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Question 1
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What is the probable identity of the drug used in the treatment arm of the clinical trial for schizophrenia that showed a statistically significant reduction in negative symptoms as measured by PANSS?
Your Answer: Minocycline
Explanation:The effectiveness of minocycline, a tetracycline antibiotic, in providing neuroprotection has been observed in vitro. This study aimed to evaluate the impact of minocycline on negative symptoms in individuals diagnosed with schizophrenia at the beginning of the trial and after one year of follow-up. Minocycline is recognized for its ability to be well-tolerated in acne treatment and its capacity to cross the blood-brain barrier. Preliminary findings have indicated that it may be effective in preventing the onset of negative symptoms in schizophrenia. There have been no clinical trials conducted on the other antibiotics.
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This question is part of the following fields:
- Psychopharmacology
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Question 2
Correct
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Which imaging technique is not considered functional?
Your Answer: CT
Explanation:Neuroimaging techniques can be divided into structural and functional types, although this distinction is becoming less clear as new techniques emerge. Structural techniques include computed tomography (CT) and magnetic resonance imaging (MRI), which use x-rays and magnetic fields, respectively, to produce images of the brain’s structure. Functional techniques, on the other hand, measure brain activity by detecting changes in blood flow of oxygen consumption. These include functional MRI (fMRI), emission tomography (PET and SPECT), perfusion MRI (pMRI), and magnetic resonance spectroscopy (MRS). Some techniques, such as diffusion tensor imaging (DTI), combine both structural and functional information to provide a more complete picture of the brain’s anatomy and function. DTI, for example, uses MRI to estimate the paths that water takes as it diffuses through white matter, allowing researchers to visualize white matter tracts.
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This question is part of the following fields:
- Neurosciences
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Question 3
Incorrect
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A 25-year-old female who has a past of opioid addiction has successfully maintained sobriety and is seeking support in controlling her urges.
What would be the most suitable medication intervention for managing her cravings?Your Answer: Naltrexone
Correct Answer: Acamprosate calcium
Explanation:Pharmacological Treatments for Alcohol Dependence
Acamprosate, when used in conjunction with counselling, has been found to be effective in helping alcohol-dependent patients with strong cravings maintain abstinence. Bupropion hydrochloride, which is primarily used as an antidepressant, has also been shown to be effective in maintaining smoking cessation. Disulfiram, on the other hand, causes an unpleasant systemic reaction when alcohol is consumed due to the buildup of acetaldehyde. Nalmefene has recently been licensed for the reduction of alcohol consumption in alcohol-dependent patients with a high drinking risk level who do not have physical withdrawal symptoms and do not require immediate detoxification. Finally, naltrexone, an opioid-receptor antagonist, may be used in the treatment of alcohol dependence after successful withdrawal.
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This question is part of the following fields:
- Psychopharmacology
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Question 4
Correct
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What is impaired in pure word deafness?
Your Answer: Ability to understand speech
Explanation:Pure word deafness is a condition where a person is unable to comprehend speech despite having normal hearing abilities for other sounds. The individual is capable of speaking, reading, and writing with ease and understanding, but cannot grasp the meaning of spoken words. They perceive words as mere sounds without any recognition of their significance. This condition is also referred to as subcortical auditory dysphasia.
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This question is part of the following fields:
- History And Mental State
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Question 5
Incorrect
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The initial stage of moral development, as per Lawrence Kohlberg, is:
Your Answer: Authority and social order obedience driven orientation
Correct Answer: Obedience and punishment orientation
Explanation:Kohlberg’s Six Stages of Moral Development
Kohlberg’s theory of moral development consists of six stages that can be categorized into three levels. The first level is the preconventional stage, which is characterized by obedience and punishment orientation, where the focus is on the direct consequences of actions and unquestioning deference to power. The second stage is the self-interest orientation, where right behavior is defined purely by what is in the individual’s own interest.
The second level is the conventional stage, which is characterized by interpersonal accord and conformity, where the focus is on how the individual will appear to others. The behavior should accord with a consensus view on what is good. The second stage is the authority and social order obedience driven, where what is lawful is judged to be morally right. Right behavior is dictated by societal rules, and there is a greater respect for social order and the need for laws.
The third level is the postconventional stage, which is characterized by the social contract orientation, where individual rights determine behavior. The individual views laws and rules as flexible tools for improving human purposes. The fourth stage is the universal ethical principles orientation, where the right action is the one that is consistent with abstract reasoning using universal ethical principles.
It is important to note that the age ranges for Kohlberg’s developmental stages are rough guides, and sources vary widely. Kohlberg developed his stage theory following an experiment he conducted on 72 boys aged 10-16. However, the theory is criticized as sexist as it only included boys.
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This question is part of the following fields:
- Psychological Development
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Question 6
Correct
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What drug is considered to have a lower risk of abuse because it is a prodrug that needs to be activated after being absorbed into the bloodstream?
Your Answer: Lisdexamfetamine
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 7
Incorrect
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A 25-year-old woman is distressed by the sensation of being watched and monitored. She feels as though someone is always observing her actions and knows everything she does, especially right after she completes a task. What is the most appropriate term to describe this experience?
Your Answer: Passivity of volition
Correct Answer: Running commentary
Explanation:Auditory Hallucinations: Running Commentary, Audible Thoughts, Thought Broadcast, and Thought Withdrawal
Running commentary is a type of auditory hallucination that is classified as a first rank symptom. Patients who experience running commentary hear voices that comment on their activities. The commentary may occur before, during, of after the patient’s actions.
Audible thoughts are another type of auditory hallucination where patients hear their own thoughts spoken aloud. They may hear people repeating their thoughts out loud just after they have thought them, answering their thoughts, of saying aloud what they are about to think. This can cause their thoughts to repeat the voices they hear.
Thought broadcast is a passivity experience where patients believe that their thoughts are being taken away from their heads and widely broadcast. This is also classified as a first rank symptom.
Thought withdrawal is another type of passivity experience where patients believe that their thoughts are being taken away from their heads against their will.
It is important to note that these symptoms are often associated with schizophrenia and other psychotic disorders. Proper diagnosis and treatment are crucial for managing these symptoms and improving the patient’s quality of life.
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This question is part of the following fields:
- Descriptive Psychopathology
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Question 8
Correct
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During which stage does Bowlby's theory of attachment refer to as 'attachment in the making'?
Your Answer: 6 weeks to 6 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 9
Correct
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A post marketing trial is also referred to as which phase of a clinical trial?
Your Answer: Phase IV
Explanation:Clinical Trials: Phases and Objectives
Clinical trials are conducted in four phases to evaluate the safety and efficacy of drugs of treatments. In Phase I, a small group of healthy individuals (15-20) is given the drug to determine its safety, dosage range, and side effects. Phase II involves a larger group (100-300) to assess the drug’s effectiveness and safety. In Phase III, the drug is given to a larger population (1,000-3,000) to confirm its efficacy, compare it with existing treatments, and collect data for safe use. Phase IV, also known as post-marketing trials, is conducted after the drug is licensed to gather additional information on safety and potential uses. These trials are crucial in determining the safety and efficacy of drugs and treatments before they are made available to the public.
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This question is part of the following fields:
- Classification And Assessment
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Question 10
Incorrect
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What is the association with theta rhythms?
Your Answer:
Correct Answer: Seen in meditative practice
Explanation:Electroencephalography
Electroencephalography (EEG) is a clinical test that records the brain’s spontaneous electrical activity over a short period of time using multiple electrodes placed on the scalp. It is mainly used to rule out organic conditions and can help differentiate dementia from other disorders such as metabolic encephalopathies, CJD, herpes encephalitis, and non-convulsive status epilepticus. EEG can also distinguish possible psychotic episodes and acute confusional states from non-convulsive status epilepticus.
Not all abnormal EEGs represent an underlying condition, and psychotropic medications can affect EEG findings. EEG abnormalities can also be triggered purposely by activation procedures such as hyperventilation, photic stimulation, certain drugs, and sleep deprivation.
Specific waveforms are seen in an EEG, including delta, theta, alpha, sigma, beta, and gamma waves. Delta waves are found frontally in adults and posteriorly in children during slow wave sleep, and excessive amounts when awake may indicate pathology. Theta waves are generally seen in young children, drowsy and sleeping adults, and during meditation. Alpha waves are seen posteriorly when relaxed and when the eyes are closed, and are also seen in meditation. Sigma waves are bursts of oscillatory activity that occur in stage 2 sleep. Beta waves are seen frontally when busy of concentrating, and gamma waves are seen in advanced/very experienced meditators.
Certain conditions are associated with specific EEG changes, such as nonspecific slowing in early CJD, low voltage EEG in Huntington’s, diffuse slowing in encephalopathy, and reduced alpha and beta with increased delta and theta in Alzheimer’s.
Common epileptiform patterns include spikes, spike/sharp waves, and spike-waves. Medications can have important effects on EEG findings, with clozapine decreasing alpha and increasing delta and theta, lithium increasing all waveforms, lamotrigine decreasing all waveforms, and valproate having inconclusive effects on delta and theta and increasing beta.
Overall, EEG is a useful tool in clinical contexts for ruling out organic conditions and differentiating between various disorders.
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This question is part of the following fields:
- Neurosciences
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