00
Correct
00
Incorrect
00 : 00 : 0 00
Session Time
00 : 00
Average Question Time ( Secs)
  • Question 1 - What gene is thought to increase the likelihood of individuals developing frontotemporal dementia?...

    Incorrect

    • What gene is thought to increase the likelihood of individuals developing frontotemporal dementia?

      Your Answer: Apolipoprotein E

      Correct Answer: Progranulin

      Explanation:

      Genes Associated with Dementia

      Dementia is a complex disorder that can be caused by various genetic and environmental factors. Several genes have been implicated in different forms of dementia. For instance, familial Alzheimer’s disease, which represents less than 1-6% of all Alzheimer’s cases, is associated with mutations in PSEN1, PSEN2, APP, and ApoE genes. These mutations are inherited in an autosomal dominant pattern. On the other hand, late-onset Alzheimer’s disease is a genetic risk factor associated with the ApoE gene, particularly the APOE4 allele. However, inheriting this allele does not necessarily mean that a person will develop Alzheimer’s.

      Other forms of dementia, such as familial frontotemporal dementia, Huntington’s disease, CADASIL, and dementia with Lewy bodies, are also associated with specific genes. For example, C9orf72 is the most common mutation associated with familial frontotemporal dementia, while Huntington’s disease is caused by mutations in the HTT gene. CADASIL is associated with mutations in the Notch3 gene, while dementia with Lewy bodies is associated with the APOE, GBA, and SNCA genes.

      In summary, understanding the genetic basis of dementia is crucial for developing effective treatments and preventive measures. However, it is important to note that genetics is only one of the many factors that contribute to the development of dementia. Environmental factors, lifestyle choices, and other health conditions also play a significant role.

    • This question is part of the following fields:

      • Genetics
      22
      Seconds
  • Question 2 - What is the lowest daily amount of paroxetine that is effective for treating...

    Correct

    • What is the lowest daily amount of paroxetine that is effective for treating depression in adults?

      Your Answer: 20 mg

      Explanation:

      Antidepressants: Minimum Effective Doses

      According to the Maudsley 13th, the following are the minimum effective doses for various antidepressants:

      – Citalopram: 20 mg/day
      – Fluoxetine: 20 mg/day
      – Fluvoxamine: 50 mg/day
      – Paroxetine: 20 mg/day
      – Sertraline: 50 mg/day
      – Mirtazapine: 30 mg/day
      – Venlafaxine: 75 mg/day
      – Duloxetine: 60 mg/day
      – Agomelatine: 25 mg/day
      – Moclobemide: 300 mg/day
      – Trazodone: 150 mg/day

      Note that these are minimum effective doses and may vary depending on individual factors and response to treatment. It is important to consult with a healthcare professional before starting of changing any medication regimen.

    • This question is part of the following fields:

      • Psychopharmacology
      8.7
      Seconds
  • Question 3 - What factor is most likely to worsen a patient's psoriasis? ...

    Incorrect

    • What factor is most likely to worsen a patient's psoriasis?

      Your Answer: Clozapine

      Correct Answer: Lithium

      Explanation:

      Lithium – Pharmacology

      Pharmacokinetics:
      Lithium salts are rapidly absorbed following oral administration and are almost exclusively excreted by the kidneys unchanged. Blood samples for lithium should be taken 12 hours post-dose.

      Ebstein’s:
      Ebstein’s anomaly is a congenital malformation consisting of a prolapse of the tricuspid valve into the right ventricle. It occurs in 1:20,000 of the general population. Initial data suggested it was more common in those using lithium but this had not held to be true.

      Contraindications:
      Addison’s disease, Brugada syndrome, cardiac disease associated with rhythm disorders, clinically significant renal impairment, untreated of untreatable hypothyroidism, low sodium levels.

      Side-effects:
      Common side effects include nausea, tremor, polyuria/polydipsia, rash/dermatitis, blurred vision, dizziness, decreased appetite, drowsiness, metallic taste, and diarrhea. Side-effects are often dose-related.

      Long-term use is associated with hypothyroidism, hyperthyroidism, hypercalcemia/hyperparathyroidism, irreversible nephrogenic diabetes insipidus, and reduced GFR.

      Lithium-induced diabetes insipidus:
      Treatment options include stopping lithium (if feasible), keeping levels within 0.4-0.8 mmol/L, once-daily dose of the drug taken at bedtime, amiloride, thiazide diuretics, indomethacin, and desmopressin.

      Toxicity:
      Lithium salts have a narrow therapeutic/toxic ratio. Risk factors for lithium toxicity include drugs altering renal function, decreased circulating volume, infections, fever, decreased oral intake of water, renal insufficiency, and nephrogenic diabetes insipidus. Features of lithium toxicity include GI symptoms and neuro symptoms.

      Pre-prescribing:
      Before prescribing lithium, renal function, cardiac function, thyroid function, FBC, and BMI should be checked. Women of childbearing age should be advised regarding contraception, and information about toxicity should be provided.

      Monitoring:
      Lithium blood levels should be checked weekly until stable, and then every 3-6 months once stable. Thyroid and renal function should be checked every 6 months. Patients should be issued with an information booklet, alert card, and record book.

    • This question is part of the following fields:

      • Psychopharmacology
      28.6
      Seconds
  • Question 4 - Which of the following is not a factor that increases the risk of...

    Correct

    • Which of the following is not a factor that increases the risk of developing neuroleptic malignant syndrome when administering antipsychotics?

      Your Answer: Being female

      Explanation:

      Serotonin Syndrome and Neuroleptic Malignant Syndrome are two conditions that can be difficult to differentiate. Serotonin Syndrome is caused by excess serotonergic activity in the CNS and is characterized by neuromuscular abnormalities, altered mental state, and autonomic dysfunction. On the other hand, Neuroleptic Malignant Syndrome is a rare acute disorder of thermoregulation and neuromotor control that is almost exclusively caused by antipsychotics. The symptoms of both syndromes can overlap, but there are some distinguishing clinical features. Hyper-reflexia, ocular clonus, and tremors are more prominent in Serotonin Syndrome, while Neuroleptic Malignant Syndrome is characterized by uniform ‘lead-pipe’ rigidity and hyporeflexia. Symptoms of Serotonin Syndrome usually resolve within a few days of stopping the medication, while Neuroleptic Malignant Syndrome can take up to 14 days to remit with appropriate treatment. The following table provides a useful guide to the main differentials of Serotonin Syndrome and Neuroleptic Malignant Syndrome.

    • This question is part of the following fields:

      • Psychopharmacology
      41.8
      Seconds
  • Question 5 - What is the mechanism of action of sildenafil? ...

    Correct

    • What is the mechanism of action of sildenafil?

      Your Answer: Inhibition of phosphodiesterase

      Explanation:

      Nitrous oxide functions as a vasodilator during penile erection by diffusing through the muscle cell membrane and binding to guanylyl cyclase. This enzyme catalyzes the conversion of GTP to cyclic GMP, which activates a cGMP-dependent protein kinase. This kinase stimulates the uptake of calcium by the endoplasmic reticulum of the muscle cell, leading to muscle relaxation and vasodilation, resulting in an erection.

      To end the erection, cGMP is converted into GMP by a specific phosphodiesterase (PDE). There are ten families of PDEs, with PDE5 being the primary PDE found in vascular smooth muscle. Sildenafil (Viagra) is a specific inhibitor of PDE5, blocking the breakdown of cGMP and prolonging the effects of cGMP, thereby prolonging the erection.

      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
      16.5
      Seconds
  • Question 6 - What is the cause of Kluver-Bucy syndrome, which occurs as a result of...

    Incorrect

    • What is the cause of Kluver-Bucy syndrome, which occurs as a result of damage to which part of the brain?

      Your Answer: Cerebellum

      Correct Answer: Temporal lobe

      Explanation:

      Kluver-Bucy syndrome is a neurological disorder that results from dysfunction in both the right and left medial temporal lobes of the brain. This condition is characterized by a range of symptoms, including docility, altered dietary habits, hyperorality, and changes in sexual behavior. Additionally, individuals with Kluver-Bucy syndrome may experience visual agnosia, which is a condition that impairs their ability to recognize and interpret visual stimuli.

    • This question is part of the following fields:

      • Neurosciences
      14
      Seconds
  • Question 7 - Which statement accurately describes sporadic CJD? ...

    Incorrect

    • Which statement accurately describes sporadic CJD?

      Your Answer: The EEG characteristically shows slowing only

      Correct Answer: It tends to affect older rather than younger people

      Explanation:

      Variant CJD primarily affects younger individuals, while sporadic CJD is more commonly seen in older individuals.

      Creutzfeldt-Jakob Disease: Differences between vCJD and CJD

      Creutzfeldt-Jakob Disease (CJD) is a prion disease that includes scrapie, BSE, and Kuru. However, there are important differences between sporadic (also known as classic) CJD and variant CJD. The table below summarizes these differences.

      vCJD:
      – Longer duration from onset of symptoms to death (a year of more)
      – Presents with psychiatric and behavioral symptoms before neurological symptoms
      – MRI shows pulvinar sign
      – EEG shows generalized slowing
      – Originates from infected meat products
      – Affects younger people (age 25-30)

      CJD:
      – Shorter duration from onset of symptoms to death (a few months)
      – Presents with neurological symptoms
      – MRI shows bilateral anterior basal ganglia high signal
      – EEG shows biphasic and triphasic waves 1-2 per second
      – Originates from genetic mutation (bad luck)
      – Affects older people (age 55-65)

      Overall, understanding the differences between vCJD and CJD is important for diagnosis and treatment.

    • This question is part of the following fields:

      • Neurosciences
      44
      Seconds
  • Question 8 - The nomenclature of PrPSc, the disease-linked form of mammalian prion protein PrP, was...

    Incorrect

    • The nomenclature of PrPSc, the disease-linked form of mammalian prion protein PrP, was derived from a long-observed prion disease in which animal?

      Your Answer: Cattle

      Correct Answer: Sheep

      Explanation:

      The term PrPSc originated from scrapie, a prion disease that affects sheep. In humans, the normal isoform of prion protein is PrPC, while the abnormal form is known as PrPres (protease-resistant) of PrPSc. Scrapie has been observed in sheep for over 300 years, while BSE in cattle was only identified in the 1980s. Feline spongiform encephalopathy (FSE) is a prion disease that affects cats, and Chronic wasting disease (CWD) is a similar condition that affects deer.

    • This question is part of the following fields:

      • Neurosciences
      10.9
      Seconds
  • Question 9 - Which of the following is linked to losing weight? ...

    Incorrect

    • Which of the following is linked to losing weight?

      Your Answer: Lamotrigine

      Correct Answer: Topiramate

      Explanation:

      Topiramate is a medication used for epilepsy and bipolar affective disorder. It works by inhibiting voltage gated sodium channels and increasing GABA levels. Unlike most psychotropic drugs, it is associated with weight loss.

    • This question is part of the following fields:

      • Psychopharmacology
      18.1
      Seconds
  • Question 10 - Which of the following is classified as a large molecule neurotransmitter? ...

    Incorrect

    • Which of the following is classified as a large molecule neurotransmitter?

      Your Answer: Glutamate

      Correct Answer: Oxytocin

      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
      74.3
      Seconds
  • Question 11 - What is the reason for the induction of CYP1A2, and how does it...

    Incorrect

    • What is the reason for the induction of CYP1A2, and how does it related to the need for higher doses of clozapine in certain individuals?

      Your Answer: St John's Wort

      Correct Answer: Smoking

      Explanation:

      The Cytochrome P450 system is a group of enzymes that metabolize drugs by altering their functional groups. The system is located in the liver and small intestine and is involved in drug interactions through enzyme induction of inhibition. Notable inducers include smoking, alcohol, and St John’s Wort, while notable inhibitors include grapefruit juice and some SSRIs. CYP2D6 is important due to genetic polymorphism, and CYP3A4 is the most abundant subfamily and is commonly involved in interactions. Grapefruit juice inhibits both CYP1A2 and CYP3A4, while tobacco smoking induces CYP1A2. The table summarizes the main substrates, inhibitors, and inducers for each CYP enzyme.

    • This question is part of the following fields:

      • Psychopharmacology
      46.5
      Seconds
  • Question 12 - Which of the options below is not a symptom commonly associated with antidepressant...

    Correct

    • Which of the options below is not a symptom commonly associated with antidepressant withdrawal syndrome?

      Your Answer: Agomelatine

      Explanation:

      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
      10.7
      Seconds
  • Question 13 - The layers of the neocortex from the 1st to the 6th are arranged...

    Incorrect

    • The layers of the neocortex from the 1st to the 6th are arranged as follows:

      Your Answer: Internal granular, internal pyramidal, multiform, molecular, external granular, external pyramidal

      Correct Answer: Molecular, external granular, external pyramidal, internal granular, internal pyramidal, multiform

      Explanation:

      The layers of neocortex from outermost to innermost include: the molecular, external granular layer, external pyramidal, internal granular, internal pyramidal and multiform layer.

    • This question is part of the following fields:

      • Neuro-anatomy
      51.4
      Seconds
  • Question 14 - The thalamic nuclei that project over wide regions of the neocortex are: ...

    Incorrect

    • The thalamic nuclei that project over wide regions of the neocortex are:

      Your Answer: Midline nuclei only

      Correct Answer: Specific relay nuclei

      Explanation:

      The thalamus is considered the relay station for sensory and motor stimuli. There are three basic types of thalamic nuclei: relay nuclei, association nuclei and non-specific nuclei. Relay nuclei receive very well defined inputs and project this signal to functionally distinct areas of the cerebral cortex. These include the nuclei that relay primary sensations and also the nuclei involved in feedback of cerebellar signals and basal gangliar output.

    • This question is part of the following fields:

      • Neuro-anatomy
      16.4
      Seconds
  • Question 15 - A physically fit 56-year-old man is started on lithium for a recurrent depressive...

    Incorrect

    • A physically fit 56-year-old man is started on lithium for a recurrent depressive illness. His lithium level after one week on a dose of 400 mg at night is 0.1 mmol/L. After a dose increase to 600 mg at night, his level rises to 1.0 mmol/L ten days later. His plasma urea is within normal limits. What is the most probable reason for these findings?

      Your Answer: Normal pharmacokinetics

      Correct Answer: Variable adherence

      Explanation:

      If an individual is taking lithium regularly, a steady state level should be achieved within a week. If there are unexpected changes in the serum lithium level in an otherwise healthy person, it may indicate non-compliance with medication. The concomitant use of NSAIDs is unlikely to cause a significant increase in serum lithium levels, and mild renal impairment of normal plasma urea levels would not typically result in such an increase. Additionally, a normal pharmacokinetic profile would be expected to reach a steady state level after a week of regular dosing. Normal plasma urea levels suggest that dehydration is not a likely cause of the changes in serum lithium levels.

    • This question is part of the following fields:

      • Psychopharmacology
      24.8
      Seconds
  • Question 16 - What does each codon code for? ...

    Incorrect

    • What does each codon code for?

      Your Answer: Protein

      Correct Answer: Amino acid

      Explanation:

      Codons and Amino Acids

      Codons are made up of three bases and each codon codes for an amino acid. There are 64 different triplet sequences, with three of them indicating the end of the polypeptide chain. The start codon always has the code AUG in mRNA and codes for the amino acid methionine. This leaves 61 codons that code for a total of 20 different amino acids. As a result, most of the amino acids are represented by more than one codon. Amino acids are the building blocks of proteins, which can form short polymer chains called peptides of longer chains called polypeptides of proteins.

    • This question is part of the following fields:

      • Genetics
      76.7
      Seconds
  • Question 17 - A young girl who has had herpes encephalitis develops a severe carbohydrate craving...

    Correct

    • A young girl who has had herpes encephalitis develops a severe carbohydrate craving and weight gain. What would be your suspicion?

      Your Answer: Klüver-Bucy syndrome

      Explanation:

      Kluver-Bucy Syndrome: Causes and Symptoms

      Kluver-Bucy syndrome is a neurological disorder that results from bilateral medial temporal lobe dysfunction, particularly in the amygdala. This condition is characterized by a range of symptoms, including hyperorality (a tendency to explore objects with the mouth), hypersexuality, docility, visual agnosia, and dietary changes.

      The most common causes of Kluver-Bucy syndrome include herpes, late-stage Alzheimer’s disease, frontotemporal dementia, trauma, and bilateral temporal lobe infarction. In some cases, the condition may be reversible with treatment, but in others, it may be permanent and require ongoing management. If you of someone you know is experiencing symptoms of Kluver-Bucy syndrome, it is important to seek medical attention promptly to determine the underlying cause and develop an appropriate treatment plan.

    • This question is part of the following fields:

      • Neurosciences
      7.7
      Seconds
  • Question 18 - What investigation results would indicate a diagnosis of SIADH? ...

    Correct

    • What investigation results would indicate a diagnosis of SIADH?

      Your Answer: Increased urine sodium

      Explanation:

      Hyponatraemia is a condition where the serum sodium level in a patient falls below 135 mmol/L, with severe hyponatraemia being defined as a level below 120 mmol/L. The causes of hyponatraemia can be classified based on the patient’s fluid status, which can be hypovolaemic, euvolemic, of hypervolaemic. Hypovolaemic hyponatraemia occurs when there is a reduction in extracellular fluid volume and serum sodium levels, often due to gastrointestinal losses. Euvolemic hyponatraemia is the most common type and occurs when the extracellular fluid volume is normal. This type can be caused by conditions such as SIADH, hypothyroidism, primary polydipsia, and medications. Hypervolaemic hyponatraemia is associated with increased extracellular volume and occurs when fluid retention is greater than sodium retention, often due to cardiac and renal failures of liver cirrhosis.

      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
      38.9
      Seconds
  • Question 19 - In which part of the skull is the structure located in the posterior...

    Incorrect

    • In which part of the skull is the structure located in the posterior cranial fossa?

      Your Answer: Greater wing of the sphenoid bone

      Correct Answer: Foramen magnum

      Explanation:

      The base of the skull contains a sizable opening called the foramen magnum, which permits the spinal cord to pass through.

      Cranial Fossae and Foramina

      The cranium is divided into three regions known as fossae, each housing different cranial lobes. The anterior cranial fossa contains the frontal lobes and includes the frontal and ethmoid bones, as well as the lesser wing of the sphenoid. The middle cranial fossa contains the temporal lobes and includes the greater wing of the sphenoid, sella turcica, and most of the temporal bones. The posterior cranial fossa contains the occipital lobes, cerebellum, and medulla and includes the occipital bone.

      There are several foramina in the skull that allow for the passage of various structures. The most important foramina likely to appear in exams are listed below:

      – Foramen spinosum: located in the middle fossa and allows for the passage of the middle meningeal artery.
      – Foramen ovale: located in the middle fossa and allows for the passage of the mandibular division of the trigeminal nerve.
      – Foramen lacerum: located in the middle fossa and allows for the passage of the small meningeal branches of the ascending pharyngeal artery and emissary veins from the cavernous sinus.
      – Foramen magnum: located in the posterior fossa and allows for the passage of the spinal cord.
      – Jugular foramen: located in the posterior fossa and allows for the passage of cranial nerves IX, X, and XI.

      Understanding the location and function of these foramina is essential for medical professionals, as they play a crucial role in the diagnosis and treatment of various neurological conditions.

    • This question is part of the following fields:

      • Neurosciences
      43.4
      Seconds
  • Question 20 - What is the lowest daily amount of citalopram that is effective for treating...

    Incorrect

    • What is the lowest daily amount of citalopram that is effective for treating depression in adults?

      Your Answer: 10 mg

      Correct Answer: 20 mg

      Explanation:

      Antidepressants: Minimum Effective Doses

      According to the Maudsley 13th, the following are the minimum effective doses for various antidepressants:

      – Citalopram: 20 mg/day
      – Fluoxetine: 20 mg/day
      – Fluvoxamine: 50 mg/day
      – Paroxetine: 20 mg/day
      – Sertraline: 50 mg/day
      – Mirtazapine: 30 mg/day
      – Venlafaxine: 75 mg/day
      – Duloxetine: 60 mg/day
      – Agomelatine: 25 mg/day
      – Moclobemide: 300 mg/day
      – Trazodone: 150 mg/day

      Note that these are minimum effective doses and may vary depending on individual factors and response to treatment. It is important to consult with a healthcare professional before starting of changing any medication regimen.

    • This question is part of the following fields:

      • Psychopharmacology
      19.4
      Seconds
  • Question 21 - For which specific symptom would you recommend a patient to begin taking buspirone?...

    Correct

    • For which specific symptom would you recommend a patient to begin taking buspirone?

      Your Answer: Can cause dry mouth

      Explanation:

      Buspirone is a type of anti-anxiety medication that belongs to the azapirone (azaspirodecanedione) class of drugs. It is used to treat the same conditions as benzodiazepines. Unlike benzodiazepines, buspirone is a partial agonist of the serotonin 5HT1A receptor and does not cause sedation, physical dependence, of psychomotor impairment. However, it may cause side effects such as dizziness, headache, excitement, and nausea. Other less common side effects include dry mouth, tachycardia/palpitations/chest pain, drowsiness/confusion, seizures, fatigue, and sweating. Buspirone is not recommended for individuals with epilepsy, severe hepatic impairment, moderate to severe renal impairment, during pregnancy, of while breastfeeding.

    • This question is part of the following fields:

      • Psychopharmacology
      13.7
      Seconds
  • Question 22 - A 35-year-old individual who wants to quit smoking is considering bupropion. What class...

    Incorrect

    • A 35-year-old individual who wants to quit smoking is considering bupropion. What class of antidepressant does bupropion fall under?

      Your Answer: Tricyclic antidepressant (TCA)

      Correct Answer: Norepinephrine dopamine reuptake inhibitor (NDRI)

      Explanation:

      Bupropion is classified as a norepinephrine dopamine reuptake inhibitor (NDRI) and is used in smoking cessation by increasing dopamine levels in the limbic area, which reduces cravings. Other types of reuptake inhibitors include norepinephrine reuptake inhibitors (NRIs) such as atomoxetine and reboxetine, selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine, paroxetine, citalopram, escitalopram, sertraline, and fluvoxamine, serotonin-norepinephrine reuptake inhibitors (SNRIs) such as venlafaxine, desvenlafaxine, duloxetine, and milnacipran, and tricyclic antidepressants such as amitriptyline, nortriptyline, trazodone, and nefazodone.

    • This question is part of the following fields:

      • Psychopharmacology
      26.5
      Seconds
  • Question 23 - What is an example of an adverse drug reaction that is related to...

    Correct

    • What is an example of an adverse drug reaction that is related to the immune system?

      Your Answer: Cytotoxic

      Explanation:

      Out of these options, only the cytotoxic reaction is immunologic and specifically mediated by antibodies.

      Adverse Drug Reactions (ADRs) refer to the harmful effects associated with the use of a medication at a normal dose. These reactions are classified into two types: Type A and Type B. Type A reactions can be predicted from the pharmacology of the drug and are dose-dependent, meaning they can be reversed by withdrawing the drug. On the other hand, Type B reactions cannot be predicted from the known pharmacology of the drug and include allergic reactions.

      Type A reactions account for up to 80% of all ADRs, while Type B reactions are less common. Allergic reactions are a type of Type B reaction and are further subdivided by Gell and Coombs into four types: Type I (IgE-mediated) reactions, Type II (cytotoxic) reactions, Type III (immune complex) reactions, and Type IV (cell-mediated) reactions. Proper identification and management of ADRs are crucial in ensuring patient safety and optimizing treatment outcomes.

    • This question is part of the following fields:

      • Psychopharmacology
      14.3
      Seconds
  • Question 24 - What condition is identified by the existence of Pick bodies? ...

    Incorrect

    • What condition is identified by the existence of Pick bodies?

      Your Answer: Lewy body dementia

      Correct Answer: Frontotemporal dementia

      Explanation:

      Frontotemporal Lobar Degeneration (FTLD) is a pathological term that refers to a group of neurodegenerative disorders that affect the frontal and temporal lobes of the brain. FTLD is classified into several subtypes based on the main protein component of neuronal and glial abnormal inclusions and their distribution. The three main proteins associated with FTLD are Tau, TDP-43, and FUS. Each FTD clinical phenotype has been associated with different proportions of these proteins. Macroscopic changes in FTLD include atrophy of the frontal and temporal lobes, with focal gyral atrophy that resembles knives. Microscopic changes in FTLD-Tau include neuronal and glial tau aggregation, with further sub-classification based on the existence of different isoforms of tau protein. FTLD-TDP is characterized by cytoplasmic inclusions of TDP-43 in neurons, while FTLD-FUS is characterized by cytoplasmic inclusions of FUS.

    • This question is part of the following fields:

      • Neurosciences
      18.7
      Seconds
  • Question 25 - 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:

      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
      0
      Seconds
  • Question 26 - What is the name of the gene located on chromosome 1 that is...

    Incorrect

    • What is the name of the gene located on chromosome 1 that is a candidate for schizophrenia and codes for a multifunctional protein that affects neuronal development and adult brain function, including neurite architecture, neuronal migration, intracellular transport, and synaptic transmission?

      Your Answer:

      Correct Answer: DISC1

      Explanation:

      Schizophrenia is a complex disorder that is associated with multiple candidate genes. No single gene has been identified as the sole cause of schizophrenia, and it is believed that the more genes involved, the greater the risk. Some of the important candidate genes for schizophrenia include DTNBP1, COMT, NRG1, G72, RGS4, DAOA, DISC1, and DRD2. Among these, neuregulin, dysbindin, and DISC1 are the most replicated and plausible genes, with COMT being the strongest candidate gene due to its role in dopamine metabolism. Low activity of the COMT gene has been associated with obsessive-compulsive disorder and schizophrenia. Neuregulin 1 is a growth factor that stimulates neuron development and differentiation, and increased neuregulin signaling in schizophrenia may suppress the NMDA receptor, leading to lowered glutamate levels. Dysbindin is involved in the biogenesis of lysosome-related organelles, and its expression is decreased in schizophrenia. DISC1 encodes a multifunctional protein that influences neuronal development and adult brain function, and it is disrupted in schizophrenia. It is located at the breakpoint of a balanced translocation identified in a large Scottish family with schizophrenia, schizoaffective disorder, and other major mental illnesses.

    • This question is part of the following fields:

      • Genetics
      0
      Seconds
  • Question 27 - A 32-year-old woman who has been diagnosed with bipolar disorder for several years...

    Incorrect

    • A 32-year-old woman who has been diagnosed with bipolar disorder for several years reports experiencing fatigue, increased weight, and feeling cold. Which psychotropic medication is most likely responsible for these symptoms?

      Your Answer:

      Correct Answer: Lithium

      Explanation:

      Lithium is well-known for causing various thyroid disorders, including hypothyroidism, hyperthyroidism, and thyroiditis.

    • This question is part of the following fields:

      • Psychopharmacology
      0
      Seconds
  • Question 28 - Choose the correct answer: The interposed nuclei… ...

    Incorrect

    • Choose the correct answer: The interposed nuclei…

      Your Answer:

      Correct Answer: Are the emboliform and globose nuclei in the paravermis

      Explanation:

      The interposed nuclei are a part of deep cerebellar complex and are composed of the globose nucleus and the emboliform nucleus. It receives afferent fibers from the anterior lobe of the cerebellum and sends output via the superior cerebellar peduncle to the red nucleus.

    • This question is part of the following fields:

      • Neuro-anatomy
      0
      Seconds
  • Question 29 - Which of the following findings would provide the strongest evidence for a diagnosis...

    Incorrect

    • Which of the following findings would provide the strongest evidence for a diagnosis of lithium toxicity in a man who has just started taking lithium and is reporting feeling unwell during a clinic visit?

      Your Answer:

      Correct Answer: Ataxia

      Explanation:

      Lithium – Pharmacology

      Pharmacokinetics:
      Lithium salts are rapidly absorbed following oral administration and are almost exclusively excreted by the kidneys unchanged. Blood samples for lithium should be taken 12 hours post-dose.

      Ebstein’s:
      Ebstein’s anomaly is a congenital malformation consisting of a prolapse of the tricuspid valve into the right ventricle. It occurs in 1:20,000 of the general population. Initial data suggested it was more common in those using lithium but this had not held to be true.

      Contraindications:
      Addison’s disease, Brugada syndrome, cardiac disease associated with rhythm disorders, clinically significant renal impairment, untreated of untreatable hypothyroidism, low sodium levels.

      Side-effects:
      Common side effects include nausea, tremor, polyuria/polydipsia, rash/dermatitis, blurred vision, dizziness, decreased appetite, drowsiness, metallic taste, and diarrhea. Side-effects are often dose-related.

      Long-term use is associated with hypothyroidism, hyperthyroidism, hypercalcemia/hyperparathyroidism, irreversible nephrogenic diabetes insipidus, and reduced GFR.

      Lithium-induced diabetes insipidus:
      Treatment options include stopping lithium (if feasible), keeping levels within 0.4-0.8 mmol/L, once-daily dose of the drug taken at bedtime, amiloride, thiazide diuretics, indomethacin, and desmopressin.

      Toxicity:
      Lithium salts have a narrow therapeutic/toxic ratio. Risk factors for lithium toxicity include drugs altering renal function, decreased circulating volume, infections, fever, decreased oral intake of water, renal insufficiency, and nephrogenic diabetes insipidus. Features of lithium toxicity include GI symptoms and neuro symptoms.

      Pre-prescribing:
      Before prescribing lithium, renal function, cardiac function, thyroid function, FBC, and BMI should be checked. Women of childbearing age should be advised regarding contraception, and information about toxicity should be provided.

      Monitoring:
      Lithium blood levels should be checked weekly until stable, and then every 3-6 months once stable. Thyroid and renal function should be checked every 6 months. Patients should be issued with an information booklet, alert card, and record book.

    • This question is part of the following fields:

      • Psychopharmacology
      0
      Seconds
  • Question 30 - Which statement about the anatomy of the basal ganglia is accurate? ...

    Incorrect

    • Which statement about the anatomy of the basal ganglia is accurate?

      Your Answer:

      Correct Answer: The subthalamic nucleus is part of the basal ganglia

      Explanation:

      The Basal Ganglia: Functions and Disorders

      The basal ganglia are a group of subcortical structures that play a crucial role in controlling movement and some cognitive processes. The components of the basal ganglia include the striatum (caudate, putamen, nucleus accumbens), subthalamic nucleus, globus pallidus, and substantia nigra (divided into pars compacta and pars reticulata). The putamen and globus pallidus are collectively referred to as the lenticular nucleus.

      The basal ganglia are connected in a complex loop, with the cortex projecting to the striatum, the striatum to the internal segment of the globus pallidus, the internal segment of the globus pallidus to the thalamus, and the thalamus back to the cortex. This loop is responsible for regulating movement and cognitive processes.

      However, problems with the basal ganglia can lead to several conditions. Huntington’s chorea is caused by degeneration of the caudate nucleus, while Wilson’s disease is characterized by copper deposition in the basal ganglia. Parkinson’s disease is associated with degeneration of the substantia nigra, and hemiballism results from damage to the subthalamic nucleus.

      In summary, the basal ganglia are a crucial part of the brain that regulate movement and some cognitive processes. Disorders of the basal ganglia can lead to significant neurological conditions that affect movement and other functions.

    • This question is part of the following fields:

      • Neurosciences
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Genetics (1/4) 25%
Psychopharmacology (8/14) 57%
Neurosciences (2/4) 50%
Neuro-anatomy (0/2) 0%
Passmed