00
Correct
00
Incorrect
00 : 00 : 00
Session Time
00 : 00
Average Question Time ( Mins)
  • Question 1 - If the new antihypertensive therapy is implemented for the secondary prevention of stroke,...

    Incorrect

    • If the new antihypertensive therapy is implemented for the secondary prevention of stroke, it would result in an absolute annual risk reduction of 0.5% compared to conventional therapy. However, the cost of the new treatment is £100 more per patient per year. Therefore, what would the cost of implementing the new therapy for each stroke prevented?

      Your Answer: £50,000

      Correct Answer: £20,000

      Explanation:

      The new drug reduces the annual incidence of stroke by 0.5% and costs £100 more than conventional therapy. This means that for every 200 patients treated, one stroke would be prevented with the new drug compared to conventional therapy. The Number Needed to Treat (NNT) is 200 per year to prevent one stroke. Therefore, the annual cost of this treatment to prevent one stroke would be £20,000, which is the cost of treating 200 patients with the new drug (£100 x 200).

    • This question is part of the following fields:

      • Research Methods, Statistics, Critical Review And Evidence-Based Practice
      61.5
      Seconds
  • Question 2 - What should be avoided in individuals with hepatic impairment? ...

    Incorrect

    • What should be avoided in individuals with hepatic impairment?

      Your Answer: Citalopram

      Correct Answer: Duloxetine

      Explanation:

      Duloxetine undergoes hepatic metabolism and its clearance is significantly decreased even in cases of mild impairment. There have been documented cases of hepatocellular injury and, although rare, jaundice. A single case of fulminant hepatic failure has also been reported. Therefore, individuals with hepatic impairment should not take duloxetine as it is contraindicated (as stated in the Maudsley 14th Ed).

      Hepatic Impairment: Recommended Drugs

      Patients with hepatic impairment may experience reduced ability to metabolize drugs, toxicity, enhanced dose-related side effects, reduced ability to synthesize plasma proteins, and elevated levels of drugs subject to first-pass metabolism due to reduced hepatic blood flow. The Maudsley Guidelines 14th Ed recommends the following drugs for patients with hepatic impairment:

      Antipsychotics: Paliperidone (if depot required), Amisulpride, Sulpiride

      Antidepressants: Sertraline, Citalopram, Paroxetine, Vortioxetine (avoid TCA and MAOI)

      Mood stabilizers: Lithium

      Sedatives: Lorazepam, Oxazepam, Temazepam, Zopiclone 3.75mg (with care)

    • This question is part of the following fields:

      • Psychopharmacology
      16
      Seconds
  • Question 3 - Which type of injury of damage typically leads to utilization behaviour? ...

    Incorrect

    • Which type of injury of damage typically leads to utilization behaviour?

      Your Answer: Parietal lobe

      Correct Answer: Frontal lobe

      Explanation:

      Abnormal Motor Behaviours Associated with Utilization Behaviour

      Utilization behaviour (UB) is a condition where patients exhibit exaggerated and inappropriate motor responses to environmental cues and objects. This behaviour is automatic and instrumentally correct, but not contextually appropriate. For instance, a patient may start brushing their teeth when presented with a toothbrush, even in a setting where it is not expected. UB is caused by frontal lobe lesions that result in a loss of inhibitory control.

      Other motor abnormalities associated with UB include imitation behaviour, where patients tend to imitate the examiner’s behaviour, and the alien hand sign, where patients experience bizarre hand movements that they cannot control. Manual groping behaviour is also observed, where patients automatically manipulate objects placed in front of them. The grasp reflex, which is normal in infants, should not be present in children and adults. It is an automatic tendency to grip objects of stimuli, such as the examiner’s hand.

      Environmental Dependency Syndrome is another condition associated with UB. It describes deficits in personal control of action and an overreliance on social and physical environmental stimuli to guide behaviour in a social context. For example, a patient may start commenting on pictures in an examiner’s office, believing it to be an art gallery.

    • This question is part of the following fields:

      • Neurosciences
      17.6
      Seconds
  • Question 4 - What is the purpose of using the AUDIT questionnaire? ...

    Correct

    • What is the purpose of using the AUDIT questionnaire?

      Your 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
      35.7
      Seconds
  • Question 5 - What is true about fragile X syndrome? ...

    Incorrect

    • What is true about fragile X syndrome?

      Your Answer: It only affects males

      Correct Answer: Length of trinucleotide repeat sequence correlates with the amount of cognitive impairment

      Explanation:

      Fragile X syndrome is inherited in an X-linked manner and is caused by a mutation in the FMR1 gene. The condition is characterized by excessive trinucleotide repeats (CGG). While women can be mildly affected, the severity of cognitive impairment is directly related to the length of the trinucleotide repeat sequence.

      Fragile X Syndrome: A Genetic Disorder Causing Learning Disability and Psychiatric Symptoms

      Fragile X Syndrome is a genetic disorder that causes mental retardation, an elongated face, large protruding ears, and large testicles in men. Individuals with this syndrome tend to be shy, avoid eye contact, and have difficulties reading facial expressions. They also display stereotypic movements such as hand flapping. Fragile X Syndrome is the most common inherited cause of learning disability.

      The speech of affected individuals is often abnormal, with abnormalities of fluency. This disorder is caused by the amplification of a CGG repeat in the 5 untranslated region of the fragile X mental retardation 1 gene (FMR1). These CGG repeats disrupt synthesis of the fragile X protein (FMRP), which is essential for brain function and growth. The gene is located at Xq27. The greater number of repeats, the more severe the condition, as with other trinucleotide repeat disorders.

      The fragile X phenotype typically involves a variety of psychiatric symptoms, including features of autism, attention deficit/hyperactivity disorder, anxiety, and aggression. Both males and females can be affected, but males are more severely affected because they have only one X chromosome. The prevalence estimate of Fragile X Syndrome is 1/3600-4000.

    • This question is part of the following fields:

      • Genetics
      30
      Seconds
  • Question 6 - At what stage of cognitive development, as per Jean Piaget, do children exhibit...

    Incorrect

    • At what stage of cognitive development, as per Jean Piaget, do children exhibit egocentric behavior?

      Your Answer: Concrete operational stage

      Correct Answer: Preoperational stage

      Explanation:

      Piaget’s theory of cognitive development highlights that Preoperational children are egocentric, meaning they view the world solely from their own perspective and cannot comprehend that others may have different viewpoints. Piaget believed that cognitive development is a result of the interplay between innate abilities and environmental factors, and progresses through four distinct stages: the sensorimotor stage, Preoperational stage, concrete operational stage, and formal operational stage. While Piaget’s theory has greatly contributed to our understanding of cognitive development, it has also faced criticism over time. Other notable theories in this field include Vygotsky’s theory, Bruner’s theory, and the information-processing approach. Vygotsky’s theory, for instance, examines human development across three levels: cultural, interpersonal, and individual.

    • This question is part of the following fields:

      • Psychological Development
      42.2
      Seconds
  • Question 7 - Which hypothalamic nucleus plays the most significant role in establishing the set point...

    Correct

    • Which hypothalamic nucleus plays the most significant role in establishing the set point for daily circadian rhythms?

      Your Answer: Suprachiasmatic

      Explanation:

      Functions of the Hypothalamus

      The hypothalamus is a vital part of the brain that plays a crucial role in regulating various bodily functions. It receives and integrates sensory information about the internal environment and directs actions to control internal homeostasis. The hypothalamus contains several nuclei and fiber tracts, each with specific functions.

      The suprachiasmatic nucleus (SCN) is responsible for regulating circadian rhythms. Neurons in the SCN have an intrinsic rhythm of discharge activity and receive input from the retina. The SCN is considered the body’s master clock, but it has multiple connections with other hypothalamic nuclei.

      Body temperature control is mainly under the control of the preoptic, anterior, and posterior nuclei, which have temperature-sensitive neurons. As the temperature goes above 37ºC, warm-sensitive neurons are activated, triggering parasympathetic activity to promote heat loss. As the temperature goes below 37ºC, cold-sensitive neurons are activated, triggering sympathetic activity to promote conservation of heat.

      The hypothalamus also plays a role in regulating prolactin secretion. Dopamine is tonically secreted by dopaminergic neurons that project from the arcuate nucleus of the hypothalamus into the anterior pituitary gland via the tuberoinfundibular pathway. The dopamine that is released acts on lactotrophic cells through D2-receptors, inhibiting prolactin synthesis. In the absence of pregnancy of lactation, prolactin is constitutively inhibited by dopamine. Dopamine antagonists result in hyperprolactinemia, while dopamine agonists inhibit prolactin secretion.

      In summary, the hypothalamus is a complex structure that regulates various bodily functions, including circadian rhythms, body temperature, and prolactin secretion. Dysfunction of the hypothalamus can lead to various disorders, such as sleep-rhythm disorder, diabetes insipidus, hyperprolactinemia, and obesity.

    • This question is part of the following fields:

      • Neurosciences
      15.9
      Seconds
  • Question 8 - What is the mechanism by which antipsychotic use leads to erectile dysfunction? ...

    Incorrect

    • What is the mechanism by which antipsychotic use leads to erectile dysfunction?

      Your Answer: Α1 receptor agonism

      Correct Answer: Cholinergic receptor antagonism

      Explanation:

      Antipsychotics and Sexual Dysfunction: Causes, Risks, and Management

      Sexual dysfunction is a common side effect of antipsychotic medication, with the highest risk associated with risperidone and haloperidol due to their effect on prolactin levels. Clozapine, olanzapine, quetiapine, aripiprazole, asenapine, and lurasidone are associated with lower rates of sexual dysfunction. The Arizona Sexual Experiences Scale (ASEX) can be used to measure sexual dysfunction before and during treatment. Management options include excluding other causes, watchful waiting, dose reduction, switching to a lower risk agent, adding aripiprazole, considering an antidote medication, of using sildenafil for erectile dysfunction. It is important to address sexual dysfunction to improve quality of life and medication adherence.

    • This question is part of the following fields:

      • Psychopharmacology
      10
      Seconds
  • Question 9 - What is the term used to describe a scenario where a study participant...

    Correct

    • What is the term used to describe a scenario where a study participant alters their behavior due to the awareness of being observed?

      Your Answer: Hawthorne effect

      Explanation:

      Simpson’s Paradox is a real phenomenon where the comparison of association between variables can change direction when data from multiple groups are merged into one. The other three options are not valid terms.

      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
      11.2
      Seconds
  • Question 10 - What was the main reason for categorizing antipsychotics into typical and atypical groups?...

    Correct

    • What was the main reason for categorizing antipsychotics into typical and atypical groups?

      Your Answer: Propensity for EPS

      Explanation:

      Antipsychotics were initially classified as typical of atypical based on their propensity for EPS, with only clozapine and quetiapine being considered fully atypical due to their low risk of EPS. However, a more recent classification system categorizes antipsychotics as first- of second-generation (FGAs/SGAs) based on their introduction date.

    • This question is part of the following fields:

      • Psychopharmacology
      9.8
      Seconds
  • Question 11 - Which of the following conditions is characterized by an increase in the size...

    Correct

    • Which of the following conditions is characterized by an increase in the size of the ventricles on structural neuroimaging over time?

      Your Answer: Alzheimer's dementia

      Explanation:

      Neuroimaging studies have shown that Alzheimer’s dementia is linked to a gradual increase in ventricular size, while schizophrenia is associated with non-progressive enlargement of the lateral and third ventricles. Although some studies have reported increased ventricular size in individuals with affective disorders, the findings are not consistent. Additionally, individuals with antisocial personality disorder may have reduced prefrontal gray matter volume.

    • This question is part of the following fields:

      • Neurosciences
      8.7
      Seconds
  • Question 12 - Who is responsible for creating the term 'antidepressant'? ...

    Incorrect

    • Who is responsible for creating the term 'antidepressant'?

      Your Answer: Charpentier

      Correct Answer: Lurie

      Explanation:

      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
      7.9
      Seconds
  • Question 13 - An adolescent boy attends a counseling session for an assessment. His school counselor...

    Incorrect

    • An adolescent boy attends a counseling session for an assessment. His school counselor believes him to be struggling with identity issues and in need of support.
      He is accompanied by his mother who shares that they recently moved to the United States from Mexico. From his mother, you learn that he has been struggling to fit in with his peers and feels disconnected from his Mexican heritage. He has been trying to adopt American customs and has been avoiding speaking Spanish.
      Which approach to acculturation is implied?

      Your Answer: Assimilation

      Correct Answer: Separation

      Explanation:

      She has maintained her home culture and not assimilated into the dominant culture, which is known as separation.

      Multiculturalism is the coexistence of various cultural of ethnic groups within a shared social and political framework. Acculturation is the process of cultural and psychological change that occurs when different cultural groups come into contact with each other. Canadian psychologist John Berry identified four paths to acculturation: assimilation, integration, separation, and marginalization. Assimilation involves giving up one’s home culture and adopting the dominant culture, while integration involves maintaining one’s home culture while also embracing the dominant culture. Separation involves maintaining one’s home culture while being isolated from the dominant culture, and marginalization involves giving up one’s home culture and failing to related properly to the dominant culture. There is a cultural debate regarding assimilation and multiculturalism, with two forms of assimilation recognized: total assimilation, which involves the obliteration of the non-dominant culture, and melting pot assimilation, which refers to a less extreme version where a new form of the dominant culture emerges. Laissez-faire multiculturalism refers to multiculturalism that occurs without planning, such as the existence of Chinatowns in most cities.

    • This question is part of the following fields:

      • Social Psychology
      59.9
      Seconds
  • Question 14 - 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
      0
      Seconds
  • Question 15 - What category of adverse drug reaction does insomnia and anxiety resulting from benzodiazepine...

    Incorrect

    • What category of adverse drug reaction does insomnia and anxiety resulting from benzodiazepine withdrawal fall under?

      Your Answer:

      Correct Answer: Type E

      Explanation:

      The MHRA categorizes adverse drug reactions into five types. Type A reactions occur when a drug’s normal pharmacological actions are exaggerated at the usual therapeutic dose, and are typically dose-dependent. Type B reactions are unexpected responses that do not align with the drug’s known pharmacological actions. Type C reactions persist for an extended period of time, while Type D reactions become apparent after some time has passed since the medication was used. Finally, Type E reactions are linked to the discontinuation of a medication.

    • This question is part of the following fields:

      • Psychopharmacology
      0
      Seconds
  • Question 16 - What is the role of the Golgi apparatus in a neuron? ...

    Incorrect

    • What is the role of the Golgi apparatus in a neuron?

      Your Answer:

      Correct Answer: Packaging of macromolecules

      Explanation:

      Melanin

      Melanin is a pigment found in various parts of the body, including the skin, hair, and eyes. It is produced by specialized cells called melanocytes, which are located in the skin’s basal layer. The function of melanin in the body is not fully understood, but it is thought to play a role in protecting the skin from the harmful effects of ultraviolet (UV) radiation from the sun. Additionally, melanin may be a by-product of neurotransmitter synthesis, although this function is not well established. Overall, the role of melanin in the body is an area of ongoing research.

    • This question is part of the following fields:

      • Neurosciences
      0
      Seconds
  • Question 17 - When used in higher doses, which medication should be prescribed twice daily? ...

    Incorrect

    • When used in higher doses, which medication should be prescribed twice daily?

      Your Answer:

      Correct Answer: Amisulpride

      Explanation:

      Antipsychotics are commonly used to treat various mental health conditions. Most atypical antipsychotics require twice daily administration due to their short half-lives, except for olanzapine, aripiprazole, and risperidone. These medications have longer half-lives and can be administered once daily. A recent randomized controlled trial compared once versus twice daily dosing of risperidone and olanzapine and found no significant difference in effectiveness and efficacy outcomes. However, the study suggests that once-daily dosing may be preferable due to lower mean dose and better side effect profile, especially for olanzapine.

    • This question is part of the following fields:

      • Psychopharmacology
      0
      Seconds
  • Question 18 - Which option is incorrectly categorized? ...

    Incorrect

    • Which option is incorrectly categorized?

      Your Answer:

      Correct Answer: Olanzapine - Benzoxazole

      Explanation:

      Olanzapine belongs to the thienobenzodiazepine class.

      Antipsychotics can be classified in different ways, with the most common being typical (first generation) and atypical (second generation) types. Typical antipsychotics block dopamine (D2) receptors and have varying degrees of M1, Alpha-1, and H1 receptor blockade. Atypical antipsychotics have a lower propensity for extrapyramidal side-effects and are attributed to the combination of relatively lower D2 antagonism with 5HT2A antagonism. They are also classified by structure, with examples including phenothiazines, butyrophenones, thioxanthenes, diphenylbutylpiperidine, dibenzodiazepines, benzoxazoles, thienobenzodiazepine, substituted benzamides, and arylpiperidylindole (quinolone). Studies have found little evidence to support the superiority of atypicals over typicals in terms of efficacy, discontinuation rates, of adherence, with the main difference being the side-effect profile. The Royal College also favors classification by structure.

    • This question is part of the following fields:

      • Psychopharmacology
      0
      Seconds
  • Question 19 - What is the definition of volitional passivity? ...

    Incorrect

    • What is the definition of volitional passivity?

      Your Answer:

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

      Explanation:

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

    • This question is part of the following fields:

      • Descriptive Psychopathology
      0
      Seconds
  • Question 20 - Select the most important statement concerning the mental state examination: ...

    Incorrect

    • Select the most important statement concerning the mental state examination:

      Your Answer:

      Correct Answer: In the mental state examination, facial appearance provides information about affect

      Explanation:

      The mental state examination involves evaluating and documenting characteristics of mental illness in order to diagnose a clinical syndrome. It includes observing and describing the significant aspects of a person’s mental state at a specific moment in time. This assessment can be conducted before obtaining a patient’s medical history.

    • This question is part of the following fields:

      • History And Mental State
      0
      Seconds
  • Question 21 - Which of the following is not an example of glial cells? ...

    Incorrect

    • Which of the following is not an example of glial cells?

      Your Answer:

      Correct Answer: Purkinje cells

      Explanation:

      The initial exam question erroneously included neurons as a potential answer instead of Purkinje cells. However, this was deemed too simplistic and was subsequently revised. It is important to note that glial cells serve as support cells for neurons, whereas Purkinje cells are a specific type of neuron and therefore cannot be classified as glial cells.

      Glial Cells: The Support System of the Central Nervous System

      The central nervous system is composed of two basic cell types: neurons and glial cells. Glial cells, also known as support cells, play a crucial role in maintaining the health and function of neurons. There are several types of glial cells, including macroglia (astrocytes and oligodendrocytes), ependymal cells, and microglia.

      Astrocytes are the most abundant type of glial cell and have numerous functions, such as providing structural support, repairing nervous tissue, nourishing neurons, contributing to the blood-brain barrier, and regulating neurotransmission and blood flow. There are two main types of astrocytes: protoplasmic and fibrous.

      Oligodendrocytes are responsible for the formation of myelin sheaths, which insulate and protect axons, allowing for faster and more efficient transmission of nerve impulses.

      Ependymal cells line the ventricular system and are involved in the circulation of cerebrospinal fluid (CSF) and fluid homeostasis in the brain. Specialized ependymal cells called choroid plexus cells produce CSF.

      Microglia are the immune cells of the CNS and play a crucial role in protecting the brain from infection and injury. They also contribute to the maintenance of neuronal health and function.

      In summary, glial cells are essential for the proper functioning of the central nervous system. They provide structural support, nourishment, insulation, and immune defense to neurons, ensuring the health and well-being of the brain and spinal cord.

    • This question is part of the following fields:

      • Neurosciences
      0
      Seconds
  • Question 22 - What is the estimated number of alcohol units consumed by a 40-year-old man...

    Incorrect

    • What is the estimated number of alcohol units consumed by a 40-year-old man who drinks a 10-glass (70 cl) bottle of 37.5% ABV vodka every day, on a weekly basis?

      Your Answer:

      Correct Answer: 190

      Explanation:

      To calculate the units of alcohol in a drink, multiply the volume in litres by the percentage alcohol by volume (ABV). For example, a 70 cl (0.7 L) bottle of vodka with a 37.5% ABV contains 26 units. Consuming a bottle of this vodka every day for a week would result in approximately 190 units of alcohol (26 units x 7 days).

    • This question is part of the following fields:

      • Description And Measurement
      0
      Seconds
  • Question 23 - A 45-year-old male on an acute psychiatric unit was diagnosed with severe depression...

    Incorrect

    • A 45-year-old male on an acute psychiatric unit was diagnosed with severe depression with psychotic features. He is being treated with oral haloperidol, venlafaxine, mirtazapine, and procyclidine, but his adherence to the medication regimen is inconsistent. He experiences restlessness, sweating, tremors, shivering, myoclonus, and confusion.
      What is the probable reason for these symptoms?

      Your Answer:

      Correct Answer: Serotonin syndrome

      Explanation:

      The symptoms listed are indicative of serotonin syndrome, which is a potential risk when prescribing two antidepressants. If left untreated, serotonin syndrome can lead to seizures and even death. Treatment typically involves supportive measures such as benzodiazepines and IV access, as well as serotonin receptor antagonists like cyproheptadine. Anticholinergic syndrome, on the other hand, presents with symptoms such as fever, dry skin and mucous membranes, mydriasis, and hyperthermia. Antidepressant discontinuation syndrome can cause a range of neurological, gastrointestinal, and affective symptoms. Idiopathic parkinsonism is characterized by tremors, rigidity, and bradykinesia, while neuroleptic malignant syndrome presents with symptoms such as hyperthermia, rigidity, confusion, tachycardia, and elevated CK and WCC levels.

    • This question is part of the following fields:

      • Psychopharmacology
      0
      Seconds
  • Question 24 - 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
      0
      Seconds
  • Question 25 - A teenager with a borderline personality disorder begins to skip school and spend...

    Incorrect

    • A teenager with a borderline personality disorder begins to skip school and spend more time alone. They also start engaging in increased substance use. The school counselor notes that this occurs at a time when the academic work has become very challenging.
      Which of the following defense mechanisms is suggested?

      Your Answer:

      Correct Answer: Acting out

      Explanation:

      Common examples of acting out include avoiding therapy sessions and using alcohol as a means of avoiding the challenging work of therapy.

      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
      0
      Seconds
  • Question 26 - A man observes the image of an elderly man in the patterns of...

    Incorrect

    • A man observes the image of an elderly man in the patterns of his coffee grounds. What is the term for this perceptual anomaly?

      Your Answer:

      Correct Answer: Pareidolic illusion

      Explanation:

      Pareidolic illusions are vivid illusions that can occur from indistinct stimuli, such as seeing a face in the clouds. These illusions are a result of fantasy and vivid visual imagery and can intensify with concentration. Affect illusions arise from a particular mood state and disappear with concentration. Autoscopic hallucinations involve seeing oneself, such as in an out-of-body experience. Charles Bonnet syndrome is a type of hallucination that occurs in elderly people with reduced visual acuity. Complete illusions occur in the context of inattention, where an incomplete stimulus is perceived as complete. For more information, refer to Casey PR and Kelly B’s book, Fish’s Clinical Psychopathology: Signs and Symptoms in Psychiatry.

    • This question is part of the following fields:

      • Descriptive Psychopathology
      0
      Seconds
  • Question 27 - Which of the following is an example of selection bias? ...

    Incorrect

    • Which of the following is an example of selection bias?

      Your Answer:

      Correct 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
      0
      Seconds
  • Question 28 - Before administering regular doses of which long-acting injectable antipsychotic medication, a test dose...

    Incorrect

    • Before administering regular doses of which long-acting injectable antipsychotic medication, a test dose must be given?

      Your Answer:

      Correct Answer: Zuclopenthixol

      Explanation:

      According to the Maudsley Guidelines, it is recommended to administer a test dose for all first generation antipsychotics. Following the test dose, it is advised to wait 4-10 days before administering the next dose.

      , coma, respiratory depression (rare)

    • This question is part of the following fields:

      • Psychopharmacology
      0
      Seconds
  • Question 29 - 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
      0
      Seconds
  • Question 30 - What are the potential side effects of lithium that you would inform a...

    Incorrect

    • What are the potential side effects of lithium that you would inform a patient about before starting the medication?

      Your Answer:

      Correct Answer: Fine tremor

      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 31 - What is the most reliable way to determine someone's current level of intelligence?...

    Incorrect

    • What is the most reliable way to determine someone's current level of intelligence?

      Your Answer:

      Correct Answer: WAIS

      Explanation:

      The field of psychiatry uses various cognitive tests to assess different areas of cognition, including premorbid intelligence, intelligence, memory, attention, language, and others. Some commonly used tests include the National Adult Reading Test (NART) for premorbid intelligence, the Wechsler Adult Intelligence scale (WAIS) and Raven’s Progressive Matrices for intelligence, the Rey-Osterrieth Complex Figure for memory, and the Stroop test, Wisconsin card sorting test, Tower of London, and Continuous Performance Tasks for attention. The Boston naming test and Animal fluency are used to assess language skills. The Halstead-Reitan battery is used specifically for assessing brain damage. These tests are often included in the MRCPsych exams.

    • This question is part of the following fields:

      • Classification And Assessment
      0
      Seconds
  • Question 32 - What is a true statement about migraines? ...

    Incorrect

    • What is a true statement about migraines?

      Your Answer:

      Correct Answer: They can be precipitated by stress

      Explanation:

      Migraine

      Migraine is a common condition that affects 5-10% of the population, with a higher prevalence in women than men (2-3:1). It typically starts in childhood of adolescence and has a strong familial association, with 2/3 of cases reporting a family history of migraine.

      The most prominent symptom of migraine is headache, which is usually unilateral but can occur on both sides. Other symptoms include anorexia, nausea and vomiting, photophobia, and intolerance of noise.

      In about 1/3 of cases, migraines are preceded by a visual aura (known as classic migraine). The most common form of visual aura is the ‘fortification spectra’ (semicircle of zigzag lights), but other disturbances such as micropsia, macropsia, zoom vision, mosaic vision, scotomas, and even hallucinations can occur.

      Basilar migraines are a subtype of migraine where headache and aura are accompanied by difficulty speaking, vertigo, ringing in ears, of other brainstem-related symptoms, but not motor weakness.

      Migraine can be triggered by various factors, including alcohol, cheese, chocolate, skipping meals, missing sleep, and oral contraceptives. Stress is also a common precipitant of migraine.

    • This question is part of the following fields:

      • Classification And Assessment
      0
      Seconds
  • Question 33 - The initial stage of moral development, as per Lawrence Kohlberg, is: ...

    Incorrect

    • The initial stage of moral development, as per Lawrence Kohlberg, is:

      Your Answer:

      Correct Answer: Obedience and punishment orientation

      Explanation:

      Kohlberg’s Six Stages of Moral Development

      Kohlberg’s theory of moral development consists of six stages that can be categorized into three levels. The first level is the preconventional stage, which is characterized by obedience and punishment orientation, where the focus is on the direct consequences of actions and unquestioning deference to power. The second stage is the self-interest orientation, where right behavior is defined purely by what is in the individual’s own interest.

      The second level is the conventional stage, which is characterized by interpersonal accord and conformity, where the focus is on how the individual will appear to others. The behavior should accord with a consensus view on what is good. The second stage is the authority and social order obedience driven, where what is lawful is judged to be morally right. Right behavior is dictated by societal rules, and there is a greater respect for social order and the need for laws.

      The third level is the postconventional stage, which is characterized by the social contract orientation, where individual rights determine behavior. The individual views laws and rules as flexible tools for improving human purposes. The fourth stage is the universal ethical principles orientation, where the right action is the one that is consistent with abstract reasoning using universal ethical principles.

      It is important to note that the age ranges for Kohlberg’s developmental stages are rough guides, and sources vary widely. Kohlberg developed his stage theory following an experiment he conducted on 72 boys aged 10-16. However, the theory is criticized as sexist as it only included boys.

    • This question is part of the following fields:

      • Psychological Development
      0
      Seconds
  • Question 34 - Which route of administration is known to have the highest degree of first...

    Incorrect

    • Which route of administration is known to have the highest degree of first pass effect?

      Your Answer:

      Correct Answer: Oral

      Explanation:

      The First Pass Effect in Psychiatric Drugs

      The first-pass effect is a process in drug metabolism that significantly reduces the concentration of a drug before it reaches the systemic circulation. This phenomenon is related to the liver and gut wall, which absorb and metabolize the drug before it can enter the bloodstream. Psychiatric drugs are not exempt from this effect, and some undergo a significant reduction in concentration before reaching their target site. Examples of psychiatric drugs that undergo a significant first-pass effect include imipramine, fluphenazine, morphine, diazepam, and buprenorphine. On the other hand, some drugs undergo little to no first-pass effect, such as lithium and pregabalin.

      Orally administered drugs are the most affected by the first-pass effect. However, there are other routes of administration that can avoid of partly avoid this effect. These include sublingual, rectal (partly avoids first pass), intravenous, intramuscular, transdermal, and inhalation. Understanding the first-pass effect is crucial in drug development and administration, especially in psychiatric drugs, where the concentration of the drug can significantly affect its efficacy and safety.

    • This question is part of the following fields:

      • Psychopharmacology
      0
      Seconds
  • Question 35 - What defense mechanism is being demonstrated when an athlete initially dislikes a hockey...

    Incorrect

    • What defense mechanism is being demonstrated when an athlete initially dislikes a hockey teammate and eventually begins to believe that the teammate hates them?

      Your Answer:

      Correct Answer: Projection

      Explanation:

      This scenario illustrates the concept of projection, where the athlete is projecting their own feelings of hatred onto their team mate. However, it does not involve projective identification as there is no indication of how the team mate is internalizing of reacting to the projection.

      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
      0
      Seconds
  • Question 36 - What was the interview method utilized in the epidemiological catchment area study? ...

    Incorrect

    • What was the interview method utilized in the epidemiological catchment area study?

      Your Answer:

      Correct Answer: Diagnostic interview schedule (DIS)

      Explanation:

      The epidemiological catchment area (ECA) study conducted in the USA during the 1980s was a significant study that utilized the diagnostic interview schedule (DIS) to interview individuals across five sites. This study provided valuable information about the prevalence of mental disorders in the USA.

      The ONS 2000 psychiatric morbidity survey utilized the clinical interview schedule-revised (CIS-R), which can be administered by lay interviewers. The Composite International Diagnostic Interview (CIDI) is another structured interview used by the World Health Organization (WHO) to assess individuals according to ICD-10 and DSM IV. The Psychosis Screening Questionnaire (PSQ) was also used in the ONS 2000 psychiatric morbidity survey.

      The Structured Clinical Interview for DSM-IV (SCID) was used in the European Study of Epidemiology of Mental Disorders (ESEMeD). These various diagnostic tools and surveys provide valuable information about the prevalence and diagnosis of mental disorders. For further reading, resources such as the Harvard Medical School and National Institute of Mental Health provide additional information on these diagnostic tools and their uses.

    • This question is part of the following fields:

      • Epidemiology
      0
      Seconds
  • Question 37 - Which of the following statements most accurately defines tangentiality? ...

    Incorrect

    • Which of the following statements most accurately defines tangentiality?

      Your Answer:

      Correct Answer: It is a disorder of the form of thought

      Explanation:

      Karl Jaspers, a German psychiatrist and philosopher, first described tangentiality as a formal thought disorder where the patient deviates from the topic at hand and introduces new but related words. Although the examiner can usually follow the patient’s train of thought, the patient often loses track of the interviewer’s question. While tangentiality is not specific to any particular mental disorder, it can be present in conditions such as mania, hypomania, and schizophrenia. Other examples of formal thought disorder include loosening of associations, circumstantiality, thought block, perseveration, and flight of ideas.

    • This question is part of the following fields:

      • Descriptive Psychopathology
      0
      Seconds
  • Question 38 - A chromosome that has a very short p arm, making it difficult to...

    Incorrect

    • A chromosome that has a very short p arm, making it difficult to observe, is known as:

      Your Answer:

      Correct Answer: Telocentric

      Explanation:

      Understanding Centromeres

      A centromere is a crucial part of DNA that connects two sister chromatids. It plays a vital role in cell division by keeping the sister chromatids aligned and allowing the chromosomes to be lined up during metaphase. The position of the centromere divides the chromosome into two arms, the long (q) and the short (p). Chromosomes are classified based on the position of the centromere. Metacentric chromosomes have arms of roughly equal length, and they can be formed by Robertsonian translocations. Acrocentric chromosomes can also be involved in Robertsonian translocations. Monocentric chromosomes have only one centromere and form a narrow constriction, while holocentric chromosomes have the entire length of the chromosome acting as the centromere. Understanding the role and classification of centromeres is essential in comprehending the process of cell division.

    • This question is part of the following fields:

      • Genetics
      0
      Seconds
  • Question 39 - Who is recognized as the originator of the mental age concept? ...

    Incorrect

    • Who is recognized as the originator of the mental age concept?

      Your Answer:

      Correct Answer: Binet

      Explanation:

      Mental Age and IQ

      The concept of mental age (MA) was introduced by Alfred Binet in 1905. It involves administering a series of tests to a person of child, which are then ranked according to the age at which people are expected to complete them. The mental age can be used to calculate the intelligence quotient (IQ) using the formula: IQ = MA/CA x 100, where CA is the chronological age. An IQ of 100 indicates that the mental and chronological ages are equal. IQ tends to remain stable throughout life. The Stanford-Binet test was the first IQ test, while the WAIS-IV (Wechsler Adult Intelligence Scale) is the most commonly used IQ test today.

    • This question is part of the following fields:

      • Psychological Development
      0
      Seconds
  • Question 40 - While on a weekend pass to visit his family, a middle-aged man with...

    Incorrect

    • While on a weekend pass to visit his family, a middle-aged man with bipolar disorder destroys his sister's car.
      When asked about his behavior, he explains that he saw a black cat cross his path and knew he had to destroy something to ward off bad luck.
      What is this an instance of?

      Your Answer:

      Correct Answer: Delusional percept

      Explanation:

      Delusional perceptions involve attaching a delusional meaning to an accurate perception, which can feel like a significant realization. This differs from interpreting accurate perceptions in a way that aligns with pre-existing delusions. These perceptions are considered a primary symptom.

    • This question is part of the following fields:

      • Descriptive Psychopathology
      0
      Seconds
  • Question 41 - A clinician wishes to assess the perceived impact of antipsychotic medications on their...

    Incorrect

    • A clinician wishes to assess the perceived impact of antipsychotic medications on their adolescent patient with a diagnosis of schizophrenia. Which rating scale is most commonly utilized for this purpose?

      Your Answer:

      Correct Answer: Drug attitude inventory

      Explanation:

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

    • This question is part of the following fields:

      • Advanced Psychological Processes And Treatments
      0
      Seconds
  • Question 42 - What were the findings of studies on OCD in individuals with intellectual disabilities?...

    Incorrect

    • What were the findings of studies on OCD in individuals with intellectual disabilities?

      Your Answer:

      Correct Answer: Ordering is the most common compulsion

      Explanation:

      In adults with learning disability, ordering is the most prevalent compulsion, whereas hand-washing, checking, and cleaning are more common in the general population. The prevalence rate of OCD in learning disability is higher at 2.5% compared to the general population. However, it can be challenging to distinguish OCD from other behaviors associated with learning disability syndromes, such as tics, stereotyped behaviors, and autism spectrum disorder. Additionally, assessing obsessional thoughts in individuals with learning disability can be challenging due to their difficulty in articulating them.

    • This question is part of the following fields:

      • Psychiatry Of Learning Disability
      0
      Seconds
  • Question 43 - What is a frequently observed side effect of varenicline? ...

    Incorrect

    • What is a frequently observed side effect of varenicline?

      Your Answer:

      Correct Answer: Abnormal dreams

      Explanation:

      While varenicline may cause uncommon of rare side effects, abnormal dreams are a frequently reported one.

      Varenicline for Smoking Cessation: Safety and Efficacy

      Varenicline is a medication used to aid smoking cessation by reducing cravings and pleasurable effects of tobacco products. It has a high affinity for the alpha 4 beta 2 nicotinic receptor and is recommended by NICE for smoking cessation. Varenicline is safe to use in cases of liver dysfunction as it undergoes very little hepatic metabolism. It has been found to be nearly 80% more effective than bupropion and more effective than 24-hour nicotine replacement therapy in two large randomized controlled trials. The initial course of treatment could last 12 weeks, with an additional 12 weeks offered to those who have successfully quit smoking. However, varenicline has been observed to exacerbate underlying psychiatric illness, including depression, and is associated with changes in behavior of thinking, anxiety, psychosis, mood swings, aggressive behavior, suicidal ideation, and behavior. Patients with a psychiatric history should be closely monitored while taking varenicline. One randomized controlled trial has challenged this concern. The FDA has issued a safety announcement that varenicline may be associated with a small, increased risk of certain cardiovascular adverse events in patients with cardiovascular disease. The very common side effects of varenicline include nasopharyngitis, abnormal dreams, insomnia, headache, and nausea.

    • This question is part of the following fields:

      • Psychopharmacology
      0
      Seconds
  • Question 44 - You are asked to evaluate a woman on a general medical ward who...

    Incorrect

    • You are asked to evaluate a woman on a general medical ward who has been admitted for a chest infection. The medical team suspects that she may be experiencing depression and has initiated treatment. You notice that her QTc interval measures at 490 msec and are concerned about the medications she is taking. If she were to be prescribed any of the following medications, which one would be the most likely culprit for her prolonged QTc?

      Your Answer:

      Correct Answer: Erythromycin

      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
      0
      Seconds
  • Question 45 - Which gene is believed to have the most significant influence on the likelihood...

    Incorrect

    • Which gene is believed to have the most significant influence on the likelihood of developing alcohol addiction?

      Your Answer:

      Correct Answer: ADH1B

      Explanation:

      Genetics and Alcoholism

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

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

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

    • This question is part of the following fields:

      • Genetics
      0
      Seconds
  • Question 46 - Which disorder is more frequently identified in individuals from higher socioeconomic backgrounds? ...

    Incorrect

    • Which disorder is more frequently identified in individuals from higher socioeconomic backgrounds?

      Your Answer:

      Correct Answer: Bipolar affective disorder

      Explanation:

      Individuals from higher social classes are more likely to be diagnosed with bipolar affective disorder and eating disorders, while those from lower social classes are more commonly diagnosed with alcohol dependence, depression, schizophrenia, and substance misuse disorders.

    • This question is part of the following fields:

      • Epidemiology
      0
      Seconds
  • Question 47 - Which individual brought clozapine into clinical use? ...

    Incorrect

    • Which individual brought clozapine into clinical use?

      Your Answer:

      Correct Answer: Kane

      Explanation:

      Imipramine antidepressant effects were discovered by Kuhn. Kane introduced clozapine into clinical practice after conducting a successful double-blind multicenter trial comparing it with chlorpromazine in treatment-resistant schizophrenia. Charpentier synthesized chlorpromazine, while Klein discovered the use of iproniazid. Cade discovered the beneficial effect of lithium in treating mania.

    • This question is part of the following fields:

      • History Of Psychiatry
      0
      Seconds
  • Question 48 - Which of the following statements aligns best with the principles of learning theory?...

    Incorrect

    • Which of the following statements aligns best with the principles of learning theory?

      Your Answer:

      Correct Answer: Variable ratio is the most resistant to extinction

      Explanation:

      Advertisements typically use backward conditioning, where the unconditioned stimulus precedes the conditioned stimulus, resulting in minimal conditioning. Latent learning refers to learning that occurs without any immediate effect on performance. Delayed (forward) conditioning, where the CS is presented before the US and continues until the US is presented, is generally the most effective form of conditioning, especially with short delays. In animal experiments, the optimal CS-US interval is 0.5 seconds. Trace conditioning, where the CS ends before the onset of the US, becomes less effective with longer delays. Simultaneous conditioning occurs when the onset of both stimuli is simultaneous. Variable ratio (VR) schedules provide reinforcement after a varying number of responses, making them highly resistant to extinction. Gambling machines often use VR schedules, resulting in high response rates.

    • This question is part of the following fields:

      • Basic Psychological Processes
      0
      Seconds
  • Question 49 - A child explains during a conversation that 'When I saw the man holding...

    Incorrect

    • A child explains during a conversation that 'When I saw the man holding a glass of wine, I knew my father was dead'.

      This is most indicative of what?

      Your Answer:

      Correct Answer: Delusional perception

      Explanation:

      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
      0
      Seconds
  • Question 50 - Which of the following is the least likely to worsen a physiological tremor?...

    Incorrect

    • Which of the following is the least likely to worsen a physiological tremor?

      Your Answer:

      Correct Answer: Lorazepam

      Explanation:

      Physiological tremors can be intensified by several drugs, while alcohol and benzodiazepines have a tendency to reduce tremors.

      Types of Tremor

      Essential Tremor

      Otherwise known as benign essential tremor, this is the most common type of tremor. It is not associated with any underlying pathology. It usually begins in the 40’s, affects mainly the hands, and is slowly progressive. It tends to worsen with heightened emotion. It usually presents with unilateral upper limb involvement then progresses to both limbs.

      Parkinsonian Tremor

      This tremor is associated with Parkinson’s disease. It is classically described as ‘pill rolling’ due to the characteristic appearance of the fingers.

      Cerebellar Tremor

      Otherwise known as an intention tremor. This is a slow, coarse tremor which gets worse with purposeful movement. This is seen in lithium toxicity (note that the tremor seen as a side effect of long term lithium is fine and classed as physiological).

      Psychogenic Tremor

      Also known as a hysterical tremor. This type of tremor tends to appear and disappear suddenly and is hard to characterise due to its changeable nature. It tends to improve with distraction.

      Physiologic Tremor

      This is a very-low-amplitude fine tremor that is barely visible to the naked eye. It is present in every normal person while maintaining a posture of movement. It becomes enhanced and visible in many conditions such as anxiety, hyperthyroidism, alcohol withdrawal, and as drug induced side effects.

      It is useful to have a basic idea about the frequencies of different types of tremor.

      Type of Tremor Frequency

      Intention 2-3Hz

      Parkinsonian 5Hz

      Essential 7Hz

      Physiological 10Hz

      Psychogenic variable

    • This question is part of the following fields:

      • Classification And Assessment
      0
      Seconds
  • Question 51 - What is the most frequently occurring side effect of rivastigmine? ...

    Incorrect

    • What is the most frequently occurring side effect of rivastigmine?

      Your Answer:

      Correct Answer: Nausea

      Explanation:

      Pharmacological management of dementia involves the use of acetylcholinesterase inhibitors (AChE inhibitors) and memantine. AChE inhibitors prevent the breakdown of acetylcholine, which is deficient in Alzheimer’s due to the loss of cholinergic neurons. Donepezil, galantamine, and rivastigmine are commonly used AChE inhibitors in the management of Alzheimer’s. However, gastrointestinal side effects such as nausea and vomiting are common with these drugs.

      Memantine, on the other hand, is an NMDA receptor antagonist that blocks the effects of pathologically elevated levels of glutamate that may lead to neuronal dysfunction. It has a half-life of 60-100 hours and is primarily renally eliminated. Common adverse effects of memantine include somnolence, dizziness, hypertension, dyspnea, constipation, headache, and elevated liver function tests.

      Overall, pharmacological management of dementia aims to improve cognitive function and slow down the progression of the disease. However, it is important to note that these drugs do not cure dementia and may only provide temporary relief of symptoms.

    • This question is part of the following fields:

      • Psychopharmacology
      0
      Seconds
  • Question 52 - The axons of the POST ganglionic neurons are mostly? ...

    Incorrect

    • The axons of the POST ganglionic neurons are mostly?

      Your Answer:

      Correct Answer: C fibers

      Explanation:

      According to Erlanger- Grasser classification preganglionic fibers are B fibers whereas post ganglionic fibers are C fibers.

    • This question is part of the following fields:

      • Neuro-anatomy
      0
      Seconds
  • Question 53 - What is the entity responsible for producing myelin in the central nervous system?...

    Incorrect

    • What is the entity responsible for producing myelin in the central nervous system?

      Your Answer:

      Correct Answer: Oligodendrocyte

      Explanation:

      Glial Cells: The Support System of the Central Nervous System

      The central nervous system is composed of two basic cell types: neurons and glial cells. Glial cells, also known as support cells, play a crucial role in maintaining the health and function of neurons. There are several types of glial cells, including macroglia (astrocytes and oligodendrocytes), ependymal cells, and microglia.

      Astrocytes are the most abundant type of glial cell and have numerous functions, such as providing structural support, repairing nervous tissue, nourishing neurons, contributing to the blood-brain barrier, and regulating neurotransmission and blood flow. There are two main types of astrocytes: protoplasmic and fibrous.

      Oligodendrocytes are responsible for the formation of myelin sheaths, which insulate and protect axons, allowing for faster and more efficient transmission of nerve impulses.

      Ependymal cells line the ventricular system and are involved in the circulation of cerebrospinal fluid (CSF) and fluid homeostasis in the brain. Specialized ependymal cells called choroid plexus cells produce CSF.

      Microglia are the immune cells of the CNS and play a crucial role in protecting the brain from infection and injury. They also contribute to the maintenance of neuronal health and function.

      In summary, glial cells are essential for the proper functioning of the central nervous system. They provide structural support, nourishment, insulation, and immune defense to neurons, ensuring the health and well-being of the brain and spinal cord.

    • This question is part of the following fields:

      • Neurosciences
      0
      Seconds
  • Question 54 - As part of a cognitive evaluation, can you tell me the name of...

    Incorrect

    • As part of a cognitive evaluation, can you tell me the name of the current Prime Minister? This will help assess which type of memory?

      Your Answer:

      Correct Answer: Semantic

      Explanation:

      According to Gelder (2009), semantic memory pertains to knowledge of facts and concepts that can be consciously recalled. Unlike episodic memory, which is also a type of declarative memory, semantic memory is not tied to any particular personal experience.

      Memory Forms

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

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

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

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

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

    • This question is part of the following fields:

      • Social Psychology
      0
      Seconds
  • Question 55 - What is a true statement about sigma waves in relation to EEG? ...

    Incorrect

    • What is a true statement about sigma waves in relation to EEG?

      Your Answer:

      Correct Answer: They are absent in familial fatal insomnia

      Explanation:

      Sigma waves are typically observed during stage 2 sleep and are considered a normal occurrence during sleep. They usually follow muscle twitches and are believed to help maintain a peaceful state during sleep. These waves are produced in the reticular nucleus of the thalamus and arise from the interplay between the thalamus and the cortex. However, in familial fatal insomnia (a prion disease), the absence of sigma waves is a characteristic feature.

      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
      0
      Seconds
  • Question 56 - What is the accurate statement about Thurstone's scale? ...

    Incorrect

    • What is the accurate statement about Thurstone's scale?

      Your Answer:

      Correct Answer: It is time consuming

      Explanation:

      The Thurstone scale’s reliability is limited due to the process of constructing it. While a large number of statements are collected and edited for clarity and relevance, the final form of the scale only includes items that have high interjudge agreement and fall at equal intervals. This selective process may result in a scale that is not entirely reliable.

    • This question is part of the following fields:

      • Description And Measurement
      0
      Seconds
  • Question 57 - A mutation affecting the transcriptional activity of a new gene associated with Alzheimer's...

    Incorrect

    • A mutation affecting the transcriptional activity of a new gene associated with Alzheimer's disease is reported. The mutation is most likely to be in which of the following?

      Your Answer:

      Correct Answer: Promoter region

      Explanation:

      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
      0
      Seconds
  • Question 58 - Which statement accurately describes ribonucleic acid (RNA)? ...

    Incorrect

    • Which statement accurately describes ribonucleic acid (RNA)?

      Your Answer:

      Correct Answer: RNA is typically shorter than DNA

      Explanation:

      Enzymes called RNA polymerases, not transferases, transcribe RNA from DNA.

      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
      0
      Seconds
  • Question 59 - What is a personality disorder that falls under cluster A? ...

    Incorrect

    • What is a personality disorder that falls under cluster A?

      Your Answer:

      Correct Answer: Paranoid

      Explanation:

      Personality Disorder Classification

      A personality disorder is a persistent pattern of behavior and inner experience that deviates significantly from cultural expectations, is inflexible and pervasive, and causes distress of impairment. The DSM-5 and ICD-11 have different approaches to classifying personality disorders. DSM-5 divides them into 10 categories, grouped into clusters A, B, and C, while ICD-11 has a general category with six trait domains that can be added. To diagnose a personality disorder, the general diagnostic threshold must be met before determining the subtype(s) present. The criteria for diagnosis include inflexibility and pervasiveness of the pattern, onset in adolescence of early adulthood, stability over time, and significant distress of impairment. The disturbance must not be better explained by another mental disorder, substance misuse, of medical condition.

      Course

      Borderline and antisocial personality disorders tend to become less evident of remit with age, while others, particularly obsessive-compulsive and schizotypal, may persist.

      Classification

      The DSM-5 divides personality disorders into separate clusters A, B, and C, with additional groups for medical conditions and unspecified disorders. The ICD-11 dropped the separate categories and instead lists six trait domains that can be added to the general diagnosis.

    • This question is part of the following fields:

      • Classification And Assessment
      0
      Seconds
  • Question 60 - Which substance has the greatest amount of time required for half of its...

    Incorrect

    • Which substance has the greatest amount of time required for half of its atoms to decay?

      Your Answer:

      Correct Answer: Diazepam

      Explanation:

      Benzodiazepines are a class of drugs commonly used to treat anxiety and sleep disorders. It is important to have a working knowledge of the more common benzodiazepines and their half-life. Half-life refers to the amount of time it takes for half of the drug to be eliminated from the body.

      Some of the more common benzodiazepines and their half-life include diazepam with a half-life of 20-100 hours, clonazepam with a half-life of 18-50 hours, chlordiazepoxide with a half-life of 5-30 hours, nitrazepam with a half-life of 15-38 hours, temazepam with a half-life of 8-22 hours, lorazepam with a half-life of 10-20 hours, alprazolam with a half-life of 10-15 hours, oxazepam with a half-life of 6-10 hours, zopiclone with a half-life of 5-6 hours, zolpidem with a half-life of 2 hours, and zaleplon with a half-life of 2 hours. Understanding the half-life of these drugs is important for determining dosages and timing of administration.

    • This question is part of the following fields:

      • Psychopharmacology
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Research Methods, Statistics, Critical Review And Evidence-Based Practice (1/2) 50%
Psychopharmacology (1/4) 25%
Neurosciences (2/3) 67%
Classification And Assessment (1/1) 100%
Genetics (0/1) 0%
Psychological Development (0/1) 0%
Social Psychology (0/1) 0%
Passmed