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  • Question 1 - What strategies can be implemented to decrease alcohol intake in individuals who continue...

    Incorrect

    • What strategies can be implemented to decrease alcohol intake in individuals who continue to consume alcohol?

      Your Answer: Acamprosate

      Correct Answer: Nalmefene

      Explanation:

      In the treatment of harmful alcohol use, Nalmefene is a novel medication that can help reduce the desire for alcohol. After successful withdrawal, NICE recommends the use of acamprosate, disulfiram, and naltrexone (which is approved for use in opioid dependence) to manage alcohol dependence. Bupropion is utilized to manage nicotine dependence.

    • This question is part of the following fields:

      • Psychopharmacology
      16.1
      Seconds
  • Question 2 - What scales are used to assess the intensity of manic symptoms? ...

    Correct

    • What scales are used to assess the intensity of manic symptoms?

      Your Answer: YMRS

      Explanation:

      In psychiatry, various questionnaires and interviews are used to assess different conditions and areas. It is important for candidates to know whether certain assessment tools are self-rated of require clinical assistance. The table provided by the college lists some of the commonly used assessment tools and indicates whether they are self-rated of clinician-rated. For example, the HAMD and MADRS are clinician-rated scales used to assess the severity of depression, while the GDS is a self-rated scale used to screen for depression in the elderly. The YMRS is a clinician-rated scale used to assess the severity of mania in patients with bipolar disorder, while the Y-BOCS is used to measure both the severity of OCD and the response to treatment. The GAF provides a single measure of global functioning, while the CGI requires the clinician to rate the severity of the patient’s illness at the time of assessment. The CAMDEX is a tool developed to assist in the early diagnosis and measurement of dementia in the elderly.

    • This question is part of the following fields:

      • Classification And Assessment
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  • Question 3 - 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: Reboxetine

      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
      44.6
      Seconds
  • Question 4 - What are the two purine bases? ...

    Incorrect

    • What are the two purine bases?

      Your Answer: Adenine and cytosine

      Correct Answer: Adenine and guanine

      Explanation:

      Nucleotides: The Building Blocks of DNA and RNA

      Nucleotides are the fundamental units of DNA (deoxyribonucleic acid) and RNA (ribonucleic acid). Each nucleotide consists of three components: a sugar molecule (deoxyribose in DNA and ribose in RNA), a phosphate group, and a nitrogenous base. The nitrogenous bases can be classified into two categories: purines and pyrimidines. The purine bases include adenine and guanine, while the pyrimidine bases are cytosine, thymine (in DNA), and uracil (in RNA).

      The arrangement of nucleotides in DNA and RNA determines the genetic information that is passed from one generation to the next. The sequence of nitrogenous bases in DNA forms the genetic code that determines the traits of an organism. RNA, on the other hand, plays a crucial role in protein synthesis by carrying the genetic information from DNA to the ribosomes, where proteins are synthesized.

      Understanding the structure and function of nucleotides is essential for understanding the molecular basis of life. The discovery of the structure of DNA and the role of nucleotides in genetic information has revolutionized the field of biology and has led to many breakthroughs in medicine, biotechnology, and genetics.

    • This question is part of the following fields:

      • Genetics
      13.9
      Seconds
  • Question 5 - Which ethical situation is associated with the Tarasoff decision? ...

    Incorrect

    • Which ethical situation is associated with the Tarasoff decision?

      Your Answer: Protecting a failing colleague who is putting their patients at risk

      Correct Answer: The failure to protect the rights of potential victims

      Explanation:

      Double Agentry in Psychiatry

      Double agentry is a term used to describe a situation where a psychiatrist’s conflict of interest interferes with their ability to act in the best interests of their patient. Psychiatrists often have to balance the interests of multiple parties, such as the patient, family, society, and hospital commissioners, which is known as multiagency.

      The Tarasoff case is a prime example of double agentry in psychiatry. Two therapists failed to warn a woman that their patient had expressed an intention to kill her. They chose not to do so to respect the patient’s confidentiality, but failed to recognize their duty of care to both the patient and the potential victim. Unfortunately, the woman was eventually murdered by the patient.

      This case, which occurred in California, led to a change in the law that now requires therapists to have a legal duty to both their patients and potential victims. It highlights the importance of psychiatrists being aware of their responsibilities to all parties involved and ensuring that they act in the best interests of their patients while also fulfilling their duty of care to others.

    • This question is part of the following fields:

      • Social Psychology
      165.8
      Seconds
  • Question 6 - In what century did psychiatry become established as a distinct medical field? ...

    Incorrect

    • In what century did psychiatry become established as a distinct medical field?

      Your Answer:

      Correct Answer: 18th century

      Explanation:

      Psychiatry emerged as a distinct medical field in the late 1700s, leading to the establishment of specialized asylums designed to provide therapeutic care for individuals with mental illnesses who were previously confined in institutions.

    • This question is part of the following fields:

      • History Of Psychiatry
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  • Question 7 - Under which classification does Flupentixol fall? ...

    Incorrect

    • Under which classification does Flupentixol fall?

      Your Answer:

      Correct Answer: Thioxanthene

      Explanation:

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

    • This question is part of the following fields:

      • Psychopharmacology
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  • Question 8 - What is the mechanism of action of memantine? ...

    Incorrect

    • What is the mechanism of action of memantine?

      Your Answer:

      Correct Answer: NMDA receptor antagonist

      Explanation:

      Although cholinergic agents have been tested in Alzheimer’s disease, they have shown limited effectiveness. On the other hand, memantine, a N-methyl-D-aspartate (NMDA) receptor antagonist, works by reducing the impact of glutamate mediated toxicity and has shown promise in treating the disease. Additionally, anti-amyloid strategies are currently being developed and, if successful, could directly target the disease process.

    • This question is part of the following fields:

      • Psychopharmacology
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  • Question 9 - Which of the following characteristics is not associated with the sensorimotor stage of...

    Incorrect

    • Which of the following characteristics is not associated with the sensorimotor stage of development?

      Your Answer:

      Correct Answer: Animism

      Explanation:

      The preoperational stage is characterized by the presence of animistic thinking.

      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 10 - During an evaluation, it appears difficult to obtain a straightforward response from your...

    Incorrect

    • During an evaluation, it appears difficult to obtain a straightforward response from your elderly client. They do eventually provide an answer, but only after an extended conversation about the intricacies of the topic, including precise and detailed information about each aspect. What is this occurrence referred to as?

      Your Answer:

      Correct Answer: Circumstantiality

      Explanation:

      Different types of thought disorders are associated with specific personality traits of mental illnesses. Circumstantiality involves taking a long and detailed route to get to the initial point. Loosening of association makes it difficult to follow how one idea connects to the previous one, resulting in derailment. Overinclusive thinking blurs the boundaries between words and concepts, causing unrelated ideas to be associated with each other. Tangentiality involves answers that are related to the question but do not directly answer it.

    • This question is part of the following fields:

      • Assessment
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  • Question 11 - An academic fellow is looking to conduct a research project on Alzheimer's disease...

    Incorrect

    • An academic fellow is looking to conduct a research project on Alzheimer's disease in a region with a high incidence rate. Which region would be the most suitable for his study?

      Your Answer:

      Correct Answer: Latin America

      Explanation:

      The prevalence of dementia among individuals aged 60 and above, adjusted to the western Europe population by global burden of disease region, is greatest in Latin America, with a rate of 8.5%. The prevalence rates for other regions are as follows: Central Europe – 5.8%, East Asia – 5%, Sub-Saharan Africa, east – 4%, and Sub-Saharan Africa, west – 2.1%.

    • This question is part of the following fields:

      • Stigma And Culture
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  • Question 12 - What medication prescribed for depression is most likely to result in decreased sexual...

    Incorrect

    • What medication prescribed for depression is most likely to result in decreased sexual drive?

      Your Answer:

      Correct Answer: Venlafaxine

      Explanation:

      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
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  • Question 13 - For male patients with learning disabilities who have newly diagnosed generalised tonic-clonic epilepsy,...

    Incorrect

    • For male patients with learning disabilities who have newly diagnosed generalised tonic-clonic epilepsy, NICE recommends which of the following as the first-line treatment?

      Your Answer:

      Correct Answer: Sodium valproate

      Explanation:

      If the question had been about a female patient with learning difficulties, the pharmacological management of epilepsy may need to be adjusted based on factors such as hormonal changes and potential interactions with birth control medication.

      Epilepsy: An Overview

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

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

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

    • This question is part of the following fields:

      • Classification And Assessment
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  • Question 14 - In what type of epilepsy is it most common to experience an aura?...

    Incorrect

    • In what type of epilepsy is it most common to experience an aura?

      Your Answer:

      Correct Answer: Complex partial

      Explanation:

      This question is presented in two variations on the exam, with one implying that auras are primarily linked to temporal lobe epilepsy and the other to complex partial seizures. In reality, partial seizures are most commonly associated with auras compared to other types of seizures. While partial seizures can originate in any lobe of the brain, those that arise in the temporal lobe are most likely to produce an aura. Therefore, both versions of the question are accurate.

      Epilepsy and Aura

      An aura is a subjective sensation that is a type of simple partial seizure. It typically lasts only a few seconds and can help identify the site of cortical onset. There are eight recognized types of auras, including somatosensory, visual, auditory, gustatory, olfactory, autonomic, abdominal, and psychic.

      In about 80% of cases, auras precede temporal lobe seizures. The most common auras in these seizures are abdominal and psychic, which can cause a rising epigastric sensation of feelings of fear, déjà vu, of jamais vu. Parietal lobe seizures may begin with a contralateral sensation, usually of the positive type, such as an electrical sensation of tingling. Occipital lobe seizures may begin with contralateral visual changes, such as colored lines, spots, of shapes, of even a loss of vision. Temporal-parietal-occipital seizures may produce more formed auras.

      Complex partial seizures are defined by impairment of consciousness, which means decreased responsiveness and awareness of oneself and surroundings. During a complex partial seizure, a patient is unresponsive and does not remember events that occurred.

    • This question is part of the following fields:

      • Neurosciences
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  • Question 15 - A 62-year-old male with a prolonged history of alcohol abuse arrives at the...

    Incorrect

    • A 62-year-old male with a prolonged history of alcohol abuse arrives at the Emergency department displaying evident disorientation, a lateral gaze palsy, and lack of coordination. His blood alcohol concentration measures at 68 mg per 100 mls blood, while his electrolytes, complete blood count, and liver function tests appear normal. What is the most probable diagnosis?

      Your Answer:

      Correct Answer: Wernicke's encephalopathy

      Explanation:

      If a patient presents with confusion, eye signs (ophthalmoplegia of nystagmus), and an ataxic gait, Wernicke’s encephalopathy should be suspected. This serious, but reversible, condition is most commonly caused by alcohol dependence and is due to a lack of Vitamin B1 (thiamine). Acute alcohol intoxication is unlikely as the patient’s blood alcohol level is below the legal limit for driving. Amnesic syndrome is not the correct diagnosis as it is characterized by impairment of new learning without obvious confusion. Normal pressure hydrocephalus is characterized by urinary incontinence, gait disturbance, and cognitive decline. Subdural hematoma is not a likely diagnosis as there is no history of head injury.

    • This question is part of the following fields:

      • Diagnosis
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  • Question 16 - Which gene is mutated to cause the CGG repeats observed in fragile X...

    Incorrect

    • Which gene is mutated to cause the CGG repeats observed in fragile X syndrome?

      Your Answer:

      Correct Answer: FMR1

      Explanation:

      Fragile X is caused by a mutation in FMR1 that leads to the presence of CGG trinucleotide repeats. The remaining genes mentioned are associated with dementia.

      Fragile X Syndrome: A Genetic Disorder Causing Learning Disability and Psychiatric Symptoms

      Fragile X Syndrome is a genetic disorder that causes mental retardation, an elongated face, large protruding ears, and large testicles in men. Individuals with this syndrome tend to be shy, avoid eye contact, and have difficulties reading facial expressions. They also display stereotypic movements such as hand flapping. Fragile X Syndrome is the most common inherited cause of learning disability.

      The speech of affected individuals is often abnormal, with abnormalities of fluency. This disorder is caused by the amplification of a CGG repeat in the 5 untranslated region of the fragile X mental retardation 1 gene (FMR1). These CGG repeats disrupt synthesis of the fragile X protein (FMRP), which is essential for brain function and growth. The gene is located at Xq27. The greater number of repeats, the more severe the condition, as with other trinucleotide repeat disorders.

      The fragile X phenotype typically involves a variety of psychiatric symptoms, including features of autism, attention deficit/hyperactivity disorder, anxiety, and aggression. Both males and females can be affected, but males are more severely affected because they have only one X chromosome. The prevalence estimate of Fragile X Syndrome is 1/3600-4000.

    • This question is part of the following fields:

      • Genetics
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  • Question 17 - Which one of these bases is not classified as a pyrimidine? ...

    Incorrect

    • Which one of these bases is not classified as a pyrimidine?

      Your Answer:

      Correct Answer: Adenine

      Explanation:

      Nucleotides: The Building Blocks of DNA and RNA

      Nucleotides are the fundamental units of DNA (deoxyribonucleic acid) and RNA (ribonucleic acid). Each nucleotide consists of three components: a sugar molecule (deoxyribose in DNA and ribose in RNA), a phosphate group, and a nitrogenous base. The nitrogenous bases can be classified into two categories: purines and pyrimidines. The purine bases include adenine and guanine, while the pyrimidine bases are cytosine, thymine (in DNA), and uracil (in RNA).

      The arrangement of nucleotides in DNA and RNA determines the genetic information that is passed from one generation to the next. The sequence of nitrogenous bases in DNA forms the genetic code that determines the traits of an organism. RNA, on the other hand, plays a crucial role in protein synthesis by carrying the genetic information from DNA to the ribosomes, where proteins are synthesized.

      Understanding the structure and function of nucleotides is essential for understanding the molecular basis of life. The discovery of the structure of DNA and the role of nucleotides in genetic information has revolutionized the field of biology and has led to many breakthroughs in medicine, biotechnology, and genetics.

    • This question is part of the following fields:

      • Genetics
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  • Question 18 - A psychology graduate student is interested in studying the psychosocial factors related to...

    Incorrect

    • A psychology graduate student is interested in studying the psychosocial factors related to alcohol misuse. They decide to use the health belief model as a framework for their research. One of the constructs of the health belief model pertains to the severity of the illness and its outcomes. How can this construct be applied to the study of alcohol abuse?

      Your Answer:

      Correct Answer: Perceived severity

      Explanation:

      The health belief model is a social cognition model that aims to predict and understand health-related behaviors. It consists of four main constructs: perceived susceptibility, perceived severity, perceived benefits, and perceived barriers. Perceived severity refers to an individual’s understanding of the seriousness of a disease. Perceived susceptibility, also known as perceived vulnerability, refers to an individual’s perception of their risk of contracting the disease if they continue with their current behavior. Perceived benefits refer to an individual’s perception of the advantages of adopting a different course of action, including the extent to which it reduces the risk of the disease of its severity. Perceived barriers refer to an individual’s perception of the disadvantages of adopting the recommended action, as well as any obstacles that may hinder its successful implementation.

    • This question is part of the following fields:

      • Advanced Psychological Processes And Treatments
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  • Question 19 - Which terms are most commonly associated with Goffman? ...

    Incorrect

    • Which terms are most commonly associated with Goffman?

      Your Answer:

      Correct Answer: Total Institutions

      Explanation:

      D.W. Winnicott – Good enough mother, transitional object: Winnicott believed that a good enough mother is one who provides a secure and nurturing environment for her child, allowing them to develop a sense of self and independence. He also introduced the concept of the transitional object, such as a teddy bear of blanket, which helps a child transition from the mother’s care to the outside world.

      Carl Jung – Collective unconscious, archetype, anima, animus: Jung believed in the existence of a collective unconscious, a shared pool of knowledge and experience that all humans possess. He also introduced the concept of archetypes, universal symbols and patterns that are present in the collective unconscious. The anima and animus are archetypes representing the feminine and masculine aspects of the psyche.

      Melanie Klein – Paranoid-schizoid position, depressive position, splitting: Klein introduced the concept of the paranoid-schizoid position, a stage of development in which a child experiences intense anxiety and fear of persecution. She also introduced the depressive position, a stage in which the child learns to integrate positive and negative feelings towards others. Splitting is the defense mechanism in which a person sees things as either all good of all bad.

      Sigmund Freud – Free association, transference, ego, super-ego, id, eros, thanatos, defense mechanisms, oedipus Complex, the unconscious: Freud is known for his theories on the unconscious mind, including the id, ego, and super-ego. He also introduced the concepts of eros (the life instinct) and thanatos (the death instinct), as well as defense mechanisms such as repression and denial. The Oedipus complex is a theory about a child’s sexual desire for their opposite-sex parent.

      Wilfred Bion – Basic assumption group: Bion introduced the concept of the basic assumption group, a group that forms around a shared fantasy of assumption. He believed that these groups can be helpful of harmful, depending on the assumptions they are based on.

      Karen Horney – Womb envy: Horney believed that men experience womb envy, a feeling of inferiority and jealousy towards women due to their inability to bear children. She also introduced the concept of neurotic needs, such as the need for affection and the need for power.

      Erving Goffman – Total institution: Goffman introduced the concept of the total institution, a place where people are completely cut off from the outside world and subjected to strict rules and regulations. Examples include prisons and mental hospitals.

      Siegfried Foulkes – Foundation matrix: Foulkes introduced the concept of the foundation matrix, a group’s shared history and experiences that shape their current dynamics and interactions.

    • This question is part of the following fields:

      • Social Psychology
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  • Question 20 - What is the accurate statement about renowned psychologists and their associated theories? ...

    Incorrect

    • What is the accurate statement about renowned psychologists and their associated theories?

      Your Answer:

      Correct Answer: Margaret Mahler is associated with separation-individuation

      Explanation:

      Historical Figures in Psychology

      Melanie Klein is known for developing play therapy, which involves interpreting the symbolic meaning of a child’s actions during play and relating them to their feelings towards their parents. Margaret Mahler, on the other hand, focused on the development of the ego within the context of object relationships. She emphasized how interpersonal relationships become internalized within the self, rather than the gratification of instincts of biological needs. Mahler coined the term separation-individuation to describe the process by which internal maps of the self and others are formed during the first three years of life.

      Transactional analysis, developed by Dr. Eric Berne in the 1960s, is based on the idea that we have three parts to our personality (child, adult, and parent) and that these converse with one another in transactions. Finally, Jean-Martin Charcot and Pierre Janet are both associated with hysteria, with Charcot being known for his work with hypnosis.

    • This question is part of the following fields:

      • History Of Psychiatry
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  • Question 21 - Which CNS histopathological characteristic is the most distinctive for prion diseases? ...

    Incorrect

    • Which CNS histopathological characteristic is the most distinctive for prion diseases?

      Your Answer:

      Correct Answer: Spongiform (vacuolation) change

      Explanation:

      The presence of spongiform (vacuolation) change is a highly specific indicator of prion diseases. While neuronal loss and gliosis are common in many CNS disorders, spongiform change is unique to prion diseases. This change is characterized by the appearance of vacuoles in the deep cortical layers, cerebellar cortex, of subcortical grey matter. Scar formation and acute immune responses are associated with reactive proliferation of astrocytes and microglia, respectively. In contrast, Alzheimer’s dementia is characterized by the presence of amyloid plaques.

    • This question is part of the following fields:

      • Neurosciences
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  • Question 22 - What is the term used to describe the automatic obedience observed in catatonia?...

    Incorrect

    • What is the term used to describe the automatic obedience observed in catatonia?

      Your Answer:

      Correct Answer: Mitgehen

      Explanation:

      Mitmachen and Mitgehen are two types of reflexive compliance. Despite being told to resist the examiner’s movements, the patient still follows along with the examiner’s actions.

      – 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 23 - A 25-year-old woman walking home late at night notices someone beckoning to her...

    Incorrect

    • A 25-year-old woman walking home late at night notices someone beckoning to her from a distance in the darkness. As she approaches, she realizes it's just a tree branch swaying in the wind. What is this occurrence called?

      Your Answer:

      Correct Answer: Affect illusion

      Explanation:

      Affect illusions occur when a person’s mood affects their perception of everyday objects, leading to misinterpretation. These illusions are temporary and can be dispelled with increased attention. Completion illusions occur when the brain fills in incomplete perceptions with extrapolation from previous experiences to create meaning. An example is reading misprints in newspapers as if they were written correctly. Reflex hallucinations occur when a stimulus in one modality produces a hallucination in another modality. Pareidolic illusions involve a mixture of sensory perceptions and imagination, such as seeing faces in clouds.

    • This question is part of the following fields:

      • Descriptive Psychopathology
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  • Question 24 - What is the mechanism believed to be responsible for the therapeutic effect of...

    Incorrect

    • What is the mechanism believed to be responsible for the therapeutic effect of buspirone?

      Your Answer:

      Correct Answer: 5HT1A partial agonism

      Explanation:

      Mechanisms of Action of Different Drugs

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

    • This question is part of the following fields:

      • Psychopharmacology
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  • Question 25 - What is the primary component of alpha-synuclein? ...

    Incorrect

    • What is the primary component of alpha-synuclein?

      Your Answer:

      Correct Answer: Lewy bodies

      Explanation:

      Lewy body dementia is a neurodegenerative disorder that is characterized by both macroscopic and microscopic changes in the brain. Macroscopically, there is cerebral atrophy, but it is less marked than in Alzheimer’s disease, and the brain weight is usually in the normal range. There is also pallor of the substantia nigra and the locus coeruleus, which are regions of the brain that produce dopamine and norepinephrine, respectively.

      Microscopically, Lewy body dementia is characterized by the presence of intracellular protein accumulations called Lewy bodies. The major component of a Lewy body is alpha synuclein, and as they grow, they start to draw in other proteins such as ubiquitin. Lewy bodies are also found in Alzheimer’s disease, but they tend to be in the amygdala. They can also be found in healthy individuals, although it has been suggested that these may be pre-clinical cases of dementia with Lewy bodies. Lewy bodies are also found in other neurodegenerative disorders such as progressive supranuclear palsy, corticobasal degeneration, and multiple system atrophy.

      In Lewy body dementia, Lewy bodies are mainly found within the brainstem, but they are also found in non-brainstem regions such as the amygdaloid nucleus, parahippocampal gyrus, cingulate cortex, and cerebral neocortex. Classic brainstem Lewy bodies are spherical intraneuronal cytoplasmic inclusions, characterized by hyaline eosinophilic cores, concentric lamellar bands, narrow pale halos, and immunoreactivity for alpha synuclein and ubiquitin. In contrast, cortical Lewy bodies typically lack a halo.

      Most brains with Lewy body dementia also show some plaques and tangles, although in most instances, the lesions are not nearly as severe as in Alzheimer’s disease. Neuronal loss and gliosis are usually restricted to brainstem regions, particularly the substantia nigra and locus ceruleus.

    • This question is part of the following fields:

      • Neurosciences
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  • Question 26 - What is the closest estimate of heritability in schizophrenia? ...

    Incorrect

    • What is the closest estimate of heritability in schizophrenia?

      Your Answer:

      Correct Answer: 55%

      Explanation:

      Heritability: Understanding the Concept

      Heritability is a concept that is often misunderstood. It is not a measure of the extent to which genes cause a condition in an individual. Rather, it is the proportion of phenotypic variance attributable to genetic variance. In other words, it tells us how much of the variation in a condition seen in a population is due to genetic factors. Heritability is calculated using statistical techniques and can range from 0.0 to 1.0. For human behavior, most estimates of heritability fall in the moderate range of .30 to .60.

      The quantity (1.0 – heritability) gives the environment ability of the trait. This is the proportion of phenotypic variance attributable to environmental variance. The following table provides estimates of heritability for major conditions:

      Condition Heritability estimate (approx)
      ADHD 85%
      Autism 70%
      Schizophrenia 55%
      Bipolar 55%
      Anorexia 35%
      Alcohol dependence 35%
      Major depression 30%
      OCD 25%

      It is important to note that heritability tells us nothing about individuals. It is a population-level measure that helps us understand the relative contributions of genetic and environmental factors to a particular condition.

    • This question is part of the following fields:

      • Genetics
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  • Question 27 - A 42-year-old man presents with a potassium reading of 3.1 mmol/L. As there...

    Incorrect

    • A 42-year-old man presents with a potassium reading of 3.1 mmol/L. As there is no apparent cause, you schedule an appointment to conduct a thorough assessment. During the history-taking, you discover that he experiences strong cravings to consume large amounts of food and frequently engages in binge eating. He then takes laxatives but denies inducing vomiting. These episodes occur approximately three times per week, and his body mass index is 19.5 kg/m2. What is the most probable diagnosis?

      Your Answer:

      Correct Answer: Bulimia nervosa

      Explanation:

      Diagnosis of Bulimia Nervosa

      Bulimia nervosa is the likely diagnosis for the patient, given her recurrent binges and use of laxatives to compensate for them. The DSM-IV criteria for bulimia nervosa require that these features occur more than twice weekly for three months. Weight loss is not a diagnostic requirement. In both anorexia nervosa and bulimia nervosa, self-worth is judged largely of exclusively in terms of shape and weight, and obtaining a reliable dietary history from the patient is unlikely. A key feature of bulimia nervosa is a feeling of loss of control during binge eating episodes.

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      Bulimia nervosa is the likely diagnosis for the patient, given her recurrent binges and use of laxatives to compensate for them. The DSM-IV criteria for bulimia nervosa require that these features occur more than twice weekly for three months. Weight loss is not a diagnostic requirement.

      In both anorexia nervosa and bulimia nervosa, self-worth is judged largely of exclusively in terms of shape and weight, and obtaining a reliable dietary history from the patient is unlikely.

      A key feature of bulimia nervosa is a feeling of loss of control during binge eating episodes.

    • This question is part of the following fields:

      • Diagnosis
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  • Question 28 - What is the cause of Balint's syndrome? ...

    Incorrect

    • What is the cause of Balint's syndrome?

      Your Answer:

      Correct Answer: Bilateral parieto-occipital lobe dysfunction

      Explanation:

      Parietal Lobe Dysfunction: Types and Symptoms

      The parietal lobe is a part of the brain that plays a crucial role in processing sensory information and integrating it with other cognitive functions. Dysfunction in this area can lead to various symptoms, depending on the location and extent of the damage.

      Dominant parietal lobe dysfunction, often caused by a stroke, can result in Gerstmann’s syndrome, which includes finger agnosia, dyscalculia, dysgraphia, and right-left disorientation. Non-dominant parietal lobe dysfunction, on the other hand, can cause anosognosia, dressing apraxia, spatial neglect, and constructional apraxia.

      Bilateral damage to the parieto-occipital lobes, a rare condition, can lead to Balint’s syndrome, which is characterized by oculomotor apraxia, optic ataxia, and simultanagnosia. These symptoms can affect a person’s ability to shift gaze, interact with objects, and perceive multiple objects at once.

      In summary, parietal lobe dysfunction can manifest in various ways, and understanding the specific symptoms can help diagnose and treat the underlying condition.

    • This question is part of the following fields:

      • Neurosciences
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  • Question 29 - What is the term used to describe an intense and brief emotional reaction...

    Incorrect

    • What is the term used to describe an intense and brief emotional reaction to a minor trigger?

      Your Answer:

      Correct Answer: Emotional lability

      Explanation:

      Understanding Emotional Lability

      Emotional lability is a condition characterized by an excessive and brief emotional response to a minor stimulus. It is a common symptom of various neurological and psychiatric disorders, including traumatic brain injury, multiple sclerosis, Parkinson’s disease, bipolar disorder, and borderline personality disorder. People with emotional lability may experience sudden and intense mood swings, such as crying, laughing, anger, of irritability, that are out of proportion to the situation.

      One of the most challenging aspects of emotional lability is the lack of control over one’s emotions. Pathological crying of laughing is a common manifestation of emotional lability, where a person may burst into tears of laughter without any apparent reason of context. This can be embarrassing, distressing, and socially isolating, as it may be perceived as a sign of weakness, instability, of immaturity.

      Treatment for emotional lability depends on the underlying cause and severity of the symptoms. In some cases, medication, such as antidepressants, antipsychotics, of mood stabilizers, may be prescribed to regulate the mood and reduce the frequency and intensity of emotional outbursts. Psychotherapy, such as cognitive-behavioral therapy of dialectical behavior therapy, can also help individuals with emotional lability to develop coping skills, emotional regulation strategies, and interpersonal communication skills.

      It is important to note that emotional lability is not a character flaw of a personal weakness, but a medical condition that requires proper diagnosis and treatment. Seeking professional help from a qualified healthcare provider can help individuals with emotional lability to improve their quality of life, enhance their relationships, and regain their emotional stability and resilience.

    • This question is part of the following fields:

      • Classification And Assessment
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  • Question 30 - Which statement accurately describes the SF-36? ...

    Incorrect

    • Which statement accurately describes the SF-36?

      Your Answer:

      Correct Answer: It is a self-administered questionnaire

      Explanation:

      SF-36: A Patient-Reported Survey for Measuring Functioning and Well-Being

      The SF-36, also known as the Short-form 36, is a survey consisting of 36 items that patients can complete to rate their functioning and well-being. The survey is designed to measure eight different scales, with four pertaining to physical health and four to mental health. The physical health scales include physical functioning, role limitations due to physical health problems, bodily pain, and general health. The mental health scales include vitality (energy/fatigue), social functioning, role limitations due to emotional problems, and mental health (psychological distress and psychological well-being). Patients can complete the survey on their own, and it typically takes around eight minutes to finish.

    • This question is part of the following fields:

      • Classification And Assessment
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SESSION STATS - PERFORMANCE PER SPECIALTY

Psychopharmacology (0/2) 0%
Classification And Assessment (1/1) 100%
Genetics (0/1) 0%
Social Psychology (0/1) 0%
Passmed