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  • Question 1 - What is the term used to describe a child who shows distress when...

    Incorrect

    • What is the term used to describe a child who shows distress when their mother leaves the room but avoids contact with her upon her return?

      Your Answer:

      Correct Answer: Anxious-resistant attachment

      Explanation:

      Attachment (Ainsworth)

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

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

    • This question is part of the following fields:

      • Psychological Development
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  • Question 2 - Which cognitive function is the Stroop test intended to detect difficulties with? ...

    Incorrect

    • Which cognitive function is the Stroop test intended to detect difficulties with?

      Your Answer:

      Correct Answer: Response inhibition

      Explanation:

      The Stroop test involves presenting words to the subject that spell a color but are written in a different color. The subject is required to identify the color of the text as quickly as possible, rather than reading the word itself. This test assesses the subject’s ability to make an appropriate response when presented with conflicting signals. This ability is believed to originate from the anterior cingulate, which is located between the left and right frontal lobes.

      Frontal Lobe Tests

      The frontal lobe is responsible for a variety of cognitive functions, including initiation, abstraction, problem-solving, decision-making, response inhibition, and set shifting. Different tests can be used to assess these functions.

      Verbal and categorical fluency tests can be used to assess initiation. These tests require individuals to generate as many words of items as possible within a specific category of starting letter.

      Proverbs, similarities, and cognitive estimates are examples of tests that can be used to assess abstraction. These tests require individuals to identify similarities between objects of concepts, make judgments based on incomplete information, of estimate quantities.

      Tower of London, Cambridge stockings, and gambling tasks are examples of tests that can be used to assess problem-solving and decision-making. These tests require individuals to plan and execute a sequence of actions to achieve a goal of make decisions based on uncertain outcomes.

      Alternating sequences, go-no-go test, Luria motor test, trail making test, Wisconsin card sorting test, and Stroop test are examples of tests that can be used to assess response inhibition and set shifting. These tests require individuals to inhibit prepotent responses, switch between tasks of mental sets, of ignore irrelevant information.

      Overall, these tests can provide valuable information about an individual’s frontal lobe functioning and can be used to diagnose and treat various neurological and psychiatric conditions.

    • This question is part of the following fields:

      • Classification And Assessment
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  • Question 3 - After receiving a negative evaluation from his supervisor, John spends the entire evening...

    Incorrect

    • After receiving a negative evaluation from his supervisor, John spends the entire evening playing basketball with his buddy. What would be the most appropriate way to describe this behavior?

      Your Answer:

      Correct Answer: Sublimation

      Explanation:

      In the given example, Mark is using sublimation as a defence mechanism to express his internal impulses in a socially acceptable way. It is not an example of aggression. Similarly, playing tennis cannot be considered as constructive gratifying service to others, which is a characteristic of altruism. Instead, it is an example of displacement, where Mark is transferring his emotional response to a situation that carries less emotional risk. Mark is externalizing his feelings through sublimation, rather than turning them into self-harm.

    • This question is part of the following fields:

      • Basic Psychological Processes
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  • Question 4 - What is the most frequently observed endocrine abnormality in sick euthyroid syndrome? ...

    Incorrect

    • What is the most frequently observed endocrine abnormality in sick euthyroid syndrome?

      Your Answer:

      Correct Answer: Low T3

      Explanation:

      Sick Euthyroid Syndrome: Abnormal Thyroid Function in Non-Thyroidal Illness

      Sick euthyroid syndrome, also known as low T3 syndrome, is a condition where thyroid function tests show abnormal results, typically low T3 levels, while T4 and TSH levels remain normal. This condition is commonly observed in patients with non-thyroidal illness. For instance, individuals with anorexia who have undergone prolonged starvation may develop this syndrome.

    • This question is part of the following fields:

      • Classification And Assessment
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  • Question 5 - What is the effect of being heterozygous for the APOE4 allele on the...

    Incorrect

    • What is the effect of being heterozygous for the APOE4 allele on the risk of Alzheimer's compared to those who do not have the allele?

      Your Answer:

      Correct Answer: Increases it by a factor of 3

      Explanation:

      Genetics plays a role in the development of Alzheimer’s disease, with different genes being associated with early onset and late onset cases. Early onset Alzheimer’s, which is rare, is linked to three genes: amyloid precursor protein (APP), presenilin one (PSEN-1), and presenilin two (PSEN-2). The APP gene, located on chromosome 21, produces a protein that is a precursor to amyloid. The presenilins are enzymes that cleave APP to produce amyloid beta fragments, and alterations in the ratios of these fragments can lead to plaque formation. Late onset Alzheimer’s is associated with the apolipoprotein E (APOE) gene on chromosome 19, with the E4 variant increasing the risk of developing the disease. People with Down’s syndrome are also at high risk of developing Alzheimer’s due to inheriting an extra copy of the APP gene.

    • This question is part of the following fields:

      • Genetics
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  • Question 6 - The primary auditory cortex is: ...

    Incorrect

    • The primary auditory cortex is:

      Your Answer:

      Correct Answer: Brodmann area 41

      Explanation:

      A Brodmann area in the brain is defined by cytoarchitecture, histology and organization of cells:
      Primary Sensory 3,1,2
      Primary Motor 4
      Premotor 6
      Primary Visual 17
      Primary Auditory 41
      Brocas 44

    • This question is part of the following fields:

      • Neuro-anatomy
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  • Question 7 - What has been demonstrated to have a protective effect on the nervous system?...

    Incorrect

    • What has been demonstrated to have a protective effect on the nervous system?

      Your Answer:

      Correct Answer: Memantine

      Explanation:

      Studies have demonstrated that memantine possesses neuroprotective properties for individuals with Alzheimer’s disease and those who have suffered from traumatic brain injury.

      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
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  • Question 8 - A teenager expresses frustration that when they tell their peers what their parents...

    Incorrect

    • A teenager expresses frustration that when they tell their peers what their parents do for a living, they feel judged and treated differently. What is the term for this type of stigma?

      Your Answer:

      Correct Answer: Courtesy stigma

      Explanation:

      Courtesy stigma, also known as stigma by association, is a genuine type of stigma that targets individuals who are connected to those with mental health issues, such as family members and healthcare providers. The remaining terms are not valid.

      Stigma is a term used to describe the negative attitudes and beliefs that people hold towards individuals who are different from them. There are several types of stigma, including discredited and discreditable stigma, felt stigma, enacted stigma, and courtesy stigma. Discredited stigma refers to visible stigmas such as race, gender, of physical disability, while discreditable stigma refers to concealable stigmas such as mental illness of HIV infection. Felt stigma is the shame and fear of discrimination that prevents people from seeking help, while enacted stigma is the experience of unfair treatment by others. Finally, courtesy stigma refers to the stigma that attaches to those who are associated with a stigmatized person.

    • This question is part of the following fields:

      • Social Psychology
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  • Question 9 - What is the most frequent adverse effect of atomoxetine? ...

    Incorrect

    • What is the most frequent adverse effect of atomoxetine?

      Your Answer:

      Correct Answer: Headache

      Explanation:

      ADHD medications can be classified into stimulant and non-stimulant drugs. The therapeutic effects of these drugs are believed to be mediated through the action of noradrenaline in the prefrontal cortex. Common side effects of these drugs include decreased appetite, insomnia, nervousness, headache, and nausea. Stimulant drugs like dexamphetamine, methylphenidate, and lisdexamfetamine inhibit the reuptake of dopamine and noradrenaline. Non-stimulant drugs like atomoxetine, guanfacine, and clonidine work by increasing noradrenaline levels in the synaptic cleft through different mechanisms. The most common side effects of these drugs are decreased appetite, somnolence, headache, and abdominal pain.

    • This question is part of the following fields:

      • Psychopharmacology
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  • Question 10 - Which attitude scale involves a group of evaluators who rate each statement to...

    Incorrect

    • Which attitude scale involves a group of evaluators who rate each statement to determine its level of positivity towards a particular concept?

      Your Answer:

      Correct Answer: Thurstone scale

      Explanation:

      Attitude scales are used to measure a person’s feelings and thoughts towards something. There are several types of attitude scales, including the Thurstone scale, Likert scale, semantic differential scale, and Gutman scale. The Thurstone scale involves creating a list of statements and having judges score them based on their negativity of positivity towards an issue. Respondents then indicate whether they agree of disagree with each statement. The Likert scale asks respondents to indicate their degree of agreement of disagreement with a series of statements using a five-point scale. The semantic differential scale presents pairs of opposite adjectives and asks respondents to rate their position on a five- of seven-point scale. The Gutman scale involves a list of statements that can be ordered hierarchically, with each statement having a corresponding weight. Respondents’ scores on the scale indicate the number of statements they agree with.

    • This question is part of the following fields:

      • Classification And Assessment
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  • Question 11 - Which of the following is not useful in distinguishing between delirium and dementia?...

    Incorrect

    • Which of the following is not useful in distinguishing between delirium and dementia?

      Your Answer:

      Correct Answer: Cognitive impairment

      Explanation:

      Delirium (also known as acute confusional state) is a condition characterized by a sudden decline in consciousness and cognition, with a particular impairment in attention. It often involves perceptual disturbances, abnormal psychomotor activity, and sleep-wake cycle impairment. Delirium typically develops over a few days and has a fluctuating course. The causes of delirium are varied, ranging from metabolic disturbances to medications. It is important to differentiate delirium from dementia, as delirium has a brief onset, early disorientation, clouding of consciousness, fluctuating course, and early psychomotor changes. Delirium can be classified into three subtypes: hypoactive, hyperactive, and mixed. Patients with hyperactive delirium demonstrate restlessness, agitation, and hyper vigilance, while those with hypoactive delirium present with lethargy and sedation. Mixed delirium demonstrates both hyperactive and hypoactive features. The hypoactive form is most common in elderly patients and is often misdiagnosed as depression of dementia.

    • This question is part of the following fields:

      • Old Age Psychiatry
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  • Question 12 - John is a 25-year-old man who has been referred for depression that has...

    Incorrect

    • John is a 25-year-old man who has been referred for depression that has not improved with two courses of SSRIs. He reports feeling low, but his mood improves significantly when he spends time with his friends. He used to enjoy playing video games, but now finds it difficult to concentrate on them.
      John believes that his current problems stem from his recent breakup with his girlfriend. He feels like he is carrying a heavy weight on his shoulders. He denies having trouble sleeping, but is concerned about his recent weight gain.
      He complains of having an insatiable appetite and has had to buy new clothes because his old ones no longer fit. John feels like people are treating him differently because of his weight gain. When asked about his eating habits, he becomes upset and feels like he is being judged for being overweight.
      What is the most likely diagnosis?

      Your Answer:

      Correct Answer: Atypical depression

      Explanation:

      Atypical depression can often be mistaken for a personality disorder due to its symptoms, which include sensitivity to rejection, low but reactive mood, some ability to experience pleasure (though not to normal levels), hyperphagia with at least 3 kg of weight gain in three months, hypersomnia, and a feeling of heaviness in the limbs. However, the key to diagnosing atypical depression is a change in function. It is important to gather collateral history to determine if there is a lifelong pattern of problems that have been exacerbated of if the break-up is due to the depression and the resulting sensitivity to rejection. The preferred treatment for atypical depression is MAOIs.

    • This question is part of the following fields:

      • Diagnosis
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  • Question 13 - You are interviewing a 70-year-old patient in your ward.
    When asked what he...

    Incorrect

    • You are interviewing a 70-year-old patient in your ward.
      When asked what he had for breakfast, he says toast. You then ask what is your name? and he says toast. When you asked what is your date of birth?, he continues to say toast.
      What is the most likely symptom exhibited here?

      Your Answer:

      Correct Answer: Perseveration

      Explanation:

      Common Motor Symptoms in Neurological Disorders

      Perseveration is a symptom where an individual continues to use the same words of concepts even when they are no longer relevant. This is often seen in individuals with impaired consciousness due to acute of chronic organic disorders such as dementia. Automatism, on the other hand, is when an individual exhibits exaggerated cooperation with the examiner’s request of continues to perform a movement even after it has been requested. Mannerisms are repetitive, goal-directed movements, while stereotypy refers to unusual, non-goal directed movements. Finally, stuttering is characterized by the repetition of prolongation of sounds during speech. These motor symptoms are commonly seen in various neurological disorders.

    • This question is part of the following fields:

      • Dynamic Psychopathology
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  • Question 14 - Which of the following diseases is not considered a prion disease? ...

    Incorrect

    • Which of the following diseases is not considered a prion disease?

      Your Answer:

      Correct Answer: Dhat

      Explanation:

      Dhat is a syndrome that is specific to Indian culture and affects men. Those who suffer from it experience anxiety about the presence of semen in their urine, which they believe leads to a loss of energy.

      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
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  • Question 15 - A 32-year-old woman receiving treatment for epilepsy is hospitalized due to severe abdominal...

    Incorrect

    • A 32-year-old woman receiving treatment for epilepsy is hospitalized due to severe abdominal pain in the center of her abdomen. Upon examination, it is discovered that her serum amylase levels are significantly elevated. What medication is the probable cause of this condition?

      Your Answer:

      Correct Answer: Sodium valproate

      Explanation:

      – Valproate is an anticonvulsant drug.
      – Side effects of valproate include weight gain, nausea, vomiting, hair loss, easy bruising, tremor, hepatic failure, and pancreatitis.
      – Acute drug-induced pancreatitis is a potential complication of valproate use.

    • This question is part of the following fields:

      • Psychopharmacology
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  • Question 16 - What is a known complication associated with the use of valproate? ...

    Incorrect

    • What is a known complication associated with the use of valproate?

      Your Answer:

      Correct Answer: Pancreatitis

      Explanation:

      The use of valproate can lead to pancreatitis, which is a known and potentially fatal complication.

      Valproate: Forms, Doses, and Adverse Effects

      Valproate comes in three forms: semi-sodium valproate, valproic acid, and sodium valproate. Semi-sodium valproate is a mix of sodium valproate and valproic acid and is licensed for acute mania associated with bipolar disorder. Valproic acid is also licensed for acute mania, but this is not consistent with the Maudsley Guidelines. Sodium valproate is licensed for epilepsy. It is important to note that doses of sodium valproate and semi-sodium valproate are not the same, with a slightly higher dose required for sodium valproate.

      Valproate is associated with many adverse effects, including nausea, tremor, liver injury, vomiting/diarrhea, gingival hyperplasia, memory impairment/confusional state, somnolence, weight gain, anaemia/thrombocytopenia, alopecia (with curly regrowth), severe liver damage, and pancreatitis. Increased liver enzymes are common, particularly at the beginning of therapy, and tend to be transient. Vomiting and diarrhea tend to occur at the start of treatment and remit after a few days. Severe liver damage is most likely to occur in the first six months of therapy, with the maximum risk being between two and twelve weeks. The risk also declines with advancing age.

      Valproate is a teratogen and should not be initiated in women of childbearing potential. Approximately 10% of children exposed to valproate monotherapy during pregnancy suffer from congenital malformations, with the risk being dose-dependent. The most common malformations are neural tube defects, facial dysmorphism, cleft lip and palate, craniostenosis, cardiac, renal and urogenital defects, and limb defects. There is also a dose-dependent relationship between valproate and developmental delay, with approximately 30-40% of children exposed in utero experiencing delay in their early development, such as talking and walking later, lower intellectual abilities, poor language skills, and memory problems. There is also a thought to be a 3-fold increase of autism in children exposed in utero.

    • This question is part of the following fields:

      • Psychopharmacology
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  • Question 17 - Who differentiated genuine delusions from ideas that resemble delusions? ...

    Incorrect

    • Who differentiated genuine delusions from ideas that resemble delusions?

      Your Answer:

      Correct Answer: Karl Jaspers

      Explanation:

      Karl Theodor Jaspers, a prominent German psychiatrist and philosopher, made significant contributions to modern psychiatry and philosophy. His book General Psychopathology, published in 1913, introduced many of the diagnostic criteria used today. Jaspers distinguished between primary delusions, which are inexplicable and sudden, and secondary delusions, which can be understood based on the patient’s internal and external environment. Other notable figures in the field include Eugen Bleuler, who coined the term schizophrenia, Emil Kraepelin, who introduced dementia praecox, and Kurt Schneider, who developed the first rank symptoms of schizophrenia.

    • This question is part of the following fields:

      • History Of Psychiatry
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  • Question 18 - Which theory was significantly influenced by Harlow's experiment with rhesus monkeys? ...

    Incorrect

    • Which theory was significantly influenced by Harlow's experiment with rhesus monkeys?

      Your Answer:

      Correct Answer: Attachment theory

      Explanation:

      Attachment Theory and Harlow’s Monkeys

      Attachment theory, developed by John Bowlby, suggests that children have an innate tendency to form relationships with people around them to increase their chance of survival. This attachment is different from bonding, which concerns the mother’s feelings for her infant. Children typically single out a primary caregiver, referred to as the principle attachment figure, from about 1-3 months. The quality of a person’s early attachments is associated with their adult behavior, with poor attachments leading to withdrawn individuals who struggle to form relationships and good attachments leading to socially competent adults who can form healthy relationships.

      Bowlby’s attachment model has four stages: preattachment, attachment in the making, clear-cut attachment, and formation of reciprocal attachment. The time from 6 months to 36 months is known as the critical period, during which a child is most vulnerable to interruptions in its attachment. Attachments are divided into secure and insecure types, with insecure types further divided into avoidant and ambivalent types.

      Harlow’s experiment with young rhesus monkeys demonstrated the importance of the need for closeness over food. The experiment involved giving the monkeys a choice between two different mothers, one made of soft terry cloth but provided no food and the other made of wire but provided food from an attached baby bottle. The baby monkeys spent significantly more time with their cloth mother than with their wire mother, showing the importance of attachment and closeness in early development.

    • This question is part of the following fields:

      • Psychological Development
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  • Question 19 - What is the condition that is linked to self-harm and is caused by...

    Incorrect

    • What is the condition that is linked to self-harm and is caused by an abnormality in purine metabolism?

      Your Answer:

      Correct Answer: Lesch-Nyhan syndrome

      Explanation:

      Lesch-Nyhan Syndrome: A Rare Genetic Disorder

      Lesch-Nyhan syndrome is a rare genetic disorder that causes the overproduction and accumulation of uric acid in the body, leading to various health problems such as gouty arthritis, kidney stones, and subcutaneous tophi. The condition primarily affects males and is caused by mutations in the HPRT gene located on the X-chromosome.

      People with Lesch-Nyhan syndrome typically experience motor disability, including severe dystonia, hypotonia, and choreoathetosis, which can make it difficult of impossible for them to walk of sit without assistance. They may also exhibit self-injurious behavior, such as biting and head-banging, which is the most common and distinctive behavioral problem associated with the condition. Intellectual disability is common, but severe cognitive impairment is rare.

      The absence of the HPRT enzyme, which is responsible for recycling purine bases, leads to the accumulation of uric acid and affects the development of specific neural pathways in the brain, particularly the mesotelencephalic dopamine pathways. This disruption is likely responsible for the motor disability and behavioral peculiarities associated with the condition.

      Treatment for self-injurious behavior typically involves the use of protective restraints applied to the limbs, trunk, of head to prevent self-hitting of self-biting. Dental extraction may be necessary in cases of lip of tongue biting. Behavior modification methods that involve extinction may also be used, but neuroleptics may be required during particularly stressful of difficult behavior periods. However, these medications should only be used transiently due to their sedative effects and potential side-effects.

    • This question is part of the following fields:

      • Psychological Development
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  • Question 20 - What is the purpose of using the AUDIT questionnaire? ...

    Incorrect

    • What is the purpose of using the AUDIT questionnaire?

      Your Answer:

      Correct Answer: Alcohol misuse

      Explanation:

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

    • This question is part of the following fields:

      • Classification And Assessment
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  • Question 21 - During a session of cognitive analytic therapy, a young adult client shared that...

    Incorrect

    • During a session of cognitive analytic therapy, a young adult client shared that whenever they enter a new romantic relationship, they tend to intentionally create conflict of engage in infidelity. This behavior is likely influenced by their complex and enmeshed relationship with their father, who frequently left the family home during their childhood. Additionally, the client exhibits traits of narcissism. What type of procedure is the client describing?

      Your Answer:

      Correct Answer: Snag

      Explanation:

      Traps refer to circular patterns of interaction that create ‘vicious circles’. For instance, when we feel uncertain, we may try to please others, but this can result in others taking advantage of us, which reinforces our uncertainty.

    • This question is part of the following fields:

      • Advanced Psychological Processes And Treatments
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  • Question 22 - What category of behavior does saluting fall under? ...

    Incorrect

    • What category of behavior does saluting fall under?

      Your Answer:

      Correct Answer: Mannerisms

      Explanation:

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

    • This question is part of the following fields:

      • Classification And Assessment
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  • Question 23 - On which chromosome is the candidate gene for schizophrenia that codes for the...

    Incorrect

    • On which chromosome is the candidate gene for schizophrenia that codes for the Catechol-O-Methyltransferase enzyme located?

      Your Answer:

      Correct Answer: 22

      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
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  • Question 24 - What are the roles of purposes of the amygdala? ...

    Incorrect

    • What are the roles of purposes of the amygdala?

      Your Answer:

      Correct Answer: All of the above

      Explanation:

      The Amygdala: A Key Player in Emotional Processing

      The amygdala is a small, almond-shaped structure located in the anterior temporal lobe of the brain. As a core component of the limbic system, it plays a crucial role in emotional processing and regulation.

      To better understand its function, we can use the metaphor of a car being driven on the road. The frontal lobe of the brain acts as the driver, making decisions and navigating the environment. The amygdala, on the other hand, serves as the dashboard, providing the driver with important information about the car’s status, such as temperature and fuel levels. In this way, the amygdala gives emotional meaning to sensory input, allowing us to respond appropriately to potential threats of opportunities.

      One of the amygdala’s primary functions is to activate the fight or flight response in response to perceived danger. It does this by sending signals to the hypothalamus, which in turn triggers the release of stress hormones like adrenaline and cortisol. This prepares the body to either confront the threat of flee from it.

      In addition to its role in the fight or flight response, the amygdala also plays a role in regulating appetite and eating behavior. Studies have shown that damage to the amygdala can lead to overeating and obesity, suggesting that it may be involved in the hypothalamic control of feeding behavior.

      Overall, the amygdala is a key player in emotional processing and regulation, helping us to respond appropriately to the world around us.

    • This question is part of the following fields:

      • Neurosciences
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  • Question 25 - Which of the following is not classified by the strange situation procedure as...

    Incorrect

    • Which of the following is not classified by the strange situation procedure as an attachment style?

      Your Answer:

      Correct Answer: Enmeshed

      Explanation:

      Attachment (Ainsworth)

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

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

    • This question is part of the following fields:

      • Psychological Development
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  • Question 26 - What is a true statement about the placebo effect? ...

    Incorrect

    • What is a true statement about the placebo effect?

      Your Answer:

      Correct Answer: The placebo response is greater in mild rather than severe illness

      Explanation:

      The placebo response rate is on the rise in published studies, which is believed to be due to a larger number of patients with less severe forms of illness participating in these studies.

      Understanding the Placebo Effect

      In general, a placebo is an inert substance that has no pharmacological activity but looks, smells, and tastes like the active drug it is compared to. The placebo effect is the observable improvement seen when a patient takes a placebo, which results from patient-related factors such as expectations rather than the placebo itself. Negative effects due to patient-related factors are termed the nocebo effect.

      Active placebos are treatments with chemical activity that mimic the side effects of the drug being tested in a clinical trial. They are used to prevent unblinding of the drug versus the placebo control group. Placebos need not always be pharmacological and can be procedural, such as sham electroconvulsive therapy.

      The placebo effect is influenced by factors such as the perceived strength of the treatment, the status of the treating professional, and the branding of the compound. The placebo response is greater in mild illness, and the response rate is increasing over time. Placebo response is usually short-lived, and repeated use can lead to a diminished effect, known as placebo sag.

      It is difficult to separate placebo effects from spontaneous remission, and patients who enter clinical trials generally do so when acutely unwell, making it challenging to show treatment effects. Breaking the blind may influence the outcome, and the expectancy effect may explain why active placebos are more effective than inert placebos. Overall, understanding the placebo effect is crucial in clinical trials and personalized medicine.

    • This question is part of the following fields:

      • Classification And Assessment
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  • Question 27 - Which of the following is classified as a tertiary amine? ...

    Incorrect

    • Which of the following is classified as a tertiary amine?

      Your Answer:

      Correct Answer: Clomipramine

      Explanation:

      Tricyclic Antidepressants: Uses, Types, and Side-Effects

      Tricyclic antidepressants (TCAs) are a type of medication used for depression and neuropathic pain. However, due to their side-effects and toxicity in overdose, they are not commonly used for depression anymore. TCAs can be divided into two types: first generation (tertiary amines) and second generation (secondary amines). The secondary amines have a lower side effect profile and act primarily on noradrenaline, while the tertiary amines boost serotonin and noradrenaline.

      Some examples of secondary amines include desipramine, nortriptyline, protriptyline, and amoxapine. Examples of tertiary amines include amitriptyline, lofepramine, imipramine, clomipramine, dosulepin (dothiepin), doxepin, trimipramine, and butriptyline. Common side-effects of TCAs include drowsiness, dry mouth, blurred vision, constipation, and urinary retention.

      Low-dose amitriptyline is commonly used for neuropathic pain and prophylaxis of headache. Lofepramine has a lower incidence of toxicity in overdose. However, amitriptyline and dosulepin (dothiepin) are considered the most dangerous in overdose. It is important to consult with a healthcare provider before taking any medication and to follow their instructions carefully.

    • This question is part of the following fields:

      • Psychopharmacology
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  • Question 28 - Which of the following is not recommended as a treatment for dystonia caused...

    Incorrect

    • Which of the following is not recommended as a treatment for dystonia caused by antipsychotic medication?

      Your Answer:

      Correct Answer: Tetrabenazine

      Explanation:

      Extrapyramidal side-effects (EPSE’s) are a group of side effects that affect voluntary motor control, commonly seen in patients taking antipsychotic drugs. EPSE’s include dystonias, parkinsonism, akathisia, and tardive dyskinesia. They can be frightening and uncomfortable, leading to problems with non-compliance and can even be life-threatening in the case of laryngeal dystonia. EPSE’s are thought to be due to antagonism of dopaminergic D2 receptors in the basal ganglia. Symptoms generally occur within the first few days of treatment, with dystonias appearing quickly, within a few hours of administration of the first dose. Newer antipsychotics tend to produce less EPSE’s, with clozapine carrying the lowest risk and haloperidol carrying the highest risk. Akathisia is the most resistant EPSE to treat. EPSE’s can also occur when antipsychotics are discontinued (withdrawal dystonia).

    • This question is part of the following fields:

      • Psychopharmacology
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  • Question 29 - What waveform represents a frequency range of 4-8 Hz? ...

    Incorrect

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

      Your Answer:

      Correct Answer: Theta

      Explanation:

      Electroencephalography

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

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

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

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

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

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

    • This question is part of the following fields:

      • Neurosciences
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  • Question 30 - 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
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