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Question 1
Incorrect
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At what age does stranger anxiety usually develop?
Your Answer: 12 months
Correct Answer: 8 months
Explanation:Attachment Theory and Harlow’s Monkeys
Attachment theory, developed by John Bowlby, suggests that children have an innate tendency to form relationships with people around them to increase their chance of survival. This attachment is different from bonding, which concerns the mother’s feelings for her infant. Children typically single out a primary caregiver, referred to as the principle attachment figure, from about 1-3 months. The quality of a person’s early attachments is associated with their adult behavior, with poor attachments leading to withdrawn individuals who struggle to form relationships and good attachments leading to socially competent adults who can form healthy relationships.
Bowlby’s attachment model has four stages: preattachment, attachment in the making, clear-cut attachment, and formation of reciprocal attachment. The time from 6 months to 36 months is known as the critical period, during which a child is most vulnerable to interruptions in its attachment. Attachments are divided into secure and insecure types, with insecure types further divided into avoidant and ambivalent types.
Harlow’s experiment with young rhesus monkeys demonstrated the importance of the need for closeness over food. The experiment involved giving the monkeys a choice between two different mothers, one made of soft terry cloth but provided no food and the other made of wire but provided food from an attached baby bottle. The baby monkeys spent significantly more time with their cloth mother than with their wire mother, showing the importance of attachment and closeness in early development.
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This question is part of the following fields:
- Psychological Development
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Question 2
Correct
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Which of the following pairs of instincts proposed by Freud are correct?
Your Answer: Thanatos and eros
Explanation:Theories of aggression can be categorized into three main perspectives: psychodynamic, sociological/drive, and cognitive and learning. Psychodynamic theory, proposed by Freud, suggests that aggression arises from a primary instinct called thanatos, which aims for destruction and death. Sociobiological/drive theory, proposed by Lorenz, suggests that aggression is instinctual and necessary for survival, and that stronger genes are selected through aggression. Cognitive and learning theory, proposed by Berkowitz, Rotter, Bandura, and Anderson, suggests that aggression can be learned through observational learning and is influenced by environmental factors. Bandura’s work introduced the concept of reciprocal determinism, which suggests that behavior is influenced by both the environment and the individual’s behavior. Rotter’s social learning theory emphasizes the interaction between the individual and their environment, while Anderson and Bushman’s general aggression model considers the role of social, cognitive, developmental, and biological factors on aggression.
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This question is part of the following fields:
- Social Psychology
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Question 3
Correct
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What is the meaning of the term autochthonous delusion?
Your Answer: A primary delusion
Explanation:Borderline Learning Disability
Borderline learning disability is a term used to describe individuals with an IQ between 70-85. This category is not officially recognized as a diagnosis by the ICD-11. It is estimated that approximately 15% of the population falls within this range (Chaplin, 2005). Unlike mild learning disability, borderline learning disability is not typically associated with deficits in adaptive functioning, such as grooming, dressing, safety, of money management.
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This question is part of the following fields:
- Classification And Assessment
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Question 4
Correct
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What is the typical artery that is blocked in cases of Alexia without agraphia?
Your Answer: Posterior cerebral artery
Explanation:Aphasia is a language impairment that affects the production of comprehension of speech, as well as the ability to read of write. The areas involved in language are situated around the Sylvian fissure, referred to as the ‘perisylvian language area’. For repetition, the primary auditory cortex, Wernicke, Broca via the Arcuate fasciculus (AF), Broca recodes into articulatory plan, primary motor cortex, and pyramidal system to cranial nerves are involved. For oral reading, the visual cortex to Wernicke and the same processes as for repetition follows. For writing, Wernicke via AF to premotor cortex for arm and hand, movement planned, sent to motor cortex. The classification of aphasia is complex and imprecise, with the Boston Group classification and Luria’s aphasia interpretation being the most influential. The important subtypes of aphasia include global aphasia, Broca’s aphasia, Wernicke’s aphasia, conduction aphasia, anomic aphasia, transcortical motor aphasia, and transcortical sensory aphasia. Additional syndromes include alexia without agraphia, alexia with agraphia, and pure word deafness.
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This question is part of the following fields:
- Neurosciences
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Question 5
Incorrect
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What is considered a 'neurological soft sign' in children?
Your Answer: Positive Stroop test
Correct Answer: Impaired fist-edge-palm test
Explanation:Subtle impairments of motor or sensory function that are not specific to a particular neurological condition and are referred to as neurological ‘soft’ signs. These signs are prevalent in individuals with schizophrenia and may serve as a potential endophenotype.
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This question is part of the following fields:
- Description And Measurement
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Question 6
Correct
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What structure has been found to exhibit excessive activity in individuals with depression?
Your Answer: Amygdala
Explanation:Neuroimaging and Depression
Research on depression using neuroimaging has revealed several important findings. One such finding is that the volume of the amygdala decreases with an increasing number of depressive episodes. Additionally, studies using positron emission tomography (PET) have shown that individuals with depression have elevated baseline amygdala activity that is positively correlated with the severity of their depression. Furthermore, depressed individuals exhibit greater amygdala reactivity to negative emotional stimuli compared to healthy controls.
Another area of interest is the subgenual anterior cingulate cortex (ACC), where increased levels of activity have been observed in depressed individuals. Several studies have also reported decreased volume in the subgenual ACC associated with depression. Finally, researchers have found that depressed individuals exhibit less reactivity in the dorsolateral prefrontal cortex (DLPFC) to affective stimuli compared to healthy controls.
In summary, neuroimaging research suggests that the amygdala and subgenual ACC are overactive in depression, while the DLPFC is underactive. These findings provide important insights into the neural mechanisms underlying depression and may inform the development of more effective treatments.
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This question is part of the following fields:
- Neurosciences
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Question 7
Correct
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What condition has been linked to a more affluent social status?
Your Answer: Anorexia nervosa
Explanation:Social Status and Psychiatric Disorders
Research has shown that certain psychiatric disorders are more prevalent in lower social classes. These disorders include schizophrenia, personality disorder, alcohol dependence, and major depression. On the other hand, anorexia nervosa has been found to be more common in higher social classes. These findings suggest a relationship between social status and mental health, with individuals from lower social classes being at a higher risk for certain psychiatric disorders. This information can be useful in developing targeted interventions and support for individuals from lower social classes who may be struggling with mental health issues.
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This question is part of the following fields:
- Social Psychology
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Question 8
Correct
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What is an example of an atypical antipsychotic medication?
Your Answer: Clozapine
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.
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This question is part of the following fields:
- Psychopharmacology
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Question 9
Incorrect
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You are seeing a 35-year-old male in your office. He has been referred by his primary care physician due to symptoms of increased appetite, weight gain, excessive sleepiness, feeling physically heavy, and sensitivity to rejection. He asks you about the most effective treatments for his condition. What would be the best response to his question?
Your Answer: Imipramine
Correct Answer: Phenelzine
Explanation:The question pertains to a classic case of atypical depression, which is best treated with phenelzine, a MAOI. While imipramine and other TCAs have some evidence for treating atypical depression, they are not as effective as MAOIs. Nowadays, SSRIs are commonly used as a first-line treatment, but they have a weaker evidence base compared to MAOIs and TCAs. Vortioxetine is a new antidepressant that has complex effects on the 5HT system, but it has not been studied for its efficacy in treating atypical depression. Similarly, venlafaxine has not been studied for this indication either.
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This question is part of the following fields:
- Psychopharmacology
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Question 10
Incorrect
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What is a personality disorder that falls under the cluster C category?
Your Answer: Histrionic
Correct Answer: Dependent
Explanation:Personality Disorder Classification
A personality disorder is a persistent pattern of behavior and inner experience that deviates significantly from cultural expectations, is inflexible and pervasive, and causes distress of impairment. The DSM-5 and ICD-11 have different approaches to classifying personality disorders. DSM-5 divides them into 10 categories, grouped into clusters A, B, and C, while ICD-11 has a general category with six trait domains that can be added. To diagnose a personality disorder, the general diagnostic threshold must be met before determining the subtype(s) present. The criteria for diagnosis include inflexibility and pervasiveness of the pattern, onset in adolescence of early adulthood, stability over time, and significant distress of impairment. The disturbance must not be better explained by another mental disorder, substance misuse, of medical condition.
Course
Borderline and antisocial personality disorders tend to become less evident of remit with age, while others, particularly obsessive-compulsive and schizotypal, may persist.
Classification
The DSM-5 divides personality disorders into separate clusters A, B, and C, with additional groups for medical conditions and unspecified disorders. The ICD-11 dropped the separate categories and instead lists six trait domains that can be added to the general diagnosis.
UK Epidemiology
The prevalence of personality disorders in Great Britain, according to the British National Survey of Psychiatric Morbidity, is 4.4%, with cluster C being the most common at 2.6%, followed by cluster A at 1.6% and cluster B at 1.2%. The most prevalent specific personality disorder is obsessive-compulsive (anankastic) at 1.9%.
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This question is part of the following fields:
- Classification And Assessment
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Question 11
Incorrect
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What type of apraxia is indicated when a patient is given a pencil during a neurological examination and they attempt to use it to brush their teeth after looking at it for a minute?
Your Answer: Ideational
Correct Answer: Ideomotor
Explanation:The inability to carry out complex instructions is referred to as Ideational Apraxia, while the inability to perform previously learned actions with the appropriate tools is known as Ideomotor Apraxia.
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.
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This question is part of the following fields:
- Neurosciences
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Question 12
Correct
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A child with a learning disability is observed to have prominent ears and a stretched-out face. They seem extremely timid and exhibit minimal eye contact. What trinucleotide repeats do you anticipate?
Your Answer: CGG
Explanation:Fragile X is a genetic syndrome that results in mental retardation, an elongated face, large protruding ears, and enlarged testicles (in males). Individuals with this syndrome tend to be shy, have difficulty making eye contact, and struggle with reading facial expressions. They may also exhibit stereotypic movements such as hand flapping. The cause of fragile X is a mutation in the FMR1 gene, which is crucial for neural development and functioning. This gene is located at Xq27, and in individuals with fragile X, there are excessive trinucleotide repeats (CGG) at this gene. Similar to other trinucleotide repeat disorders (such as Huntington’s, myotonic dystrophy, Friedreich’s ataxia, and spinocerebellar ataxia), the severity of the condition increases with the number of repeats.
Trinucleotide Repeat Disorders: Understanding the Genetic Basis
Trinucleotide repeat disorders are genetic conditions that arise due to the abnormal presence of an expanded sequence of trinucleotide repeats. These disorders are characterized by the phenomenon of anticipation, which refers to the amplification of the number of repeats over successive generations. This leads to an earlier onset and often a more severe form of the disease.
The table below lists the trinucleotide repeat disorders and the specific repeat sequences involved in each condition:
Condition Repeat Sequence Involved
Fragile X Syndrome CGG
Myotonic Dystrophy CTG
Huntington’s Disease CAG
Friedreich’s Ataxia GAA
Spinocerebellar Ataxia CAGThe mutations responsible for trinucleotide repeat disorders are referred to as ‘dynamic’ mutations. This is because the number of repeats can change over time, leading to a range of clinical presentations. Understanding the genetic basis of these disorders is crucial for accurate diagnosis, genetic counseling, and the development of effective treatments.
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This question is part of the following fields:
- Genetics
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Question 13
Incorrect
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Which movement disorder is most likely to exhibit rhythmic movements?
Your Answer: Myoclonus
Correct Answer: Tremor
Explanation:Movement Disorders: Key Features
Movement disorders refer to a range of conditions that affect voluntary muscle movements. These disorders can be caused by various factors, including neurological conditions, medication side effects, and metabolic imbalances. The following table outlines some of the key features of common movement disorders:
Akinesia: Absence of loss of control of voluntary muscle movements, often seen in severe Parkinson’s disease.
Bradykinesia: Slowness of voluntary movement, a core symptom of Parkinson’s disease.
Akathisia: Subjective feeling of inner restlessness, often caused by antipsychotic medication use.
Athetosis: Continuous stream of slow, flowing, writhing involuntary movements, often seen in cerebral palsy, stroke, and Huntington’s disease.
Chorea: Brief, quasi-purposeful, irregular contractions that appear to flow from one muscle to the next, often seen in Huntington’s disease and Wilson’s disease.
Dystonia: Involuntary sustained of intermittent muscle contractions that cause twisting and repetitive movements, abnormal postures, of both.
Dyskinesia: General term referring to problems with voluntary movements and the presence of involuntary movements, often drug-induced.
Myoclonus: A sequence of repeated, often non-rhythmic, brief shock-like jerks due to sudden involuntary contraction of relaxation of one of more muscles.
Parkinsonism: Syndrome characterized by tremor, rigidity, and bradykinesia.
Tic: Sudden, repetitive, non-rhythmic, stereotyped motor movement of vocalization involving discrete muscle groups, often seen in Tourette’s syndrome.
Tremor: Involuntary, rhythmic, alternating movement of one of more body parts, often seen in essential tremor, Parkinson’s disease, and alcohol withdrawal.
Hemiballismus: Repetitive, but constantly varying, large amplitude involuntary movements of the proximal parts of the limbs, often seen in stroke and traumatic brain injury.
Stereotypies: Repetitive, simple movements that can be voluntarily suppressed, often seen in autism and intellectual disability.
It is important to consider the underlying conditions and factors that may contribute to movement disorders in order to properly diagnose and treat these conditions.
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This question is part of the following fields:
- Classification And Assessment
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Question 14
Correct
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A 50-year-old male patient is admitted to your inpatient ward after intentionally overdosing on his newly prescribed interferon medication for a neurological condition. During your physical assessment, you shine a penlight into his right eye and observe both pupils constricting. However, shining the light into his left eye does not elicit a response.
Which cranial nerve may be affected by this observation?Your Answer: II
Explanation:The pupils are innervated by both sides of the midbrain and respond to ambient light levels. If there is an optic nerve lesion, the non-damaged nerve becomes dominant and both pupils respond to ambient light from that nerve. A helpful mnemonic for remembering the cranial nerves and their functions is OOOTTAFVGVAH for the nerves and SSMMBMBSBBMM for their functions. To recall the innervation of the extraocular muscles, one can use SO4 LR6. The optic nerve is II, oculomotor is III and supplies all extraocular muscles except for the superior oblique and lateral rectus, trochlear is IV and innervates the superior oblique muscle for depression and intorsion, trigeminal is V and supplies sensory information and muscles of mastication, and abducens is VI and controls the lateral rectus muscle of the eye.
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This question is part of the following fields:
- Neurological Examination
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Question 15
Correct
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What is the number of centromeres present in a cell containing 20 chromatids?
Your Answer: 10
Explanation:Cytokinesis: The Final Stage of Cell Division
Cytokinesis is the final stage of cell division, where the cell splits into two daughter cells, each with a nucleus. This process is essential for the growth and repair of tissues in multicellular organisms. In mitosis, cytokinesis occurs after telophase, while in meiosis, it occurs after telophase I and telophase II.
During cytokinesis, a contractile ring made of actin and myosin filaments forms around the cell’s equator, constricting it like a belt. This ring gradually tightens, pulling the cell membrane inward and creating a furrow that deepens until it reaches the center of the cell. Eventually, the furrow meets in the middle, dividing the cell into two daughter cells.
In animal cells, cytokinesis is achieved by the formation of a cleavage furrow, while in plant cells, a cell plate forms between the two daughter nuclei, which eventually develops into a new cell wall. The timing and mechanism of cytokinesis are tightly regulated by a complex network of proteins and signaling pathways, ensuring that each daughter cell receives the correct amount of cytoplasm and organelles.
Overall, cytokinesis is a crucial step in the cell cycle, ensuring that genetic material is equally distributed between daughter cells and allowing for the growth and development of multicellular organisms.
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This question is part of the following fields:
- Genetics
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Question 16
Correct
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What is the function of the Nissl substance within a neuron?
Your Answer: Protein synthesis
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.
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This question is part of the following fields:
- Neurosciences
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Question 17
Incorrect
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What is the most frequent adverse effect of atomoxetine?
Your Answer: Hyperhidrosis
Correct Answer: Abdominal pain
Explanation:ADHD medications can be classified into stimulant and non-stimulant drugs. The therapeutic effects of these drugs are believed to be mediated through the action of noradrenaline in the prefrontal cortex. Common side effects of these drugs include decreased appetite, insomnia, nervousness, headache, and nausea. Stimulant drugs like dexamphetamine, methylphenidate, and lisdexamfetamine inhibit the reuptake of dopamine and noradrenaline. Non-stimulant drugs like atomoxetine, guanfacine, and clonidine work by increasing noradrenaline levels in the synaptic cleft through different mechanisms. The most common side effects of these drugs are decreased appetite, somnolence, headache, and abdominal pain.
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This question is part of the following fields:
- Psychopharmacology
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Question 18
Incorrect
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Which of the following is not a category tested using the MMSE?
Your Answer:
Correct Answer: Verbal fluency
Explanation:The MMSE does not evaluate verbal fluency as it is a measure of the frontal lobe function, which is assessed through the ACE-R.
Mini Mental State Exam (MMSE)
The Mini Mental State Exam (MMSE) was developed in 1975 by Folstein et al. Its original purpose was to differentiate between organic and functional disorders, but it is now mainly used to detect and track the progression of cognitive impairment. The exam is scored out of 30 and is divided into seven categories: orientation to place and time, registration, attention and concentration, recall, language, visual construction, and attention to written command. Each category has a possible score, and the total score can indicate the severity of cognitive impairment. A score equal to or greater than 27 indicates normal cognition, while scores below this can indicate severe, moderate, of mild cognitive impairment. The MMSE is a useful tool for detecting and tracking cognitive impairment.
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This question is part of the following fields:
- Classification And Assessment
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Question 19
Incorrect
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What is the synonym for consequentialism?
Your Answer:
Correct Answer: Teleology
Explanation:Teleology, derived from the Greek words for goal and theory, is a moral philosophy that emphasizes the outcomes of actions as the initial consideration in evaluating ethical behavior. This category of theories is also known as consequentialism, as it focuses on the consequences of an action as the basis for determining its morality. Consequentialism evaluates the morality of an action based on the balance of its positive and negative outcomes. Utilitarianism of social consequentialism is the most prevalent form of consequentialism, although it is not the only one.
Ethical theory and principles are important in medical ethics. There are three key ethical theories that have dominated medical ethics: utilitarianism, deontological, and virtue-based. Utilitarianism is based on the greatest good for the greatest number and is a consequentialist theory. Deontological ethics emphasize moral duties and rules, rather than consequences. Virtue ethics is based on the ethical characteristics of a person and is associated with the concept of a good, happy, flourishing life.
More recent frameworks have attempted to reconcile different theories and values. The ‘four principles’ of ‘principlism’ approach, developed in the United States, is based on four common, basic prima facie moral commitments: autonomy, beneficence, non-maleficence, and justice. Autonomy refers to a patient’s right to make their own decisions, beneficence refers to the expectation that a doctor will act in a way that will be helpful to the patient, non-maleficence refers to the fact that doctors should avoid harming their patients, and justice refers to the expectation that all people should be treated fairly and equally.
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This question is part of the following fields:
- Social Psychology
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Question 20
Incorrect
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Which substance follows zero order kinetics during metabolism?
Your Answer:
Correct Answer: Phenytoin
Explanation:The half-life of a drug is the time taken for its concentration to fall to one half of its value. Drugs with long half-lives may require a loading dose to achieve therapeutic plasma concentrations rapidly. It takes about 4.5 half-lives to reach steady state plasma levels. Most drugs follow first order kinetics, where a constant fraction of the drug in the body is eliminated per unit time. However, some drugs may follow zero order kinetics, where the plasma concentration of the drug decreases at a constant rate, despite the concentration of the drug. For drugs with nonlinear kinetics of dose-dependent kinetics, the relationship between the AUC of CSS and dose is not linear, and the kinetic parameters may vary depending on the administered dose.
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This question is part of the following fields:
- Psychopharmacology
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Question 21
Incorrect
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Identify the option that represents a secondary amine.
Your Answer:
Correct Answer: Protriptyline
Explanation:Tricyclic Antidepressants: Uses, Types, and Side-Effects
Tricyclic antidepressants (TCAs) are a type of medication used for depression and neuropathic pain. However, due to their side-effects and toxicity in overdose, they are not commonly used for depression anymore. TCAs can be divided into two types: first generation (tertiary amines) and second generation (secondary amines). The secondary amines have a lower side effect profile and act primarily on noradrenaline, while the tertiary amines boost serotonin and noradrenaline.
Some examples of secondary amines include desipramine, nortriptyline, protriptyline, and amoxapine. Examples of tertiary amines include amitriptyline, lofepramine, imipramine, clomipramine, dosulepin (dothiepin), doxepin, trimipramine, and butriptyline. Common side-effects of TCAs include drowsiness, dry mouth, blurred vision, constipation, and urinary retention.
Low-dose amitriptyline is commonly used for neuropathic pain and prophylaxis of headache. Lofepramine has a lower incidence of toxicity in overdose. However, amitriptyline and dosulepin (dothiepin) are considered the most dangerous in overdose. It is important to consult with a healthcare provider before taking any medication and to follow their instructions carefully.
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This question is part of the following fields:
- Psychopharmacology
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Question 22
Incorrect
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What substance is classified as a butyrylcholinesterase inhibitor?
Your Answer:
Correct Answer: Rivastigmine
Explanation:Semorinemab is a potential treatment for dementia that works by targeting the N-terminal region of the tau protein. By binding to tau, it aims to reduce its spread within neurons and slow down the progression of the disease.
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.
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This question is part of the following fields:
- Psychopharmacology
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Question 23
Incorrect
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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).
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This question is part of the following fields:
- Neurosciences
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Question 24
Incorrect
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What is a true statement about the working memory?
Your Answer:
Correct Answer: The central executive enables the performance of verbal and visual tasks concurrently
Explanation:The working memory is overseen by the central executive, which manages all its functions. Although the exact location of the central executive is not fully comprehended, it is believed to involve various regions of the brain.
Memory Forms
Memory is the ability to store, retain, and retrieve information. There are different forms of memory, including sensory memory, short-term/working memory, and long-term memory.
Sensory memory is the capacity for briefly retaining the large amounts of information that people encounter daily. It includes echoic memory (gathered through auditory stimuli), iconic memory (gathered through sight), and haptic memory (acquired through touch).
Short-term memory is the ability to keep a small amount of information available for a short period of time. Atkinson and Shiffrin’s multistore model (1968) suggests the existence of a short-term storehouse with limited capacity. Baddeley and Hitch (1974) further developed the concept of short-term memory, which eventually became known as Baddeley’s multi-storehouse model (2000). This model includes the central executive, visuospatial sketchpad, phonological buffer/loop, and episodic buffer.
Long-term memory includes declarative (of explicit) memories, which can be consciously retrieved, and nondeclarative (of implicit) memories, which cannot. Declarative memory includes episodic memory (stores personal experiences) and semantic memory (stores information about facts and concepts). Non-declarative memory includes procedural memory (recalls motor and executive skills), associative memory (storage and retrieval of information through association with other information), and non-associative memory (refers to newly learned behavior through repeated exposure to an isolated stimulus).
Overall, memory is a complex and essential cognitive function that plays a crucial role in learning, reasoning, and understanding.
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This question is part of the following fields:
- Social Psychology
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Question 25
Incorrect
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What is a true statement about dystonia?
Your Answer:
Correct Answer: It can occur on withdrawal of an antipsychotic
Explanation:Maudsley Guidelines: Dystonia
Dystonia is a type of adverse reaction that can occur in patients taking typical antipsychotics. It is characterized by symptoms such as torticollis and oculogyric spasm. About 10% of patients who are exposed to these medications may develop acute dystonia. This reaction is more likely to occur in the early stages of treatment of after a dose increase. Additionally, it can also happen when the patient stops taking the drug. Therefore, it is important to monitor patients closely for signs of dystonia and adjust the medication as needed.
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This question is part of the following fields:
- Psychopharmacology
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Question 26
Incorrect
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Question 27
Incorrect
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A 45-year-old woman who is on methadone treatment for opioid addiction needs to take antipsychotic medication for a new episode of psychosis. She has had a positive response to haloperidol in the past. What is the most crucial test to monitor potential side effects of this medication combination?
Your Answer:
Correct Answer: ECG
Explanation:When using methadone and haloperidol together, it is important to closely monitor the QTc interval due to their significant effect on it. EEG and electrolyte screening are not necessary. While liver function tests may be useful to perform periodically, they are not the primary concern with this combination. It is important to be cautious of respiratory depression when using high doses of methadone in combination with other sedative medications, but respiratory function tests are unlikely to provide helpful information.
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This question is part of the following fields:
- Psychopharmacology
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Question 28
Incorrect
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Which options are typically not utilized for managing extrapyramidal side-effects?
Your Answer:
Correct Answer: Dopamine agonists
Explanation:EPSE’s result from the blocking of dopaminergic D2 receptors, so theoretically, dopamine agonists could alleviate them. However, they are not typically prescribed because they could worsen the underlying psychotic condition. Amantadine is an exception, as it is believed to work by stimulating dopamine receptors. It should be noted, however, that amantadine has complex effects and may exacerbate psychotic symptoms in certain patients.
Extrapyramidal side-effects (EPSE’s) are a group of side effects that affect voluntary motor control, commonly seen in patients taking antipsychotic drugs. EPSE’s include dystonias, parkinsonism, akathisia, and tardive dyskinesia. They can be frightening and uncomfortable, leading to problems with non-compliance and can even be life-threatening in the case of laryngeal dystonia. EPSE’s are thought to be due to antagonism of dopaminergic D2 receptors in the basal ganglia. Symptoms generally occur within the first few days of treatment, with dystonias appearing quickly, within a few hours of administration of the first dose. Newer antipsychotics tend to produce less EPSE’s, with clozapine carrying the lowest risk and haloperidol carrying the highest risk. Akathisia is the most resistant EPSE to treat. EPSE’s can also occur when antipsychotics are discontinued (withdrawal dystonia).
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This question is part of the following fields:
- Psychopharmacology
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Question 29
Incorrect
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Who is credited with developing the Separation-Individuation theory of child development?
Your Answer:
Correct Answer: Mahler
Explanation:Mahler’s Separation-Individuation theory of child development proposes that personality development occurs in distinct stages. The first stage, the Autistic phase, occurs during the first few weeks of life, where the child is mostly sleeping and cut off from the world. The second stage, the Symbiotic phase, lasts until around six months of age, where the child sees themselves and their mother as a single unit. The third stage, Separation-Individuation, has four subphases. The first subphase, Differentiation, occurs between six to ten months, where the child begins to see themselves as an individual and experiences separation anxiety. The second subphase, Practicing, occurs between ten to sixteen months, where the child explores connections with the external world and people other than the mother. The third subphase, Rapprochement, occurs between sixteen to twenty-four months, where the child struggles to balance their desire for independence and proximity to the mother, often resulting in tantrums and the use of transitional objects. The fourth subphase, Object constancy, occurs between twenty-four to thirty-six months, where the child accepts the idea of object constancy and is more comfortable with the mother being separate for periods of time.
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This question is part of the following fields:
- Psychological Development
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Question 30
Incorrect
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What is a true statement about attachment?
Your Answer:
Correct Answer: Separation anxiety tends to occur after stranger anxiety
Explanation:The critical period for development of attachment and social skills is between 6 and 36 months of age. During this time, infants and toddlers are particularly sensitive to their caregivers’ responses and interactions, which can shape their emotional and social development. This period is crucial for establishing secure attachments and developing social skills that will influence their relationships throughout their lives.
Attachment Theory and Harlow’s Monkeys
Attachment theory, developed by John Bowlby, suggests that children have an innate tendency to form relationships with people around them to increase their chance of survival. This attachment is different from bonding, which concerns the mother’s feelings for her infant. Children typically single out a primary caregiver, referred to as the principle attachment figure, from about 1-3 months. The quality of a person’s early attachments is associated with their adult behavior, with poor attachments leading to withdrawn individuals who struggle to form relationships and good attachments leading to socially competent adults who can form healthy relationships.
Bowlby’s attachment model has four stages: preattachment, attachment in the making, clear-cut attachment, and formation of reciprocal attachment. The time from 6 months to 36 months is known as the critical period, during which a child is most vulnerable to interruptions in its attachment. Attachments are divided into secure and insecure types, with insecure types further divided into avoidant and ambivalent types.
Harlow’s experiment with young rhesus monkeys demonstrated the importance of the need for closeness over food. The experiment involved giving the monkeys a choice between two different mothers, one made of soft terry cloth but provided no food and the other made of wire but provided food from an attached baby bottle. The baby monkeys spent significantly more time with their cloth mother than with their wire mother, showing the importance of attachment and closeness in early development.
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This question is part of the following fields:
- Psychological Development
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