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  • Question 1 - You are conducting an annual medication review for a female patient in an...

    Correct

    • You are conducting an annual medication review for a female patient in an outpatient clinic. While reviewing her ECG, you notice that her QTc value is 660 ms, which puts her at high risk for arrhythmia. You decide to seek cardiology advice and during the handover, the cardiologist asks for your opinion on which medication may be responsible for the QTc prolongation. Which medication do you think is likely to be the culprit in this case?

      Your Answer: Clarithromycin

      Explanation:

      While antipsychotics, tricyclic antidepressants, and citalopram are known to cause QTc prolongation and require ECG monitoring, they are not the only drugs that can cause this condition. However, in psychiatric practice, they are the most commonly prescribed drugs associated with QTc prolongation. It is important to note that clarithromycin is a high-risk drug for QTc prolongation, unlike the other drugs listed, which are considered low risk.

    • This question is part of the following fields:

      • Psychopharmacology
      41.8
      Seconds
  • Question 2 - Which enzyme is responsible for the conversion of tyrosine to dihydroxyphenylalanine? ...

    Correct

    • Which enzyme is responsible for the conversion of tyrosine to dihydroxyphenylalanine?

      Your Answer: Tyrosine hydroxylase

      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
      12.2
      Seconds
  • Question 3 - Which statement about 5-Hydroxyindoleacetic acid (5-HIAA) is accurate? ...

    Correct

    • Which statement about 5-Hydroxyindoleacetic acid (5-HIAA) is accurate?

      Your Answer: Low CSF levels are found in people with depression

      Explanation:

      Depression, suicidality, and aggression have been linked to low levels of 5-HIAA in the CSF.

      The Significance of 5-HIAA in Depression and Aggression

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

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

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

    • This question is part of the following fields:

      • Neurosciences
      18.4
      Seconds
  • Question 4 - The term used to describe the ability of a 25 year old man...

    Correct

    • The term used to describe the ability of a 25 year old man to smell music is:

      Your Answer: Synaesthesia

      Explanation:

      Synaesthesia is a condition in which stimulation of one sensory pathway results in experiences in another sensory pathway, such as perceiving a scent as a sound of visualizing a sound as a color.

      Altered Perceptual Experiences

      Disorders of perception can be categorized into sensory distortions and sensory deceptions. Sensory distortions involve changes in the intensity, spatial form, of quality of a perception. Examples include hyperaesthesia, hyperacusis, and micropsia. Sensory deceptions, on the other hand, involve new perceptions that are not based on any external stimulus. These include illusions and hallucinations.

      Illusions are altered perceptions of a stimulus, while hallucinations are perceptions in the absence of a stimulus. Completion illusions, affect illusions, and pareidolic illusions are examples of illusions. Auditory, visual, gustatory, olfactory, and tactile hallucinations are different types of hallucinations. Pseudohallucinations are involuntary and vivid sensory experiences that are interpreted in a non-morbid way. They are different from true hallucinations in that the individual is able to recognize that the experience is an internally generated event.

      Understanding the different types of altered perceptual experiences is important in the diagnosis and treatment of various mental health conditions.

    • This question is part of the following fields:

      • Classification And Assessment
      7.7
      Seconds
  • Question 5 - What is the term used to describe a child who shows distress when...

    Incorrect

    • What is the term used to describe a child who shows distress when their mother leaves the room but avoids contact with her upon her return?

      Your Answer: Anxious-avoidant attachment

      Correct Answer: Anxious-resistant attachment

      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
      22.2
      Seconds
  • Question 6 - A client in their 50s taking risperidone reports an atypical feeling during ejaculation...

    Correct

    • A client in their 50s taking risperidone reports an atypical feeling during ejaculation and absence of semen. Which receptor is responsible for this side effect due to the medication's antagonism?

      Your Answer: Adrenergic

      Explanation:

      Antipsychotic medications change the tension of the bladder of urethral sphincter, which can result in the backward flow of semen into the bladder during ejaculation. This effect is believed to be caused by blocking the 1-adrenergic receptor.

      Antipsychotics: Common Side Effects and Relative Adverse Effects

      Antipsychotics are medications used to treat various mental health conditions, including schizophrenia and bipolar disorder. However, they can also cause side effects that can be bothersome of even serious. The most common side effects of antipsychotics are listed in the table below, which includes the adverse effects associated with their receptor activity.

      Antidopaminergic effects: These effects are related to the medication’s ability to block dopamine receptors in the brain. They can cause galactorrhoea, gynecomastia, menstrual disturbance, lowered sperm count, reduced libido, Parkinsonism, dystonia, akathisia, and tardive dyskinesia.

      Anticholinergic effects: These effects are related to the medication’s ability to block acetylcholine receptors in the brain. They can cause dry mouth, blurred vision, urinary retention, and constipation.

      Antiadrenergic effects: These effects are related to the medication’s ability to block adrenaline receptors in the body. They can cause postural hypotension and ejaculatory failure.

      Histaminergic effects: These effects are related to the medication’s ability to block histamine receptors in the brain. They can cause drowsiness.

      The Maudsley Guidelines provide a rough guide to the relative adverse effects of different antipsychotics. The table below summarizes their findings, with +++ indicating a high incidence of adverse effects, ++ indicating a moderate incidence, + indicating a low incidence, and – indicating a very low incidence.

      Drug Sedation Weight gain Diabetes EPSE Anticholinergic Postural Hypotension Prolactin elevation
      Amisulpride – + + + – – +++
      Aripiprazole – +/- – +/- – – –
      Asenapine + + +/- +/- – – +/-
      Clozapine +++ +++ +++ – +++ +++ –
      Flupentixol + ++ + ++ ++ + +++
      Fluphenazine + + + +++ ++ + +++
      Haloperidol + + +/- +++ + + +++
      Olanzapine ++ +++ +++ +/- + + +
      Paliperidone + ++ + + + ++ +++
      Pimozide + + – + + + +++
      Quetiapine ++ ++ ++ – + ++ –
      Risperidone + ++ + + + ++ +++
      Zuclopenthixol ++ ++ + ++ ++ + +++

      Overall, it is important to discuss the potential side effects of antipsychotics with a healthcare provider and to monitor for any adverse effects while taking these medications.

    • This question is part of the following fields:

      • Psychopharmacology
      25.3
      Seconds
  • Question 7 - The woman utilizes the ego defense mechanism of sublimation by channeling her emotional...

    Correct

    • The woman utilizes the ego defense mechanism of sublimation by channeling her emotional energy into her scientific work instead of seeking a new romantic relationship.

      Your Answer: Sublimation

      Explanation:

      Sublimation involves redirecting unfulfilled drives, such as those related to sex and procreation, towards socially acceptable activities. This mechanism is considered mature in terms of ego defense.

    • This question is part of the following fields:

      • Dynamic Psychopathology
      44.8
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  • Question 8 - What substance acts as an α2-adrenergic receptor agonist and mimics the effects of...

    Correct

    • What substance acts as an α2-adrenergic receptor agonist and mimics the effects of noradrenaline?

      Your Answer: Clonidine

      Explanation:

      ADHD medications can be classified into stimulant and non-stimulant drugs. The therapeutic effects of these drugs are believed to be mediated through the action of noradrenaline in the prefrontal cortex. Common side effects of these drugs include decreased appetite, insomnia, nervousness, headache, and nausea. Stimulant drugs like dexamphetamine, methylphenidate, and lisdexamfetamine inhibit the reuptake of dopamine and noradrenaline. Non-stimulant drugs like atomoxetine, guanfacine, and clonidine work by increasing noradrenaline levels in the synaptic cleft through different mechanisms. The most common side effects of these drugs are decreased appetite, somnolence, headache, and abdominal pain.

    • This question is part of the following fields:

      • Psychopharmacology
      34.8
      Seconds
  • Question 9 - 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
      6.1
      Seconds
  • Question 10 - A child who has recently been commenced on antipsychotics is found in bed...

    Correct

    • A child who has recently been commenced on antipsychotics is found in bed adopting a strange posture, what would you suspect?

      Your Answer: Dystonia

      Explanation:

      Drug-induced dystonias typically manifest within a few days of initiating antipsychotic medication (of following a significant dosage increase). While they can affect any muscle group, they most frequently occur in the head and neck region.

      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
      23.4
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  • Question 11 - What factor would increase the likelihood of serotonin syndrome in an individual who...

    Correct

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

      Your Answer: Tramadol

      Explanation:

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

    • This question is part of the following fields:

      • Psychopharmacology
      11.9
      Seconds
  • Question 12 - Choose the medication with the most extended half-life: ...

    Correct

    • Choose the medication with the most extended half-life:

      Your Answer: Nitrazepam

      Explanation:

      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
      20.6
      Seconds
  • Question 13 - A 30-year-old male with a history of depression is interested in trying agomelatine...

    Correct

    • A 30-year-old male with a history of depression is interested in trying agomelatine as a potential treatment. Can you explain the mechanism of action of agomelatine?

      Your Answer: MT1 and MT2 receptor agonist

      Explanation:

      Agomelatine acts as a melatonergic agonist at MT1 and MT2 receptors and also as a 5-HT2C antagonist, indirectly increasing norepinephrine and dopamine levels to alleviate depression. Moclobemide, an MAO-A inhibitor, boosts serotonin, dopamine, and norepinephrine levels in the brain, resulting in antidepressant effects. Fluoxetine, a selective serotonin reuptake inhibitor, elevates serotonin levels, while venlafaxine, a serotonin and norepinephrine reuptake inhibitor, enhances the concentration of both chemicals in the brain, leading to antidepressant benefits.

    • This question is part of the following fields:

      • Psychopharmacology
      14.1
      Seconds
  • Question 14 - What is the frequency of the A allele in the population of 400...

    Incorrect

    • What is the frequency of the A allele in the population of 400 diploid individuals, given that 15 individuals have the AA genotype and 25 have the Aa genotype?

      Your Answer: 0.1

      Correct Answer: 0.07

      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
      50.5
      Seconds
  • Question 15 - Which ethical code was the first to emphasize the importance of obtaining the...

    Correct

    • Which ethical code was the first to emphasize the importance of obtaining the human subject's voluntary consent in research?

      Your Answer: The Nuremberg code

      Explanation:

      The Nuremberg Code and its Significance in Medical Ethics

      The Nuremberg Code is a set of ethical guidelines that resulted from the trial of German physicians accused of war crimes and crimes against humanity in 1946. The physicians were charged with conducting medical experiments on concentration camp prisoners without their consent. This led to the creation of the Nuremberg Code, which was the first international document to advocate for voluntary participation and informed consent in medical experimentation.

      The Nuremberg Code has since become a cornerstone of medical ethics and has been adopted by many countries and organizations around the world. It emphasizes the importance of protecting the rights and welfare of human subjects in medical research and requires that any experimentation be conducted with the voluntary and informed consent of the participants.

      The significance of the Nuremberg Code cannot be overstated, as it has helped to shape the way medical research is conducted and has led to greater awareness and respect for the rights of human subjects. It serves as a reminder of the atrocities committed during the Holocaust and the importance of ethical considerations in medical research.

    • This question is part of the following fields:

      • Social Psychology
      16.2
      Seconds
  • Question 16 - How would you define the term archetype in the context of psychodynamic theory?...

    Correct

    • How would you define the term archetype in the context of psychodynamic theory?

      Your Answer: A symbolic image in the collective unconscious

      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
      18.6
      Seconds
  • Question 17 - Which medications have the potential to reduce the contraceptive effect of oral contraceptives?...

    Correct

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

      Your Answer: St John's Wort

      Explanation:

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

      Interactions with Oral Contraceptives

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

    • This question is part of the following fields:

      • Psychopharmacology
      15
      Seconds
  • Question 18 - In what circumstances does Lyonization always take place? ...

    Correct

    • In what circumstances does Lyonization always take place?

      Your Answer: Klinefelter's syndrome

      Explanation:

      Klinefelter’s syndrome is a condition that occurs when a male has one of more extra copies of the X chromosome in their cells. This extra genetic material interferes with male sexual development, causing the testes to function abnormally and reducing testosterone levels. This can lead to delayed of incomplete puberty, genital abnormalities, gynecomastia, reduced facial and body hair, and infertility. Additionally, individuals with Klinefelter’s syndrome may experience learning disabilities, delayed speech and language development, and a shy personality. The syndrome is typically caused by one extra X chromosome in each cell, but can also be caused by two of three extra X chromosomes. The severity of symptoms increases with the number of extra sex chromosomes. Some individuals with Klinefelter’s syndrome have the extra X chromosome in only some of their cells, which can result in milder symptoms. Lyonization, which occurs when there are multiple X chromosomes in a cell, is present to some degree in all individuals with Klinefelter’s syndrome.

      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
      14.5
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  • Question 19 - A 45-year-old woman complains of feeling excessively sleepy during the day and experiencing...

    Correct

    • A 45-year-old woman complains of feeling excessively sleepy during the day and experiencing auditory hallucinations upon waking up. She also reports instances of feeling paralyzed even after awakening. What is the probable diagnosis?

      Your Answer: Narcolepsy

      Explanation:

      The symptoms described in the scenario are indicative of narcolepsy, specifically hypnopompic hallucinations and sleep paralysis. Narcolepsy is characterized by a set of symptoms including sleep attacks, cataplexy, sleep paralysis, and hypnagogic or hypnopompic hallucinations. Primary hypersomnia is excessive daytime sleepiness without the associated features of other sleep disorders of narcolepsy. REM sleep behavioral disorder (RBD) is characterized by complex behaviors during sleep, typically occurring during the longest periods of REM sleep and accompanied by vivid dream recall. Sleep terror disorder, also known as night terror, occurs during partial arousal from delta sleep and is typically amnestic. In contrast, the patient in the scenario was able to recall the episode of sleep paralysis. Schizophrenia cannot be diagnosed based on the symptoms described, as the criteria for hallucinations and an additional symptom from criterion A must be present for a significant portion of the time, and the symptoms can be attributed to narcolepsy.

    • This question is part of the following fields:

      • Diagnosis
      28.1
      Seconds
  • Question 20 - What parenting style emphasizes obedience and status through the implementation of strict rules?...

    Incorrect

    • What parenting style emphasizes obedience and status through the implementation of strict rules?

      Your Answer: Authoritative

      Correct Answer: Authoritarian

      Explanation:

      Parenting Styles

      In the 1960s, psychologist Diana Baumrind conducted a study on over 100 preschool-age children and identified four important dimensions of parenting: disciplinary strategies, warmth and nurturance, communication styles, and expectations of maturity and control. Based on these dimensions, she suggested that most parents fall into one of three parenting styles, with a fourth category added later by Maccoby and Martin.

      Authoritarian parenting is characterized by strict rules and punishment for noncompliance, with little explanation given for the rules. These parents prioritize status and obedience over nurturing their children. This style tends to result in obedient and proficient children, but they may rank lower in happiness, social competence, and self-esteem.

      Authoritative parents are similar to authoritarian parents, but they tend to be more responsive to their children. They set strict rules but provide explanations for them and nurture their children when they fail to meet expectations. The focus is on setting standards while also being supportive. This style tends to result in happy, capable, and successful children.

      Permissive parents rarely discipline their children and avoid confrontation, allowing their children to self-regulate. They prefer to take on the role of a friend rather than a disciplinarian. This style often results in children who rank low in happiness and self-regulation, experience problems with authority, and perform poorly in school.

      Uninvolved parenting is characterized by little involvement and few demands. This style ranks lowest across all life domains, with children lacking self-control, having low self-esteem, and being less competent than their peers.

    • This question is part of the following fields:

      • Psychological Development
      15.1
      Seconds
  • Question 21 - Identify the option that represents a secondary amine. ...

    Correct

    • Identify the option that represents a secondary amine.

      Your Answer: Desipramine

      Explanation:

      Tricyclic Antidepressants: First and Second Generation

      Tricyclic antidepressants are classified into two generations: first generation of tertiary amines, and second generation of secondary amines. The secondary amines are known to have fewer side effects and primarily affect noradrenaline, while the tertiary amines are believed to enhance both serotonin and noradrenaline.

      Secondary amines include Desipramine, Nortriptyline, Protriptyline, and Amoxapine. On the other hand, tertiary amines include Amitriptyline, Lofepramine, Imipramine, Clomipramine, Dosulepin (Dothiepin), Doxepin, Trimipramine, and Butriptyline.

      By understanding the differences between the two generations of tricyclic antidepressants, healthcare professionals can better tailor their treatment plans to their patients’ needs.

    • This question is part of the following fields:

      • Psychopharmacology
      17.6
      Seconds
  • Question 22 - Who is credited with creating the term 'bipolar'? ...

    Incorrect

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

      Your Answer: Kasanin

      Correct Answer: Kleist

      Explanation:

      History of Psychiatric Terms

      In the exams, it is important to be familiar with the individuals associated with certain psychiatric terms. For example, Kraepelin is associated with dementia praecox and manic depression, while Bleuler is associated with schizophrenia. Other terms and their associated individuals include Hebephrenia (Hecker), Catatonia (Kahlbaum), Schizoaffective (Kasanin), Neurasthenia (Beard), Unipolar and bipolar (Kleist), Hypnosis (Braid), Group dynamics (Lewin), Group psychotherapy (Moreno), Psychopathic inferiority (Koch), Psychiatry (Reil), and Institutional Neurosis (Barton).

      It should be noted that there is some debate over the origins of certain terms. While Kraepelin is often credited with coining the term dementia praecox, some sources suggest that it was first used in its Latin form by Arnold Pick in 1891. The original term demence precoce was first used by Morel in 1852. Despite this, the College appears to favor the Kraepelin attribution.

    • This question is part of the following fields:

      • Social Psychology
      16.2
      Seconds
  • Question 23 - Which factor is most closely linked to the development of dementia in individuals...

    Incorrect

    • Which factor is most closely linked to the development of dementia in individuals with HIV?

      Your Answer: HIVE

      Correct Answer: Monocyte infiltration and microglial activation

      Explanation:

      The strongest association with HIV dementia is the infiltration of monocytes and activation of microglia in the brain. While the presence of HIV encephalopathy is somewhat linked to HIV associated dementia, the extent of monocyte infiltration and microglial activation is the best indicator of AIDS dementia. Microglia can cause damage to neurons by releasing oxidative radicals, nitric oxide, and cytokines. The correlation between viral load and HAD is not significant. Astrocytes have limited susceptibility to HIV infection, and neuronal infection is rare and unlikely to have a significant impact on HIV-related CNS disorders.

    • This question is part of the following fields:

      • Neurosciences
      30.2
      Seconds
  • Question 24 - What type of group is most susceptible to groupthink? ...

    Incorrect

    • What type of group is most susceptible to groupthink?

      Your Answer: Collaborative

      Correct Answer: Homogeneous

      Explanation:

      Groupthink, Groupshift, and Deindividuation are potential problems that can occur when working in groups. Groupthink is a phenomenon where the desire for harmony of conformity in the group results in an incorrect of deviant decision-making outcome. This occurs when group members try to minimise conflict and reach a consensus decision without critical evaluation of alternative ideas of viewpoints. Several conditions must take place for groupthink to occur, such as group isolation, loyalty, loss of individual creativity, and an illusion of invulnerability. Symptoms of groupthink include an illusion of invulnerability, belief in inherent morality of the group, collective rationalisation, stereotypes of ‘out-groups,’ self-censorship, illusion of unanimity, direct pressure on dissenters, and self-appointed mindguards. To reduce groupthink, leaders should allow each member to challenge ideas and present objections, talk about and solicit ideas with people outside the group, invite outside experts to attend meetings, avoid expressing opinions about the preferred outcome, and assign a ‘Devil’s Advocate’ at all meetings to challenge any and all ideas.

      Groupshift is the phenomenon in which the initial positions of individual members of a group are exaggerated toward a more extreme position. For example, when people are in groups, they assess risk differently from when they are alone. In the group, they are likely to make riskier decisions as the shared risk makes the individual risk seem to be less.

      Deindividuation is a concept in social psychology that is generally thought of as the loss of self-awareness in groups. Theories of deindividuation propose that it is a psychological state of decreased self-evaluation and a decreased evaluation of apprehension causing abnormal collective behaviour, such as violent crowds and lynch mobs. Conversely, it also explains people’s tendency to donate more readily to charity when in groups.

    • This question is part of the following fields:

      • Social Psychology
      20.7
      Seconds
  • Question 25 - Patients who attempt suicide often have decreased levels of which substance in their...

    Correct

    • Patients who attempt suicide often have decreased levels of which substance in their CSF?

      Your Answer: 5-HIAA

      Explanation:

      Depression, suicidality, and aggression have been linked to decreased levels of 5-HIAA in the CSF.

      The Significance of 5-HIAA in Depression and Aggression

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

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

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

    • This question is part of the following fields:

      • Neurosciences
      15.3
      Seconds
  • Question 26 - What is the most effective method for distinguishing between Alzheimer's disease and Lewy...

    Incorrect

    • What is the most effective method for distinguishing between Alzheimer's disease and Lewy body dementia?

      Your Answer: Functional MRI

      Correct Answer: Dat scan

      Explanation:

      It’s important to note that DaT-SCAN and SPECT are not the same thing. DaT-SCAN specifically refers to the radioactive isotope called Ioflupane, which is utilized in the creation of a SPECT image.

      Alzheimer’s disease can be differentiated from healthy older individuals by using SPECT imaging to detect temporal and parietal hypoperfusion, according to studies such as one conducted by W. Jagust in 2001. Additionally, SPECT imaging has proven to be a useful tool in distinguishing between Alzheimer’s disease and Lewy body dementia, as demonstrated in a study by Vaamonde-Gamo in 2005. The image provided shows a SPECT scan of a patient with Alzheimer’s disease compared to one with Lewy body dementia, with the latter showing lower perfusion in the occipital cortex and the former showing lower perfusion in medial temporal areas.

    • This question is part of the following fields:

      • Neurosciences
      24.9
      Seconds
  • Question 27 - What is a true statement about attachment theory? ...

    Incorrect

    • What is a true statement about attachment theory?

      Your Answer: Secure attachments are divided into avoidant and ambivalent types

      Correct Answer: Bowlby's 'attachment in the making' phase occurs from 6 weeks to 8 months

      Explanation:

      Attachment Theory and Harlow’s Monkeys

      Attachment theory, developed by John Bowlby, suggests that children have an innate tendency to form relationships with people around them to increase their chance of survival. This attachment is different from bonding, which concerns the mother’s feelings for her infant. Children typically single out a primary caregiver, referred to as the principle attachment figure, from about 1-3 months. The quality of a person’s early attachments is associated with their adult behavior, with poor attachments leading to withdrawn individuals who struggle to form relationships and good attachments leading to socially competent adults who can form healthy relationships.

      Bowlby’s attachment model has four stages: preattachment, attachment in the making, clear-cut attachment, and formation of reciprocal attachment. The time from 6 months to 36 months is known as the critical period, during which a child is most vulnerable to interruptions in its attachment. Attachments are divided into secure and insecure types, with insecure types further divided into avoidant and ambivalent types.

      Harlow’s experiment with young rhesus monkeys demonstrated the importance of the need for closeness over food. The experiment involved giving the monkeys a choice between two different mothers, one made of soft terry cloth but provided no food and the other made of wire but provided food from an attached baby bottle. The baby monkeys spent significantly more time with their cloth mother than with their wire mother, showing the importance of attachment and closeness in early development.

    • This question is part of the following fields:

      • Psychological Development
      35.4
      Seconds
  • Question 28 - Whose work on imprinting had a significant impact on the field of attachment?...

    Incorrect

    • Whose work on imprinting had a significant impact on the field of attachment?

      Your Answer: Bowlby

      Correct Answer: Lorenz

      Explanation:

      Imprinting – A Rapid, Unreinforced, Irreversible Attachment in Animals and Humans

      Imprinting is a fascinating phenomenon observed in some animals and humans, where a phase-sensitive attachment is formed towards the first conspicuous object seen after birth of hatching. Konrad Lorenz’s classic experiment with Greylag geese demonstrated that imprinting consists of three stages – following response, attachment development, and sexual preference formation. Imprinting is a rapid process that can occur within minutes, and it does not require any reinforcement to happen. It also occurs during a clearly defined period known as the critical period, and once it happens, it is irreversible.

      Imprinting has been observed in various species, including birds, mammals, and even humans. In humans, imprinting can occur during the early stages of life and can influence social and emotional development. For example, infants may develop an attachment towards their primary caregiver, which can shape their future relationships and social interactions.

      Overall, imprinting is a fascinating and complex phenomenon that highlights the importance of early experiences in shaping an individual’s behavior and preferences.

    • This question is part of the following fields:

      • Psychological Development
      11.4
      Seconds
  • Question 29 - What is a true statement about the endocannabinoid system? ...

    Correct

    • What is a true statement about the endocannabinoid system?

      Your Answer: CB2 receptors are expressed at much lower levels in the central nervous system compared to CB1

      Explanation:

      The Endocannabinoid System and its Role in Psychosis

      The endocannabinoid system (ECS) plays a crucial role in regulating various physiological functions in the body, including cognition, sleep, energy metabolism, and inflammation. It is composed of endogenous cannabinoids, cannabinoid receptors, and proteins that transport, synthesize, and degrade endocannabinoids. The two best-characterized cannabinoid receptors are CB1 and CB2, which primarily couple to inhibitory G proteins and modulate different neurotransmitter systems in the brain.

      Impairment of the ECS after cannabis consumption has been linked to an increased risk of psychotic illness. However, enhancing the ECS with cannabidiol (CBD) has shown anti-inflammatory and antipsychotic outcomes in both healthy study participants and in preliminary clinical trials on people with psychotic illness of at high risk of developing psychosis. Studies have also found increased anandamide levels in the cerebrospinal fluid and blood, as well as increased CB1 expression in peripheral immune cells of people with psychotic illness compared to healthy controls. Overall, understanding the role of the ECS in psychosis may lead to new therapeutic approaches for treating this condition.

    • This question is part of the following fields:

      • Neurosciences
      33.9
      Seconds
  • Question 30 - What stage of sleep do most adults spend the majority of their time...

    Incorrect

    • What stage of sleep do most adults spend the majority of their time in during the night?

      Your Answer: Stage 4

      Correct Answer: Stage 2

      Explanation:

      – Dement and Kleitman (1957) classified sleep into five stages.
      – Normal adults spend the majority of their sleep in Stage 2 (55%).
      – Non-REM sleep is divided into four stages: Stage 1 (5%), Stage 2 (55%), Stage 3 (5%), and Stage 4 (10%).
      – REM sleep is Stage 5 and normal adults spend 25% of their sleep in this stage.

    • This question is part of the following fields:

      • Neurosciences
      15.1
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Psychopharmacology (8/8) 100%
Neurosciences (5/8) 63%
Classification And Assessment (2/2) 100%
Psychological Development (0/4) 0%
Dynamic Psychopathology (1/1) 100%
Genetics (1/2) 50%
Social Psychology (2/4) 50%
Diagnosis (1/1) 100%
Passmed