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  • Question 1 - A 30-year-old man with schizophrenia believes that his thoughts are being stolen from...

    Incorrect

    • A 30-year-old man with schizophrenia believes that his thoughts are being stolen from his mind every night. When asked for proof, he points to the clouds in the sky, claiming they are taking his thoughts away. Which of the following is the most probable delusion?

      Your Answer: None of the above

      Correct Answer: Delusional perception

      Explanation:

      Delusions are false beliefs that are fixed and can be categorized as primary of secondary. Primary delusions include delusional intuition, delusional perception, delusional atmosphere, and delusional memory. Delusional atmosphere refers to a feeling that something is not right in the world around the patient, without any change in perception. Delusional intuition arises suddenly and occurs in a single stage, while delusional perception is a two-stage phenomenon where the patient misinterprets a normal perception with a delusional meaning. Delusional memory involves remembering past events with a delusional meaning. An example of delusional perception is when a patient misinterprets the marks of freckles and believes that water is being taken out of their body.

    • This question is part of the following fields:

      • Descriptive Psychopathology
      21.2
      Seconds
  • Question 2 - Which symptom is most commonly associated with occlusion of the anterior cerebral artery?...

    Incorrect

    • Which symptom is most commonly associated with occlusion of the anterior cerebral artery?

      Your Answer: Contralateral hemiplegia of arm more than leg

      Correct Answer: Transcortical motor aphasia

      Explanation:

      Brain Blood Supply and Consequences of Occlusion

      The brain receives blood supply from the internal carotid and vertebral arteries, which form the circle of Willis. The circle of Willis acts as a shunt system in case of vessel damage. The three main vessels arising from the circle are the anterior cerebral artery (ACA), middle cerebral artery (MCA), and posterior cerebral artery (PCA). Occlusion of these vessels can result in various neurological deficits. ACA occlusion may cause hemiparesis of the contralateral foot and leg, sensory loss, and frontal signs. MCA occlusion is the most common and can lead to hemiparesis, dysphasia/aphasia, neglect, and visual field defects. PCA occlusion may cause alexia, loss of sensation, hemianopia, prosopagnosia, and cranial nerve defects. It is important to recognize these consequences to provide appropriate treatment.

    • This question is part of the following fields:

      • Neurosciences
      12.9
      Seconds
  • Question 3 - A caregiver at a residential home asks if it's okay to secretly give...

    Incorrect

    • A caregiver at a residential home asks if it's okay to secretly give medication to an elderly resident with moderate dementia who has been refusing their medication for the past two days. What is the best course of action in this situation?

      Your Answer: Medication should never be administered covertly

      Correct Answer: She should arrange a full team discussion to consider the patient's best interests

      Explanation:

      While there are situations where covert administration of medication may be necessary, it is important to approach this practice with caution due to its controversial nature. In cases where covert medication is deemed necessary to improve a patient’s mental health, it is recommended to convene a ‘best interests meeting’ involving the multidisciplinary team and family. The patient’s capacity should be taken into account, regardless of whether they are detained of not. While the views of the patient’s next of kin should be considered, they should not be the sole determining factor.

    • This question is part of the following fields:

      • Basic Ethics And Philosophy Of Psychiatry
      18.5
      Seconds
  • Question 4 - A child repeats whatever the teacher says. What sign are they exhibiting? ...

    Incorrect

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

      Your Answer: Logoclonia

      Correct Answer: Echolalia

      Explanation:

      – Catatonia is a psychiatric syndrome characterized by disturbed motor functions, mood, and thought.
      – Key behaviors associated with catatonia include stupor, posturing, waxy flexibility, negativism, automatic obedience, mitmachen, mitgehen, ambitendency, psychological pillow, forced grasping, obstruction, echopraxia, aversion, mannerisms, stereotypies, motor perseveration, echolalia, and logorrhoea.
      – These behaviors are often tested in exam questions.
      – Karl Ludwig Kahlbaum is credited with the original clinical description of catatonia.

    • This question is part of the following fields:

      • Classification And Assessment
      9.1
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  • Question 5 - What is the presumed cause of the sexual dysfunction associated with SSRIs? ...

    Incorrect

    • What is the presumed cause of the sexual dysfunction associated with SSRIs?

      Your Answer: 5-HT1 agonist

      Correct Answer: 5-HT2 agonism

      Explanation:

      The inhibition of sexual behavior is caused by the activation of 5-HT2 receptors. However, this effect can be reversed by using 5-HT2 antagonists like cyproheptadine and 5-HT1a agonists like buspirone. These drugs are effective in treating sexual dysfunction caused by selective serotonin reuptake inhibitors (SSRIs).

      Antidepressants can cause sexual dysfunction as a side-effect, although the rates vary. The impact on sexual desire, arousal, and orgasm can differ depending on the type of antidepressant. It is important to rule out other causes and consider non-pharmacological strategies such as reducing the dosage of taking drug holidays. If necessary, switching to a lower risk antidepressant of using pharmacological options such as phosphodiesterase inhibitors of mirtazapine augmentation can be considered. The Maudsley Guidelines 14th Edition provides a helpful table outlining the risk of sexual dysfunction for different antidepressants.

    • This question is part of the following fields:

      • Psychopharmacology
      12.8
      Seconds
  • Question 6 - Which condition is most likely to be present when a woman is described...

    Incorrect

    • Which condition is most likely to be present when a woman is described as having poor dental hygiene, disheveled hair, and an unkempt appearance during a mental state examination?

      Your Answer: Anorexia nervosa

      Correct Answer: Schizophrenia

      Explanation:

      Mental State Exam: Appearance

      The appearance of a patient can provide valuable clues to an underlying disorder. It is important to note that the following examples are not always present, but they can be helpful for educational purposes.

      Individuals experiencing hypomania or mania may tend to wear bright and colorful clothing and may apply unusual of garish makeup. On the other hand, unfashionable and mismatched clothing may indicate schizoid personality traits of autistic spectrum disorders.

      An excessively tidy appearance may suggest an obsessional personality. It is important to consider these cues in conjunction with other aspects of the mental state exam to arrive at an accurate diagnosis. Proper observation and interpretation of a patient’s appearance can aid in the development of an effective treatment plan.

    • This question is part of the following fields:

      • Classification And Assessment
      6.2
      Seconds
  • Question 7 - What is the main component of pick bodies? ...

    Incorrect

    • What is the main component of pick bodies?

      Your Answer: Amyloid

      Correct Answer: Tau

      Explanation:

      Pyramidal cell neurons known as Betz cells are situated in the grey matter of the motor cortex.

      Frontotemporal Lobar Degeneration (FTLD) is a pathological term that refers to a group of neurodegenerative disorders that affect the frontal and temporal lobes of the brain. FTLD is classified into several subtypes based on the main protein component of neuronal and glial abnormal inclusions and their distribution. The three main proteins associated with FTLD are Tau, TDP-43, and FUS. Each FTD clinical phenotype has been associated with different proportions of these proteins. Macroscopic changes in FTLD include atrophy of the frontal and temporal lobes, with focal gyral atrophy that resembles knives. Microscopic changes in FTLD-Tau include neuronal and glial tau aggregation, with further sub-classification based on the existence of different isoforms of tau protein. FTLD-TDP is characterized by cytoplasmic inclusions of TDP-43 in neurons, while FTLD-FUS is characterized by cytoplasmic inclusions of FUS.

    • This question is part of the following fields:

      • Neurosciences
      39.2
      Seconds
  • Question 8 - A suspect awaiting trial provides vague responses to the inquiries posed by the...

    Incorrect

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

      Your Answer: Pseudologia fantastica

      Correct Answer: Ganser syndrome

      Explanation:

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

    • This question is part of the following fields:

      • Descriptive Psychopathology
      3.2
      Seconds
  • Question 9 - What is the name of the neurotransmitter that has an inhibitory effect? ...

    Incorrect

    • What is the name of the neurotransmitter that has an inhibitory effect?

      Your Answer:

      Correct Answer: GABA

      Explanation:

      Excitatory neurotransmitters include glutamate, histamine, acetylcholine, and noradrenaline, as they increase ion flow and the likelihood of action potential in neurons. However, GABA functions as an inhibitory neurotransmitter, reducing ion flow and decreasing the probability of action potential.

    • This question is part of the following fields:

      • Neurosciences
      0
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  • Question 10 - A child complains of becoming clumsy since they had a head injury. You...

    Incorrect

    • A child complains of becoming clumsy since they had a head injury. You notice they are unable to control fine movements. A neurological exam does not reveal any motor of sensory deficit. Which type of apraxia is present?

      Your Answer:

      Correct Answer: Limb kinetic

      Explanation:

      Apraxia: Understanding the Inability to Carry Out Learned Voluntary Movements

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

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

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

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

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

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

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

    • This question is part of the following fields:

      • Neurosciences
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  • Question 11 - Which of the following is not a licensed treatment for obsessive compulsive disorder?...

    Incorrect

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

      Your Answer:

      Correct Answer: Citalopram

      Explanation:

      Antidepressants (Licensed Indications)

      The following table outlines the specific licensed indications for antidepressants in adults, as per the Maudsley Guidelines and the British National Formulary. It is important to note that all antidepressants are indicated for depression.

      – Nocturnal enuresis in children: Amitriptyline, Imipramine, Nortriptyline
      – Phobic and obsessional states: Clomipramine
      – Adjunctive treatment of cataplexy associated with narcolepsy: Clomipramine
      – Panic disorder and agoraphobia: Citalopram, Escitalopram, Sertraline, Paroxetine, Venlafaxine
      – Social anxiety/phobia: Escitalopram, Paroxetine, Sertraline, Moclobemide, Venlafaxine
      – Generalised anxiety disorder: Escitalopram, Paroxetine, Duloxetine, Venlafaxine
      – OCD: Escitalopram, Fluoxetine, Fluvoxamine, Paroxetine, Sertraline, Clomipramine
      – Bulimia nervosa: Fluoxetine
      – PTSD: Paroxetine, Sertraline

    • This question is part of the following fields:

      • Psychopharmacology
      0
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  • Question 12 - You are evaluating a 28-year-old male patient who has been referred to you...

    Incorrect

    • You are evaluating a 28-year-old male patient who has been referred to you by his primary care physician. He has a history of hyper-sexuality and reports that he engages in masturbation up to 8 times a day. He states that he is constantly preoccupied with sexual thoughts and is attracted to post-pubescent girls around the age of 16. He has a prior conviction for indecent exposure and grooming offenses. What is the most effective antidepressant treatment for his paraphilic disorder?

      Your Answer:

      Correct Answer: Sertraline

      Explanation:

      Sertraline and other selective serotonin reuptake inhibitors (SSRIs) are effective in treating paraphilias by reducing libido and delaying orgasm. While all serotonergic antidepressants have sexual effects, they are most common with SSRIs. Although these effects are typically considered side effects, they can be beneficial in treating paraphilias.

      Sexual side effects are prevalent with many antidepressants, with SSRIs having the highest incidence at 60-70%. Venlafaxine has a 70% incidence, duloxetine has a 46% incidence, monoamine oxidase inhibitors (MAOIs) have a 40% incidence, tricyclic antidepressants (TCAs) have a 30% incidence (but are more common with clomipramine), mirtazapine has a 25% incidence, reboxetine has a 5-10% incidence, and the incidence with trazodone is unknown.

      Cyproterone acetate (Androcur) is an effective treatment for hypersexuality as an anti-androgen that reduces testosterone to pre-pubescent levels. These findings are based on the Maudsley Guidelines, 11th edition, page 210.

    • This question is part of the following fields:

      • Psychopharmacology
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  • Question 13 - What is the term used in Piaget's theory of child development to describe...

    Incorrect

    • What is the term used in Piaget's theory of child development to describe the process of modifying a schema based on new information?

      Your Answer:

      Correct Answer: Accommodation

      Explanation:

      Piaget’s Stages of Development and Key Concepts

      Piaget developed four stages of development that describe how children think and acquire knowledge. The first stage is the Sensorimotor stage, which occurs from birth to 18-24 months. In this stage, infants learn through sensory observation and gain control of their motor functions through activity, exploration, and manipulation of the environment.

      The second stage is the Preoperational stage, which occurs from 2 to 7 years. During this stage, children use symbols and language more extensively, but they are unable to think logically of deductively. They also use a type of magical thinking and animistic thinking.

      The third stage is the Concrete Operational stage, which occurs from 7 to 11 years. In this stage, egocentric thought is replaced by operational thought, which involves dealing with a wide array of information outside the child. Children in this stage begin to use limited logical thought and can serialise, order, and group things into classes on the basis of common characteristics.

      The fourth and final stage is the Formal Operations stage, which occurs from 11 through the end of adolescence. This stage is characterized by the ability to think abstractly, to reason deductively, to define concepts, and also by the emergence of skills for dealing with permutations and combinations.

      Piaget also developed key concepts, including schema, assimilation, and accommodation. A schema is a category of knowledge and the process of obtaining that knowledge. Assimilation is the process of taking new information into an existing schema, while accommodation involves altering a schema in view of additional information.

      Overall, Piaget’s stages of development and key concepts provide a framework for understanding how children learn and acquire knowledge.

    • This question is part of the following fields:

      • Psychological Development
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  • Question 14 - What factors contribute to the development of depression in relation to social background?...

    Incorrect

    • What factors contribute to the development of depression in relation to social background?

      Your Answer:

      Correct Answer: Brown and Harris

      Explanation:

      Depression (Brown and Harris)

      In 1978, Brown and Harris conducted a study on 458 women in the inner London area of Camberwell to investigate the causes of depression. The study resulted in the development of a model that identified four vulnerability factors for depressive illness in women. These factors included having three of more children under the age of 14 at home, lacking an intimate relationship with a husband of boyfriend, lacking employment outside of the home, and experiencing the loss of a mother before the age of 11 years. The model emphasized the role of psychosocial factors in the development of depression.

    • This question is part of the following fields:

      • Social Psychology
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  • Question 15 - 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:

      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
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  • Question 16 - 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:

      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
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  • Question 17 - What substance precedes the production of serotonin? ...

    Incorrect

    • What substance precedes the production of serotonin?

      Your Answer:

      Correct Answer: 5-hydroxytryptophan

      Explanation:

      Serotonin: Synthesis and Breakdown

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

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

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

    • This question is part of the following fields:

      • Neurosciences
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  • Question 18 - What is the definition of copropraxia? ...

    Incorrect

    • What is the definition of copropraxia?

      Your Answer:

      Correct Answer: Use of obscene gestures

      Explanation:

      Copropraxia is a neurological condition characterized by the involuntary expression of socially unacceptable gestures. It is similar to coprolalia, which is the involuntary expression of socially unacceptable words. Other related conditions include echolalia, which involves copying others’ words, and echopraxia, which involves copying others’ actions. Coprophagia, on the other hand, refers to the act of eating faeces, while palilialia involves repeating one’s own sounds. These conditions can be distressing for those who experience them and can have a significant impact on their daily lives. Treatment options may include medication, therapy, and support groups.

    • This question is part of the following fields:

      • Classification And Assessment
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  • Question 19 - A client is referred to your clinic by their physician due to a...

    Incorrect

    • A client is referred to your clinic by their physician due to a recent decline in their mood. The client reports difficulty swallowing pills and shares that during their last visit with a psychiatrist, they were given an antidepressant in the form of a patch. Can you identify which antidepressant was previously prescribed to this client?

      Your Answer:

      Correct Answer: Selegiline

      Explanation:

      Alternative Routes of Administration for Antidepressants

      While most antidepressants are taken orally, there are a few alternative routes of administration available. However, it is important to note that these non-oral preparations should only be used when absolutely necessary, as they may not have a UK licence.

      One effective alternative route is sublingual administration of fluoxetine liquid. Buccal administration of selegiline is also available. Crushed amitriptyline has been shown to be effective when administered via this route.

      Intravenous administration is another option, with several antidepressants available in IV preparations, including citalopram, escitalopram, mirtazapine, amitriptyline, clomipramine, and allopregnanolone (which is licensed in the US for postpartum depression). Ketamine has also been shown to be effective when administered intravenously.

      Intramuscular administration of flupentixol has been shown to have a mood elevating effect, but amitriptyline was discontinued as an IM preparation due to the high volumes required.

      Transdermal administration of selegiline is available, and suppositories containing amitriptyline, clomipramine, imipramine, and trazodone have been manufactured by pharmacies, although there is no clear data on their effectiveness. Sertraline tablets and doxepin capsules have also been given rectally.

    • This question is part of the following fields:

      • Psychopharmacology
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  • Question 20 - What is a true statement about the Brief Psychosis Rating Scale (BPRS)? ...

    Incorrect

    • What is a true statement about the Brief Psychosis Rating Scale (BPRS)?

      Your Answer:

      Correct Answer: It can be used for patients who are unable to read of write

      Explanation:

      Brief Psychiatric Rating Scale: An Instrument for Evaluating Psychopathology in Psychiatric Patients

      The Brief Psychiatric Rating Scale (BPRS) is a widely used tool for assessing psychopathology in psychiatric patients. It was developed in the 1960s by Overall and Gorham, using factor analysis, to evaluate the severity of schizophrenic states and provide clinicians with a quick way to assess patient change. Initially, the BPRS consisted of 16 items, but two more items were added to create the standard 18-item version. Later, an expanded 24-item version was introduced to measure additional aspects of schizophrenia, such as bizarre behavior, self-neglect, suicidality, elevated mood, motor hyperactivity, and distractibility.

      The BPRS is rated by a clinician, who assesses each item on a 7-point scale of severity. Higher scores indicate greater severity of symptoms. The assessment relies on a combination of self-report and observation. Several variables are rated based on observation, while the rest are assessed through a short interview. The total score severity, using the 18-item version, has been estimated as mildly ill (31), moderately ill (41), and markedly ill (53). The administration of the BPRS can take 10-40 minutes, and versions have been validated for use in both children and older adults. As it is clinician-administered, the BPRS does not require patients to be able to read of write.

    • This question is part of the following fields:

      • Classification And Assessment
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  • Question 21 - A 70-year-old patient is admitted to a medical ward with fulminant hepatic failure....

    Incorrect

    • A 70-year-old patient is admitted to a medical ward with fulminant hepatic failure. The admitting team observe the patient displaying a tremor, sunflower cataracts, difficulty speaking, and personality change. What is the most probable diagnosis?

      Your Answer:

      Correct Answer: Wilson's disease

      Explanation:

      Understanding Wilson’s Disease: Causes, Symptoms, and Management

      Wilson’s disease, also known as hepatolenticular degeneration, is a genetic disorder that affects copper storage in the body. This condition is caused by a defect in the ATP7B gene, which leads to the accumulation of copper in the liver and brain. The onset of symptoms usually occurs between the ages of 10 and 25, with liver disease being the most common presentation in children and neurological symptoms in young adults.

      The excessive deposition of copper in the tissues can cause a range of symptoms, including hepatitis, cirrhosis, basal ganglia degeneration, speech and behavioral problems, asterixis, chorea, dementia, Kayser-Fleischer rings, sunflower cataract, renal tubular acidosis, haemolysis, and blue nails. Diagnosis is based on reduced serum ceruloplasmin, reduced serum copper, and increased 24-hour urinary copper excretion.

      The traditional first-line treatment for Wilson’s disease is penicillamine, which chelates copper. Trientine hydrochloride is an alternative chelating agent that may become first-line treatment in the future. Tetrathiomolybdate is a newer agent that is currently under investigation.

      In summary, Wilson’s disease is a genetic disorder that affects copper storage in the body, leading to a range of symptoms that can affect the liver, brain, and eyes. Early diagnosis and treatment are essential to prevent complications and improve outcomes.

    • This question is part of the following fields:

      • Classification And Assessment
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  • Question 22 - What is the contribution of Crow to the understanding of schizophrenia? ...

    Incorrect

    • What is the contribution of Crow to the understanding of schizophrenia?

      Your Answer:

      Correct Answer: He divided patients with schizophrenia into type I and type II

      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.

    • This question is part of the following fields:

      • Classification And Assessment
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  • Question 23 - Which ethical principle in medicine was upheld by the case of Cruzan v....

    Incorrect

    • Which ethical principle in medicine was upheld by the case of Cruzan v. Director, Missouri Department of Health?

      Your Answer:

      Correct Answer: Confidentiality can be breached where another's life is under threat

      Explanation:

      Legal Principles in Healthcare

      In the case of Tarasoff vs. the Regents of the University of California, it was established that patient confidentiality can be breached if there is a threat of harm to another person. Practitioners have a duty to take reasonable steps to protect the threatened individual, which may include notifying the police of warning the intended victim.

      Another important legal principle in healthcare is the Bolam test. This principle states that a practitioner’s care is not considered negligent if a responsible body of similar professionals supports the practice, even if it is not the standard care. These legal principles help to ensure that healthcare professionals are held accountable for their actions and that patients receive appropriate care.

    • This question is part of the following fields:

      • Basic Ethics And Philosophy Of Psychiatry
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  • Question 24 - QTc prolongation is associated with which of the following metabolic changes? ...

    Incorrect

    • QTc prolongation is associated with which of the following metabolic changes?

      Your Answer:

      Correct Answer: Hypokalaemia

      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
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  • Question 25 - The Camberwell Family Interview assesses mainly which of the following? ...

    Incorrect

    • The Camberwell Family Interview assesses mainly which of the following?

      Your Answer:

      Correct Answer: Expressed emotion

      Explanation:

      The Camberwell Family Interview for Measuring Expressed Emotion

      The Camberwell Family Interview is a tool designed to assess the level of expressed emotion within families. This interview was created with the aim of identifying the emotional climate within a family, particularly in relation to individuals with mental health issues. The interview is structured and standardized, with a set of questions that are asked to each family member separately. The questions are designed to elicit information about the family’s emotional atmosphere, including levels of criticism, hostility, and emotional over-involvement.

      The Camberwell Family Interview is a valuable tool for mental health professionals, as it can help them to identify families that may be at risk of exacerbating mental health issues in their loved ones. By measuring expressed emotion, mental health professionals can gain insight into the family’s emotional dynamics and work with them to create a more supportive and positive environment. The interview can also be used to track changes in the family’s emotional climate over time, allowing mental health professionals to monitor progress and adjust treatment plans accordingly. Overall, the Camberwell Family Interview is an important tool for understanding and addressing the emotional needs of families affected by mental health issues.

    • This question is part of the following fields:

      • Psychological Development
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  • Question 26 - What substance acts as a partial agonist on nicotinic receptors? ...

    Incorrect

    • What substance acts as a partial agonist on nicotinic receptors?

      Your Answer:

      Correct Answer: Varenicline

      Explanation:

      Varenicline is a medication that helps people quit smoking by partially activating specific nicotine receptors in the body.

      Mechanisms of Action of Different Drugs

      Understanding the mechanisms of action of different drugs is crucial for medical professionals. It is a common topic in exams and can earn easy marks if studied well. This article provides a list of drugs and their mechanisms of action in different categories such as antidepressants, anti dementia drugs, mood stabilizers, anxiolytic/hypnotic drugs, antipsychotics, drugs of abuse, and other drugs. For example, mirtazapine is a noradrenaline and serotonin specific antidepressant that works as a 5HT2 antagonist, 5HT3 antagonist, H1 antagonist, alpha 1 and alpha 2 antagonist, and moderate muscarinic antagonist. Similarly, donepezil is a reversible acetylcholinesterase inhibitor used as an anti dementia drug, while valproate is a GABA agonist and NMDA antagonist used as a mood stabilizer. The article also explains the mechanisms of action of drugs such as ketamine, phencyclidine, buprenorphine, naloxone, atomoxetine, varenicline, disulfiram, acamprosate, and sildenafil.

    • This question is part of the following fields:

      • Psychopharmacology
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  • Question 27 - Which part of a neuron is accountable for generating energy? ...

    Incorrect

    • Which part of a neuron is accountable for generating energy?

      Your Answer:

      Correct Answer: Mitochondria

      Explanation:

      Melanin

      Melanin is a pigment found in various parts of the body, including the skin, hair, and eyes. It is produced by specialized cells called melanocytes, which are located in the skin’s basal layer. The function of melanin in the body is not fully understood, but it is thought to play a role in protecting the skin from the harmful effects of ultraviolet (UV) radiation from the sun. Additionally, melanin may be a by-product of neurotransmitter synthesis, although this function is not well established. Overall, the role of melanin in the body is an area of ongoing research.

    • This question is part of the following fields:

      • Neurosciences
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  • Question 28 - What is true about the discontinuation syndrome of antidepressants? ...

    Incorrect

    • What is true about the discontinuation syndrome of antidepressants?

      Your Answer:

      Correct Answer: Symptoms rapidly disappear upon readministration of the drug

      Explanation:

      Antidepressants can cause discontinuation symptoms when patients stop taking them, regardless of the type of antidepressant. These symptoms usually occur within 5 days of stopping the medication and can last up to 3 weeks. Symptoms include flu-like symptoms, dizziness, insomnia, vivid dreams, irritability, crying spells, and sensory symptoms. SSRIs and related drugs with short half-lives, such as paroxetine and venlafaxine, are particularly associated with discontinuation symptoms. Tapering antidepressants at the end of treatment is recommended to prevent these symptoms. TCAs and MAOIs are also associated with discontinuation symptoms, with amitriptyline and imipramine being the most common TCAs and all MAOIs being associated with prominent discontinuation symptoms. Patients at highest risk for discontinuation symptoms include those on antidepressants with shorter half-lives, those who have been taking antidepressants for 8 weeks of longer, those using higher doses, younger people, and those who have experienced discontinuation symptoms before. Agomelatine is not associated with any discontinuation syndrome. If a discontinuation reaction occurs, restarting the antidepressant of switching to an alternative with a longer half-life and tapering more slowly may be necessary. Explanation and reassurance are often sufficient for mild symptoms. These guidelines are based on the Maudsley Guidelines 14th Edition and a study by Tint (2008).

    • This question is part of the following fields:

      • Psychopharmacology
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  • Question 29 - Which waveform represents a frequency that is less than 4 Hz? ...

    Incorrect

    • Which waveform represents a frequency that is less than 4 Hz?

      Your Answer:

      Correct Answer: Delta

      Explanation:

      Electroencephalography

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

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

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

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

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

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

    • This question is part of the following fields:

      • Neurosciences
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  • Question 30 - Which of these is not a part of MELAS syndrome? ...

    Incorrect

    • Which of these is not a part of MELAS syndrome?

      Your Answer:

      Correct Answer: Asystole

      Explanation:

      Non-Mendelian inheritance patterns include mitochondrial inheritance, trinucleotide expansion, mosaicism, and genomic imprinting. These patterns do not follow the typical Mendelian principles. Examples of non-Mendelian mitochondrial inheritance include Leber’s hereditary optic neuropathy and MELAS syndrome, which is characterized by mitochondrial myopathy, encephalopathy, lactic acidosis, and recurrent stroke.

      On the other hand, Mendelian genetic inheritance patterns include autosomal dominant, autosomal recessive, and sex-linked disorders such as X-linked dominant and X-linked recessive.

      Mitochondrial DNA abnormalities can lead to various diseases, including MELAS syndrome. Mitochondrial DNA is inherited solely from the mother’s ovum, and the embryo’s mitochondria are entirely maternally derived. Most mitochondrial diseases manifest as myopathies and neuropathies.

    • This question is part of the following fields:

      • Genetics
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SESSION STATS - PERFORMANCE PER SPECIALTY

Descriptive Psychopathology (0/2) 0%
Neurosciences (1/3) 33%
Basic Ethics And Philosophy Of Psychiatry (0/1) 0%
Classification And Assessment (1/2) 50%
Passmed