalyzed by tryptophan hydroxylase. Second, decarboxylation of 5-hydroxytryptophan to serotonin (5-hydroxytryptamine) is catalyzed by L-aromatic amino acid decarboxylase.

      Serotonin is taken up from the synapse by a monoamine transporter (SERT). Substances that block this transporter include MDMA, amphetamine, cocaine, TCAs, and SSRIs. Serotonin is broken down by monoamine oxidase (MAO) and then by aldehyde dehydrogenase to 5-Hydroxyindoleacetic acid (5-HIAA).

    • This question is part of the following fields:

      • Neurosciences
      7.4
      Seconds
  • Question 93 - How can one distinguish between serotonin syndrome and NMS? ...

    Correct

    • How can one distinguish between serotonin syndrome and NMS?

      Your Answer: Speed of onset following initiation of medication

      Explanation:

      Serotonin syndrome may sometimes result in increased levels of CPK.

      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
      10.7
      Seconds
  • Question 94 - In what society is the fear of 'losing face' and the desire to...

    Correct

    • In what society is the fear of 'losing face' and the desire to avoid it associated with a significant number of suicides?

      Your Answer: South Asian

      Explanation:

      Mediterranean countries typically have lower suicide rates compared to South Asian cultures, where the public loss of credibility, of losing face, is often catastrophize and can lead to a higher incidence of suicide, as seen in Sri Lanka.

    • This question is part of the following fields:

      • Stigma And Culture
      3.1
      Seconds
  • Question 95 - A child repeats whatever the teacher says. What sign are they exhibiting? ...

    Correct

    • A child repeats whatever the teacher says. What sign are they exhibiting?

      Your Answer: Echolalia

      Explanation:

      – 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
      3.6
      Seconds
  • Question 96 - Regarding the pharmacokinetics of psychotropic drugs, which statement is accurate? ...

    Correct

    • Regarding the pharmacokinetics of psychotropic drugs, which statement is accurate?

      Your Answer: Carbamazepine induces its own biotransformation

      Explanation:

      Enzyme induction can accelerate drug metabolism and increase the risk of inadequate treatment. This process is often triggered by drugs such as ethanol, rifampin, barbiturates (e.g. phenobarbital, primidone), phenytoin, and carbamazepine. Carbamazepine, for instance, induces its own metabolism through cytochrome P450 enzymes 3A4 and 2E1. Typically, enzyme induction boosts glucuronyl transferase activity, which enhances drug conjugation.

    • This question is part of the following fields:

      • Psychopharmacology
      5.6
      Seconds
  • Question 97 - What is the primary mechanism by which valproate stabilizes mood? ...

    Correct

    • What is the primary mechanism by which valproate stabilizes mood?

      Your Answer: GABA agonism

      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
      5.7
      Seconds
  • Question 98 - What is the prevalence of suicidal thoughts throughout one's lifetime? ...

    Correct

    • What is the prevalence of suicidal thoughts throughout one's lifetime?

      Your Answer: 9.20%

      Explanation:

      In a survey conducted by Nock et al.1, which involved interviewing more than 80,000 individuals across 17 countries, it was discovered that 9.2% of people have experienced suicidal thoughts at some point in their lives. Additionally, the survey found that 2.7% of individuals have attempted suicide, while 3.1% have made plans to do so.

    • This question is part of the following fields:

      • Epidemiology
      4.3
      Seconds
  • Question 99 - A high school student passes their final exams having based their revision solely...

    Correct

    • A high school student passes their final exams having based their revision solely on past exam papers. On the other hand, another student who has studied extensively from textbooks fails the same exams despite having gained vast knowledge. What does this scenario illustrate?

      Your Answer: Practice effect

      Explanation:

      When preparing for the MRCPsych exam, it is not advisable to solely rely on textbooks. One question that has been appearing on the exam is about the Hawthorne effect, which describes how individuals alter their behavior when they are aware of being observed. Another cognitive bias is the halo effect, where the perception of one trait is influenced by the perception of another trait, such as assuming intelligence based on the presence of glasses. It is worth noting that this question was originally written here.

      The Practice Effect and Its Impact on Test Scores

      The practice effect is a phenomenon that occurs when individuals take a test multiple times, resulting in higher scores due to their previous experience. This effect is most noticeable when the time between the two tests is short. The practice effect can have a significant impact on test scores, as individuals who have taken a test before are likely to perform better than those who have not. This effect is particularly relevant in educational settings, where students may take multiple tests throughout a semester of academic year. Understanding the practice effect can help educators and researchers better interpret test scores and make more informed decisions about student performance.

    • This question is part of the following fields:

      • Social Psychology
      5.5
      Seconds
  • Question 100 - What is the personality trait that is not included in the big five?...

    Incorrect

    • What is the personality trait that is not included in the big five?

      Your Answer:

      Correct Answer: Generosity

      Explanation:

      The Big Five Personality Traits, also known as OCEAN, are five broad categories that can be used to describe an individual’s personality. These categories include Openness to Experience, Conscientiousness, Extraversion (also known as Surgency), Agreeableness, and Neuroticism (also known as Emotional Stability). Each of these traits can be further broken down into specific characteristics that help to define an individual’s personality. For example, Openness to Experience includes traits such as imagination, creativity, and a willingness to try new things. Conscientiousness includes traits such as organization, responsibility, and dependability. Extraversion includes traits such as sociability, assertiveness, and energy level. Agreeableness includes traits such as kindness, empathy, and cooperation. Finally, Neuroticism includes traits such as anxiety, moodiness, and emotional instability. Understanding these personality traits can be helpful in a variety of settings, such as in the workplace of in personal relationships.

    • This question is part of the following fields:

      • Classification And Assessment
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Psychopharmacology (22/28) 79%
Neurosciences (6/10) 60%
Descriptive Psychopathology (3/4) 75%
Classification And Assessment (15/19) 79%
Genetics (11/12) 92%
Social Psychology (13/13) 100%
Psychological Development (2/3) 67%
Neurological Examination (1/1) 100%
Advanced Psychological Processes And Treatments (2/2) 100%
History Of Psychiatry (1/1) 100%
Basic Ethics And Philosophy Of Psychiatry (1/1) 100%
Stigma And Culture (1/2) 50%
Description And Measurement (1/1) 100%
Epidemiology (2/2) 100%
Passmed