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Question 1
Incorrect
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A teenager who is texting while driving almost hits a group of pedestrians. When he stops the car, one of the pedestrians approaches him and yells. The teenager feels ashamed of his behavior and is reminded to be more cautious when driving. What type of operant conditioning is this an example of?
Your Answer: Negative punishment
Correct Answer: Positive punishment
Explanation:The women’s shouting, which is an unpleasant stimulus, serves as a positive punisher that reduces the likelihood of the behavior (speeding) occurring again. This is distinct from reinforcement, which involves the introduction of a positive stimulus to increase the likelihood of a behavior being repeated.
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.
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This question is part of the following fields:
- Social Psychology
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Question 2
Correct
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What is a true statement about Levinson's theory of human development?
Your Answer: Stages are based on age ranges rather than on developmental events
Explanation:Erik Erikson and Daniel Levinson expanded the understanding of adult development. Erikson proposed a life-span model of human development consisting of eight successive psychosocial stages, each associated with an inherent conflict of crisis that the individual must encounter and successfully resolve to proceed with development. Levinson proposed a developmental theory consisting of universal stages of phases that extend from the infancy state to the elderly state, based on biographical interviews of 40 men in America. Both theorists maintained that personality develops in a predetermined order and builds upon each previous stage, and that failure to successfully negotiate a stage can result in a reduced ability to complete further stages and therefore a more unhealthy personality and sense of self. However, Levinson’s theory is age-based rather than event-based, and his model proposed a ‘life sequence’ consisting of a series of alternating stable (structure-building) periods and cross-era transitional (structure-changing) periods, with transitional periods typically lasting 5 years.
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This question is part of the following fields:
- Psychological Development
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Question 3
Incorrect
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Which cranial nerve nuclei would be affected by a midbrain lesion?
Your Answer: Vagus
Correct Answer: Oculomotor
Explanation:Overview of Cranial Nerves and Their Functions
The cranial nerves are a complex system of nerves that originate from the brain and control various functions of the head and neck. There are twelve cranial nerves, each with a specific function and origin. The following table provides a simplified overview of the cranial nerves, including their origin, skull exit, modality, and functions.
The first cranial nerve, the olfactory nerve, originates from the telencephalon and exits through the cribriform plate. It is a sensory nerve that controls the sense of smell. The second cranial nerve, the optic nerve, originates from the diencephalon and exits through the optic foramen. It is a sensory nerve that controls vision.
The third cranial nerve, the oculomotor nerve, originates from the midbrain and exits through the superior orbital fissure. It is a motor nerve that controls eye movement, pupillary constriction, and lens accommodation. The fourth cranial nerve, the trochlear nerve, also originates from the midbrain and exits through the superior orbital fissure. It is a motor nerve that controls eye movement.
The fifth cranial nerve, the trigeminal nerve, originates from the pons and exits through different foramina depending on the division. It is a mixed nerve that controls chewing and sensation of the anterior 2/3 of the scalp. It also tenses the tympanic membrane to dampen loud noises.
The sixth cranial nerve, the abducens nerve, originates from the pons and exits through the superior orbital fissure. It is a motor nerve that controls eye movement. The seventh cranial nerve, the facial nerve, also originates from the pons and exits through the internal auditory canal. It is a mixed nerve that controls facial expression, taste of the anterior 2/3 of the tongue, and tension on the stapes to dampen loud noises.
The eighth cranial nerve, the vestibulocochlear nerve, originates from the pons and exits through the internal auditory canal. It is a sensory nerve that controls hearing. The ninth cranial nerve, the glossopharyngeal nerve, originates from the medulla and exits through the jugular foramen. It is a mixed nerve that controls taste of the posterior 1/3 of the tongue, elevation of the larynx and pharynx, and swallowing.
The tenth cranial nerve, the vagus nerve, also originates from the medulla and exits through the jugular foramen. It is a mixed nerve that controls swallowing, voice production, and parasympathetic supply to nearly all thoracic and abdominal viscera. The eleventh cranial nerve, the accessory nerve, originates from the medulla and exits through the jugular foramen. It is a motor nerve that controls shoulder shrugging and head turning.
The twelfth cranial nerve, the hypoglossal nerve, originates from the medulla and exits through the hypoglossal canal. It is a motor nerve that controls tongue movement. Overall, the cranial nerves play a crucial role in controlling various functions of the head and neck, and any damage of dysfunction can have significant consequences.
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This question is part of the following fields:
- Neurosciences
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Question 4
Correct
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How can one differentiate between a pseudohallucination and a hallucination?
Your Answer: The experience is recognised as internally generated
Explanation: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.
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This question is part of the following fields:
- Classification And Assessment
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Question 5
Correct
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What are some characteristics of depression in older adults?
Your Answer: More severe
Explanation:The elderly population is at a higher risk of experiencing severe depression and requiring hospitalization. Depression rates in residential homes and medical wards can be as high as 20-30%, and the risk of suicide also increases with age.
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This question is part of the following fields:
- Epidemiology
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Question 6
Incorrect
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Which of the following is not commonly linked to restless legs syndrome?
Your Answer: Renal failure
Correct Answer: Chronic obstructive pulmonary disease
Explanation:RLS is not a risk factor for COPD, but COPD is a risk factor for sleep apnoea.
Sleep Disorders
The International Classification of Sleep Disorders (ISCD) categorizes sleep disorders into several main categories and subclasses. Dyssomnias are intrinsic sleep disorders that include narcolepsy, psychopsychologic insomnia, idiopathic hypersomnia, restless leg syndrome, periodic limb movement disorder, and obstructive sleep apnea. Extrinsic sleep disorders include inadequate sleep hygiene and alcohol-dependent sleep disorder. Circadian rhythm disorders consist of jet lag syndrome, shift work sleep disorder, irregular sleep-wake pattern, delayed sleep phase syndrome, and advanced sleep phase disorder. Parasomnias include arousal disorders such as sleepwalking and sleep terrors, sleep-wake transition disorders such as rhythmic movement disorder, sleep talking, and nocturnal leg cramps, and parasomnias associated with REM sleep such as nightmares and sleep paralysis. Sleep disorders associated with medical/psychiatric disorders and proposed sleep disorders are also included in the classification.
Narcolepsy is a disorder of unknown cause that is characterized by excessive sleepiness, cataplexy, and other REM sleep phenomena such as sleep paralysis and hypnagogic hallucinations. Periodic limb movement disorder is characterized by periodic episodes of repetitive and highly stereotyped limb movements that occur during sleep. Restless legs syndrome is a disorder characterized by disagreeable leg sensations that usually occur prior to sleep onset and that cause an almost irresistible urge to move the legs. Jet lag syndrome consists of varying degrees of difficulties in initiating or maintaining sleep, excessive sleepiness, decrements in subjective daytime alertness and performance, and somatic symptoms following rapid travel across multiple time zones. Shift work sleep disorder consists of symptoms of insomnia of excessive sleepiness that occur as transient phenomena in relation to work schedules. Non 24 hour sleep wake syndrome consists of a chronic steady pattern comprising one to two hour daily delays in sleep onset and wake times in an individual living in society. Sleepwalking consists of a series of complex behaviors that are initiated during slow-wave sleep and result in walking during sleep. Sleep terrors are characterized by a sudden arousal from slow wave sleep with a piercing scream of cry, accompanied by autonomic and behavioral manifestations of intense fear. Rhythmic movement disorder comprises a group of stereotyped, repetitive movements involving large muscles, usually of the head and neck. Sleep starts are sudden, brief contractions of the legs, sometimes also involving the arms and head, that occur at sleep onset. Nocturnal leg cramps are painful sensations of muscular tightness of tension, usually in the calf but occasionally in the foot, that occur during the sleep episode. Nightmares are frightening dreams that usually awaken the sleeper from REM sleep. Sleep paralysis is a common condition characterized by transient paralysis of skeletal muscles which occurs when awakening from sleep of less often while falling asleep.
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This question is part of the following fields:
- Social Psychology
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Question 7
Incorrect
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What individual proposed a differentiation between fundamental and supplementary symptoms in schizophrenia?
Your Answer: Schneider
Correct Answer: Bleuler
Explanation:Historical Classification of Schizophrenia
The classification of schizophrenia has evolved over time, with various individuals contributing to its development. In 1801, Phillippe Pinel used the term ‘demencé’ to describe the loss of mental abilities in chronically ill patients. Benedict Morel coined the term ‘demencé precocé’ in 1852 to describe young patients with premature dementia. Kahlbaum was the first to describe ‘paraphrenia hebetica’ in the 1860s, which was later elaborated as ‘hebephrenia’ by Hecker in 1871.
In 1893, Emil Kraepelin used the term dementia praecox to describe the condition, emphasizing the importance of delusions, hallucinations, impaired attention, thought incoherence, stereotyped movements and expressions, deterioration of emotional life, and a loss of drive as key symptoms. In 1908, Eugen Bleuler coined the term ‘schizophrenia’ to replace dementia praecox, denoting ‘a splitting of the psychic functions.’ Bleuler expanded the concept to include presentations that did not include a ‘terminal state.’
Bleuler introduced a distinction between basic and accessory symptoms and primary and secondary symptoms. Basic symptoms are necessarily present in any case of schizophrenia, while accessory symptoms may of may not occur. The fundamental features of schizophrenia were loosening of associations, disturbances of affectivity, ambivalence, and autism. The alteration of associations is the only symptom that Bleuler regarded as both basic and primary, and can thus be described as the core disturbance in the Bleulerian conception of schizophrenia.
In 1939, Langfeldt introduced the term ‘schizophreniform psychosis’ to describe patients with Bleulerian schizophrenia who did not follow a progressively deteriorating course. In the 1960s, Rado/Meehl introduced the term ‘schizotypy’ to recognize the concept of a continuum of spectrum of schizophrenia-related phenotypes. In the 1980s, Crow proposed a subclassification of schizophrenia, dividing patients into types I and II. Type I patients present with positive symptoms such as delusions and hallucinations, while type II patients present with negative symptoms such as affective flattening and poverty of speech.
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This question is part of the following fields:
- Classification And Assessment
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Question 8
Correct
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How do mental health services contribute to social inclusion?
Your Answer: Consult service users and carers about how to provide services
Explanation:1. Social inclusion is a key goal of mental health policy in the UK and Europe.
2. Achieving social inclusion requires significant social change.
3. Mental health services can promote social inclusion in certain circumstances.
4. Consulting with service users and carers is one strategy to promote social inclusion in psychiatry. -
This question is part of the following fields:
- Stigma And Culture
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Question 9
Correct
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What is the appropriate approach for paternalistic intervention in preventing teenage suicide?
Your Answer: Beauchamp views paternalism as applying only to autonomous individuals
Explanation:Beauchamp (1993) argued that paternalism only applies to individuals who are capable of making decisions for themselves. In cases where an individual lacks autonomy, healthcare staff have a duty to make decisions on their behalf in their best interests. This includes preventing non-autonomous individuals from attempting suicide.
Deep autonomy provides further justification for paternalistic suicide prevention measures. While acknowledging an autonomous person’s right to take their own life, it could be argued that intervening in a suicide attempt allows the person to reflect and reconsider their decision.
The ‘cry for help’ model can also justify paternalistic interventions as individuals can be given help in finding happiness rather than resorting to suicide in a moment of hopelessness.
However, longer-term suicide prevention measures are generally criticized in the literature, especially in the case of autonomous individuals. Detaining an autonomous individual in a psychiatric hospital for an extended period solely to prevent suicide would be an unjustifiable abuse of civil liberty in the vast majority of cases.
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This question is part of the following fields:
- Basic Ethics And Philosophy Of Psychiatry
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Question 10
Incorrect
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What condition primarily impacts females?
Your Answer: Angelman syndrome
Correct Answer: Rett syndrome
Explanation:Genetic Conditions and Their Features
Genetic conditions are disorders caused by abnormalities in an individual’s DNA. These conditions can affect various aspects of a person’s health, including physical and intellectual development. Some of the most common genetic conditions and their features are:
– Downs (trisomy 21): Short stature, almond-shaped eyes, low muscle tone, and intellectual disability.
– Angelman syndrome (Happy puppet syndrome): Flapping hand movements, ataxia, severe learning disability, seizures, and sleep problems.
– Prader-Willi: Hyperphagia, excessive weight gain, short stature, and mild learning disability.
– Cri du chat: Characteristic cry, hypotonia, down-turned mouth, and microcephaly.
– Velocardiofacial syndrome (DiGeorge syndrome): Cleft palate, cardiac problems, and learning disabilities.
– Edwards syndrome (trisomy 18): Severe intellectual disability, kidney malformations, and physical abnormalities.
– Lesch-Nyhan syndrome: Self-mutilation, dystonia, and writhing movements.
– Smith-Magenis syndrome: Pronounced self-injurious behavior, self-hugging, and a hoarse voice.
– Fragile X: Elongated face, large ears, hand flapping, and shyness.
– Wolf Hirschhorn syndrome: Mild to severe intellectual disability, seizures, and physical abnormalities.
– Patau syndrome (trisomy 13): Severe intellectual disability, congenital heart malformations, and physical abnormalities.
– Rett syndrome: Regression and loss of skills, hand-wringing movements, and profound learning disability.
– Tuberous sclerosis: Hamartomatous tumors, epilepsy, and behavioral issues.
– Williams syndrome: Elfin-like features, social disinhibition, and advanced verbal skills.
– Rubinstein-Taybi syndrome: Short stature, friendly disposition, and moderate learning disability.
– Klinefelter syndrome: Extra X chromosome, low testosterone, and speech and language issues.
– Jakob’s syndrome: Extra Y chromosome, tall stature, and lower mean intelligence.
– Coffin-Lowry syndrome: Short stature, slanting eyes, and severe learning difficulty.
– Turner syndrome: Short stature, webbed neck, and absent periods.
– Niemann Pick disease (types A and B): Abdominal swelling, cherry red spot, and feeding difficulties.It is important to note that these features may vary widely among individuals with the same genetic condition. Early diagnosis and intervention can help individuals with genetic conditions reach their full potential and improve their quality of life.
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This question is part of the following fields:
- Genetics
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Question 11
Incorrect
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Which antidepressant would be the best option for a patient who has been diagnosed with depression and has also experienced a heart attack in the recent past?
Your Answer: Duloxetine
Correct Answer: Sertraline
Explanation:Antidepressant Medications and Ischaemic Heart Disease
The SADHART investigation has shown that sertraline is a safe and effective antidepressant for patients with ischaemic heart disease. However, other medications have not yet been proven safe for this population.
Amitriptyline, a tricyclic antidepressant, is not recommended for patients with comorbid coronary heart disease due to its high relative risk of myocardial infarction and direct cardiac effects. It may also induce weight gain and increase the risk of diabetes, both of which are known risk factors for cardiovascular disease.
Mirtazapine has been studied as a safe second line/alternative treatment to SSRIs in post MI depression, but it can also cause weight gain. Further research is needed to determine the safety and efficacy of other antidepressant medications in patients with ischaemic heart disease.
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This question is part of the following fields:
- Psychopharmacology
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Question 12
Correct
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What factors are considered in the management of psychogenic polydipsia?
Your Answer: Fluid restriction
Explanation:Psychogenic polydipsia is a condition where there is excessive consumption of fluids leading to polyuria, and it is commonly seen in psychiatric conditions such as schizophrenia and developmental disorders. The exact mechanism is unknown, but it is thought to be due to a defect in thirst and a dysfunction in AVP regulation. Patients with psychogenic polydipsia rarely complain of thirst but instead provide delusional explanations for their excessive drinking of state that drinking reduces their anxiety and makes them feel better. If fluid intake exceeds the capacity for excretion, then the resultant hyponatremia may produce signs of water intoxication. It is best managed by fluid restriction. Differential diagnosis should be done to rule out other causes of polyuria and polydipsia. Investigations such as fluid balance charts, urine dipstick, serum U&E and calcium, and urine and plasma osmolality should be arranged. Primary polydipsia can be subclassified into psychogenic and dipsogenic types.
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This question is part of the following fields:
- Classification And Assessment
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Question 13
Correct
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Who is credited with creating the term 'neurasthenia'?
Your Answer: Beard
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.
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This question is part of the following fields:
- Social Psychology
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Question 14
Correct
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What is the equation for Hardy-Weinberg?
Your Answer: p² + 2pq + q²= 1
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.
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This question is part of the following fields:
- Genetics
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Question 15
Incorrect
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Reframing and the domino effect are characteristics of which family therapy approach?
Your Answer: Bowen's family systems approach
Correct Answer: Strategic systemic therapy
Explanation:Strategic systemic therapy incorporates reframing and the domino effect. Haley’s approach assumes that symptoms are perpetuated by attempts to suppress them, and reframing involves giving negative emotions of behaviors a positive connotation. The domino effect refers to the improvement of additional problems after resolving an initial issue. Bowen’s family systems approach emphasizes the patient’s ability to maintain their individuality amidst familial tension. The Milan systemic approach uses circular questioning among family members, while Bateson’s paradoxical therapy involves intentionally engaging in undesirable behaviors. Minuchin’s structural model prioritizes the family hierarchy, rules, and boundaries.
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This question is part of the following fields:
- Advanced Psychological Processes And Treatments
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Question 16
Incorrect
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What ethical perspective are both teenagers employing when discussing the potential impact of assisting a patient in dying on the public's trust in doctors?
Your Answer: Deontological
Correct Answer: Utilitarian
Explanation:The two main ethical approaches in philosophy are teleological ethics, which focuses on the end result, and deontological ethics, which focuses on an individual’s actions being morally right regardless of the end result. In medicine, deontology is patient-centered, while utilitarianism is society-centered. Deontological ethics judges the moral status of actions according to rules of principles, such as the duty not to harm the patient versus the duty to help them. Kantian ethics is a strict form of deontological ethics that emphasizes behaving as though one’s behavior is creating a universal ethical rule. Utilitarianism is a teleological approach that prioritizes the action that leads to the greatest happiness of the greatest number, regardless of how it is brought about. In medicine, autonomy is one of four ethical principles, along with beneficence, non-maleficence, and justice, that enable patients to choose their own treatment and ensure fairness and equality.
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This question is part of the following fields:
- Basic Ethics And Philosophy Of Psychiatry
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Question 17
Incorrect
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Can you identify the brain structure that is not found in both cerebral hemispheres?
Your Answer: Caudate
Correct Answer: Pineal gland
Explanation:Neuroanatomical Structures
The pineal gland is a unique structure in the brain that is not present bilaterally. It is a small endocrine gland responsible for producing melatonin, a hormone derived from serotonin. Along with the pituitary gland and circumventricular organs, the pineal gland is one of the few unpaired structures in the brain.
In contrast, the caudate nucleus is a paired structure located within the basal ganglia. It is present bilaterally and plays a crucial role in motor control and learning.
The midbrain contains the Mammillary body, which is also a paired structure involved in long-term memory formation. These structures work together to help us remember and recall past experiences.
Finally, the supraoptic nucleus is duplicated in each cerebral hemisphere. This structure is involved in regulating water balance and plays a critical role in maintaining homeostasis in the body.
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This question is part of the following fields:
- Neurosciences
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Question 18
Correct
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How can an individual's race be distinguished from their ethnicity based on certain factors?
Your Answer: Biological measurement
Explanation:The concept of ‘race’ is based on physical traits and is believed to have a biological foundation, while ‘ethnicity’ is the preferred term used by researchers studying different cultures to describe groups of people who share a common identity, ancestry, and history, as well as some shared beliefs. It is important to note that a particular race, such as Caucasian, can encompass multiple ethnicities.
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This question is part of the following fields:
- Stigma And Culture
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Question 19
Correct
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Which antibiotic may have anti-inflammatory and neuroprotective effects and could be used in combination with clozapine to treat schizophrenia that is resistant to other treatments?
Your Answer: Minocycline
Explanation:There is evidence to suggest that minocycline has anti-inflammatory and neuroprotective properties. Additionally, both an open study and a randomized controlled trial indicate that it may have positive effects on cognitive and negative symptoms.
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This question is part of the following fields:
- Psychopharmacology
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Question 20
Incorrect
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One statement that is false regarding the genetics of ADHD is: ADHD is caused by a single gene mutation.
Your Answer: Relatives of affected individuals with ADHD have an increased risk of the condition
Correct Answer: ADHD has been associated with the neuregulin 1 gene
Explanation:While ADHD has been linked to various genes, neuregulin 1 is not among them. However, it has been suggested to play a role in schizophrenia.
ADHD and Genetics
Decades of research have shown that genetics play a crucial role in the development of attention deficit hyperactivity disorder (ADHD) and its comorbidity with other disorders. However, twin estimates of heritability being less than 100% suggest that environmental factors also play a role. Parents and siblings of a child with ADHD are more likely to have ADHD themselves, but the way ADHD is inherited is complex and not related to a single genetic fault. The heritability of ADHD is around 74%, and longitudinal studies show that two-thirds of ADHD youth will continue to have impairing symptoms of ADHD in adulthood. Adoption studies suggest that the familial factors of ADHD are attributable to genetic factors rather than shared environmental factors. The heritability is similar in males and females, and studies suggest that the diagnosis of ADHD is the extreme of a continuous distribution of ADHD symptoms in the population. Several candidate genes, including DAT1, DRD4, DRD5, 5 HTT, HTR1B, and SNAP25, have been identified as significantly associated with ADHD.
Source: Faraone (2019) Genetics of attention deficit hyperactivity disorder. Molecular Psychiatry volume 24, pages 562–575 (2019).
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This question is part of the following fields:
- Genetics
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Question 21
Correct
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What parenting style is most likely to result in children who are both happy and successful?
Your Answer: Authoritative
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.
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This question is part of the following fields:
- Psychological Development
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Question 22
Correct
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You encounter a 30-year-old patient in the Emergency department who reports experiencing intense visual hallucinations while listening to music. How would you characterize this symptom?
Your Answer: Reflex hallucinations
Explanation:Types of Hallucinations
Reflex hallucinations occur when a stimulus in one sensory modality leads to hallucinations in another sensory modality. Autoscopy is the experience of seeing one’s own body projected into external space, typically in front of oneself. Extracampine hallucinations are those that occur outside of an individual’s sensory fields. Écho de la pensée refers to the experience of hearing voices that repeat one’s thoughts immediately after thinking them. Functional hallucinations occur when an external stimulus triggers hallucinations that are experienced simultaneously and in the same modality as the initial stimulus.
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This question is part of the following fields:
- Descriptive Psychopathology
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Question 23
Correct
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Which statement accurately describes the Patient Health Questionnaire (PHQ-9) as an assessment tool for depression?
Your Answer: Includes questions about thoughts of self-harm
Explanation:Depression screening can be done using two questions that ask about feeling down, depressed, of hopeless and having little interest of pleasure in doing things. A ‘yes’ answer to either question prompts a more in-depth assessment using tools such as the Hospital Anxiety and Depression (HAD) scale of the Patient Health Questionnaire (PHQ-9). The HAD scale consists of 14 questions, while the PHQ-9 asks about 9 problems over the last 2 weeks. NICE grades depression into ‘less severe’ and ‘more severe’ based on a PHQ-9 score of <16 and >16, respectively. The severity of depression can range from subthreshold and mild to moderate and severe. It is important to assess depression severity to determine appropriate treatment options.
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This question is part of the following fields:
- Classification And Assessment
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Question 24
Correct
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Which condition related to catatonia involves the patient being placed in uncomfortable positions that are sustained for a significant amount of time?
Your Answer: Waxy flexibility
Explanation:Waxy flexibility involves the examiner imposing postures on the patient, while posturing involves spontaneous postures. On the other hand, mitgehen is a type of automatic obedience where the examiner can easily move the patient’s body with a gentle touch, but unlike waxy flexibility, the body part quickly returns to its original position.
– Catatonia is a psychiatric syndrome characterized by disturbed motor functions, mood, and thought.
– Key behaviors associated with catatonia include stupor, posturing, waxy flexibility, negativism, automatic obedience, mitmachen, mitgehen, ambitendency, psychological pillow, forced grasping, obstruction, echopraxia, aversion, mannerisms, stereotypies, motor perseveration, echolalia, and logorrhoea.
– These behaviors are often tested in exam questions.
– Karl Ludwig Kahlbaum is credited with the original clinical description of catatonia. -
This question is part of the following fields:
- Classification And Assessment
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Question 25
Incorrect
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A 10-year-old girl has been referred to your clinic for assessment in relation to difficulties with attention at school and challenging behaviour on interaction with peers.
She describes struggling to maintain attention and to complete her assigned work in a timely manner. She often reaches the correct answer but some time after her peers have done so. This leads to frustration and at times she struggles to express her feelings and will lash out at her peers.
At home she manages her own dressing and chores unaided, although sometimes she requires occasional prompting to maintain on task.
Based on a full clinical history and previous meeting with her mother you suspect a degree of learning disability and request full scale IQ assessment.
What FSIQ value will most likely be returned?Your Answer: 19
Correct Answer: 65
Explanation:This boy may need some assistance with tasks, but he is able to complete them on his own. He may take longer to reach the correct answer compared to his peers, which is indicative of a mild learning disability. Individuals with more severe learning disabilities may require more support in their daily lives, and may also experience motor deficits. IQ levels can be described as follows: profound (below 20), severe (20-34), moderate (35-49), mild (50-70), and normal range (above 70).
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This question is part of the following fields:
- Description And Measurement
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Question 26
Incorrect
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Which of the following conditions is characterized by an increase in the size of the ventricles on structural neuroimaging over time?
Your Answer: Schizophrenia
Correct Answer: Alzheimer's dementia
Explanation:Neuroimaging studies have shown that Alzheimer’s dementia is linked to a gradual increase in ventricular size, while schizophrenia is associated with non-progressive enlargement of the lateral and third ventricles. Although some studies have reported increased ventricular size in individuals with affective disorders, the findings are not consistent. Additionally, individuals with antisocial personality disorder may have reduced prefrontal gray matter volume.
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This question is part of the following fields:
- Neurosciences
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Question 27
Incorrect
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What area of the brain is affected in bilateral dysfunction that leads to Klüver-Bucy syndrome?
Your Answer: Hippocampus
Correct Answer: Amygdala
Explanation:Kluver-Bucy Syndrome: Causes and Symptoms
Kluver-Bucy syndrome is a neurological disorder that results from bilateral medial temporal lobe dysfunction, particularly in the amygdala. This condition is characterized by a range of symptoms, including hyperorality (a tendency to explore objects with the mouth), hypersexuality, docility, visual agnosia, and dietary changes.
The most common causes of Kluver-Bucy syndrome include herpes, late-stage Alzheimer’s disease, frontotemporal dementia, trauma, and bilateral temporal lobe infarction. In some cases, the condition may be reversible with treatment, but in others, it may be permanent and require ongoing management. If you of someone you know is experiencing symptoms of Kluver-Bucy syndrome, it is important to seek medical attention promptly to determine the underlying cause and develop an appropriate treatment plan.
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This question is part of the following fields:
- Neurosciences
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Question 28
Correct
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Which statement accurately describes familial Alzheimer's disease?
Your Answer: The presenilin-1 gene is located on chromosome 14
Explanation:Genetics plays a role in the development of Alzheimer’s disease, with different genes being associated with early onset and late onset cases. Early onset Alzheimer’s, which is rare, is linked to three genes: amyloid precursor protein (APP), presenilin one (PSEN-1), and presenilin two (PSEN-2). The APP gene, located on chromosome 21, produces a protein that is a precursor to amyloid. The presenilins are enzymes that cleave APP to produce amyloid beta fragments, and alterations in the ratios of these fragments can lead to plaque formation. Late onset Alzheimer’s is associated with the apolipoprotein E (APOE) gene on chromosome 19, with the E4 variant increasing the risk of developing the disease. People with Down’s syndrome are also at high risk of developing Alzheimer’s due to inheriting an extra copy of the APP gene.
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This question is part of the following fields:
- Genetics
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Question 29
Incorrect
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What is a true statement about Anton-Babinski syndrome?
Your Answer: Those affected believe they are infested with insects
Correct Answer: Confabulation is a characteristic feature
Explanation:Anton’s syndrome, also known as Anton-Babinski syndrome, is a condition that results from damage to the occipital lobe. People with this syndrome are cortically blind, but they are not aware of it and deny having any problem, a condition known as anosognosia. They may start falling over furniture as they cannot see, but they believe they can still see and describe their surroundings in detail, even though their descriptions are incorrect (confabulation). This syndrome is characterized by a lack of awareness of visual impairment, which can lead to significant difficulties in daily life.
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This question is part of the following fields:
- Neurosciences
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Question 30
Correct
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Which of the following lower brain structures can cause either decreased or increased appetite when damaged?
Your Answer: Hypothalamus
Explanation:Hunger and thirst are regulated by the hypothalamus, while emotional responses and perceptions of others’ emotions are controlled by the amygdala. The brainstem is responsible for arousal, while the cerebellum controls voluntary movement and balance. The medulla, on the other hand, controls breathing and heartbeat.
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This question is part of the following fields:
- Neurosciences
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