00
Correct
00
Incorrect
00 : 00 : 00
Session Time
00 : 00
Average Question Time ( Secs)
  • Question 1 - What test can be used to detect constructional apraxia? ...

    Incorrect

    • What test can be used to detect constructional apraxia?

      Your Answer: Duess Test

      Correct Answer: Clock drawing test

      Explanation:

      Individuals with constructional apraxia are unable to replicate drawings of arrange objects to create patterns of designs.

      Clock Drawing Test: A Screening Tool for Cognitive Dysfunction

      The clock drawing test is a widely used screening tool for cognitive dysfunction. It involves asking the patient to draw a clock on a piece of paper, placing the numbers on the clock face and drawing the hands to indicate 10 minutes past 11. This simple task assesses a range of cognitive functions, including visuospatial ability, motor function, attention, and comprehension.

      The test is quick and easy to administer, making it a useful tool for healthcare professionals to identify potential cognitive impairment in patients. The clock drawing test has been shown to be effective in detecting cognitive dysfunction in a variety of conditions, including Alzheimer’s and Parkinson’s disease.

      The image below illustrates examples of clocks drawn correctly by healthy controls and those drawn by patients with Alzheimer’s and Parkinson’s disease. By comparing the drawings, healthcare professionals can quickly identify potential cognitive dysfunction and take appropriate action.

    • This question is part of the following fields:

      • Classification And Assessment
      17.8
      Seconds
  • Question 2 - Which one of the following is a 10 item scale used as a...

    Incorrect

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

      Your Answer: AQ-10

      Correct Answer: AUDIT

      Explanation:

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

    • This question is part of the following fields:

      • Description And Measurement
      10
      Seconds
  • Question 3 - Which sensory component is correctly matched with its corresponding cranial nerve reflex? ...

    Incorrect

    • Which sensory component is correctly matched with its corresponding cranial nerve reflex?

      Your Answer: Accommodation reflex - III cranial nerve

      Correct Answer: Gag reflex - IX cranial nerve

      Explanation:

      The question specifically requests the sensory aspect.

      Cranial Nerve Reflexes

      When it comes to questions on cranial nerve reflexes, it is important to match the reflex to the nerves involved. Here are some examples:

      – Pupillary light reflex: involves the optic nerve (sensory) and oculomotor nerve (motor).
      – Accommodation reflex: involves the optic nerve (sensory) and oculomotor nerve (motor).
      – Jaw jerk: involves the trigeminal nerve (sensory and motor).
      – Corneal reflex: involves the trigeminal nerve (sensory) and facial nerve (motor).
      – Vestibulo-ocular reflex: involves the vestibulocochlear nerve (sensory) and oculomotor, trochlear, and abducent nerves (motor).

      Another example of a cranial nerve reflex is the gag reflex, which involves the glossopharyngeal nerve (sensory) and the vagus nerve (motor). This reflex is important for protecting the airway from foreign objects of substances that may trigger a gag reflex. It is also used as a diagnostic tool to assess the function of these nerves.

    • This question is part of the following fields:

      • Neurosciences
      42.1
      Seconds
  • Question 4 - A patient in their 60s taking an antipsychotic is found to have a...

    Correct

    • A patient in their 60s taking an antipsychotic is found to have a QTc of 490ms. What would be the most appropriate alternative to their current antipsychotic medication?

      Your Answer: Aripiprazole

      Explanation:

      Amantadine and QTc Prolongation

      Amantadine is a medication used to treat Parkinson’s disease and influenza. It has been associated with QTc prolongation, which can increase the risk of Torsades de points. Therefore, caution should be exercised when prescribing amantadine to patients with risk factors for QT prolongation. If a patient is already taking amantadine and develops a prolonged QTc interval, the medication should be discontinued and an alternative treatment considered. It is important to monitor the QTc interval in patients taking amantadine, especially those with risk factors for QT prolongation.

    • This question is part of the following fields:

      • Psychopharmacology
      18.1
      Seconds
  • Question 5 - What term did Allport use to describe a personality trait that has a...

    Correct

    • What term did Allport use to describe a personality trait that has a significant impact on almost all of a person's actions?

      Your Answer: Cardinal

      Explanation:

      Trait Theory: Understanding Personality Traits

      Trait theory is a psychological approach that seeks to understand personality by identifying and categorizing specific traits. The theory was first introduced by Gordon Allport, who classified personality traits into three levels.

      At the highest level, we have cardinal traits. These are traits that are so pervasive that they dominate a person’s behavior and activities. Only a few people possess cardinal traits, but for those who do, these traits are the ruling force of their personality. Cardinal traits are usually evident to most people who know the individual.

      The second level of traits is central traits. These are easily detected characteristics within a person, traits that all people have a certain number of, usually around five to ten on average. Central traits are the building blocks of personality and help to define a person’s overall character.

      Finally, we have secondary traits. These are less evident and only manifest in select circumstances. They are not as important as central of cardinal traits, but they still play a role in shaping a person’s behavior and personality.

      Overall, trait theory provides a useful framework for understanding personality and how it develops over time. By identifying and categorizing specific traits, psychologists can gain insights into why people behave the way they do and how they can change their behavior to achieve their goals.

    • This question is part of the following fields:

      • Social Psychology
      9.6
      Seconds
  • Question 6 - An HIV+ patient in their 60s attends clinic in view of ongoing depression....

    Correct

    • An HIV+ patient in their 60s attends clinic in view of ongoing depression. You note a number of cutaneous lesions in the form of purple-red macules on their face and neck. These are also apparent on the mucous membranes. Which of the following would you most suspect?:

      Your Answer: Kaposi's sarcoma

      Explanation:

      Kaposi’s sarcoma is a type of tumor that is caused by human herpesvirus 8. When it is associated with AIDS, it typically appears as red to purple-red macules on the skin that quickly progress to papules, nodules, and plaques. These lesions tend to occur on the head, back, neck, trunk, and mucous membranes, and can also be found in the lymph nodes, stomach, intestines, and lungs in more advanced cases. Individuals with severe mental illness are at a higher risk of contracting and transmitting HIV, and are more likely to have HIV infection compared to the general population. Therefore, it is important to have a basic understanding of the symptoms of this condition.

      HIV and Mental Health: Understanding the Relationship and Treatment Options

      Human immunodeficiency virus (HIV) is a blood-borne virus that causes cellular immune deficiency, resulting in a decrease in the number of CD4+ T-cells. People with severe mental illness are at increased risk of contracting and transmitting HIV, and the prevalence of HIV infection among them is higher than in the general population. Antiretroviral drugs are used to manage HIV, but they are not curative.

      Depression is the most common mental disorder in the HIV population, and it can result from HIV of the psycho-social consequences of having the condition. HIV-associated neurocognitive disorder (HAND) is the umbrella term for the spectrum of neurocognitive impairment induced by HIV, ranging from mild impairment through to dementia. Poor episodic memory is the most frequently reported cognitive difficulty in HIV-positive individuals.

      Treatment options for mental health issues in people with HIV include atypical antipsychotics for psychosis, SSRIs for depression and anxiety, valproate for bipolar disorder, and antiretroviral therapy for HAND. It is important to avoid benzodiazepines for delirium and MAOIs for depression. Understanding the relationship between HIV and mental health and providing appropriate treatment options can improve the quality of life for people living with HIV.

    • This question is part of the following fields:

      • Psychopharmacology
      19.9
      Seconds
  • Question 7 - Which medication has been associated with the occurrence of extrapyramidal side effects? ...

    Incorrect

    • Which medication has been associated with the occurrence of extrapyramidal side effects?

      Your Answer: Diphenhydramine

      Correct Answer: Fluoxetine

      Explanation:

      EPSEs have been linked to the use of fluoxetine, and all of the treatment options are utilized to address them.

      Extrapyramidal side-effects (EPSE’s) are a group of side effects that affect voluntary motor control, commonly seen in patients taking antipsychotic drugs. EPSE’s include dystonias, parkinsonism, akathisia, and tardive dyskinesia. They can be frightening and uncomfortable, leading to problems with non-compliance and can even be life-threatening in the case of laryngeal dystonia. EPSE’s are thought to be due to antagonism of dopaminergic D2 receptors in the basal ganglia. Symptoms generally occur within the first few days of treatment, with dystonias appearing quickly, within a few hours of administration of the first dose. Newer antipsychotics tend to produce less EPSE’s, with clozapine carrying the lowest risk and haloperidol carrying the highest risk. Akathisia is the most resistant EPSE to treat. EPSE’s can also occur when antipsychotics are discontinued (withdrawal dystonia).

    • This question is part of the following fields:

      • Psychopharmacology
      16.9
      Seconds
  • Question 8 - What is a licensed treatment for bulimia nervosa? ...

    Incorrect

    • What is a licensed treatment for bulimia nervosa?

      Your Answer: Sertraline

      Correct Answer: Fluoxetine

      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
      14.2
      Seconds
  • Question 9 - At what developmental stage does a child acquire the ability to engage in...

    Correct

    • At what developmental stage does a child acquire the ability to engage in symbolic play, as per Piaget's theory?

      Your Answer: Preoperational

      Explanation:

      preconventional Stage of Moral Development

      Kohlberg’s first stage of moral development is the preconventional stage. In this stage, children’s moral reasoning is based on avoiding punishment and seeking rewards. They follow rules to avoid getting in trouble and to gain approval from authority figures. Children in this stage are not yet able to understand the perspective of others of consider the consequences of their actions on others. They may also believe that what is right is what benefits them personally. As they grow and develop, children will move on to the next stages of moral development, which involve more complex reasoning and consideration of others’ perspectives.

    • This question is part of the following fields:

      • Basic Psychological Processes
      14
      Seconds
  • Question 10 - A teacher is eager to teach her middle school student better study habits....

    Incorrect

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

      Your Answer: Chaining

      Correct Answer: Shaping

      Explanation:

      Operant Conditioning: Reinforcement, Punishment, and More

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

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

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

    • This question is part of the following fields:

      • Social Psychology
      13.2
      Seconds
  • Question 11 - What is the enzyme that breaks down APP into harmless protein fragments? ...

    Correct

    • What is the enzyme that breaks down APP into harmless protein fragments?

      Your Answer: Alpha-secretase

      Explanation:

      Alpha-Secretase: A Potential Treatment for Alzheimer’s Disease

      Alpha-secretase is a promising avenue for preventing and treating Alzheimer’s disease. When amyloid precursor protein (APP) crosses the cell membrane, it can be cleaved by various enzymes. Alpha-secretase cleaves APP in a way that produces non-toxic protein fragments. However, beta and gamma-secretase are two other enzymes that can cleave APP, resulting in shorter, stickier fragments called beta-amyloid. These fragments can join together to form insoluble amyloid plaques. Researchers are developing drugs that can either stimulate alpha-secretase of block beta- and gamma-secretase, with the hope of preventing or treating Alzheimer’s disease.

    • This question is part of the following fields:

      • Neurosciences
      11.6
      Seconds
  • Question 12 - A senior citizen is sharing a thorough recollection of their military experience with...

    Correct

    • A senior citizen is sharing a thorough recollection of their military experience with their therapist. The therapist wishes to shift the discussion and suggests, I believe you've provided me with ample information on that topic. Shall we discuss your medication now?

      Your Answer: Transition

      Explanation:

      Interview Techniques: The Importance of Transition

      Effective communication is crucial in any healthcare setting, particularly in psychiatry where patients may be hesitant to share personal information. One technique that can aid in the interview process is transition. Transition involves signaling to the patient that the interviewer has gathered enough information on a particular topic and is ready to move on to another subject.

      Transition can be especially helpful when discussing sensitive of uncomfortable topics, as it allows the patient to feel heard and validated while also providing a sense of structure to the interview. Additionally, it can prevent the interview from becoming too focused on one topic, which may not be the most pressing concern for the patient.

      It is important to use clear and concise language when transitioning to a new topic, and to ensure that the patient is comfortable with the change in direction. This can be achieved by asking if there is anything else they would like to add of if they have any questions before moving on.

      Overall, incorporating transition into the interview process can improve communication and help patients feel more comfortable sharing their experiences and concerns.

    • This question is part of the following fields:

      • Classification And Assessment
      17.8
      Seconds
  • Question 13 - What is a known risk factor for QT prolongation when analyzing an ECG?...

    Incorrect

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

      Your Answer: Hypercalcemia

      Correct Answer: Hypokalemia

      Explanation:

      Amantadine and QTc Prolongation

      Amantadine is a medication used to treat Parkinson’s disease and influenza. It has been associated with QTc prolongation, which can increase the risk of Torsades de points. Therefore, caution should be exercised when prescribing amantadine to patients with risk factors for QT prolongation. If a patient is already taking amantadine and develops a prolonged QTc interval, the medication should be discontinued and an alternative treatment considered. It is important to monitor the QTc interval in patients taking amantadine, especially those with risk factors for QT prolongation.

    • This question is part of the following fields:

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

    Incorrect

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

      Your Answer: RNA polymerase

      Correct 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
      16.6
      Seconds
  • Question 15 - A mutation affecting the transcriptional activity of a new gene associated with Alzheimer's...

    Correct

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

      Your Answer: Promoter region

      Explanation:

      Genomics: Understanding DNA, RNA, Transcription, and Translation

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

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

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

    • This question is part of the following fields:

      • Genetics
      13.3
      Seconds
  • Question 16 - A middle-aged individual reports regularly wearing their partner's clothing without feeling sexually aroused,...

    Correct

    • A middle-aged individual reports regularly wearing their partner's clothing without feeling sexually aroused, maintaining a positive relationship with their partner, and having no desire to permanently identify as the opposite gender. What diagnosis would be most appropriate for this individual's situation?

      Your Answer: Dual-role transvestism

      Explanation:

      Types of Gender and Sexual Identity

      Dual-role transvestism refers to the act of wearing clothing typically associated with the opposite sex without experiencing discomfort with one’s biological gender of a desire to permanently live as the opposite sex. This behavior is not accompanied by sexual arousal, which distinguishes it from fetishistic transvestism. Fetishistic transvestism, on the other hand, involves wearing clothing of the opposite sex for the purpose of sexual arousal. Transsexualism is a desire to live as a member of the opposite sex, often accompanied by discomfort with one’s biological gender and a desire for gender reassignment. Sexual dysfunction encompasses a range of difficulties with sexual desire and performance.

    • This question is part of the following fields:

      • Diagnosis
      15.8
      Seconds
  • Question 17 - What is the meaning of animus in the context of Jungian therapy? ...

    Incorrect

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

      Your Answer: The life force

      Correct Answer: The unconscious male aspect present in every female

      Explanation:

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

    • This question is part of the following fields:

      • Dynamic Psychopathology
      18.1
      Seconds
  • Question 18 - How would Marcia classify the following as identity foreclosure? ...

    Correct

    • How would Marcia classify the following as identity foreclosure?

      Your Answer: A teenage boy tells you that they will be a doctor when they are older. It is clear that this represents the preference of the boy’s parents who have applied pressure and that the boy has not yet explored his options

      Explanation:

      Erikson and Marcia acknowledge that identity development is a lifelong process, but they also agree that adolescence is the period of most significant growth in this area. Individuals who are in a state of identity foreclosure have already made a commitment to an identity without fully exploring their options. This often occurs during early adolescence when individuals may feel anxious about uncertainty of change, of when they face pressure from their parents, peers, of cultural norms. As a result, they may make a preliminary commitment to an identity without investing in the exploration process.

      Development: Erikson and Marcia

      Erikson’s theory of psychosocial development outlines eight stages of ego growth, each marked by a specific crisis that must be resolved for positive development. These stages range from trust vs. mistrust in infancy to integrity vs. despair in old age. Successful resolution of each crisis leads to positive growth and development.

      Marcia expanded on Erikson’s theory, focusing on identity formation during adolescence. He described four separate identity statuses, which represent the four possible combinations of commitment and exploration. Identity confusion/diffusion occurs when adolescents neither explore nor commit to any identities. Foreclosure occurs when an individual commits to an identity without exploring options. A moratorium is a state in which adolescents are actively exploring options but have not yet made commitments. Individuals who have explored different options, discovered their purpose, and have made identity commitments are in a state of identity achievement.

      Overall, both Erikson and Marcia’s theories emphasize the importance of positive resolution of developmental crises and the role of exploration and commitment in identity formation.

    • This question is part of the following fields:

      • Psychological Development
      49.5
      Seconds
  • Question 19 - What is the origin of the concept of first rank symptoms? ...

    Correct

    • What is the origin of the concept of first rank symptoms?

      Your Answer: Kurt Schneider

      Explanation:

      It is important to note that Carl Schneider should not be mistaken for Kurt Schneider. While Carl Schneider was a psychiatrist who had ties to the Nazi party and played a significant role in the Action T4 Euthanasia program, Kurt Schneider was a different individual altogether.

      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
      6.9
      Seconds
  • Question 20 - A friend contacts you about her elderly mother who has come to her...

    Correct

    • A friend contacts you about her elderly mother who has come to her complaining of withdrawal symptoms. She suspects that her mother may be seeking drugs for non-medical reasons. The mother explains that she recently moved into a retirement home and does not have access to her usual pain medication. What non-addictive options are available to alleviate her withdrawal symptoms?

      Your Answer: Lofexidine

      Explanation:

      Lofexidine is administered to relieve the symptoms of withdrawal from heroin and opiates. Alprazolam and lormetazepam belong to the benzodiazepine class of drugs and are likely to cause physical dependence with prolonged use. Codeine is an analgesic opiate and frequent use can result in significant physical dependence. Phenobarbitone is a potent barbiturate with anaesthetic properties and its regular use can lead to the development of physical dependence.

    • This question is part of the following fields:

      • Psychopharmacology
      11.9
      Seconds
  • Question 21 - What is a true statement about valproate? ...

    Incorrect

    • What is a true statement about valproate?

      Your Answer: Sodium valproate is licensed for the prophylaxis of bipolar disorder

      Correct Answer: If using sodium valproate rather than semi-sodium valproate higher doses are required

      Explanation:

      The liver is responsible for metabolizing valproate, and drugs that disrupt the CYP enzymes can greatly impact its levels. Valproic acid and semi-sodium valproate are approved for treating bipolar disorder, while sodium valproate is solely approved for epilepsy.

      Valproate: Forms, Doses, and Adverse Effects

      Valproate comes in three forms: semi-sodium valproate, valproic acid, and sodium valproate. Semi-sodium valproate is a mix of sodium valproate and valproic acid and is licensed for acute mania associated with bipolar disorder. Valproic acid is also licensed for acute mania, but this is not consistent with the Maudsley Guidelines. Sodium valproate is licensed for epilepsy. It is important to note that doses of sodium valproate and semi-sodium valproate are not the same, with a slightly higher dose required for sodium valproate.

      Valproate is associated with many adverse effects, including nausea, tremor, liver injury, vomiting/diarrhea, gingival hyperplasia, memory impairment/confusional state, somnolence, weight gain, anaemia/thrombocytopenia, alopecia (with curly regrowth), severe liver damage, and pancreatitis. Increased liver enzymes are common, particularly at the beginning of therapy, and tend to be transient. Vomiting and diarrhea tend to occur at the start of treatment and remit after a few days. Severe liver damage is most likely to occur in the first six months of therapy, with the maximum risk being between two and twelve weeks. The risk also declines with advancing age.

      Valproate is a teratogen and should not be initiated in women of childbearing potential. Approximately 10% of children exposed to valproate monotherapy during pregnancy suffer from congenital malformations, with the risk being dose-dependent. The most common malformations are neural tube defects, facial dysmorphism, cleft lip and palate, craniostenosis, cardiac, renal and urogenital defects, and limb defects. There is also a dose-dependent relationship between valproate and developmental delay, with approximately 30-40% of children exposed in utero experiencing delay in their early development, such as talking and walking later, lower intellectual abilities, poor language skills, and memory problems. There is also a thought to be a 3-fold increase of autism in children exposed in utero.

    • This question is part of the following fields:

      • Psychopharmacology
      18.6
      Seconds
  • Question 22 - 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
      16.3
      Seconds
  • Question 23 - Which ethical theory serves as the foundation for the principles of autonomy, beneficence,...

    Correct

    • Which ethical theory serves as the foundation for the principles of autonomy, beneficence, non-maleficence, and justice?

      Your Answer: Principlism

      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
      15.3
      Seconds
  • Question 24 - A client complains of feeling ill after abruptly discontinuing paroxetine. What symptom is...

    Incorrect

    • A client complains of feeling ill after abruptly discontinuing paroxetine. What symptom is most indicative of discontinuation syndrome associated with selective serotonin reuptake inhibitors?

      Your Answer: Myoclonic jerks

      Correct Answer: Diarrhoea

      Explanation:

      Discontinuation syndrome of selective serotonin reuptake inhibitors may manifest with diverse symptoms such as abdominal pain, vomiting, and diarrhea.

      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
      15.6
      Seconds
  • Question 25 - At what Tanner stage does menarche typically occur? ...

    Correct

    • At what Tanner stage does menarche typically occur?

      Your Answer: 4

      Explanation:

      Puberty

      Puberty is a natural process that occurs in both boys and girls. The age range for the onset of puberty is between 8-14 years for females and 9-14 years for males, with the mean age of onset being 11 years for girls and 12 years for boys. The duration of puberty is typically 3-4 years. The onset of puberty is marked by the appearance of secondary sex characteristics, such as breast development in females and testicular enlargement in males. These characteristics evolve over time and are rated into 5 stages according to Tanner’s criteria. The sequence of events differs between boys and girls, with the onset of breast development (thelarche) generally preceding the onset of the first period (menarche) by around 2 years in girls. The pubertal growth spurt occurs during stages 3 to 4 in most boys and during stages 2 and 3 in girls. Precocious puberty, which occurs earlier than usual, is more common in girls than in boys. The age of onset of puberty in girls has been decreasing over time, with environmental factors such as nutrition potentially playing a role in this trend.

    • This question is part of the following fields:

      • Psychological Development
      8
      Seconds
  • Question 26 - A 28 year old man with anxiety is referred to clinic by his...

    Incorrect

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

      Your Answer: Phenylalanine

      Correct Answer: Vanillylmandelic acid

      Explanation:

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

      Pheochromocytoma: Symptoms and Diagnosis

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

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

    • This question is part of the following fields:

      • Classification And Assessment
      21.1
      Seconds
  • Question 27 - Which imaging technique is not considered functional? ...

    Correct

    • Which imaging technique is not considered functional?

      Your Answer: CT

      Explanation:

      Neuroimaging techniques can be divided into structural and functional types, although this distinction is becoming less clear as new techniques emerge. Structural techniques include computed tomography (CT) and magnetic resonance imaging (MRI), which use x-rays and magnetic fields, respectively, to produce images of the brain’s structure. Functional techniques, on the other hand, measure brain activity by detecting changes in blood flow of oxygen consumption. These include functional MRI (fMRI), emission tomography (PET and SPECT), perfusion MRI (pMRI), and magnetic resonance spectroscopy (MRS). Some techniques, such as diffusion tensor imaging (DTI), combine both structural and functional information to provide a more complete picture of the brain’s anatomy and function. DTI, for example, uses MRI to estimate the paths that water takes as it diffuses through white matter, allowing researchers to visualize white matter tracts.

    • This question is part of the following fields:

      • Neurosciences
      6.2
      Seconds
  • Question 28 - What illness is brought about by prions? ...

    Correct

    • What illness is brought about by prions?

      Your Answer: Creutzfeldt-Jakob disease

      Explanation:

      Prions are responsible for causing Creutzfeldt-Jakob disease (CJD), a fatal and uncommon condition that leads to progressive neurodegeneration. The disease is characterized by swiftly advancing dementia as one of its primary symptoms.

    • This question is part of the following fields:

      • Neurosciences
      3
      Seconds
  • Question 29 - Which category of movement disorders do tics fall under? ...

    Correct

    • Which category of movement disorders do tics fall under?

      Your Answer: Hyperkinesia

      Explanation:

      Hyperkinesia is a defining feature of tics.

      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
      7.3
      Seconds
  • Question 30 - A child who has experienced a head injury can no longer tie his...

    Correct

    • A child who has experienced a head injury can no longer tie his shoelaces despite normal motor function. Which type of memory is affected?

      Your Answer: Procedural

      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
      7.6
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Classification And Assessment (3/5) 60%
Description And Measurement (0/1) 0%
Neurosciences (3/4) 75%
Psychopharmacology (3/8) 38%
Social Psychology (3/4) 75%
Basic Psychological Processes (1/1) 100%
Genetics (1/2) 50%
Diagnosis (1/1) 100%
Dynamic Psychopathology (0/1) 0%
Psychological Development (2/3) 67%
Passmed