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  • Question 1 - Who are the co-authors of the book 'Social origins of depression'? ...

    Incorrect

    • Who are the co-authors of the book 'Social origins of depression'?

      Your Answer: Jerome Frank

      Correct Answer: George Brown

      Explanation:

      The objective of the book ‘Social origins of Depression’ was to identify the societal elements that play a role in the onset of depression, particularly in women.

      History of major works in psychiatry
      Michel Foucault – Madness and civilization
      Sigmund Freud – The interpretation of dreams, Beyond the Pleasure Principle, The Psychopathology of everyday life
      Thomas Szasz – The myth of mental illness
      Erving Goffman – Asylums, The Presentation of Self in Everyday Life
      Ronald Laing – The divided self
      Emile Durkheim – Le suicide. Durkheim proposed social causes for suicide. Until his work was published, suicide had been thought of as an individual act only.
      Tom Main – The Ailment
      Jerome Frank – Persuasion and Healing
      George Brown and Tirril Harris – Social origins of depression

    • This question is part of the following fields:

      • Social Psychology
      26.9
      Seconds
  • Question 2 - A 65-year-old patient with schizophrenia reports experiencing sluggish thinking and difficulty initiating thoughts....

    Incorrect

    • A 65-year-old patient with schizophrenia reports experiencing sluggish thinking and difficulty initiating thoughts. However, no apparent issues with the patient's thoughts are observed during conversation. What would you document in your mental state examination?

      Your Answer: Restricted Thinking

      Correct Answer: Inhibited Thinking

      Explanation:

      Formal Thought Disorders

      In formal thought disorders, changes in the speed, coherence, and cogency of thought can be observed from a patient’s speech. These disorders can also be self-reported and may be accompanied by enhanced use of nonverbal language. One possible indication is a lack of an adequate connection between two consecutive thoughts, which is called ‘asyndesis’.

      There are several types of formal thought disorders, including inhibited thinking, retarded thinking, circumstantial thinking, restricted thinking, perseverative thinking, rumination, pressured thinking, flight of ideas, tangential thinking, thought blocking, disruption of thought, incoherence/derailment, and neologisms.

      Inhibited thinking is about the subjective experience of the patient, who may feel that their thinking process is slowed down of blocked by an inner wall of resistance. Retarded thinking, on the other hand, is about the observed quality of thought as inferred through speech, where the flow of thought processes is slowed down and sluggish.

      Circumstantial thinking refers to an inability to separate the essential from the unessential during a conversation without rendering the conversation incoherent. Restricted thinking involves a limited range of thought content, fixation on one particular topic of a small number of topics only, and a stereotyped pattern of thinking.

      Perseverative thinking is characterized by the persistent repetition of previously used words, phrases, of details to the point where they become meaningless in the context of the current stage of the interview. Rumination is the endless mental preoccupation with, of excessive concern over, mostly unpleasant thoughts.

      Pressured thinking, also known as crowding of thought, is when the patient feels helplessly exposed to the pressures of floods of different ideas of thoughts. Flight of ideas involves an increasing multitude of thoughts and ideas which are no longer firmly guided by clear goal-directed thinking.

      Tangential thinking occurs when the patient appears to understand the contents of the questions addressed to them but provides answers which are completely out of context. Thought blocking of disruption of thought refers to sudden disruption of an otherwise normal flow of thought of speech for no obvious reason.

      Incoherence of derailment is when the interviewer is unable to establish sensible connections between the patient’s thinking and verbal output, which is sometimes also called derailment. Neologisms involve the formation of new words of usage of words which disregard normal conventions and are generally not easily understandable.

    • This question is part of the following fields:

      • Classification And Assessment
      47.9
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  • Question 3 - What is the purpose of using confrontation during a clinical examination? ...

    Incorrect

    • What is the purpose of using confrontation during a clinical examination?

      Your Answer: Frontal lobe function

      Correct Answer: Visual field loss

      Explanation:

      Confrontation Test

      The confrontation test is a method used to assess a patient’s visual fields. This test involves comparing the patient’s visual field with that of the examiner. To perform the test, both the patient and the examiner cover one eye, and the examiner then brings their fingers into view from a peripheral position. By comparing the patient’s response to the examiner’s, the examiner can determine any visual field defects that may be present. The confrontation test is a simple and effective way to assess a patient’s visual fields and can be performed quickly and easily in a clinical setting.

    • This question is part of the following fields:

      • Classification And Assessment
      12.8
      Seconds
  • Question 4 - What is impaired in pure word deafness? ...

    Correct

    • 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.

    • This question is part of the following fields:

      • History And Mental State
      22.2
      Seconds
  • Question 5 - Can you identify a condition that falls under the category of tauopathy? ...

    Incorrect

    • Can you identify a condition that falls under the category of tauopathy?

      Your Answer: Huntington's disease

      Correct Answer: Pick's disease

      Explanation:

      Tau and Tauopathies

      Tau proteins are essential for maintaining the stability of microtubules in neurons. Microtubules provide structural support to the cell and facilitate the transport of molecules within the cell. Tau proteins are predominantly found in the axons of neurons and are absent in dendrites. The gene that codes for tau protein is located on chromosome 17.

      When tau proteins become hyperphosphorylated, they clump together, forming neurofibrillary tangles. This process leads to the disintegration of cells, which is a hallmark of several neurodegenerative disorders collectively known as tauopathies.

      The major tauopathies include Alzheimer’s disease, Pick’s disease (frontotemporal dementia), progressive supranuclear palsy, and corticobasal degeneration. These disorders are characterized by the accumulation of tau protein in the brain, leading to the degeneration of neurons and cognitive decline. Understanding the role of tau proteins in these disorders is crucial for developing effective treatments for these devastating diseases.

    • This question is part of the following fields:

      • Genetics
      71.8
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  • Question 6 - What condition is inherited in a pattern consistent with X-linked recessive inheritance? ...

    Correct

    • What condition is inherited in a pattern consistent with X-linked recessive inheritance?

      Your Answer: Hunter's syndrome

      Explanation:

      Inheritance Patterns and Examples

      Autosomal Dominant:
      Neurofibromatosis type 1 and 2, tuberous sclerosis, achondroplasia, Huntington disease, and Noonan’s syndrome are all examples of conditions that follow an autosomal dominant inheritance pattern. This means that only one copy of the mutated gene is needed to cause the condition.

      Autosomal Recessive:
      Phenylketonuria, homocystinuria, Hurler’s syndrome, galactosaemia, Tay-Sach’s disease, Friedreich’s ataxia, Wilson’s disease, and cystic fibrosis are all examples of conditions that follow an autosomal recessive inheritance pattern. This means that two copies of the mutated gene are needed to cause the condition.

      X-Linked Dominant:
      Vitamin D resistant rickets and Rett syndrome are examples of conditions that follow an X-linked dominant inheritance pattern. This means that the mutated gene is located on the X chromosome and only one copy of the gene is needed to cause the condition.

      X-Linked Recessive:
      Cerebellar ataxia, Hunter’s syndrome, and Lesch-Nyhan are examples of conditions that follow an X-linked recessive inheritance pattern. This means that the mutated gene is located on the X chromosome and two copies of the gene are needed to cause the condition.

      Mitochondrial:
      Leber’s hereditary optic neuropathy and Kearns-Sayre syndrome are examples of conditions that follow a mitochondrial inheritance pattern. This means that the mutated gene is located in the mitochondria and is passed down from the mother to her offspring.

    • This question is part of the following fields:

      • Genetics
      28
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  • Question 7 - What is a true statement about evaluating obesity? ...

    Incorrect

    • What is a true statement about evaluating obesity?

      Your Answer: The BMI cut-off for obesity differs for males and females

      Correct Answer: A waist circumference of 100 cm in an adult male is considered normal

      Explanation:

      Assessment and Management of Obesity

      Obesity is a condition that can increase the risk of various health problems, including type 2 diabetes, coronary heart disease, some types of cancer, and stroke. The body mass index (BMI) is a commonly used tool to assess obesity, calculated by dividing a person’s weight in kilograms by their height in meters squared. For adults over 20 years old, BMI falls into one of the following categories: underweight, normal of healthy weight, pre-obesity/overweight, obesity class I, obesity class II, and obesity class III.

      Waist circumference can also be used in combination with BMI to guide interventions. Diet and exercise are the main interventions up to a BMI of 35, unless there are comorbidities such as type 2 diabetes, hypertension, cardiovascular disease, osteoarthritis, dyslipidemia, and sleep apnea. Physical activity recommendations suggest that adults should accumulate at least 150 minutes of moderate intensity activity of 75 minutes of vigorous intensity activity per week. Dietary recommendations suggest diets that have a 600 kcal/day deficit.

      Pharmacological options such as Orlistat of Liraglutide may be considered for those with a BMI of 30 kg/m2 of more, of 28 if associated risk factors. Surgical options such as bariatric surgery may be considered for those with a BMI of 40 kg/m2 of more, of between 35 kg/m2 and 40 kg/m2 with other significant diseases that could be improved with weight loss.

    • This question is part of the following fields:

      • Classification And Assessment
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  • Question 8 - Which of the following statements accurately describes relative risk? ...

    Incorrect

    • Which of the following statements accurately describes relative risk?

      Your Answer: Relative risk = 1 - absolute risk reduction

      Correct Answer: It is the usual outcome measure of cohort studies

      Explanation:

      The relative risk is the typical measure of outcome in cohort studies. It is important to distinguish between risk and odds. For example, if 20 individuals out of 100 who take an overdose die, the risk of dying is 0.2, while the odds are 0.25 (20/80).

      Measures of Effect in Clinical Studies

      When conducting clinical studies, we often want to know the effect of treatments of exposures on health outcomes. Measures of effect are used in randomized controlled trials (RCTs) and include the odds ratio (of), risk ratio (RR), risk difference (RD), and number needed to treat (NNT). Dichotomous (binary) outcome data are common in clinical trials, where the outcome for each participant is one of two possibilities, such as dead of alive, of clinical improvement of no improvement.

      To understand the difference between of and RR, it’s important to know the difference between risks and odds. Risk is a proportion that describes the probability of a health outcome occurring, while odds is a ratio that compares the probability of an event occurring to the probability of it not occurring. Absolute risk is the basic risk, while risk difference is the difference between the absolute risk of an event in the intervention group and the absolute risk in the control group. Relative risk is the ratio of risk in the intervention group to the risk in the control group.

      The number needed to treat (NNT) is the number of patients who need to be treated for one to benefit. Odds are calculated by dividing the number of times an event happens by the number of times it does not happen. The odds ratio is the odds of an outcome given a particular exposure versus the odds of an outcome in the absence of the exposure. It is commonly used in case-control studies and can also be used in cross-sectional and cohort study designs. An odds ratio of 1 indicates no difference in risk between the two groups, while an odds ratio >1 indicates an increased risk and an odds ratio <1 indicates a reduced risk.

    • This question is part of the following fields:

      • Research Methods, Statistics, Critical Review And Evidence-Based Practice
      86.1
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  • Question 9 - How would you describe a group of DNA variations that are commonly passed...

    Incorrect

    • How would you describe a group of DNA variations that are commonly passed down together?

      Your Answer: Karyotype

      Correct Answer: Haplotype

      Explanation:

      Inheritance: Phenotype and Genotype

      Phenotype refers to the observable traits of an individual, such as height, eye colour, and blood type. These traits are a result of the interaction between an individual’s genotype and the environment. The term ‘pheno’ comes from the same root as ‘phenomenon’ and simply means ‘observe’.

      On the other hand, genotype refers to an individual’s collection of genes. These genes determine the traits that an individual will inherit from their parents. A haplotype, on the other hand, is a set of DNA variations of polymorphisms that tend to be inherited together.

      Finally, a karyotype refers to an individual’s collection of chromosomes. These chromosomes contain the genetic information that determines an individual’s traits. By examining an individual’s karyotype, scientists can determine if there are any genetic abnormalities of disorders present.

    • This question is part of the following fields:

      • Genetics
      12.5
      Seconds
  • Question 10 - A father is concerned that his daughter keeps repeating the same phrase, even...

    Incorrect

    • A father is concerned that his daughter keeps repeating the same phrase, even when he asks her a different question she still responds with the same phrase. He wants to know what this is called so he can research it online. What term describes her behavior?

      Your Answer: Echolalia

      Correct Answer: Perseveration

      Explanation:

      Verbigeration is the act of repeating words of phrases without any significant meaning, and it does not necessarily require an external stimulus to trigger it. This is different from perseveration, which is an inappropriate and persistent response to a stimulus.

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

    • This question is part of the following fields:

      • Classification And Assessment
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  • Question 11 - Which of the following is an instance of tertiary intervention? ...

    Correct

    • Which of the following is an instance of tertiary intervention?

      Your Answer: Rehabilitation

      Explanation:

      The prevention of a disease can be divided into three levels: primary, secondary, and tertiary. Tertiary prevention focuses on minimizing the effects of an existing disease and helping individuals achieve their optimal level of functioning. Primary prevention involves implementing broad changes to decrease the overall risk of a disease in a population, such as promoting healthy nutrition, positive parenting, and smoking cessation. Secondary prevention involves early detection and intervention through screening programs.

    • This question is part of the following fields:

      • Epidemiology
      59.9
      Seconds
  • Question 12 - Who was the first theorist to describe imprinting? ...

    Incorrect

    • Who was the first theorist to describe imprinting?

      Your Answer: Lorenz

      Correct Answer: Spalding

      Explanation:

      The idea of filial imprinting was initially observed in domestic chickens by Douglas Spalding in the 1800s, and later discussed by Heinroth before being made well-known by Lorenz. Additionally, Immelmann discussed sexual imprinting, while Westermarck introduced the concept of reverse sexual imprinting, which suggests that individuals who spend their early years in close proximity are less likely to be sexually attracted to each other later in life.

    • This question is part of the following fields:

      • Advanced Psychological Processes And Treatments
      27.4
      Seconds
  • Question 13 - What is the standardized score (z-score) for a woman whose haemoglobin concentration is...

    Incorrect

    • What is the standardized score (z-score) for a woman whose haemoglobin concentration is 150 g/L, given that the mean haemoglobin concentration for healthy women is 135 g/L and the standard deviation is 15 g/L?

      Your Answer: 10

      Correct Answer: 1

      Explanation:

      Z Scores: A Special Application of Transformation Rules

      Z scores are a unique way of measuring how much and in which direction an item deviates from the mean of its distribution, expressed in units of its standard deviation. To calculate the z score for an observation x from a population with mean and standard deviation, we use the formula z = (x – mean) / standard deviation. For example, if our observation is 150 and the mean and standard deviation are 135 and 15, respectively, then the z score would be 1.0. Z scores are a useful tool for comparing observations from different distributions and for identifying outliers.

    • This question is part of the following fields:

      • Research Methods, Statistics, Critical Review And Evidence-Based Practice
      56.6
      Seconds
  • Question 14 - Which inheritance pattern is not consistent with Mendelian genetics? ...

    Incorrect

    • Which inheritance pattern is not consistent with Mendelian genetics?

      Your Answer: X-linked dominant

      Correct Answer: All are types of Mendelian inheritance

      Explanation:

      The Law of Segregation and the Law of Independent Assortment are two fundamental principles of Mendelian inheritance. The Law of Segregation states that during gamete formation, the two alleles of a gene separate from each other so that each gamete receives only one allele. This means that offspring inherit one allele from each parent. The Law of Independent Assortment states that the inheritance of one gene does not affect the inheritance of another gene. This means that the alleles of different genes are distributed randomly into gametes. These laws are essential in understanding the inheritance patterns of single gene disorders. By following these laws, scientists can predict the likelihood of certain traits of disorders being passed down from one generation to the next.

    • This question is part of the following fields:

      • Genetics
      76.1
      Seconds
  • Question 15 - At what developmental stage does a child acquire the ability to engage in...

    Correct

    • At what developmental stage does a child acquire the ability to engage in symbolic play, as per Piaget's theory?

      Your Answer: Preoperational

      Explanation:

      preconventional Stage of Moral Development

      Kohlberg’s first stage of moral development is the preconventional stage. In this stage, children’s moral reasoning is based on avoiding punishment and seeking rewards. They follow rules to avoid getting in trouble and to gain approval from authority figures. Children in this stage are not yet able to understand the perspective of others of consider the consequences of their actions on others. They may also believe that what is right is what benefits them personally. As they grow and develop, children will move on to the next stages of moral development, which involve more complex reasoning and consideration of others’ perspectives.

    • This question is part of the following fields:

      • Basic Psychological Processes
      26.6
      Seconds
  • Question 16 - In what circumstances do men who are affected experience anxiety about the size...

    Incorrect

    • In what circumstances do men who are affected experience anxiety about the size reduction of their penis?

      Your Answer: Amok

      Correct Answer: Koro

      Explanation:

      Koro and Kuru are two distinct conditions that should not be mistaken for each other. While Kuru is a prion disease that is well-known for its association with cannibalism in Papua New Guinea, Koro is a different condition altogether.

      Culture bound illnesses are psychiatric conditions that are specific to one particular culture. There are many different types of culture bound illnesses, including Amok, Shenjing shuairuo, Ataque de nervios, Bilis, colera, Bouffee delirante, Brain fag, Dhat, Falling-out, blacking out, Ghost sickness, Hwa-byung, wool-hwa-byung, Koro, Latah, Locura, Mal de ojo, Nervios, Rootwork, Pibloktoq, Qi-gong psychotic reaction, Sangue dormido, Shen-k’uei, shenkui, Shin-byung, Taijin kyofusho, Spell, Susto, Zar, and Wendigo.

      Some of the most commonly discussed culture bound illnesses include Amok, which is confined to males in the Philippines and Malaysia who experience blind, murderous violence after a real of imagined insult. Ataque de nervios is a condition that occurs in those of Latino descent and is characterized by intense emotional upset, shouting uncontrollably, aggression, dissociation, seizure-like episodes, and suicidal gestures. Brain fag is a form of psychological distress first identified in Nigerian students in the 1960s but reported more generally in the African diaspora. It consists of a variety of cognitive and sensory disturbances that occur during periods of intense intellectual activity. Koro is a condition that affects Chinese patients who believe that their penis is withdrawing inside their abdomen, resulting in panic and the belief that they will die. Taijin kyofusho is a Japanese culture bound illness characterized by anxiety about and avoidance of interpersonal situations due to the thought, feeling, of conviction that one’s appearance and actions in social interactions are inadequate of offensive to others. Finally, Wendigo is a culture bound illness that occurs in Native American tribes during severe winters and scarcity of food, characterized by a distaste for food that leads to anxiety and the belief that one is turning into a cannibalistic ice spirit.

    • This question is part of the following fields:

      • Classification And Assessment
      25
      Seconds
  • Question 17 - What is another name for admission rate bias? ...

    Correct

    • What is another name for admission rate bias?

      Your Answer: Berkson's bias

      Explanation:

      Types of Bias in Statistics

      Bias is a systematic error that can lead to incorrect conclusions. Confounding factors are variables that are associated with both the outcome and the exposure but have no causative role. Confounding can be addressed in the design and analysis stage of a study. The main method of controlling confounding in the analysis phase is stratification analysis. The main methods used in the design stage are matching, randomization, and restriction of participants.

      There are two main types of bias: selection bias and information bias. Selection bias occurs when the selected sample is not a representative sample of the reference population. Disease spectrum bias, self-selection bias, participation bias, incidence-prevalence bias, exclusion bias, publication of dissemination bias, citation bias, and Berkson’s bias are all subtypes of selection bias. Information bias occurs when gathered information about exposure, outcome, of both is not correct and there was an error in measurement. Detection bias, recall bias, lead time bias, interviewer/observer bias, verification and work-up bias, Hawthorne effect, and ecological fallacy are all subtypes of information bias.

    • This question is part of the following fields:

      • Research Methods, Statistics, Critical Review And Evidence-Based Practice
      16.3
      Seconds
  • Question 18 - What components could potentially be included in the MMSE assessment? ...

    Incorrect

    • What components could potentially be included in the MMSE assessment?

      Your Answer: Recalling an address presented at the start of the test

      Correct Answer: Spelling WORLD backwards

      Explanation:

      The MMSE assesses various cognitive functions, including orientation to time and place, recall of three objects, attention, naming objects, repeating a phrase, following instructions, writing a sentence, and copying intersecting pentagons. The CLOX test involves drawing a clock both independently and after observing an examiner complete the task. The AMT includes recalling an address and date of birth. The verbal fluency test evaluates frontal lobe function by asking subjects to generate as many words as possible in a given category within a minute. These tests are all components of the MOCA (Montreal Cognitive Assessment).

    • This question is part of the following fields:

      • Cognitive Assessment
      62.6
      Seconds
  • Question 19 - What was the psychiatric breakthrough that earned Moniz the Nobel Prize in medicine...

    Incorrect

    • What was the psychiatric breakthrough that earned Moniz the Nobel Prize in medicine in 1949?

      Your Answer: LSD therapy

      Correct Answer: Frontal lobotomy

      Explanation:

      In the field of mental health treatment, several pioneers have made significant contributions. One such pioneer is Moniz, who introduced neurosurgery as a treatment for severe mental illness. This treatment, known as prefrontal lobotomy, gained popularity in the US in the late 1940s, with around 9000 operations being performed. However, with the advent of effective antipsychotic drugs, this treatment declined.

      Another significant contribution was made by Mogens Schou, who studied lithium therapy from the mid-1950s. Albert Hofmann pioneered LSD therapy in the 1940s, while William Bleckwenn proposed sodium amytal therapy in 1930.

      In 1939, Joshua Bierer established the first therapeutic community in a psychiatric setting in Essex. These pioneers have paved the way for modern mental health treatments and have helped improve the lives of countless individuals.

    • This question is part of the following fields:

      • History Of Psychiatry
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  • Question 20 - What is the term used to describe the disconnection between belief, feeling, and...

    Incorrect

    • What is the term used to describe the disconnection between belief, feeling, and behavior that can occur in individuals with severe mental illness?

      Your Answer: Loosening of associations

      Correct Answer: Double orientation

      Explanation:

      Psychiatric Terminology

      Double orientation refers to the separation of belief from feeling and behavior, which is commonly observed in chronic schizophrenics. This condition is characterized by a person holding a grandiose delusion, such as believing they are the King of England, while still living a normal life in a council house and attending a day center. Loosening of associations is a type of thought disorder, while an overvalued idea is a preoccupying belief that is arrived at through normal mental processes. Partial delusion is a delusion that is becoming less fixed of is on its way to becoming a full delusion. Vorbeireden, also known as talking past the point, is another term used in psychiatric terminology.

    • This question is part of the following fields:

      • Descriptive Psychopathology
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  • Question 21 - Which statement accurately describes the SF-36? ...

    Correct

    • Which statement accurately describes the SF-36?

      Your Answer: It is a self-administered questionnaire

      Explanation:

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

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

    • This question is part of the following fields:

      • Classification And Assessment
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  • Question 22 - Which of the following is not a recognized symptom associated with hyponatremia? ...

    Incorrect

    • Which of the following is not a recognized symptom associated with hyponatremia?

      Your Answer:

      Correct Answer: Chest pain

      Explanation:

      Hyponatremia in Psychiatric Patients

      Hyponatremia, of low serum sodium, can occur in psychiatric patients due to the disorder itself, its treatment, of other medical conditions. Symptoms include nausea, confusion, seizures, and muscular cramps. Drug-induced hyponatremia is known as the syndrome of inappropriate antidiuretic hormone hypersecretion (SIADH), which results from excessive secretion of ADH and fluid overload. Diagnosis is based on clinically euvolaemic state with low serum sodium and osmolality, raised urine sodium and osmolality. SSRIs, SNRIs, and tricyclics are the most common drugs that can cause SIADH. Risk factors for SIADH include starting a new drug, and treatment usually involves fluid restriction and sometimes demeclocycline.

    • This question is part of the following fields:

      • Psychopharmacology
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  • Question 23 - Which statement regarding the volume of distribution is not true? ...

    Incorrect

    • Which statement regarding the volume of distribution is not true?

      Your Answer:

      Correct Answer: It is calculated by dividing the drug concentration in the plasma by the amount in the body

      Explanation:

      Which of the following is NOT true regarding the equation Vd = amount in body / plasma concentration?

      Understanding the Volume of Distribution in Pharmacology

      The volume of distribution (Vd) is a crucial concept in pharmacology that helps determine how a drug distributes in the body. It is also known as the apparent volume of distribution, as it is an abstract volume. The Vd indicates whether a drug concentrates in the plasma of spreads out in the body. Drugs that are highly polar tend to stay in central compartments such as the plasma, resulting in a low Vd. Conversely, drugs that are more lipid-soluble are distributed widely, such as in fat, resulting in a high Vd.

      The Vd is calculated by dividing the amount of drug in the body by the concentration in the plasma. Clinically, the Vd is used to determine the loading dose of a drug required for a desired blood concentration and to estimate blood concentration in the treatment of overdose. The units of Vd are in volume.

      The apparent volume of distribution is dependent on the drug’s lipid of water solubility, plasma protein binding, and tissue binding. Plasma protein binding affects the Vd, as drugs that bind to plasma proteins like albumin have a smaller apparent volume of distribution. This is because they are extracted from plasma and included in drug concentration measurements, which can give a misleading impression of their volume of distribution. Understanding the Vd is essential in pharmacology to ensure the safe and effective use of drugs.

    • This question is part of the following fields:

      • Psychopharmacology
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  • Question 24 - A 12-year-old child has several tics. What is a characteristic symptom of Tourette's...

    Incorrect

    • A 12-year-old child has several tics. What is a characteristic symptom of Tourette's syndrome?

      Your Answer:

      Correct Answer: Vocal tics

      Explanation:

      Tourette’s syndrome, also known as combined vocal and motor tic disorder, is characterized by multiple motor tics and one of more vocal tics. Inattention may be present but is not a defining symptom. Coprophagia, of the act of eating feces, is not associated with Tourette’s syndrome and is more commonly seen in individuals with learning difficulties of chronic psychotic disorders. Glossolalia, of speaking in tongues, is not related to psychopathology and is not a feature of Tourette’s syndrome.

    • This question is part of the following fields:

      • Diagnosis
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  • Question 25 - Which of the following symptoms is classified as negative according to the PANSS...

    Incorrect

    • Which of the following symptoms is classified as negative according to the PANSS coding system?

      Your Answer:

      Correct Answer: Stereotyped thinking

      Explanation:

      The Positive and Negative Syndrome Scale (PANSS) is a tool used to measure the severity of symptoms in patients with schizophrenia. The scale is divided into three categories: positive symptoms, negative symptoms, and general psychopathology symptoms. Each category has several items that are scored on a seven-point severity scale. The positive symptoms include delusions, hallucinations, and hyperactivity, while the negative symptoms include blunted affect and lack of spontaneity. The general psychopathology symptoms include anxiety, depression, and poor impulse control. The PANSS is a valuable tool for clinicians to assess the severity of symptoms in patients with schizophrenia and to monitor their progress over time.

    • This question is part of the following fields:

      • Classification And Assessment
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  • Question 26 - What is divided by the Sylvian fissure? ...

    Incorrect

    • What is divided by the Sylvian fissure?

      Your Answer:

      Correct Answer: The frontal and parietal lobes from the temporal lobe

      Explanation:

      The temporal lobe is separated from the frontal and parietal lobes by the Sylvian fissure.

      The Cerebral Cortex and Neocortex

      The cerebral cortex is the outermost layer of the cerebral hemispheres and is composed of three parts: the archicortex, paleocortex, and neocortex. The neocortex accounts for 90% of the cortex and is involved in higher functions such as thought and language. It is divided into 6-7 layers, with two main cell types: pyramidal cells and nonpyramidal cells. The surface of the neocortex is divided into separate areas, each given a number by Brodmann (e.g. Brodmann’s area 17 is the primary visual cortex). The surface is folded to increase surface area, with grooves called sulci and ridges called gyri. The neocortex is responsible for higher cognitive functions and is essential for human consciousness.

    • This question is part of the following fields:

      • Neurosciences
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  • Question 27 - You observe a 42-year-old woman with delusions referred by her primary care physician....

    Incorrect

    • You observe a 42-year-old woman with delusions referred by her primary care physician. She is convinced that George Clooney is deeply in love with her. Over the past two months, she has attempted to send him 50 handwritten letters, along with numerous gifts. She frequently visits locations associated with the actor and places where he is attending public events. She believes that he is unable to express his true feelings for her due to the potential backlash from his wife and fans. What syndrome is being exhibited in this scenario?

      Your Answer:

      Correct Answer: De Clérambault's syndrome

      Explanation:

      De Clérambault’s syndrome is characterized by amorous delusions where the patient believes that a person of higher social status, often a public figure, is in love with them. These delusions are not based on any actual contact of encouragement from the subject. Patients with this syndrome may also experience delusions of persecution. Due to their strong belief in the reality of their delusions, patients often lack insight and may not seek help. Treatment can include psychotherapy and antipsychotics. Other syndromes with delusional symptoms include Capgras syndrome, Cotard’s syndrome, Ekbom’s syndrome, and Othello’s syndrome.

    • This question is part of the following fields:

      • Diagnosis
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  • Question 28 - The prevention of abnormal amyloid protein formation in senile plaques is achieved through...

    Incorrect

    • The prevention of abnormal amyloid protein formation in senile plaques is achieved through the cleavage of amyloid precursor protein by which of the following?

      Your Answer:

      Correct Answer: Alpha secretase

      Explanation:

      Amyloid Precursor Protein and its Role in Alzheimer’s Disease

      Amyloid precursor protein (APP) is a crucial component of amyloid plaques, which are a hallmark of Alzheimer’s disease. When APP is cleaved by beta-secretase, it produces beta-amyloid (Abeta), the primary component of senile plaques in Alzheimer’s disease. On the other hand, cleavage of APP by alpha-secretase prevents Abeta formation, leading to the production of non amyloidogenic secreted APPs products.

      The accumulation of Abeta in the brain is believed to be a key factor in the development and progression of Alzheimer’s disease. Abeta peptides aggregate to form amyloid plaques, which can disrupt neuronal function and lead to cognitive decline. Therefore, understanding the mechanisms that regulate APP processing and Abeta production is crucial for developing effective treatments for Alzheimer’s disease.

    • This question is part of the following fields:

      • Neurosciences
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  • Question 29 - Who first introduced the idea of the 'schizophrenogenic parent'? ...

    Incorrect

    • Who first introduced the idea of the 'schizophrenogenic parent'?

      Your Answer:

      Correct Answer: Fromm-Reichmann

      Explanation:

      The term ‘schizophrenogenic mother’ was proposed by Fromm-Reichmann, a contemporary of Freud, who believed that defective parenting caused the disorder. However, this concept has since been proven to be unfounded. Lidz later examined the impact of parents’ socialization on a child’s psychological health, further exploring this concept. Bleuler is credited with coining the term ‘schizophrenia’, while Kraepelin had previously described ‘dementia praecox’.

    • This question is part of the following fields:

      • Advanced Psychological Processes And Treatments
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  • Question 30 - Which of the following is not a visible characteristic observed in Alzheimer's disease...

    Incorrect

    • Which of the following is not a visible characteristic observed in Alzheimer's disease at a macroscopic level?

      Your Answer:

      Correct Answer: Gliosis

      Explanation:

      Gliosis is a discovery that can only be observed under a microscope.

      Alzheimer’s disease is characterized by both macroscopic and microscopic changes in the brain. Macroscopic changes include cortical atrophy, ventricular dilation, and depigmentation of the locus coeruleus. Microscopic changes include the presence of senile plaques, neurofibrillary tangles, gliosis, degeneration of the nucleus of Meynert, and Hirano bodies. Senile plaques are extracellular deposits of beta amyloid in the gray matter of the brain, while neurofibrillary tangles are intracellular inclusion bodies that consist primarily of hyperphosphorylated tau. Gliosis is marked by increases in activated microglia and reactive astrocytes near the sites of amyloid plaques. The nucleus of Meynert degenerates in Alzheimer’s, resulting in a decrease in acetylcholine in the brain. Hirano bodies are actin-rich, eosinophilic intracytoplasmic inclusions which have a highly characteristic crystalloid fine structure and are regarded as a nonspecific manifestation of neuronal degeneration. These changes in the brain contribute to the cognitive decline and memory loss seen in Alzheimer’s disease.

    • This question is part of the following fields:

      • Neurosciences
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  • Question 31 - Which of the following statements about Jean Piaget is the most precise? ...

    Incorrect

    • Which of the following statements about Jean Piaget is the most precise?

      Your Answer:

      Correct Answer: Described the psychosocial stages of development

      Explanation:

      Erik Erikson is known as the father of psychosocial development and the architect of identity due to his significant contribution of placing psychoanalytic concepts in a social and cultural context. He outlined eight stages of psychosocial development, including Trust vs. Mistrust, Autonomy vs. Shame and Doubt, Initiative vs. Guilt, Industry vs. Inferiority, Identity vs. Role diffusion, Intimacy vs. Isolation, Generativity vs. Stagnation, and Ego Integrity vs. Despair. These stages differ from Freud’s stages of psychosocial development. On the other hand, Carl Gustav Jung introduced the concept of archetypes, which include Self, Shadow, Anima, and Animus. Archetypes are the original models from which all other similar persons, objects, of concepts are derived, copied, patterned, of emulated.

    • This question is part of the following fields:

      • Psychological Development
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  • Question 32 - In what circumstances are neurofibrillary tangles less commonly observed? ...

    Incorrect

    • In what circumstances are neurofibrillary tangles less commonly observed?

      Your Answer:

      Correct Answer: Vascular dementia

      Explanation:

      Tauopathies exhibit tangles, but vascular dementia is not classified as one.

      Alzheimer’s disease is characterized by both macroscopic and microscopic changes in the brain. Macroscopic changes include cortical atrophy, ventricular dilation, and depigmentation of the locus coeruleus. Microscopic changes include the presence of senile plaques, neurofibrillary tangles, gliosis, degeneration of the nucleus of Meynert, and Hirano bodies. Senile plaques are extracellular deposits of beta amyloid in the gray matter of the brain, while neurofibrillary tangles are intracellular inclusion bodies that consist primarily of hyperphosphorylated tau. Gliosis is marked by increases in activated microglia and reactive astrocytes near the sites of amyloid plaques. The nucleus of Meynert degenerates in Alzheimer’s, resulting in a decrease in acetylcholine in the brain. Hirano bodies are actin-rich, eosinophilic intracytoplasmic inclusions which have a highly characteristic crystalloid fine structure and are regarded as a nonspecific manifestation of neuronal degeneration. These changes in the brain contribute to the cognitive decline and memory loss seen in Alzheimer’s disease.

    • This question is part of the following fields:

      • Neurosciences
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  • Question 33 - A man in his 50s, with a history of severe depression, asks for...

    Incorrect

    • A man in his 50s, with a history of severe depression, asks for your opinion on the safety of continuing his antidepressant medication while undergoing surgery. He is currently taking fluoxetine 20 mg daily.
      What is one appropriate piece of advice you can give him?

      Your Answer:

      Correct Answer: Treatment of maternal illness is the highest priority

      Explanation:

      Although there is a potential risk of infants being exposed to antidepressants through breast milk, leaving mental illness untreated can pose greater risks. The safety of psychotropic medication during breastfeeding is not well-established. Nonetheless, sertraline is considered one of the safest antidepressants for breastfeeding mothers as it is excreted in low levels. Therefore, if treatment is necessary, sertraline is a suitable option for breastfeeding mothers.

    • This question is part of the following fields:

      • Psychopharmacology
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  • Question 34 - Which brain system enables the integration of emotional sensory information between the cortex...

    Incorrect

    • Which brain system enables the integration of emotional sensory information between the cortex and hypothalamus?

      Your Answer:

      Correct Answer: Papez circuit

      Explanation:

      In 1937, James Papez proposed a neural circuit that explained how emotional experiences occur in the brain. According to Papez, sensory messages related to emotional stimuli are first received by the thalamus, which then directs them to both the cortex (stream of thinking) and hypothalamus (stream of feeling). The cingulate cortex integrates this information from the hypothalamus and sensory cortex, leading to emotional experiences. The output via the hippocampus and hypothalamus allows cortical control of emotional responses. This circuit has since been reconceptualized as the limbic system.

      The medial longitudinal fasciculus carries fibres from cranial nerves III, IV and IV. The nucleus accumbens plays a major role in the reward circuit, while the somatosensory cortex is involved in processing pain. The basal ganglia are involved in voluntary motor control.

      Overall, the Papez circuit theory provides a framework for understanding the functional neuroanatomy of emotion. It highlights the importance of the limbic system in emotional experiences and the role of various brain regions in processing different aspects of emotional stimuli.

    • This question is part of the following fields:

      • Neurosciences
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  • Question 35 - Which of the options below is not classified as a type of motor...

    Incorrect

    • Which of the options below is not classified as a type of motor neuron disease?

      Your Answer:

      Correct Answer: Multisystem atrophy

      Explanation:

      Motor neuron Disease: A Progressive Neurodegenerative Condition

      Motor neuron Disease (MND) is a condition that progressively damages the upper and lower motor neurons. This damage leads to muscle weakness and wasting, resulting in a loss of mobility in the limbs, as well as difficulties with speech, swallowing, and breathing. MND can be classified into four main types, including Amyotrophic lateral sclerosis, Progressive bulbar palsy, Progressive muscular atrophy, and Primary lateral sclerosis.

      Macroscopic pathological features of MND include atrophy of the precentral gyrus and frontotemporal regions, thinning of the spinal cord, and atrophic anterior nerve roots. Microscopic changes involve the loss of motor neurons from the ventral horn of the spinal cord and lower brainstem. MND is a devastating condition that currently has no cure, and treatment is focused on managing symptoms and improving quality of life for those affected.

    • This question is part of the following fields:

      • Neurosciences
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  • Question 36 - The spinothalamic tracts are particularly concerned with… ...

    Incorrect

    • The spinothalamic tracts are particularly concerned with…

      Your Answer:

      Correct Answer: Pain and temperature sensations

      Explanation:

      The spinothalamic tracts are ascending or sensory tracts, responsible for transmission of pain and temperature.

    • This question is part of the following fields:

      • Neuro-anatomy
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  • Question 37 - A psychology graduate student is interested in studying the psychosocial factors related to...

    Incorrect

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

      Your Answer:

      Correct Answer: Perceived severity

      Explanation:

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

    • This question is part of the following fields:

      • Advanced Psychological Processes And Treatments
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  • Question 38 - 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:

      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 39 - The father-to-be experiences nausea, vomiting, and abdominal swelling during the course of his...

    Incorrect

    • The father-to-be experiences nausea, vomiting, and abdominal swelling during the course of his partner's pregnancy. What is the medical term for this condition?

      Your Answer:

      Correct Answer: Couvade syndrome

      Explanation:

      Psychiatric Syndromes

      Couvade syndrome, also known as sympathetic pregnancy, is a conversion disorder that affects expectant fathers. It is characterized by the experience of physical symptoms of pregnancy. This is not a delusion, as the individual does not believe they are pregnant. Epidemiology, such as prevalence rates, may be useful in understanding this syndrome.

      Capgras syndrome is a delusional misidentification syndrome in which an individual believes that a familiar person has been replaced by an imposter.

      Cotard’s syndrome is a condition characterized by nihilistic delusions, such as the belief that one is dead.

      Frégoli syndrome is a delusional misidentification syndrome in which the patient falsely identifies familiar people in strangers.

      Koro is a culture-specific syndrome in which the patient believes that their penis is retracting into their abdomen and that they will die as a result.

    • This question is part of the following fields:

      • Descriptive Psychopathology
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  • Question 40 - Which one of these pathways is not associated with dopamine? ...

    Incorrect

    • Which one of these pathways is not associated with dopamine?

      Your Answer:

      Correct Answer: Limbostriatal pathway

      Explanation:

      Neurotransmitters are substances used by neurons to communicate with each other and with target tissues. They are synthesized and released from nerve endings into the synaptic cleft, where they bind to receptor proteins in the cellular membrane of the target tissue. Neurotransmitters can be classified into different types, including small molecules (such as acetylcholine, dopamine, norepinephrine, serotonin, and GABA) and large molecules (such as neuropeptides). They can also be classified as excitatory or inhibitory. Receptors can be ionotropic or metabotropic, and the effects of neurotransmitters can be fast of slow. Some important neurotransmitters include acetylcholine, dopamine, GABA, norepinephrine, and serotonin. Each neurotransmitter has a specific synthesis, breakdown, and receptor type. Understanding neurotransmitters is important for understanding the function of the nervous system and for developing treatments for neurological and psychiatric disorders.

    • This question is part of the following fields:

      • Neurosciences
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  • Question 41 - Which imaging technique is not considered functional? ...

    Incorrect

    • Which imaging technique is not considered functional?

      Your Answer:

      Correct 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.

    • This question is part of the following fields:

      • Neurosciences
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  • Question 42 - What waveform represents a frequency range of 8-12Hz? ...

    Incorrect

    • What waveform represents a frequency range of 8-12Hz?

      Your Answer:

      Correct Answer: Alpha

      Explanation:

      Electroencephalography

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

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

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

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

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

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

    • This question is part of the following fields:

      • Neurosciences
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  • Question 43 - Depression is classified under which axis of DSM V? ...

    Incorrect

    • Depression is classified under which axis of DSM V?

      Your Answer:

      Correct Answer: Axis I

      Explanation:

      The DSM-5 is a manual published by the American Psychiatric Association that categorizes mental health disorders for children and adults. In the UK, the equivalent is the ICD-10. The DSM-IV organized psychiatric diagnoses into five axes, including clinical syndromes (such as anorexia nervosa and schizophrenia), developmental and personality disorders, physical conditions that contribute to mental illness, psychosocial stressors, and the patient’s level of functioning.

    • This question is part of the following fields:

      • Classification And Assessment
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  • Question 44 - Which cranial nerve travels through the cribriform plate of the ethmoid bone on...

    Incorrect

    • Which cranial nerve travels through the cribriform plate of the ethmoid bone on its way to the brain?

      Your Answer:

      Correct Answer: Olfactory nerve

      Explanation:

      The olfactory nerves are responsible for the sense of smell. They originate in the upper part of the nose’s mucous membrane and travel through the ethmoid bone’s cribriform plate. From there, they reach the olfactory bulb, where nerve cells synapse and transmit the impulse to a second neuron. Finally, the nerves travel to the temporal lobe of the cerebrum, where the perception of smell occurs.

      Overview of Cranial Nerves and Their Functions

      The cranial nerves are a complex system of nerves that originate from the brain and control various functions of the head and neck. There are twelve cranial nerves, each with a specific function and origin. The following table provides a simplified overview of the cranial nerves, including their origin, skull exit, modality, and functions.

      The first cranial nerve, the olfactory nerve, originates from the telencephalon and exits through the cribriform plate. It is a sensory nerve that controls the sense of smell. The second cranial nerve, the optic nerve, originates from the diencephalon and exits through the optic foramen. It is a sensory nerve that controls vision.

      The third cranial nerve, the oculomotor nerve, originates from the midbrain and exits through the superior orbital fissure. It is a motor nerve that controls eye movement, pupillary constriction, and lens accommodation. The fourth cranial nerve, the trochlear nerve, also originates from the midbrain and exits through the superior orbital fissure. It is a motor nerve that controls eye movement.

      The fifth cranial nerve, the trigeminal nerve, originates from the pons and exits through different foramina depending on the division. It is a mixed nerve that controls chewing and sensation of the anterior 2/3 of the scalp. It also tenses the tympanic membrane to dampen loud noises.

      The sixth cranial nerve, the abducens nerve, originates from the pons and exits through the superior orbital fissure. It is a motor nerve that controls eye movement. The seventh cranial nerve, the facial nerve, also originates from the pons and exits through the internal auditory canal. It is a mixed nerve that controls facial expression, taste of the anterior 2/3 of the tongue, and tension on the stapes to dampen loud noises.

      The eighth cranial nerve, the vestibulocochlear nerve, originates from the pons and exits through the internal auditory canal. It is a sensory nerve that controls hearing. The ninth cranial nerve, the glossopharyngeal nerve, originates from the medulla and exits through the jugular foramen. It is a mixed nerve that controls taste of the posterior 1/3 of the tongue, elevation of the larynx and pharynx, and swallowing.

      The tenth cranial nerve, the vagus nerve, also originates from the medulla and exits through the jugular foramen. It is a mixed nerve that controls swallowing, voice production, and parasympathetic supply to nearly all thoracic and abdominal viscera. The eleventh cranial nerve, the accessory nerve, originates from the medulla and exits through the jugular foramen. It is a motor nerve that controls shoulder shrugging and head turning.

      The twelfth cranial nerve, the hypoglossal nerve, originates from the medulla and exits through the hypoglossal canal. It is a motor nerve that controls tongue movement. Overall, the cranial nerves play a crucial role in controlling various functions of the head and neck, and any damage of dysfunction can have significant consequences.

    • This question is part of the following fields:

      • Neurosciences
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  • Question 45 - Glucose transport in the brain is mediated by: ...

    Incorrect

    • Glucose transport in the brain is mediated by:

      Your Answer:

      Correct Answer: GLUT 1

      Explanation:

      The facilitative glucose transporter mediates the transport of glucose from blood into neurons and glia in the brain. The primary isoforms in the brain are GLUT1 detected at high concentrations.

    • This question is part of the following fields:

      • Neuro-anatomy
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  • Question 46 - Which enzyme is responsible for adding amino acids to RNA molecules to create...

    Incorrect

    • Which enzyme is responsible for adding amino acids to RNA molecules to create transfer RNA?

      Your Answer:

      Correct Answer: Aminoacyl tRNA synthetase

      Explanation:

      The Aminoacyl tRNA Synthetases (AARSs) are a group of enzymes that attach a specific amino acid to its corresponding tRNA molecule. There are 21 different AARS enzymes, each responsible for a different amino acid, except for lysine, which has two AARSs.

      Genomics: Understanding DNA, RNA, Transcription, and Translation

      Deoxyribonucleic acid (DNA) is a molecule composed of two chains that coil around each other to form a double helix. DNA is organised into chromosomes, and each chromosome is made up of DNA coiled around proteins called histones. RNA, on the other hand, is made from a long chain of nucleotide units and is usually single-stranded. RNA is transcribed from DNA by enzymes called RNA polymerases and is central to protein synthesis.

      Transcription is the synthesis of RNA from a DNA template, and it consists of three main steps: initiation, elongation, and termination. RNA polymerase binds at a sequence of DNA called the promoter, and the transcriptome is the collection of RNA molecules that results from transcription. Translation, on the other hand, refers to the synthesis of polypeptides (proteins) from mRNA. Translation takes place on ribosomes in the cell cytoplasm, where mRNA is read and translated into the string of amino acid chains that make up the synthesized protein.

      The process of translation involves messenger RNA (mRNA), transfer RNA (tRNA), and ribosomal RNA (rRNA). Transfer RNAs, of tRNAs, connect mRNA codons to the amino acids they encode, while ribosomes are the structures where polypeptides (proteins) are built. Like transcription, translation also consists of three stages: initiation, elongation, and termination. In initiation, the ribosome assembles around the mRNA to be read and the first tRNA carrying the amino acid methionine. In elongation, the amino acid chain gets longer, and in termination, the finished polypeptide chain is released.

    • This question is part of the following fields:

      • Genetics
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  • Question 47 - What is the truth about the discontinuation symptoms that are linked to antidepressants?...

    Incorrect

    • What is the truth about the discontinuation symptoms that are linked to antidepressants?

      Your Answer:

      Correct Answer: Suicidal thoughts are associated with discontinuation of paroxetine

      Explanation:

      Discontinuation symptoms are common when stopping most antidepressants, typically appearing within 5 days of treatment cessation. However, these symptoms are more likely to occur with short half-life drugs like paroxetine, especially when doses are missed. It’s important to note that discontinuing paroxetine may lead to suicidal thoughts, so patients should be informed of the potential risks associated with poor compliance.

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

    • This question is part of the following fields:

      • Psychopharmacology
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  • Question 48 - Which one of the following nerve fibers is involved in proprioception? ...

    Incorrect

    • Which one of the following nerve fibers is involved in proprioception?

      Your Answer:

      Correct Answer: An α fiber

      Explanation:

      Proprioception, also known as kinaesthesia, is the sense through which humans perceive their own position and movements. α nerve fibers are specifically involved in transmitting proprioception stimuli.

    • This question is part of the following fields:

      • Neuro-anatomy
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  • Question 49 - How can secondary delusion be best described? ...

    Incorrect

    • How can secondary delusion be best described?

      Your Answer:

      Correct Answer: An elderly woman believes her neighbours are spying on her. She believes this because the TV told her so

      Explanation:

      The belief that her neighbors are spying on her, which was triggered by the TV, is likely a secondary delusion stemming from a pathological encounter such as a hallucination of a referential experience.

      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.

    • This question is part of the following fields:

      • Classification And Assessment
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  • Question 50 - A woman is arrested by the police for strangling her husband. She believes...

    Incorrect

    • A woman is arrested by the police for strangling her husband. She believes he has been replaced by an impostor. Select the appropriate delusional syndrome:

      Your Answer:

      Correct Answer: Capgras

      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 51 - What is the term used to describe a drug that remains inactive until...

    Incorrect

    • What is the term used to describe a drug that remains inactive until it is converted into its active metabolite?

      Your Answer:

      Correct Answer: A prodrug

      Explanation:

      The Significance of Active Metabolites in Drug Discovery and Development

      Certain drugs are classified as prodrugs, which means that they are inactive when administered and require metabolism to become active. These drugs are converted into an active form, which is referred to as an active metabolite. Some drugs have important active metabolites, such as diazepam, dothiepin, fluoxetine, imipramine, risperidone, amitriptyline, and codeine, which are desmethyldiazepam, dothiepin sulfoxide, norfluoxetine, desipramine, 9-hydroxyrisperidone, nortriptyline, and morphine, respectively.

      The role of pharmacologically active metabolites in drug discovery and development is significant. Understanding the active metabolites of a drug can help in the development of more effective and safer drugs. Active metabolites can also provide insights into the pharmacokinetics and pharmacodynamics of a drug, which can aid in the optimization of dosing regimens. Additionally, active metabolites can have different pharmacological properties than the parent drug, which can lead to the discovery of new therapeutic uses for a drug. Therefore, the study of active metabolites is an important aspect of drug discovery and development.

    • This question is part of the following fields:

      • Psychopharmacology
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  • Question 52 - A pediatrician wants to assess the pain levels in his young patients with...

    Incorrect

    • A pediatrician wants to assess the pain levels in his young patients with sickle cell disease. He is uncertain if the children are able to rate their pain accurately and prefers a scale that can be rated by either him of the caregiver. What rating scale would be most suitable for his purposes?

      Your Answer:

      Correct Answer: Rating of medication influences (ROMI)

      Explanation:

      Several scales are available to measure medication adherence attitudes and behaviors in psychiatric patients, particularly those with schizophrenia. The Rating of Medication Influences (ROMI) scale has 20 interviewer-rated items with good inter-rater reliability. The ASK-20 Adherence Barrier Survey measures barriers to adherence with 20 clinical items. The Brief Evaluation of Medication Influences and Beliefs (BEMIB) scale is an eight-item Likert-type scale that measures costs and benefits of medication use based on the health belief model. The Drug Attitude Inventory is a 30-item self-report scale that evaluates subjective effects of antipsychotic drugs among patients with schizophrenia. The Medication Adherence Rating Scale (MARS) is a 10-item self-report scale derived from the Drug Attitude Inventory and Medication Adherence Questionnaire, and is used in patients with schizophrenia and psychosis.

    • This question is part of the following fields:

      • Advanced Psychological Processes And Treatments
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  • Question 53 - A 7-year-old boy was assisting his father with yard work last summer and...

    Incorrect

    • A 7-year-old boy was assisting his father with yard work last summer and got stung by a bee. He now avoids helping with any outdoor tasks.
      What type of learning is illustrated in this scenario?

      Your Answer:

      Correct Answer: Operant conditioning

      Explanation:

      The three major types of learning are: operant conditioning, classical conditioning, and observational learning. In operant conditioning, an individual’s behavior is instrumental in achieving a desired outcome. In classical conditioning, a neutral stimulus is paired with a stimulus that already evokes a reflex response, eventually leading to the new stimulus evoking a similar response. Observational learning involves learning through the observation of others. Shaping, a part of operant conditioning, involves reinforcing successive approximations to a desired behavior. Extinction, seen in both classical and operant conditioning, involves the observed behavior gradually stopping due to the absence of reinforcement of presentation of the stimulus alone.

    • This question is part of the following fields:

      • Psychological Development
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  • Question 54 - Which antidepressant works by inhibiting the reuptake of dopamine? ...

    Incorrect

    • Which antidepressant works by inhibiting the reuptake of dopamine?

      Your Answer:

      Correct Answer: Bupropion

      Explanation:

      Bupropion inhibits the reuptake of noradrenaline and dopamine, making it an NDRI.

      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 55 - As a teenager, Sarah struggled with her relationship with her mother who was...

    Incorrect

    • As a teenager, Sarah struggled with her relationship with her mother who was emotionally and verbally abusive. Now, as a young adult, she finds herself constantly quitting relationships within a few weeks of starting, claiming that her partner is controlling and manipulative. What underlying psychodynamic mechanism could be contributing to this pattern of behavior?

      Your Answer:

      Correct Answer: Transference

      Explanation:

      Transference: Attributing Characteristics to People in Similar Roles

      Transference is a psychological phenomenon where individuals attribute characteristics of important figures from their early life to people who resemble them of have roles echoing theirs. For instance, doctors, teachers, and bosses may be imbued with the characteristics of parents. This can lead to individuals projecting their feelings, attitudes, and expectations onto others, which can impact their relationships and interactions. Understanding transference can help individuals recognize and manage their emotions and reactions towards others.

    • This question is part of the following fields:

      • Dynamic Psychopathology
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  • Question 56 - In dementia pugilistica, which structure is commonly found to be abnormal? ...

    Incorrect

    • In dementia pugilistica, which structure is commonly found to be abnormal?

      Your Answer:

      Correct Answer: Septum pellucidum

      Explanation:

      A fenestrated cavum septum pellucidum is linked to dementia pugilistica.

      Dementia Pugilistica: A Neurodegenerative Condition Resulting from Neurotrauma

      Dementia pugilistica, also known as chronic traumatic encephalopathy (CTE), is a neurodegenerative condition that results from neurotrauma. It is commonly seen in boxers and NFL players, but can also occur in anyone with neurotrauma. The condition is characterized by symptoms such as gait ataxia, slurred speech, impaired hearing, tremors, disequilibrium, neurobehavioral disturbances, and progressive cognitive decline.

      Most cases of dementia pugilistica present with early onset cognitive deficits, and behavioral signs exhibited by patients include aggression, suspiciousness, paranoia, childishness, hypersexuality, depression, and restlessness. The progression of the condition leads to more prominent behavioral symptoms such as difficulty with impulse control, irritability, inappropriateness, and explosive outbursts of aggression.

      Neuropathological abnormalities have been identified in CTE, with the most unique feature being the abnormal accumulation of tau in neurons and glia in an irregular, focal, perivascular distribution and at the depths of cortical sulci. Abnormalities of the septum pellucidum, such as cavum and fenestration, are also a common feature.

      While the condition has become increasingly rare due to the progressive improvement in sports safety, it is important to recognize the potential long-term consequences of repeated head injuries and take steps to prevent them.

    • This question is part of the following fields:

      • Neurosciences
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  • Question 57 - What is the meaning of animus in the context of Jungian therapy? ...

    Incorrect

    • What is the meaning of animus in the context of Jungian therapy?

      Your Answer:

      Correct Answer: The unconscious male aspect present in every female

      Explanation:

      According to Jung, every individual possesses a concealed bisexuality. He referred to the feminine traits within a man as anima and the masculine traits within a woman as animus. The shadow represents the embodiment of our undesirable characteristics, while the persona is the facade we present to society.

    • This question is part of the following fields:

      • Dynamic Psychopathology
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  • Question 58 - A 72-year-old male reports feeling distressed after hearing his deceased wife's voice in...

    Incorrect

    • A 72-year-old male reports feeling distressed after hearing his deceased wife's voice in his head, asking him to come join her. He clarifies that he heard it internally and not as an external sound. What type of perceptual abnormality is reflected in his experience?

      Your Answer:

      Correct Answer: Pseudohallucinations

      Explanation:

      – Pseudohallucinations are figurative and not real
      – They are located in the inner subjective space
      – Auditory hallucinations are concrete, tangible, and real
      – They are located in the outside objective space
      – Autoscopy is the experience of seeing oneself
      – Reflex hallucination is where a stimulus in one modality produces hallucination in another modality
      – Hypnopompic hallucinations occur when waking up from sleep.

    • This question is part of the following fields:

      • Descriptive Psychopathology
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  • Question 59 - What is the defining feature of arched posturing of the head, trunk, and...

    Incorrect

    • What is the defining feature of arched posturing of the head, trunk, and extremities?

      Your Answer:

      Correct Answer: Opisthotonus

      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
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  • Question 60 - What is an example of a second generation H1 antihistamine? ...

    Incorrect

    • What is an example of a second generation H1 antihistamine?

      Your Answer:

      Correct Answer: Cetirizine

      Explanation:

      The second generation of H1 antihistamines exhibit limited ability to cross the blood-brain barrier, leading to their non-sedating properties. Furthermore, they possess greater receptor specificity and do not produce significant anticholinergic effects. These characteristics make them a more desirable option for managing allergic conditions, as they minimize the risk of adverse effects.

      Antihistamines: Types and Uses

      Antihistamines are drugs that block the effects of histamine, a neurotransmitter that regulates physiological function in the gut and potentiates the inflammatory and immune responses of the body. There are two types of antihistamines: H1 receptor blockers and H2 receptor blockers. H1 blockers are mainly used for allergic conditions and sedation, while H2 blockers are used for excess stomach acid.

      There are also first and second generation antihistamines. First generation antihistamines, such as diphenhydramine and promethazine, have uses in psychiatry due to their ability to cross the blood brain barrier and their anticholinergic properties. They tend to be sedating and are useful for managing extrapyramidal side effects. Second generation antihistamines, such as loratadine and cetirizine, show limited penetration of the blood brain barrier and are less sedating.

      It is important to note that there are contraindications to first-generation antihistamines, including benign prostatic hyperplasia, angle-closure glaucoma, and pyloric stenosis in infants. These do not apply to second-generation antihistamines.

    • This question is part of the following fields:

      • Psychopharmacology
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  • Question 61 - Which condition is most likely to exhibit a hyperkinetic gait? ...

    Incorrect

    • Which condition is most likely to exhibit a hyperkinetic gait?

      Your Answer:

      Correct Answer: Sydenham chorea

      Explanation:

      Gait disorders can be caused by a variety of conditions, including neurological, muscular, and structural abnormalities. One common gait disorder is hemiplegic gait, which is characterized by unilateral weakness on the affected side, with the arm flexed, adducted, and internally rotated, and the leg on the same side in extension with plantar flexion of the foot and toes. When walking, the patient may hold their arm to one side and drag their affected leg in a semicircle (circumduction) due to weakness of leg flexors and extended foot. Hemiplegic gait is often seen in patients who have suffered a stroke.

      Other gait disorders include ataxic gait, spastic gait, and steppage gait, each with their own unique characteristics and associated conditions. Accurate diagnosis and treatment of gait disorders is important for improving mobility and quality of life for affected individuals.

    • This question is part of the following fields:

      • Neurosciences
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  • Question 62 - Which of the following conditions is most strongly indicated by a flat affect?...

    Incorrect

    • Which of the following conditions is most strongly indicated by a flat affect?

      Your Answer:

      Correct Answer: Schizophrenia

      Explanation:

      Mental State Exam – Mood and Affect

      Affect is a term used to describe a patient’s present emotional responsiveness, which is indicated by their facial expression and tone of voice. It can be described as being within normal range, constricted (where the affect is restricted in range and intensity), blunted (similar to constricted but a bit more so), of flat (where there are virtually no signs of affective expression). Mood, on the other hand, is a more prolonged prevailing state of disposition. A feeling is an active experience of somatic sensation of a passive subjective experience of an emotion, while an emotion is best thought of as a feeling and memory intertwined. Apathy is the absence of feeling. It is important to distinguish between affect and mood, as affect is momentary and mood is more prolonged.

    • This question is part of the following fields:

      • Classification And Assessment
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  • Question 63 - A client is referred to your clinic by their physician due to a...

    Incorrect

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

      Your Answer:

      Correct Answer: Selegiline

      Explanation:

      Alternative Routes of Administration for Antidepressants

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

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

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

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

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

    • This question is part of the following fields:

      • Psychopharmacology
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  • Question 64 - The defense mechanism that best explains the concept of clerical celibacy, which aims...

    Incorrect

    • The defense mechanism that best explains the concept of clerical celibacy, which aims to convert primal and earthly urges for physical gratification into sacred yearnings for spiritual communion with God, is:

      Your Answer:

      Correct Answer: Sublimation

      Explanation:

      Some people believe that redirecting their sexual desires towards more constructive and advantageous outcomes is a form of sublimation.

      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 65 - A 17-year-old girl is involved in a car crash and is experiencing internal...

    Incorrect

    • A 17-year-old girl is involved in a car crash and is experiencing internal bleeding. She has no identified emergency contact and is declining medical intervention. As she is unable to provide consent, what options are available for her treatment?

      Your Answer:

      Correct Answer: Common law

      Explanation:

      Legal Principles and Acts Related to Mental Capacity and Treatment

      A common law principle is a legal concept that is recognized and enforced by courts based on societal customs. The doctrine of necessity allows for the use of reasonable force and necessary treatment for individuals who lack capacity and are in their best interests.

      The Mental Capacity Act Deprivation of Liberty Safeguards (DoLS) provides protection for vulnerable individuals who lack capacity and are in hospitals of care homes. It applies to those who are 18 and over, have a mental disorder of disability of the mind, and cannot give informed consent for their care of treatment.

      The Mental Capacity Act 2005 governs decision-making for individuals who may lose capacity of have an incapacitating condition. It applies to those aged 16 and over who cannot make some of all decisions for themselves.

      Children who understand proposed treatments are considered competent to give consent (Gillick competent). The Mental Health Act 1983 covers the compulsory assessment and treatment of individuals with mental disorders.

    • This question is part of the following fields:

      • Basic Ethics And Philosophy Of Psychiatry
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  • Question 66 - A woman undergoing analysis has a deep sense that she is inferior and...

    Incorrect

    • A woman undergoing analysis has a deep sense that she is inferior and unlovable. She is unable to accept this and instead directs these feelings towards her therapist. The therapist finds that after the sessions they feel that they are a substandard therapist and that they are no good at their job. It is unusual for the therapist to feel this way and they note that it only seems to happen with this one patient. Which of the following best describes the feelings experienced by the therapist?

      Your Answer:

      Correct Answer: Projective identification

      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 67 - According to Kohlberg, which of the following corresponds to the 3rd stage of...

    Incorrect

    • According to Kohlberg, which of the following corresponds to the 3rd stage of moral development?

      Your Answer:

      Correct Answer: Interpersonal accord and conformity

      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.

    • This question is part of the following fields:

      • Psychological Development
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  • Question 68 - A 65-year-old woman passed away unexpectedly due to a heart attack. She had...

    Incorrect

    • A 65-year-old woman passed away unexpectedly due to a heart attack. She had been experiencing significant difficulties with her short-term memory, which had been impacting her daily activities. Upon conducting an autopsy of her brain, it was discovered that she had widespread cerebral atrophy, as well as numerous neurofibrillary tangles and neuritic plaques. What is the probable diagnosis?

      Your Answer:

      Correct Answer: Alzheimer's disease

      Explanation:

      Neurofibrillary tangles and neuritic (senile) plaques are commonly found in the brains of elderly individuals, but they are not present in Lewy body dementia. Pick’s disease is characterized by the presence of Pick’s bodies and knife blade atrophy. Creutzfeldt-Jakob disease (CJD) is identified by the spongy appearance of the grey matter in the cerebral cortex due to multiple vacuoles. If an individual experiences short-term memory problems that affect their daily life, it may indicate the presence of dementia. Alzheimer’s disease is characterized by extensive tangles and plaques in the brain.

    • This question is part of the following fields:

      • Neurosciences
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  • Question 69 - What was the first SSRI to be introduced to the European market? ...

    Incorrect

    • What was the first SSRI to be introduced to the European market?

      Your Answer:

      Correct Answer: Zimeldine

      Explanation:

      Although fluoxetine was the first SSRI to be approved and marketed in the United States, it took over seven years of clinical trials (Phase I-Phase III) to do so. Meanwhile, Astra AB introduced zimeldine (Zelmid®), the first SSRI, to the European market in March 1982. However, zimeldine, which was derived from pheniramine, was taken off the European market in September 1983 due to severe side effects such as hypersensitivity reactions and Guillain-Barre syndrome, an acute peripheral neuropathy. The hypersensitivity reactions were similar to a flu-like syndrome and included fever, joint/muscle pain, headaches, and hepatic effects.

      A Historical Note on the Development of Zimelidine, the First Selective Serotonin Reuptake Inhibitor

      In 1960s, evidence began to emerge suggesting a significant role of serotonin in depression. This led to the development of zimelidine, the first selective serotonin reuptake inhibitor (SSRI). Zimelidine was derived from pheniramine and was marketed in Europe in 1982. However, it was removed from the market in 1983 due to severe side effects such as hypersensitivity reactions and Guillain-Barre syndrome.

      Despite its short-lived availability, zimelidine paved the way for the development of other SSRIs such as fluoxetine, which was approved by the FDA in 1987 and launched in the US market in 1988 under the trade name Prozac. The development of SSRIs revolutionized the treatment of depression and other mood disorders, providing a safer and more effective alternative to earlier antidepressants such as the tricyclics and MAO inhibitors.

    • This question is part of the following fields:

      • Psychopharmacology
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  • Question 70 - Identify the option that represents a secondary amine. ...

    Incorrect

    • Identify the option that represents a secondary amine.

      Your Answer:

      Correct Answer: Desipramine

      Explanation:

      Tricyclic Antidepressants: First and Second Generation

      Tricyclic antidepressants are classified into two generations: first generation of tertiary amines, and second generation of secondary amines. The secondary amines are known to have fewer side effects and primarily affect noradrenaline, while the tertiary amines are believed to enhance both serotonin and noradrenaline.

      Secondary amines include Desipramine, Nortriptyline, Protriptyline, and Amoxapine. On the other hand, tertiary amines include Amitriptyline, Lofepramine, Imipramine, Clomipramine, Dosulepin (Dothiepin), Doxepin, Trimipramine, and Butriptyline.

      By understanding the differences between the two generations of tricyclic antidepressants, healthcare professionals can better tailor their treatment plans to their patients’ needs.

    • This question is part of the following fields:

      • Psychopharmacology
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SESSION STATS - PERFORMANCE PER SPECIALTY

Social Psychology (0/1) 0%
Classification And Assessment (1/6) 17%
History And Mental State (1/1) 100%
Genetics (1/4) 25%
Research Methods, Statistics, Critical Review And Evidence-Based Practice (1/3) 33%
Epidemiology (1/1) 100%
Advanced Psychological Processes And Treatments (0/1) 0%
Basic Psychological Processes (1/1) 100%
Cognitive Assessment (0/1) 0%
History Of Psychiatry (0/1) 0%
Descriptive Psychopathology (0/1) 0%
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