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  • Question 1 - Which of the following is a form of synaptic plasticity? ...

    Incorrect

    • Which of the following is a form of synaptic plasticity?

      Your Answer: Neurogenesis

      Correct Answer: Working memory

      Explanation:

      Synaptic plasticity is an important neurochemical foundation of working memory and generation of memory. Synaptic plasticity is the ability of synapses to strengthen or weaken over time in response to increases or decreases in their activity.

    • This question is part of the following fields:

      • Neuro-anatomy
      15.1
      Seconds
  • Question 2 - Which germ cell layer gives rise to the developing human brain during embryonic...

    Incorrect

    • Which germ cell layer gives rise to the developing human brain during embryonic development?

      Your Answer: Endoderm

      Correct Answer: Ectoderm

      Explanation:

      The three primary cell layers in embryonic development are the ectoderm, endoderm, and mesoderm. The ectoderm is responsible for the development of the nervous system, skin, and tooth enamel. The endoderm differentiates into the epithelial lining of the gastrointestinal, respiratory, and renal tracts, while the mesoderm develops into muscle, blood, and connective tissues. Within the ectodermal layer, a neural plate thickens and folds to form the neural tube, which ultimately gives rise to the brain and spinal cord.

    • This question is part of the following fields:

      • Neurosciences
      37.2
      Seconds
  • Question 3 - What is a requirement for managing personal information under the provisions of the...

    Incorrect

    • What is a requirement for managing personal information under the provisions of the Data Protection Act?

      Your Answer: Sensitive information must be encrypted

      Correct Answer: Data must be kept for only as long as they are needed

      Explanation:

      The Data Protection Act mandates that organisations should not retain personal of sensitive information beyond the purpose for which it was collected. Furthermore, data must only be used for the intended purpose and cannot be transferred outside the EU. While encryption of sensitive information is not mandatory, appropriate technical and organisational measures must be implemented to prevent unauthorised of unlawful access to personal data.

    • This question is part of the following fields:

      • Basic Ethics And Philosophy Of Psychiatry
      277.8
      Seconds
  • Question 4 - What is the enzyme responsible for deactivating acetylcholine? ...

    Incorrect

    • What is the enzyme responsible for deactivating acetylcholine?

      Your Answer: Cholinesterase

      Correct Answer: Acetylcholinesterase

      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
      22.4
      Seconds
  • Question 5 - Which medications have the potential to reduce the contraceptive effect of oral contraceptives?...

    Incorrect

    • Which medications have the potential to reduce the contraceptive effect of oral contraceptives?

      Your Answer: Lithium

      Correct Answer: St John's Wort

      Explanation:

      Out of the given options, only St John’s Wort is explicitly stated in the interactions section of the BNF as causing a decrease in contraceptive effectiveness. While tricyclic antidepressants are also mentioned, the BNF notes that their impact may be on the effectiveness of the antidepressant rather than the contraceptive.

      Interactions with Oral Contraceptives

      Psychiatric drugs such as St John’s Wort, Carbamazepine, Phenytoin, Topiramate, and Barbiturates can interact with oral contraceptives and lead to a reduced contraceptive effect. It is important to be aware of these potential interactions to ensure the effectiveness of oral contraceptives.

    • This question is part of the following fields:

      • Psychopharmacology
      21.1
      Seconds
  • Question 6 - What is the tool used to evaluate the intelligence of children? ...

    Correct

    • What is the tool used to evaluate the intelligence of children?

      Your Answer: WISC

      Explanation:

      The WISC, a commonly utilized IQ assessment for children, consists of ten distinct evaluations that generate performance and verbal IQ scores, as well as an overall IQ score. NART, on the other hand, is a measure of premorbid IQ, while Rivermead assesses visual memory. WAIS is the adult version of the Wechsler intelligence scale, and the Wisconsin card sorting test evaluates executive function, specifically the frontal lobe.

    • This question is part of the following fields:

      • Description And Measurement
      26.4
      Seconds
  • Question 7 - An elderly man complains that his urine appears milky white, on further questioning...

    Incorrect

    • An elderly man complains that his urine appears milky white, on further questioning you ascertain that he believes he is passing semen in his urine. Which condition is he most likely to be suffering with?

      Your Answer: Koro

      Correct Answer: Dhat

      Explanation:

      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
      449.3
      Seconds
  • Question 8 - The ependyma fuse with which of the following to from the choroid plexus?...

    Correct

    • The ependyma fuse with which of the following to from the choroid plexus?

      Your Answer: Tela choroidea

      Explanation:

      The choroid plexus produces the cerebrospinal fluid (CSF) in the ventricles of the brain. It consists of modified ependymal cells. Tela choroidea is a region of pia mater of the meninges and underlying ependyma that’s a part of the choroid plexus. It is a very thin layer of the connective tissue of pia mater that overlies and covers the ependyma.

    • This question is part of the following fields:

      • Neuro-anatomy
      20.6
      Seconds
  • Question 9 - A 45-year-old man with a mild depressive disorder currently taking an SSRI reports...

    Incorrect

    • A 45-year-old man with a mild depressive disorder currently taking an SSRI reports worsening tiredness. His blood test shows a sodium level of 122 mmol/L.
      Which antidepressant would be more suitable in this situation?

      Your Answer: Fluoxetine

      Correct Answer: Agomelatine

      Explanation:

      Unlike other antidepressants, agomelatine (Valdoxan) does not affect serotonin transmission and is a melatonin agonist. It has a good safety profile and there have been no reported cases of hyponatraemia associated with its use. On the other hand, the other listed antidepressants have been linked to hyponatraemia.

    • This question is part of the following fields:

      • Psychopharmacology
      70.4
      Seconds
  • Question 10 - During an evaluation, it appears difficult to obtain a straightforward response from your...

    Correct

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

      Your Answer: Circumstantiality

      Explanation:

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

    • This question is part of the following fields:

      • Assessment
      24.6
      Seconds
  • Question 11 - What type of adverse drug reaction is typically associated with blood abnormalities like...

    Incorrect

    • What type of adverse drug reaction is typically associated with blood abnormalities like neutropenia?

      Your Answer: Type V

      Correct Answer: Type II

      Explanation:

      Immunologic Adverse Drug Reactions

      Immunologic adverse drug reactions account for a small percentage of all adverse drug reactions, ranging from 5 to 10%. These reactions are classified using the Gell and Coombs system, which categorizes them into four groups: Type I, Type II, Type III, and Type IV reactions.

      Type I reactions occur when a drug-IgE complex binds to mast cells, leading to the release of histamine and other inflammatory mediators. These reactions typically cause anaphylaxis, urticaria, and bronchospasm and occur within minutes to hours after exposure.

      Type II reactions occur when an IgG of IgM antibody binds to a cell that has been altered by a drug-hapten. These reactions often manifest as blood abnormalities, such as thrombocytopenia and neutropenia, and their timing is variable.

      Type III reactions occur when drug-antibody complexes activate the complement system, leading to fever, rash, urticaria, and vasculitis. These reactions occur 1 to 3 weeks after exposure.

      Type IV reactions arise when the MHC system presents drug molecules to T cells, resulting in allergic contact dermatitis and rashes. These reactions occur 2 to 7 days after cutaneous exposure.

    • This question is part of the following fields:

      • Psychopharmacology
      22
      Seconds
  • Question 12 - Which drug class is most likely to result in QTc interval prolongation? ...

    Correct

    • Which drug class is most likely to result in QTc interval prolongation?

      Your Answer: Antimalarials

      Explanation:

      Amantadine and QTc Prolongation

      Amantadine is a medication used to treat Parkinson’s disease and influenza. It has been associated with QTc prolongation, which can increase the risk of Torsades de points. Therefore, caution should be exercised when prescribing amantadine to patients with risk factors for QT prolongation. If a patient is already taking amantadine and develops a prolonged QTc interval, the medication should be discontinued and an alternative treatment considered. It is important to monitor the QTc interval in patients taking amantadine, especially those with risk factors for QT prolongation.

    • This question is part of the following fields:

      • Psychopharmacology
      18.7
      Seconds
  • Question 13 - What type of attachment is demonstrated by a child who is equally comforted...

    Incorrect

    • What type of attachment is demonstrated by a child who is equally comforted by a parent and a stranger?

      Your Answer: Secure

      Correct Answer: Avoidant

      Explanation:

      Attachment (Ainsworth)

      Psychologist Mary Ainsworth developed the ‘Strange Situation procedure’ to study and categorize attachment in children aged 12 to 18 months. The procedure involves seven steps, including two separations and two reunions, and takes place in one room. The child’s attachment is classified into one of three styles: secure, anxious-resistant, and anxious-avoidant. A fourth category, disorganized, is sometimes observed. Ainsworth suggested that the child’s attachment style is determined by the primary caregiver’s behavior.

      Mary Main later developed the Adult Attachment Interview and identified four categories of attachment in adults that correspond to those observed in the strange situation. The distribution of adult attachment styles correlates with those of the strange situation, with 70% of children and adults having secure attachment. Attachment styles also seem to be passed on to subsequent generations.

    • This question is part of the following fields:

      • Psychological Development
      24.5
      Seconds
  • Question 14 - What is a typical developmental milestone in children? ...

    Incorrect

    • What is a typical developmental milestone in children?

      Your Answer: At 18 months, for the first time they stand alone holding the furniture

      Correct Answer: Begins to sit unsupported at 8 months of age

      Explanation:

      Starting to sit unsupported at 8 months is considered normal as it falls within the expected range of achieving this milestone by 9 months. However, the other choices suggest a delay in development.

      The Emergence of Social Smiling in Infants

      Wormann (2014) discusses the emergence of social smiling in infants, which is usually interpreted as the first positive expression directed towards a cause. This occurs when an infant with an initially expressionless face examines the face of another person, and their face and eyes light up while the corners of their mouth pull upward. The age of the first appearance of the social smile varies across cultures, ranging from the fifth to seventh week. Additionally, there are differences in its duration and frequency between the second and seventh month of life. Understanding these milestones is important for a basic understanding of normal child development.

      Child Development Milestones:
      4 weeks Responds to noise (either by crying, of quieting), follows an object moved in front of eyes
      6 weeks Begins social smiling*
      3 months Holds head steady on sitting
      6 months Rolls from stomach to back, starts babbling
      7 months Transfers objects from hand to hand, looks for dropped object
      9 months Sits unsupported, begins to crawl
      12 months Cruising (walking by holding furniture)
      18 months Walks without assistance, speaks about 10-20 words
      2 years Runs, climbs up and down stairs alone, makes 2-3 word sentences
      3 years Dresses self except for buttons and laces, counts to 10, feeds themself well
      4 years Hops on one foot, copies a cross
      5 years Copies a triangle, skips

    • This question is part of the following fields:

      • Psychological Development
      30.7
      Seconds
  • Question 15 - One of Kraepelin's mixed affective states was which of the following? ...

    Incorrect

    • One of Kraepelin's mixed affective states was which of the following?

      Your Answer: Grandiose depression

      Correct Answer: Depression with flight of ideas

      Explanation:

      Inhibited Mania

      Inhibited mania is one of the six mixed affective states identified by Kraepelin. It is characterized by symptoms of both mania and depression, but with a predominance of depressive features. Patients with inhibited mania may experience feelings of sadness, guilt, and worthlessness, as well as decreased energy and motivation. At the same time, they may also exhibit symptoms of mania, such as increased activity, impulsivity, and irritability.

      Inhibited mania is considered an autonomous mixed episode, meaning that the patient consistently experiences symptoms of both mania and depression. This type of mixed state is associated with a poorer prognosis compared to those occurring between transitions from one mood state to another.

      Treatment for inhibited mania typically involves a combination of mood stabilizers, antidepressants, and psychotherapy. It is important for clinicians to carefully monitor patients with inhibited mania, as they may be at increased risk for suicide and other adverse outcomes.

    • This question is part of the following fields:

      • Classification And Assessment
      14.3
      Seconds
  • Question 16 - A Kayser-Fleischer ring is a characteristic sign of which of the following? ...

    Incorrect

    • A Kayser-Fleischer ring is a characteristic sign of which of the following?

      Your Answer:

      Correct Answer: Wilson's disease

      Explanation:

      Understanding Wilson’s Disease: Causes, Symptoms, and Management

      Wilson’s disease, also known as hepatolenticular degeneration, is a genetic disorder that affects copper storage in the body. This condition is caused by a defect in the ATP7B gene, which leads to the accumulation of copper in the liver and brain. The onset of symptoms usually occurs between the ages of 10 and 25, with liver disease being the most common presentation in children and neurological symptoms in young adults.

      The excessive deposition of copper in the tissues can cause a range of symptoms, including hepatitis, cirrhosis, basal ganglia degeneration, speech and behavioral problems, asterixis, chorea, dementia, Kayser-Fleischer rings, sunflower cataract, renal tubular acidosis, haemolysis, and blue nails. Diagnosis is based on reduced serum ceruloplasmin, reduced serum copper, and increased 24-hour urinary copper excretion.

      The traditional first-line treatment for Wilson’s disease is penicillamine, which chelates copper. Trientine hydrochloride is an alternative chelating agent that may become first-line treatment in the future. Tetrathiomolybdate is a newer agent that is currently under investigation.

      In summary, Wilson’s disease is a genetic disorder that affects copper storage in the body, leading to a range of symptoms that can affect the liver, brain, and eyes. Early diagnosis and treatment are essential to prevent complications and improve outcomes.

    • This question is part of the following fields:

      • Classification And Assessment
      0
      Seconds
  • Question 17 - What is the origin of agoraphobia? ...

    Incorrect

    • What is the origin of agoraphobia?

      Your Answer:

      Correct Answer: Escape conditioning is involved

      Explanation:

      Beck identified two cognitive distortions, catastrophization and selective abstraction, which play a role in the development of depression. These distortions involve magnifying negative events and selectively focusing on negative aspects, respectively.

    • This question is part of the following fields:

      • Aetiology
      0
      Seconds
  • Question 18 - If we consider Kohlberg's theory of moral development, what would be the expected...

    Incorrect

    • If we consider Kohlberg's theory of moral development, what would be the expected stage of moral development for a 12-year-old boy?

      Your Answer:

      Correct Answer: Conventional

      Explanation:

      Developmental Stages

      There are four main developmental models that are important to understand: Freud’s theory of psychosexual development, Erikson’s theory of psychosocial development, Piaget’s theory of cognitive development, and Kohlberg’s theory of moral development.

      Freud’s theory of psychosexual development includes five stages: oral, anal, phallic, latency, and genital. These stages occur from birth to adulthood and are characterized by different areas of focus and pleasure.

      Erikson’s theory of psychosocial development includes eight stages, each with a specific crisis to be resolved. These stages occur from infancy to old age and are focused on developing a sense of self and relationships with others.

      Piaget’s theory of cognitive development includes four stages: sensorimotor, preoperational, concrete operational, and formal operational. These stages occur from birth to adulthood and are focused on the development of cognitive abilities such as perception, memory, and problem-solving.

      Kohlberg’s theory of moral development includes three stages: preconventional, conventional, and postconventional. These stages occur from childhood to adulthood and are focused on the development of moral reasoning and decision-making.

      Understanding these developmental models can help individuals better understand themselves and others, as well as provide insight into how to support healthy development at each stage.

    • This question is part of the following fields:

      • Psychological Development
      0
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  • Question 19 - What is the purpose of using the AUDIT questionnaire? ...

    Incorrect

    • What is the purpose of using the AUDIT questionnaire?

      Your Answer:

      Correct Answer: Alcohol misuse

      Explanation:

      Alcohol screening tools are available to assist in the diagnosis of alcohol problems. One such tool is the AUDIT (Alcohol Use Disorders Identification Test), which consists of 10 questions and covers harmful use, hazardous use, and dependence. Another tool is the FAST (Fast Alcohol Screening Test), which has just 4 questions and was developed for use in a busy medical setting. The CAGE is a well-known 4 question screening tool, but recent research has questioned its value. Other tools include SASQ (Single alcohol screening questionnaire), PAT (Paddington Alcohol Test), MAST (Michigan Alcoholism Screening Test), and RAPS4 (Rapid Alcohol Problem Screen 4). These tools can help identify hazardous of harmful alcohol consumption and alcohol dependence.

    • This question is part of the following fields:

      • Classification And Assessment
      0
      Seconds
  • Question 20 - What is the structure that separates the frontal and parietal lobes above from...

    Incorrect

    • What is the structure that separates the frontal and parietal lobes above from the temporal lobe below?

      Your Answer:

      Correct Answer: The Sylvian fissure

      Explanation:

      Gross Anatomy

      The brain is divided into different lobes and regions by the many fissures of grooves on its surface. It is important to be aware of some anatomical landmarks such as the medial longitudinal fissure, which separates the brain into the right and left hemispheres. Another important landmark is the lateral sulcus of the Sylvian fissure, which divides the frontal and parietal lobes above from the temporal lobe below. Additionally, the central sulcus of the fissure of Rolando separates the frontal from the parietal lobe. Understanding these anatomical landmarks is crucial in identifying and locating different areas of the brain.

    • This question is part of the following fields:

      • Neurosciences
      0
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  • Question 21 - Which interview method was utilized in the NEMESIS study conducted in the Netherlands...

    Incorrect

    • Which interview method was utilized in the NEMESIS study conducted in the Netherlands to assess mental health and incidence?

      Your Answer:

      Correct Answer: Composite international diagnostic interview (CIDI)

      Explanation:

      Several structured interviews have been used in various studies to assess mental disorders. The Clinical Interview Schedule-Revised (CIS-R) was used in the ONS 2000 psychiatric morbidity survey, while the Diagnostic Interview Schedule (DIS) was used in the Epidemiological Catchment Area study. The Psychosis Screening Questionnaire (PSQ) was used in the ONS 2000 psychiatric morbidity survey, and the Structured Clinical Interview for DSM-IV (SCID) was used in the European Study of Epidemiology of Mental Disorders (ESEMeD). Additionally, the Composite International Diagnostic Interview (CIDI) is a structured interview used by the World Health Organization (WHO) to assess mental disorders according to ICD-10 and DSM-IV criteria. The NEMESIS study in the Netherlands used CIDI to determine the prevalence of mental disorders in adults aged 18-64 years. The study began in 1996 and involved 7076 participants.

    • This question is part of the following fields:

      • Epidemiology
      0
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  • Question 22 - Which of the following does the statement I saw a man shut his...

    Incorrect

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

      Your Answer:

      Correct Answer: Delusional perception

      Explanation:

      Types of Delusions

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

      – Folie a deux: a shared delusion between two or more people
      – Grandiose: belief that one has special powers, beliefs, of purpose
      – Hypochondriacal: belief that something is physically wrong with the patient
      – Ekbom’s syndrome: belief that one has been infested with insects
      – Othello syndrome: belief that a sexual partner is cheating on them
      – Capgras delusion: belief that a person close to them has been replaced by a double
      – Fregoli delusion: patient identifies a familiar person (usually suspected to be a persecutor) in other people they meet
      – Syndrome of subjective doubles: belief that doubles of him/her exist
      – Lycanthropy: belief that one has been transformed into an animal
      – De ClĂ©rambault’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 23 - As a teenager, you find yourself feeling an intense connection to one of...

    Incorrect

    • As a teenager, you find yourself feeling an intense connection to one of your classmates. You feel an overwhelming urge to assist them in any way possible.
      What psychodynamic mechanism is most likely at play here?

      Your Answer:

      Correct Answer: Countertransference

      Explanation:

      The term countertransference has two distinct interpretations. The first refers to any emotion that the therapist experiences in response to the patient. The second interpretation pertains to the emotions that the therapist experiences in response to the patient’s transference onto them. In the first interpretation, the patient may trigger the therapist’s transference, such as reminding them of their mother. In the second interpretation, the therapist’s reaction is a result of the patient perceiving them as their mother.

    • This question is part of the following fields:

      • Dynamic Psychopathology
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  • Question 24 - What is the breakdown product of serotonin? ...

    Incorrect

    • What is the breakdown product of serotonin?

      Your Answer:

      Correct Answer: 5-Hydroxyindoleacetic acid

      Explanation:

      Serotonin: Synthesis and Breakdown

      Serotonin, also known as 5-Hydroxytryptamine (5-HT), is synthesized in the central nervous system (CNS) in the raphe nuclei located in the brainstem, as well as in the gastrointestinal (GI) tract in enterochromaffin cells. The amino acid L-tryptophan, obtained from the diet, is used to synthesize serotonin. L-tryptophan can cross the blood-brain barrier, but serotonin cannot.

      The transformation of L-tryptophan into serotonin involves two steps. First, hydroxylation to 5-hydroxytryptophan is catalyzed by tryptophan hydroxylase. Second, decarboxylation of 5-hydroxytryptophan to serotonin (5-hydroxytryptamine) is catalyzed by L-aromatic amino acid decarboxylase.

      Serotonin is taken up from the synapse by a monoamine transporter (SERT). Substances that block this transporter include MDMA, amphetamine, cocaine, TCAs, and SSRIs. Serotonin is broken down by monoamine oxidase (MAO) and then by aldehyde dehydrogenase to 5-Hydroxyindoleacetic acid (5-HIAA).

    • This question is part of the following fields:

      • Neurosciences
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  • Question 25 - Where do the spinothalamic axons decussate? ...

    Incorrect

    • Where do the spinothalamic axons decussate?

      Your Answer:

      Correct Answer: Spinal cord

      Explanation:

      The second order neurons from the spinothalamic tract cross obliquely to the opposite side in the anterior grey and white commissure within one segment of the spinal cord.

    • This question is part of the following fields:

      • Neuro-anatomy
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  • Question 26 - What waveform represents a frequency range of 4-8 Hz? ...

    Incorrect

    • What waveform represents a frequency range of 4-8 Hz?

      Your Answer:

      Correct Answer: Theta

      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 27 - The majority striatal neurons, called medium spiny neurons, utilizes which neurotransmitter? ...

    Incorrect

    • The majority striatal neurons, called medium spiny neurons, utilizes which neurotransmitter?

      Your Answer:

      Correct Answer: GABA

      Explanation:

      Medium spiny neurons are inhibitory neurons which use GABA (gamma-aminobutyric acid) which exerts inhibitory actions. These cells represent 95% of neurones within the human striatum found in basal ganglia.

    • This question is part of the following fields:

      • Neuro-anatomy
      0
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  • Question 28 - Which antipsychotic medication has the strongest binding affinity for D4 receptors? ...

    Incorrect

    • Which antipsychotic medication has the strongest binding affinity for D4 receptors?

      Your Answer:

      Correct Answer: Clozapine

      Explanation:

      Mechanisms of Action of Different Drugs

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

    • This question is part of the following fields:

      • Psychopharmacology
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  • Question 29 - A teenage boy who has experienced trauma in his past has been in...

    Incorrect

    • A teenage boy who has experienced trauma in his past has been in the hospital for several weeks. You have developed a rapport with him and often stay after your shift to talk with him. However, he finds it difficult to communicate with the other nurses who do not seem to grasp the severity of his issues. During ward rounds, there are frequent disagreements between staff members about whether he should be discharged of if more support should be provided on the ward.
      What is the most appropriate psychodynamic mechanism to explain this scenario?

      Your Answer:

      Correct Answer: Splitting

      Explanation:

      The process at play in this situation can be fully described as splitting. While the young woman may experience idealisation and denigration towards staff, these terms do not fully capture the impact on the team. Splitting can lead to a division within the staff team, with those who are idealised wanting to rescue the patient and those who are denigrated wanting to punish of remove them. This process likely involves both transference and projective identification. It is important to note that the concept of black and white thinking, commonly used in cognitive-behavioral therapy, is related but not the most accurate description of this phenomenon.

    • This question is part of the following fields:

      • Dynamic Psychopathology
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  • Question 30 - A 45-year-old male has been diagnosed with insomnia and mild depression. The doctor...

    Incorrect

    • A 45-year-old male has been diagnosed with insomnia and mild depression. The doctor decides to prescribe mirtazapine as it can also improve his mood. What is the mechanism of action of mirtazapine as a sleep aid?

      Your Answer:

      Correct Answer: H1 receptor blocking

      Explanation:

      Mirtazapine blocking of histamine 1 receptors can alleviate night time insomnia, but may also result in daytime drowsiness. Additionally, the drug blocks 5HT2C, 5HT2A, and 5HT3 receptors, which increases serotonin levels. This increase in serotonin then acts on the 5HT1A receptors, resulting in improved cognition, anti-anxiety effects, and antidepressant activity.

    • This question is part of the following fields:

      • Psychopharmacology
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SESSION STATS - PERFORMANCE PER SPECIALTY

Neuro-anatomy (1/2) 50%
Neurosciences (0/2) 0%
Basic Ethics And Philosophy Of Psychiatry (0/1) 0%
Psychopharmacology (1/4) 25%
Description And Measurement (1/1) 100%
Classification And Assessment (0/2) 0%
Assessment (1/1) 100%
Psychological Development (0/2) 0%
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