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  • Question 1 - What antihistamine medication is prescribed to treat extrapyramidal side effects? ...

    Incorrect

    • What antihistamine medication is prescribed to treat extrapyramidal side effects?

      Your Answer: Cetirizine

      Correct Answer: Diphenhydramine

      Explanation:

      Diphenhydramine is a type of antihistamine that belongs to the first generation. It is commonly used to alleviate extrapyramidal side effects (EPSE). Unlike second generation antihistamines, first generation antihistamines have anticholinergic properties and can penetrate the blood-brain barrier, resulting in sedative effects. The anticholinergic effects of first generation antihistamines are beneficial for treating EPSE, which is believed to be caused by excessive acetylcholine due to reduced dopamine activity. Dopamine normally inhibits acetylcholine, but when dopamine activity is reduced, acetylcholine levels increase, leading to EPSE.

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

    • This question is part of the following fields:

      • Psychopharmacology
      9.6
      Seconds
  • Question 2 - What should be avoided for a patient who has a high level of...

    Incorrect

    • What should be avoided for a patient who has a high level of concern about gaining weight?

      Your Answer: Fluoxetine

      Correct Answer: Mirtazapine

      Explanation:

      Non-compliance is often caused by weight gain.

      Antidepressants and Weight Gain

      Studies suggest that certain types of antidepressants, such as tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs), may be more likely to cause weight gain than newer antidepressants like selective serotonin reuptake inhibitors (SSRIs). However, mirtazapine, a newer antidepressant, may have a similar risk for weight gain as TCAs. Among SSRIs, paroxetine may have a higher risk for weight gain during long-term treatment compared to other SSRIs. On the other hand, bupropion and nefazodone may have a lower risk for weight gain than SSRIs in the long term.

    • This question is part of the following fields:

      • Psychopharmacology
      12.2
      Seconds
  • Question 3 - Which statement below best describes Cotard's syndrome? ...

    Correct

    • Which statement below best describes Cotard's syndrome?

      Your Answer: Occurs mostly in elderly age group

      Explanation:

      Cotard’s syndrome is a disorder characterized by sudden onset of nihilistic delusions, including beliefs of poverty, negation, and meaninglessness. Hypochondriacal delusions and feelings of guilt may also be present. This condition is more prevalent in elderly individuals and females, and is often associated with depression and organic illnesses.

    • This question is part of the following fields:

      • Diagnosis
      14.4
      Seconds
  • Question 4 - Who is responsible for introducing the concept of 'Filter Theory' in the context...

    Incorrect

    • Who is responsible for introducing the concept of 'Filter Theory' in the context of selective attention?

      Your Answer: Deutsch and Deutsch

      Correct Answer: Broadbent

      Explanation:

      Selective attention involves filtering external stimuli and assigning meaning to things that should get our attention. Three main models have been proposed: Broadbent’s Filter model, Treisman’s Attenuation Theory, and Deutsch and Deutsch’s Late stage model. Broadbent’s model is an early selection model that filters input based on physical characteristics, while Treisman’s model is an intermediate selection model that uses a leaky filter to weaken some stimuli but allow them through. Deutsch and Deutsch’s model is a late selection model that analyzes input for meaning before filtering occurs. Treisman’s model includes a dictionary unit that emphasizes certain words have lower thresholds for getting our attention, such as our own name.

    • This question is part of the following fields:

      • Social Psychology
      5.3
      Seconds
  • Question 5 - Who is credited with creating the term 'manic depression'? ...

    Correct

    • Who is credited with creating the term 'manic depression'?

      Your Answer: Kraepelin

      Explanation:

      History of Psychiatric Terms

      In the exams, it is important to be familiar with the individuals associated with certain psychiatric terms. For example, Kraepelin is associated with dementia praecox and manic depression, while Bleuler is associated with schizophrenia. Other terms and their associated individuals include Hebephrenia (Hecker), Catatonia (Kahlbaum), Schizoaffective (Kasanin), Neurasthenia (Beard), Unipolar and bipolar (Kleist), Hypnosis (Braid), Group dynamics (Lewin), Group psychotherapy (Moreno), Psychopathic inferiority (Koch), Psychiatry (Reil), and Institutional Neurosis (Barton).

      It should be noted that there is some debate over the origins of certain terms. While Kraepelin is often credited with coining the term dementia praecox, some sources suggest that it was first used in its Latin form by Arnold Pick in 1891. The original term demence precoce was first used by Morel in 1852. Despite this, the College appears to favor the Kraepelin attribution.

    • This question is part of the following fields:

      • Social Psychology
      6.7
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  • Question 6 - What is the definition of volitional passivity? ...

    Incorrect

    • What is the definition of volitional passivity?

      Your Answer: The patient is aware of an alien presence inserting thoughts into his mind

      Correct Answer: The patient is aware of someone controlling his actions as though he were a robot

      Explanation:

      All of the options describe passivity phenomena, which are first rank symptoms. Passivity of volition involves feeling like one’s actions are controlled by someone else. Passivity of impulse is experiencing an urge that originates outside oneself. Thought insertion is the awareness of an alien presence inserting thoughts into one’s mind, which may be accompanied by visceral hallucinations. Somatic passivity is the feeling that someone is controlling things inside one’s body. Passivity of affect involves feeling emotions that originate outside oneself, which is different from incongruity of blunting of affect.

    • This question is part of the following fields:

      • Descriptive Psychopathology
      11.4
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  • Question 7 - When does babbling typically appear during the process of language acquisition? ...

    Correct

    • When does babbling typically appear during the process of language acquisition?

      Your Answer: 6-12 months

      Explanation:

      Linguistic Development and Risk Factors for Delayed Speech and Language

      The development of language skills is an important aspect of a child’s growth. The prelinguistic period, from birth to 12 months, is marked by crying, babbling, and echolalia. From 6 to 12 months, a child responds to their name and can differentiate between angry and friendly tones. By 18 to 24 months, a child can use up to 40-50 words, mainly nouns, and starts to combine words in short phrases. By 36 to 48 months, a child has a vocabulary of 900-1000 words, can use plurals and past tense, and can handle three-word sentences easily.

      However, there are risk factors associated with delayed speech and language development. These include a positive family history, male gender, twins, lower maternal education, childhood illness, being born late in the family order, young mother at birth, and low socioeconomic status. of these, a positive family history is considered the most reliable risk factor. It is important to monitor a child’s language development and seek professional help if there are concerns about delayed speech and language.

    • This question is part of the following fields:

      • Psychological Development
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      Seconds
  • Question 8 - During which stages of Tanner development do females experience their growth spurt in...

    Incorrect

    • During which stages of Tanner development do females experience their growth spurt in puberty?

      Your Answer: 1–2

      Correct Answer: 2-Mar

      Explanation:

      Puberty

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

    • This question is part of the following fields:

      • Psychological Development
      6.1
      Seconds
  • Question 9 - Acamprosate is believed to produce its positive effects in the treatment of alcohol...

    Incorrect

    • Acamprosate is believed to produce its positive effects in the treatment of alcohol dependence by targeting which type of receptors?

      Your Answer: GABA-B

      Correct Answer: Metabotropic glutamate receptors

      Explanation:

      The exact way in which acamprosate helps maintain alcohol abstinence is not fully understood. However, it is believed that chronic alcohol exposure disrupts the balance between neuronal excitation and inhibition. Studies conducted on animals suggest that acamprosate may interact with the glutamate and GABA neurotransmitter systems in the brain, which may help restore this balance. Acamprosate is thought to inhibit glutamate receptors while activating GABA receptors, specifically GABA-A and metabotropic glutamate receptors. It should be noted that some sources suggest that acamprosate affects NMDA receptors, which are a type of ionotropic glutamate receptor. However, this is not entirely accurate and may not be reflected in exam questions.

      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 10 - A boy who is secretly struggling with their sexuality puts on a show...

    Incorrect

    • A boy who is secretly struggling with their sexuality puts on a show of being interested in the opposite sex and constantly talks about their crushes on girls to their peers. What defense mechanism are they exhibiting?

      Your Answer: Displacement

      Correct Answer: Reaction formation

      Explanation:

      Intermediate Mechanism: Rationalisation

      Rationalisation is a defense mechanism commonly used by individuals to create false but credible justifications for their behavior of actions. It involves the use of logical reasoning to explain away of justify unacceptable behavior of feelings. The individual may not be aware that they are using this mechanism, and it can be difficult to identify in oneself.

      Rationalisation is considered an intermediate mechanism, as it is common in healthy individuals from ages three to ninety, as well as in neurotic disorders and in mastering acute adult stress. It can be dramatically changed by conventional psychotherapeutic interpretation.

      Examples of rationalisation include a student who fails an exam and blames the teacher for not teaching the material well enough, of a person who cheats on their partner and justifies it by saying their partner was neglectful of unaffectionate. It allows the individual to avoid taking responsibility for their actions and to maintain a positive self-image.

      Overall, rationalisation can be a useful defense mechanism in certain situations, but it can also be harmful if it leads to a lack of accountability and an inability to learn from mistakes.

    • This question is part of the following fields:

      • Classification And Assessment
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  • Question 11 - Out of the options provided, which one is the least probable cause of...

    Incorrect

    • Out of the options provided, which one is the least probable cause of delirium?

      Your Answer: Doxepin

      Correct Answer: Lansoprazole

      Explanation:

      Prescribing in the Elderly: Iatrogenic Consequences

      Many medications, both prescribed and over-the-counter, can have significant adverse effects in the elderly population. It is important to note that the lists provided below are not exhaustive, and only the most common and important examples are given.

      Medications Linked to Delirium and Other Cognitive Disorders

      Medications are the most common reversible cause of delirium and dementia in the elderly. Many medications can cause cognitive impairment, but the classes of drugs most strongly associated with the development of drug-induced dementia are opioids, benzodiazepines, and anticholinergics.

      According to a systematic review done in 2011 (Clegg, 2011), long-acting benzodiazepines (e.g., diazepam) are more troublesome than those that are shorter-acting. Opioids are associated with an approximately 2-fold increased risk of delirium in medical and surgical patients (Clegg, 2011). Pethidine appears to have a higher risk of delirium compared with other members of the opioid class. This may be because pethidine can accumulate when renal function is impaired and is converted to a metabolite with anticholinergic properties.

      Some antipsychotic drugs have considerable antimuscarinic (anticholinergic) activity (e.g., chlorpromazine and clozapine), which may cause of worsen delirium. Delirium is uncommon in newer antipsychotics (but has been reported).

      Medications Linked to Mood Changes

      The following medications are well known to precipitate mood changes:

      – Centrally-acting antihypertensives (e.g., methyldopa, reserpine, and clonidine) can cause depressive symptoms.
      – Interferon-a is capable of inducing depressive symptoms.
      – Digoxin is capable of inducing depressive symptoms.
      – Corticosteroids can cause depressive, manic, and mixed symptoms with of without psychosis.
      – Antidepressants can precipitate mania.

      Medications Linked to Psychosis

      The following medications are well known to precipitate psychosis:

      – Anti-Parkinson’s Medications (e.g., bromocriptine, amantadine, selegiline, anticholinergics (e.g., trihexyphenidyl, benztropine, benzhexol), and levodopa).
      – Corticosteroids

      Medications Linked to Anxiety

      The following medications are well known to precipitate anxiety:

      – Stimulants
      – β adrenergic inhalers

    • This question is part of the following fields:

      • Psychopharmacology
      13.1
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  • Question 12 - A teacher in a school district instructs a young student to cheat on...

    Correct

    • A teacher in a school district instructs a young student to cheat on a test to maintain high grades. The student initially resists but eventually complies when the teacher threatens to give them a failing grade. What type of power has the teacher exerted in this situation?

      Your Answer: Coercive

      Explanation:

      Power Theory

      French and Raven (1959) developed the 5 base theory of power, which identifies five types of power. These include legitimate power, which is held by an individual in an organization, referent power, which is held by a person with charisma who people gravitate towards, expert power, which is held by a person with specialist skills of knowledge, reward power, which is held by a person in a position to provide rewards, and coercive power, which is held by a person who has the ability to apply negative influences such as demotion. Other terms to be aware of include outcome power, which is the power of a person to bring about outcomes, social power, which is the power of a person to influence others so that they will bring about outcomes, and counterpower, which is the power of the oppressed to counterbalance the elite.

    • This question is part of the following fields:

      • Social Psychology
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  • Question 13 - A 65-year-old patient with a history of treatment-resistant schizophrenia has been stabilized on...

    Correct

    • A 65-year-old patient with a history of treatment-resistant schizophrenia has been stabilized on clozapine, but is experiencing clinical deterioration with a serum clozapine level below 1000 µg/L. What medication should be added if the patient's clozapine serum levels remain above this value?

      Your Answer: Sodium valproate

      Explanation:

      If serum clozapine levels remain elevated, it is recommended to add anticonvulsant cover due to the increased risk of seizures and EEG changes. While some clinicians may advocate for higher clozapine levels, there is limited evidence to support this practice. Amisulpride can be used to augment clozapine, but it is not necessary in this situation. Beta-blockers are used to treat persistent tachycardia caused by clozapine, while hyoscine hydrobromide is used to manage clozapine-associated hypersalivation. Loperamide is unlikely to be needed as clozapine is known to cause constipation.

    • This question is part of the following fields:

      • Psychopharmacology
      26.4
      Seconds
  • Question 14 - The Maudsley Guidelines recommend certain approaches for managing akathisia. ...

    Correct

    • The Maudsley Guidelines recommend certain approaches for managing akathisia.

      Your Answer: Propranolol

      Explanation:

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

    • This question is part of the following fields:

      • Psychopharmacology
      4.5
      Seconds
  • Question 15 - Which antipsychotic is most commonly associated with contact sensitization? ...

    Correct

    • Which antipsychotic is most commonly associated with contact sensitization?

      Your Answer: Chlorpromazine

      Explanation:

      Direct contact with chlorpromazine should be avoided by pharmacists and nurses due to its association with contact dermatitis.

    • This question is part of the following fields:

      • Psychopharmacology
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  • Question 16 - What is another term for a set of alleles on a chromosome that...

    Correct

    • What is another term for a set of alleles on a chromosome that typically passes down together as a unit in a family tree?

      Your Answer: Haplotype

      Explanation:

      Recombination Fraction: A Measure of Distance Between Loci

      When two loci are located on different chromosomes, they segregate independently during meiosis. However, if they are on the same chromosome, they tend to segregate together, unless crossing over occurs. Crossing over is a process in meiosis where two homologous chromosomes exchange genetic material, resulting in the shuffling of alleles. The likelihood of crossing over between two loci on a chromosome decreases as their distance from each other increases.

      Hence, blocks of alleles on a chromosome tend to be transmitted together through generations, forming a haplotype. The recombination fraction is a measure of the distance between two loci on a chromosome. The closer the loci are, the lower the recombination fraction, and the more likely they are to be transmitted together. Conversely, the further apart the loci are, the higher the recombination fraction, and the more likely they are to be separated by crossing over. The recombination fraction can range from 0% if the loci are very close to 50% if they are on different chromosomes.

    • This question is part of the following fields:

      • Genetics
      6.9
      Seconds
  • Question 17 - The study involves 341 individuals diagnosed with major depressive episode according to DSM-IV...

    Incorrect

    • The study involves 341 individuals diagnosed with major depressive episode according to DSM-IV criteria. They are randomly assigned to receive either CBT of psychodynamic psychotherapy, with each treatment consisting of 16 sessions following a manualized protocol over a period of 22 weeks. The participants are initially followed up for 22 weeks and then re-evaluated after one year. What are the probable results of the study?

      Your Answer: CBT demonstrates superiority at 22 weeks but psychodynamic therapy is superior at one year follow up

      Correct Answer: Neither therapy demonstrates superiority at any point in the trial

      Explanation:

      Recent clinical trials have shown that various psychotherapy approaches do not differ significantly in terms of effectiveness. This particular trial aimed to prove that psychodynamic psychotherapy was not inferior to other modalities at 22 weeks and one year follow-up. While non-inferiority was observed at 22 weeks, it could not be conclusively demonstrated at one year, despite no significant difference between interventions. Interestingly, individuals who received CBT appeared to require more additional treatment during the year following therapy, although this trend was not statistically significant.

    • This question is part of the following fields:

      • Advanced Psychological Processes And Treatments
      50.2
      Seconds
  • Question 18 - What aspect of memory is typically impacted in individuals experiencing difficulties with procedural...

    Correct

    • What aspect of memory is typically impacted in individuals experiencing difficulties with procedural memory?

      Your Answer: Cerebellum

      Explanation:

      Memory Forms

      Memory is the ability to store, retain, and retrieve information. There are different forms of memory, including sensory memory, short-term/working memory, and long-term memory.

      Sensory memory is the capacity for briefly retaining the large amounts of information that people encounter daily. It includes echoic memory (gathered through auditory stimuli), iconic memory (gathered through sight), and haptic memory (acquired through touch).

      Short-term memory is the ability to keep a small amount of information available for a short period of time. Atkinson and Shiffrin’s multistore model (1968) suggests the existence of a short-term storehouse with limited capacity. Baddeley and Hitch (1974) further developed the concept of short-term memory, which eventually became known as Baddeley’s multi-storehouse model (2000). This model includes the central executive, visuospatial sketchpad, phonological buffer/loop, and episodic buffer.

      Long-term memory includes declarative (of explicit) memories, which can be consciously retrieved, and nondeclarative (of implicit) memories, which cannot. Declarative memory includes episodic memory (stores personal experiences) and semantic memory (stores information about facts and concepts). Non-declarative memory includes procedural memory (recalls motor and executive skills), associative memory (storage and retrieval of information through association with other information), and non-associative memory (refers to newly learned behavior through repeated exposure to an isolated stimulus).

      Overall, memory is a complex and essential cognitive function that plays a crucial role in learning, reasoning, and understanding.

    • This question is part of the following fields:

      • Social Psychology
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  • Question 19 - A 35-year-old individual presents with symptoms consistent with social anxiety disorder. To further...

    Correct

    • A 35-year-old individual presents with symptoms consistent with social anxiety disorder. To further assess their condition, you inquire about their seating preference when dining out.

      Which of the following responses would best support your suspicion?

      Your Answer: In a quiet corner

      Explanation:

      Individuals with social phobia experience anxiety and apprehension regarding the possibility of receiving unfavorable attention from others, leading them to avoid eating in public.

    • This question is part of the following fields:

      • Diagnosis
      52.9
      Seconds
  • Question 20 - A child complains that people's heads seem to appear larger than they should...

    Correct

    • A child complains that people's heads seem to appear larger than they should in relation to their bodies.

      Which of the following best describes their experience?

      Your Answer: Dysmegalopsia

      Explanation:

      Dysmegalopsia: Difficulty in Perceiving Object Size

      Dysmegalopsia is a condition characterized by a reduced ability to accurately perceive the size of objects. This can manifest as either micropsia, where objects appear smaller than they actually are, of macropsia, where objects appear larger than they actually are. Dysmegalopsia can occur as a standalone symptom of as part of a group of symptoms known as the Alice in Wonderland Syndrome. In this syndrome, individuals may experience distortions in their perception of size, shape, and distance, as well as other sensory disturbances. Dysmegalopsia can be caused by various factors, including neurological conditions, migraines, and the use of certain medications.

    • This question is part of the following fields:

      • Classification And Assessment
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  • Question 21 - Which of the following does the statement I saw a man shut his...

    Incorrect

    • Which of the following does the statement I saw a man shut his car door today and instantly knew this was a sign that I had to kill the queen exemplify?

      Your Answer: Referential delusion

      Correct Answer: Delusional perception

      Explanation:

      Types of Delusions

      Delusions come in many different forms. It is important to familiarize oneself with these types as they may be tested in an exam. Some of the most common types of delusions include:

      – Folie a deux: a shared delusion between two or more people
      – Grandiose: belief that one has special powers, beliefs, of purpose
      – Hypochondriacal: belief that something is physically wrong with the patient
      – Ekbom’s syndrome: belief that one has been infested with insects
      – Othello syndrome: belief that a sexual partner is cheating on them
      – Capgras delusion: belief that a person close to them has been replaced by a double
      – Fregoli delusion: patient identifies a familiar person (usually suspected to be a persecutor) in other people they meet
      – Syndrome of subjective doubles: belief that doubles of him/her exist
      – Lycanthropy: belief that one has been transformed into an animal
      – De Clérambault’s syndrome: false belief that a person is in love with them
      – Cotard’s syndrome/nihilistic delusions: belief that they are dead of do not exist
      – Referential: belief that others/TV/radio are speaking directly to of about the patient
      – Delusional perception: belief that a normal percept (product of perception) has a special meaning
      – Pseudocyesis: a condition whereby a woman believes herself to be pregnant when she is not. Objective signs accompany the belief such as abdominal enlargement, menstrual disturbance, apparent foetal movements, nausea, breast changes, and labour pains.

      Remembering these types of delusions can be helpful in understanding and diagnosing patients with delusional disorders.

    • This question is part of the following fields:

      • Classification And Assessment
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  • Question 22 - 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: Mirtazapine

      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 23 - Which terms are most commonly associated with Goffman? ...

    Correct

    • Which terms are most commonly associated with Goffman?

      Your 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 24 - A 55-year-old man complains of frequent nighttime urination. He has been taking lithium...

    Incorrect

    • A 55-year-old man complains of frequent nighttime urination. He has been taking lithium for his bipolar disorder for more than two decades without any notable adverse effects.
      His eGFR is 34 mL/min, and his serum creatinine level is slightly above the normal range.
      What is the most probable diagnosis?

      Your Answer: Syndrome of inappropriate ADH secretion

      Correct Answer: Nephrogenic diabetes insipidus

      Explanation:

      Water intoxication can cause polyuria and dilutional hyponatremia, but it does not typically lead to renal impairment. It is important to differentiate this condition from nephrogenic diabetes insipidus, which can develop in a significant percentage of patients on long-term lithium therapy and may present with nocturia as an early sign. While elevated calcium levels may occur in some patients on lithium, hyperparathyroidism is not a common clinical symptom. Tubulointerstitial nephritis is a rare complication of lithium therapy. The syndrome of inappropriate ADH secretion is not typically associated with polyuria of renal impairment and is not commonly linked to lithium therapy.

    • This question is part of the following fields:

      • Psychopharmacology
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  • Question 25 - How can the rights of patients be defined as an international statement? ...

    Incorrect

    • How can the rights of patients be defined as an international statement?

      Your Answer: Declaration of Helsinki

      Correct Answer: Declaration of Lisbon

      Explanation:

      Declarations

      The World Medical Association has established global ethical standards through various declarations. These include:

      Declaration of Geneva: This declaration was created as a revision of the Hippocratic Oath after the atrocities committed in Nazi Germany.

      Declaration of Helsinki: This statement outlines ethical principles for medical research involving human subjects.

      Declaration of Tokyo: This declaration states that doctors should not participate in, condone, of allow torture, degradation, of cruel treatment of prisoners of detainees.

      Declaration of Malta: This declaration provides guidance to doctors treating individuals on hunger strike.

      Declaration of Lisbon: This international statement outlines the rights of patients.

      Declaration of Ottawa: This declaration sets out the principles necessary for optimal child health.

      Each of these declarations serves as a guide for medical professionals to uphold ethical standards in their practice.

    • This question is part of the following fields:

      • Social Psychology
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  • Question 26 - What is the accurate statement about the structural model of the mind? ...

    Incorrect

    • What is the accurate statement about the structural model of the mind?

      Your Answer: The ego is completely conscious

      Correct Answer: The superego contains the ego ideal

      Explanation:

      The superego encompasses the ‘ego ideal’, which embodies exemplary attitudes and conduct. One can liken the Superego to a moral compass of conscience.

      Freud’s Structural Theory: Understanding the Three Areas of the Mind

      According to Freud’s structural model, the human mind is divided into three distinct areas: the Id, the Ego, and the Superego. The Id is the part of the mind that contains instinctive drives and operates on the ‘pleasure principle’. It functions without a sense of time and is governed by ‘primary process thinking’. The Ego, on the other hand, attempts to modify the drives from the Id with external reality. It operates on the ‘reality principle’ and has conscious, preconscious, and unconscious aspects. It is also home to the defense mechanisms. Finally, the Superego acts as a critical agency, constantly observing a person’s behavior. Freud believed that it developed from the internalized values of a child’s main caregivers. The Superego contains the ‘ego ideal’, which represents ideal attitudes and behavior. It is often referred to as the conscience. Understanding these three areas of the mind is crucial to understanding Freud’s structural theory.

    • This question is part of the following fields:

      • Social Psychology
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  • Question 27 - What is a true statement about thiamine? ...

    Incorrect

    • What is a true statement about thiamine?

      Your Answer: Deficiency results in bleeding gums

      Correct Answer: It is required for carbohydrate catabolism

      Explanation:

      A lack of vitamin C is commonly linked to gum inflammation and bleeding.

      Thiamine Deficiency and Alcohol-Related Brain Disease

      Thiamine deficiency is a well-known cause of a neurological disorder called Wernicke-Korsakoff syndrome (WKS) in individuals with alcohol use disorder. Thiamine, also known as vitamin B1, is an essential nutrient that cannot be produced by the body and must be obtained through the diet. Thiamine is required for the proper functioning of enzymes involved in the metabolism of carbohydrates, the synthesis of neurotransmitters, nucleic acids, fatty acids, and complex sugar molecules, and the body’s defense against oxidative stress.

      Three enzymes that require thiamine as a cofactor are transketolase, pyruvate dehydrogenase (PDH), and alpha ketoglutarate dehydrogenase (KGDH), all of which participate in the breakdown of carbohydrates. Thiamine deficiency leads to suboptimal levels of functional enzymes in the cell, which can cause cell damage in the central nervous system through cell necrosis, cellular apoptosis, and oxidative stress.

      Alcoholism can contribute to thiamine deficiency through inadequate nutritional intake, decreased absorption of thiamine from the gastrointestinal tract, and impaired utilization of thiamine in the cells. Giving thiamine to patients with WKS can reverse many of the acute symptoms of the disease, highlighting the importance of this nutrient in the prevention and treatment of alcohol-related brain disease.

    • This question is part of the following fields:

      • Psychopharmacology
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  • Question 28 - What is the estimated percentage of Caucasians who have the homozygous isoform of...

    Correct

    • What is the estimated percentage of Caucasians who have the homozygous isoform of alcohol dehydrogenase ADH1B*1?

      Your Answer: 85-95%

      Explanation:

      This question is challenging as it requires an estimation of the percentage of Caucasians who possess two copies of the gene responsible for the slow-acting form of alcohol dehydrogenase.

      Genetics and Alcoholism

      Alcoholism tends to run in families, and several studies confirm that biological children of alcoholics are more likely to develop alcoholism even when adopted by parents without the condition. Monozygotic twins have a greater concordance rate for alcoholism than dizygotic twins. Heritability estimates range from 45 to 65 percent for both men and women. While genetic differences affect risk, there is no “gene for alcoholism,” and both environmental and social factors weigh heavily on the outcome.

      The genes with the clearest contribution to the risk for alcoholism and alcohol consumption are alcohol dehydrogenase 1B (ADH1B) and aldehyde dehydrogenase 2 (ALDH2). The first step in ethanol metabolism is oxidation to acetaldehyde, by ADHs. The second step is metabolism of the acetaldehyde to acetate by ALDHs. Individuals carrying even a single copy of the ALDH2*504K display the “Asian flushing reaction” when they consume even small amounts of alcohol. There is one significant genetic polymorphism of the ALDH2 gene, resulting in allelic variants ALDH2*1 and ALDH2*2, which is virtually inactive. ALDH2*2 is present in about 50 percent of the Taiwanese, Han Chinese, and Japanese populations. It is extremely rare outside Asia. Nearly no individuals of European of African descent carry this allele. ALDH2*504K has repeatedly been demonstrated to have a protective effect against alcohol use disorders.

      The three different class I gene loci, ADH1A (alpha), ADH1B (beta), and ADH1C (gamma) are situated close to each other in the region 4q2123. The alleles ADH1C*1 and ADH1B*2 code for fast metabolism of alcohol. The ADH1B*1 slow allele is very common among Caucasians, with approximately 95 percent having the homozygous ADH1B*1/1 genotype and 5 percent having the heterozygous ADH1B*1/2 genotype. The ADH1B*2 allele is the most common allele in Asian populations. In African populations, the ADH1B*1 allele is the most common.

    • This question is part of the following fields:

      • Genetics
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  • Question 29 - What is the minimum number of half-lives needed to achieve steady state plasma...

    Incorrect

    • What is the minimum number of half-lives needed to achieve steady state plasma concentrations of a drug without a loading dose?

      Your Answer: 3

      Correct Answer: 4.5

      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.

    • This question is part of the following fields:

      • Psychopharmacology
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  • Question 30 - Which component is not considered a key element in Link and Phelan's stigma...

    Correct

    • Which component is not considered a key element in Link and Phelan's stigma model?

      Your Answer: Scapegoating

      Explanation:

      Stigma Models

      Stigma refers to any attribute, trait, of disorder that marks an individual as being unacceptably different from the normal people with whom they routinely interact, and that elicits some form of community sanction. The most popular model of stigma comes from the work of Link and Phelan, which has four aspects to it.

      The first aspect is labelling, which refers to personal characteristics that mark individuals as different. These characteristics can be physical, mental, of social in nature and can include things like race, gender, sexual orientation, of mental illness.

      The second aspect is stereotyping, which involves linking labelled characteristics to undesirable characteristics. For example, people with mental illness may be stereotyped as violent of unpredictable, even though the vast majority of them are not.

      The third aspect is separating, which involves separating the labelled group and normal people by viewing them as very different. This can lead to social isolation and exclusion, which can further exacerbate the negative effects of stigma.

      The fourth and final aspect is status loss and discrimination, which refers to the devaluing, rejecting, and excluding of the labelled group. This can take many forms, including employment discrimination, housing discrimination, and social exclusion.

      Overall, the model of stigma developed by Link and Phelan provides a useful framework for understanding the complex and multifaceted nature of stigma and its effects on individuals and society as a whole.

    • This question is part of the following fields:

      • Social Psychology
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SESSION STATS - PERFORMANCE PER SPECIALTY

Psychopharmacology (3/11) 27%
Diagnosis (2/2) 100%
Social Psychology (5/8) 63%
Descriptive Psychopathology (0/1) 0%
Psychological Development (1/2) 50%
Classification And Assessment (1/3) 33%
Genetics (2/2) 100%
Advanced Psychological Processes And Treatments (0/1) 0%
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