MRCPsych Questions & Answers

Discussion in 'MRCPsych Forum' started by guest2011, May 25, 2011.

  1. guest2011

    guest2011 Moderator

    Q 1. In Piaget’s theory of cognitive development, the process of solving new problems using existing schemata is termed as;

  2. guest2011

    guest2011 Moderator

    Q 2. In Piaget’s theory of cognitive development, the concrete operational stage lasts from

    Birth to 2 years
    2 to 7 years
    7-12 years
    12 years and above
    18 years and above
  3. guest2011

    guest2011 Moderator

    Q 3. Forming hypothesis and ability to do deductive reasoning is a feature of;

    Preoperational stage
    Sensorimotor stage
    Concrete operational stage
    Formal operational stage
    None of the above
  4. guest2011

    guest2011 Moderator

    Q 4. Egocentrism is a feature of;

    Preoperational stage
    Sensorimotor stage
    Concrete operational stage
    Formal operational stage
    None of the above
  5. guest2011

    guest2011 Moderator

    Q 5. Which of the following is usually seen in the early stages of Alzheimer's disease

    A. Lacunar infarcts

    B. Atrophy of the medial parietal lobe

    C. Hippocampal atrophy

    D. Cerebellar hypertrophy

    E. Ventricular enlargement
  6. guest2011

    guest2011 Moderator

    Q 6. The following are inducers of the Cytochrome P450 system except?

    A. Smoking

    B. Alcohol

    C. Carbamazepine

    D. St John’s Wort

    E. Fluoxetine

    its inhibitor

    Cytochrome P450
    Inducers - smoking, alcohol, barbiturates, carbamazepine, Phenytoin, and St John’s Wort.
    Inhibitors - caffeine, chlorpromazine, SSRI’s, and grapefruit juice
    Last edited: May 26, 2011
  7. guest2011

    guest2011 Moderator

    Q 7. What is the relative risk of developing Alzheimer's dementia in a heterozygote for APOE 4?

    A. 3
    B. 1
    C. 14
    D. 10
    E. 20

    Ans a-3

    • Late onset Alzheimer’s
    Only one gene has been identified for late onset cases, apolipoprotein E (APOE).
    APOE is thought to be involved in the breakdown of amyloid plaques and different forms of it seem to vary in how effective they can do this. The gene is on chromosome 19 and has three alleles, APOE2, APOE3, and APOE4.
    The E4 variant is the risk factor for late onset Alzheimer’s. People homozygous for the E4 allele have between a 10 and 30 times increased risk for Alzheimer’s compared to people not carrying any E4 alleles.

    Heterozygotes for APOE4 have a 3 times increased risk. In addition each E4 allele lowers the age of onset by 10 years.
    • APOE2 - protective
    • APOE3 - neutral
    • APOE4 - increases risk

    The E4 variant is the largest known genetic risk factor for late-onset Alzheimer's Disease (AD) in a variety of ethnic groups. Caucasian and Japanese carriers of 2 E4 alleles have between 10 and 30 times the risk of developing AD by 75 years of age, as compared to those not carrying any E4 alleles. While the exact mechanism of how E4 causes such dramatic effects remains to be fully determined, evidence has been presented suggesting an interaction with amyloid.
  8. manjeet

    manjeet Guest

    Q 8. Which of the following is true regarding the genetics of Huntington’s

    A. It shows autosomal recessive inheritance

    B There is no correlation between the number of CAG repeats and the severity of the disease

    C. CAG is normally repeated no more than 27 times

    D. The Huntington's gene is located on chromosome 21

    E. The CAG length is more unstable when inherited from the father
  9. manjeet

    manjeet Guest

    Q 9. Which statement is false?
    A. Exons separated by introns --T
    B. Introns have codon that are regulatory in nature (stop & start codon). (Is it that exons have the codon not the intron)
    C. proteome constantly change not genome.

    An exon is a nucleic acid sequence that is represented in the mature form of an RNA molecule after either portions of a precursor RNA (introns) have been removed by cis-splicing or when two or more precursor RNA molecules have been ligated by trans-splicing. The mature RNA molecule can be a messenger RNA or a functional form of a non-coding RNA such as rRNA or tRNA. Depending on the context, exon can refer to the sequence in the DNA or its RNA transcript.
  10. meenal

    meenal Guest

    Ekman identified 6 primary human emotions –
    These are universal, innate and ready-wired responses
    An emotion has 3 components –

    1. Subjective cortical experience
    2. Physiological visceralchanges
    3. Associated behavioural (skeletal muscle) changes

    Theories of emotion
    James-Lange Theory
    Stimulus ˃physiological arousal ˃ emotion
    Perception of a stimulus leads to bodily (skeletal and visceral) changes. The
    peripheral responses send feedback to cortex via thalamus leading to perception of the emotion.

     A modification is facial feedback hypothesis which suggested that different facial movements elicited different emotional perceptions.
     But wide repertoires of bodily changes are not available to explain the widely variant emotions perceived. Also emotional perception occurs faster than that could be explained by a feedback theory.
     Anger- maximum rise in temperature
     Fear and Disgust- drop in temperature.
     Studies on emotions have shown that the heart rate increase produced by sadness is usually greater than that produced by happiness
  11. meenal

    meenal Guest

    Schachter-singer labelling theory:

    On perception of a stimulus, both physiological changes and a conscious experience of general arousal take place simultaneously. This generic arousal is then interpreted to either positive or negative and labelled appropriately according to the situational cues. This is also called jukebox theory or two factor theory. If appropriate label is not found, by default, negative appreciation of arousal occurs.

    Lazarus cognitive appraisal theory states that appraisal precedes affective reaction – hence affective primacy cannot be true.
  12. durgesh2011

    durgesh2011 Guest

    Cannon's theory says that the brain directly creates the experience of emotion.

    The James-Lange theory states that we experience emotion in response to physiological changes in our body. For example, we feel sad because we cry.

    The Cannon-Bard theory of emotion on the other hand, says basically the opposite: that we cry because we are sad

    James-Lange Theory
    James proposed that bodily changes follow directly the perception of the exciting fact, and our feeling of the same changes as they occur is the emotion.
    Lange's modification indicated that vasomotor changes are the emotions
    Both viewed emotion as the perception of a response by the nervous system.
    Both suggest that the underlying processes perceived as emotions are autonomic.

    Cannon-Bard Theory
    Viewed emotions as the result of concurrent brain stem & cortical events
    Cortex inhibits thalamus
    Emotion-producing stimuli remove inhibition
    Impulses released to ANS result in emotional behavior
  13. durgesh2011

    durgesh2011 Guest

    Q. 10.
    What is true?
    Translation: 1st stage of gene expression? F
    Transcription: mRNA produce by specific code (a-t, c-g) (I think it should be U instead of a T) ??
    Transcriptome : is complete set of DNA produced by genome. F
    Mutation: e.g of it are silent, Missense( single substitution), nonsense( stop codon), or frame shift( new sequence).?what is actual question

    Translation is the third stage of protein biosynthesis (part of the overall process of gene expression). In translation, messenger RNA (mRNA) produced by transcription is decoded by the ribosome to produce a specific amino acid chain, or polypeptide, that will later fold into an active protein

    Transcription is the process of creating an equivalent RNA copy of a sequence of DNA
    During transcription, a DNA sequence is read by RNA polymerase, which produces a complementary, antiparallel RNA strand. As opposed to DNA replication, transcription results in an RNA complement that includes uracil (U) in all instances where thymine (T) would have occurred in a DNA complement

    The transcriptome is the set of all RNA molecules, including mRNA, rRNA, tRNA, and other non-coding RNA produced in one or a population of cells. The term can be applied to the total set of transcripts in a given organism, or to the specific subset of transcripts present in a particular cell type. Unlike the genome, which is roughly fixed for a given cell line (excluding mutations),

    Silent mutations: which code for the same amino acid.
    Missense mutations: which code for a different amino acid.
    Nonsense mutations: which code for a stop and can truncate the protein
  14. durgesh2011

    durgesh2011 Guest

    Q. 11. Safe in overdose due to no direct effect on Cl-
    a. Alcohol
    b. diazepam
    c. chlormethiazole
    d. barbiturates
  15. durgesh2011

    durgesh2011 Guest

    Q. 12. What is false about genome?
    1. Complete set of DNA.
    2. THE base pairs (bacteria 600 000, human & mice 3billion.
    3. Red blood cells contain genome. The only type that does not have DNA
  16. durgesh2011

    durgesh2011 Guest

    Ans 3

    The term genome can be applied specifically to mean that stored on a complete set of nuclear DNA (i.e., the "nuclear genome") but can also be applied to that stored within organelles that contain their own DNA, as with the "mitochondrial genome" or the "chloroplast genome

    human The human genome is 3.1 billion base pairs spread out over 23 pairs of chromosomes (22 autosomes and the X and the Y sex chromosomes).
    mice 2.5billion
    Almost every cell in the body contains a copy of the genome (red blood cells have no genome at all).
  17. durgesh2011

    durgesh2011 Guest

    Q. Lithium levels are increased by all except?
    A. NSAIDs
    B. Thiazides
    C. osmotic diuretics
    D. sodium restriction
    E. ACE inhibitors

    Ans -osmotic diuretics -increase renal excretion of lithium and decrease lithium level
  18. durgesh2011

    durgesh2011 Guest

    Q. Which of the following can be used as a counter measure for confounding??
    a) Blinding
    b) Matching
    c) Standardised assessment
    d) randomisization

    Ans-? d) randomisization
  19. durgesh2011

    durgesh2011 Guest

    Q. In statistics/research -Number needed to treat is reciprocal of.
    A. Absolute risk
    B. Absolute risk reduction
    C. Relative risk
    D. Relative risk reduction
    E. Odds ratio

    Ans -B. Absolute risk reduction
    The NNT for a given therapy is simply the reciprocal of the absolute risk reduction for that treatment
    The NNT is particularly useful for treatments if several treatments are assessed for the same outcome measure in patients with similar conditions
  20. durgesh2011

    durgesh2011 Guest

    Q. EEG changes in frontotemporal dementia:
    a. Normal

    Patients with Alzheimer's disease tend to show a slowing of alpha activity below 8 Hz, a decrease in alpha activity, a decrease in the alpha to theta ratio, an increase in theta activity, and an increase in delta activity.

    * Patients with vascular dementia show focal slowing with an unchanged EEG rhythm.

    * Patients with frontotemporal dementia tend to have normal EEG findings, even in the face of high levels of dementia.

    * Patients with dementia with Lewy bodies show general slowing, sometimes accompanied by sharp waves.

    * Patients with Creutzfeldt-Jakob disease or other spongiform encephalopathies will show general slowing and periodic patterns.

    It's important to remember that all of these changes occur against a background of the EEG changes in normal aging. Normal age-related EEG changes include a decrease in alpha amplitudes, an attenuation of the blocking response, an increase in slow activity, and intermittent, often asymmetric, delta and/or theta activity.

    Specific wave forms are seen in an EEG and you need to be familiar with these.
    Type Frequency Normally found Normally seen in
    Delta 1-4Hz Frontally in adults and posteriorly in children Slow wave sleep and in babies
    Theta 4-8Hz Generalised Young children, drowsy adults, and with certain medications, meditation
    Alpha 8-12Hz Posteriorly When relaxed and when the eyes are closed
    Beta 12-30Hz Frontally When busy or concentrating
    Gamma 30-100Hz No specific areas Meditation

    Condition EEG findings
    CJD (sporadic only, does not apply to variant) Early on there is non specific slowing, later periodic biphasic and triphasic synchronous sharp wave complexes superimposed on a slow background rhythm
    Huntington’s Low voltage EEG, in particular no alpha (flattening)
    Delirium Diffuse slowing, decreased alpha, increased theta and delta
    Delirium tremens Hyperactive trace, fast
    Alzheimer’s Reduced alpha and beta, increased delta and theta
    Petit mal epilepsy (absence seizure) Generalised, bilateral, synchronous, 3Hz (3 waves per second) spike and wave pattern
    Generalised epilepsy Sharp spikes, 25-30Hz
    Partial epilepsy Focal spikes
    Encephalopathy Diffuse slowing
    Normal aging Diffuse slowing, which can be focal or diffuse, if focal most commonly seen in the left temporal region

    Medications can have important effects on the EEG and you must be aware of these.
    Drug class Effect on EEG
    Antipsychotics Reduce beta, increase all others (delta, alpha, theta)
    Antidepressants Reduce beta, increase all others
    Anticonvulsants No effect
    Lithium Slowing
    Benzodiazepines Increase beta, decrease alpha
  21. durgesh2011

    durgesh2011 Guest

    Q. Which measure of central tendency can be applied to data measured on interval scale?
    a) Mean
    b) Median
    c) Mode
    d) All of these

    Ans - d) All of these

    The central tendency of a variable measured at the interval level can be represented by its mode, its median, or its arithmetic mean
    All statistical measures can be used for a variable measured at the ratio level, as all necessary mathematical operations are defined. The central tendency of a variable measured at the ratio level can be represented by, in addition to its mode, its median, or its arithmetic mean, also its geometric mean or harmonic mean. In addition to the measures of statistical dispersion defined for interval variables, such as range and standard deviation, for ratio variables one can also define measures that require a ratio, such as studentized range or coefficient of variation.
  22. durgesh2011

    durgesh2011 Guest

    The following are weaknesses for cohort study except
    a) change in exposurte status
    b) lengthy and expensive
    c) loss to follow up problems
    d) non-partcipation bias
    e) not suitable for studying rare exposure

    Ans- ? e) not suitable for studying rare exposure

    A cohort study or panel study is a form of longitudinal study (a type of observational study) . It is an analysis of risk factors and follows a group of people who do not have the disease, and uses correlations to determine the absolute risk of subject contraction. It is one type of clinical study design and should be compared with a cross-sectional study

    A cohort is a group of people who share a common characteristic or experience within a defined period (e.g., are born, are exposed to a drug or a vaccine, etc.). Thus a group of people who were born on a day or in a particular period, say 1948, form a birth cohort. The comparison group may be the general population from which the cohort is drawn,

    In medicine, a cohort study is often undertaken to obtain evidence to try to refute the existence of a suspected association between cause and effect; failure to refute a hypothesis strengthens confidence in it. Crucially, the cohort is identified before the appearance of the disease under investigation

    The cohort cannot therefore be defined as a group of people who already have the disease
  23. durgesh2011

    durgesh2011 Guest

    Q. Biological units of heridity
    a. genome
    b. DNA
    c. genes
    d. autosomes
    e. allosomes
    Genes: The basic biological units of heredity
  24. durgesh2011

    durgesh2011 Guest

    Q. The Lower s allele is a risk to the following
    1 increase risk of alcohol dependence,
    2 increase effect of alcohol dependence,
    3 increase antisocial behaviour
    4 increase suicide attempts.'
    Answer: increase suicide attempts

    5-HTTLPR (serotonin-transporter-linked promoter region) The serotonin transporter (5-HTT) gene is a promising candidate for introducing the heritability of interindividual variation in personality and the genetic susceptibility for various psychiatric diseases.

    A deletion/insertion in the 5-HTTLPR was first reported to create a short (S) allele and a long (L) allele (14- and 16-repeats, respectively).

    short 5-HTTLPR allele carriers may be more sensitive to emotional information in the environment than long allele homozygotes.
  25. durgesh2011

    durgesh2011 Guest

    1-Which of the following is a portion of non coding DNA that is not translated into protein?






    2-Which of the following is a partial D2 agonist?

    3-A patient with psoriasis has noticed that it has become worse since she has started a new medication. Which of the following would you most suspect would worsen her psoriasis?

    4-You see a lady in clinic who you recently gave a diagnosis of schizophrenia. She has heard that the condition is 'in the genes' and wants to know if her brother will develop the condition. What would you tell her is the risk of her brother developing schizophrenia based purely on the fact that she has it?

    5-Use of which of the following is associated with weight loss?

  26. mahak

    mahak Guest

    Psychiatry EMQ

    A. Alzheimers Disease (mild severity)
    B. Alzheimers Disease (moderate severity)
    C. Alzheimers Disease (severe severity)
    D. Amnestic Syndrome
    E. Delirium
    F. Delirium Tremens
    G. Dementia associated with Parkinsons Disease
    H. Dementia with Lewy bodies
    I. Frontal Lobe Stroke
    J. Frontotemporal Dementia
    K. Major Depression
    L. Normal Cognition
    M. Normal Pressure Hydrocephalus
    N. Parietal Lobe Stroke
    O. Schizophrenia
    P. Temporal Lobe Stroke
    Q. Vascular Dementia
    R. Wernickes Encephalopathy

    Derek is 59 and seems to be an itinerant, carrying his belongings with him in a wheelbarrow and apparently camping on public land until he is asked to move on. He seems odd and has some rather eccentric ideas about the political system that are fixed and poorly substantiated. Neurological examination is normal. MMSE is 26/30, losing points for articulation (“no ifs ands or buts”), three stage command (1/3) and copying the intersecting pentagrams. A CT scan is normal.
  27. mahak

    mahak Guest

    Aug 2010 paper 1

    1-A man reported that whenever he is walking on the street he hears voices immediately after hearing an exhaust of a car and he also belives that people could hear what he is thinking what is this
    1-Thoght broadcasting.
    2-Functional hallucinations
    3-Reflex hallucinations
    4-Thought echo

    2-Q:. This person has names 6 different emotions:
    a. Alport
    b. Cattle
    c. Jung
    d. Ekman
    e. James Lang

    3-What is the best test that would help differentiate between Alzehiemers dematia and Lewy Body;s
    a. Structural MRI
    b. Functional MRI
    C. DaT SCAN
    d. CT Scan
    e. Perfusion study

    4-How to differentiate bereavement from depression 12 months after her husband died:
    1. Feeling guilt for something ......
    2. Feeliing low
    3. Mummification
    4. Not sleeping well
    5. ??

    5-Which of the defence mechanisms is most often used by people with narcissistic personality?
    a. Projection
    b. Projective identification
    c. Sublimation
    d. Displacement
    e. Reaction formation

    6-Which of the following instruments can be used to screen for premorbid intelligence?
    A. National adult reading test
    B. Weschler adult intelligence scale
    C. Bender visual motor gestalt test
    D. Raven’s progressive matrices
    E. Glasgow coma scale

    7-A patient repeats whatever the examiner says. He is exhibiting
    a. Echolalia
    b. Logoclonia
    c. Parapraxis
    d. Perseveration
    e. Stereotypy

    8-You are interviewing a newly admitted patient in your ward. When asked what he had for breakfast, he says 'cereals'. Then when you asked ‘what is your name?’ he says 'cereals'. When you asked ‘what is his date of birth?’ he continues to say 'cereals'. The most likely symptom exhibited here is
    a. Stereotypy
    b. Automatism
    c. Mannerism
    d. Perseveration
    e. Stuttering

    9-A hospital manager is presenting data to a trust board. He said ‘murder of 2 hospitals’ instead of ‘merger of 2 hospitals’. This is an example of
    a. parapraxis
    b. paragrammatism
    c. neologism
    d. logoclonia
    e. stock word

    10- A 45 year old man who has longstanding suspiciousness towards police becomes anxious and acts in a strange manner on seeing 2 policemen at a public event. The police become suspicious of him and arrest him as a precautionary measure. The underlying psychodynamic mechanism is
    a. Projection
    b. Projective identification
    c. Acting out
    d. Suppression
    e. Repression

    11- In which stage of Piaget’s theory of development a boy is able to make difference quantity of water is the same in tall and wide glass
    a. Preoperational stage
    b. Sensorimotor stage
    c. Concrete operational stage
    d. Formal operational stage
    e. None of the above
  28. mahak

    mahak Guest

    Q. A lady reported that her 53 year old husband, has been having abnormal movements and has lately become anxious and depressed, hi father had a similar problem annd lately her husband attended his GP appointment 30 min earlier and shouted at the receptionist . What is the likely diagnosis

    1-Lewy body dementia
    3-Generaliszed anxiety disorder
    5-Vascular dementia
  29. mahak

    mahak Guest

    Lewy body dementia
    • Fluctuating cognitive impairment
    • Hallucinations
    • Neuroleptic sensitivity (sensitivity to the side effects of antipsychotics such as sedation and EPSE's)
    • Falls
    • Rigidity, stiffness and movement difficulties
    Huntington's disease
    • Early onset 35-44
    • Associated with abnormal movements (chorea)
    • Autosomal dominant
  30. mahak

    mahak Guest

    Huntington's disease is characterised by a triad of motor, cognitive and psychiatric symptoms.

    Psychiatric presentations of Huntington's include:-
    • Depression
    • Dementia
    • Psychosis
    • Anxiety
    • Mania
    • Sexual dysfunction
    • Suicide
  31. mahak

    mahak Guest

    Q. Flupentixol is classified as which of the following?

    A. A Thioxanthene

    B. A Dibenzodiazepine

    C. A Diphenylbutylpiperidine

    D. A Butyrophenone

    E. A Phenothiazine
  32. mahak

    mahak Guest

    Q. Which of the following is a recognised factor in the aetiology of ADHD?

    A. A Young age of mother

    B. A Maternal smoking

    C. A Influenza during pregnancy

    D. A Spring birth

    E. A Maternal obesity
  33. upen

    upen Guest

    Q. Regarding Addenbrookes cognitice examination test, which of the following is true:

    1-Its a cognitive test that can test for dementia, delerium and cognition.
    2- A score of <85 indicates dementia and said to be specific for the diagnosis
    3- A sore of <85 indicates dementia and known to be sensitive for the diagnosis
    4-It does not include the MMSE
    5-Includes MMSE but its not included in the overall score
  34. upen

    upen Guest

    Q. Choose one of the following that would facilitate an interview:

    1- frequent aknwoledgment
    2-Closed questions
    3-Long pauses
    4-prolonged eye contact
    5-interupting the patient while speaking
  35. mahak

    mahak Guest

    Q. The following drug can increase lithium level

  36. mahak

    mahak Guest

    Q. 1. Defence mechanism of Narcissistic personality
    Ans: ?Projection

    Condition Associated defence mechanisms
    Phobias Repression and displacement
    Obsessive compulsive disorder Isolation, undoing, and reaction formation
    Borderline personality disorder Projection and splitting
    Narcissistic personality disorder Projection and splitting

    2. The investigation to differentiate Alzheimer's to Lewy body
    a. Structural MRI
    b. Functional MRI
    C. DaT SCAN
    d. CT Scan
    e. Perfusion study
  37. jiten

    jiten Guest

    Q. -A man reported that whenever he is walking on the streed he hears voices immediately after hearing an exhaust of a car and he also belives that people could hear what he is thinking what is this

    1-Thoght broadcasting.
    2-Functional hallucinations
    3-Reflex hallucinations
    4-Thought echo
  38. jiten

    jiten Guest

    Functional hallucinations –

    A patient experiences an hallucination at the same time as receiving a real stimulus in the same sensory modality
  39. jiten

    jiten Guest

    Q. A mother said that her son keeps repating the same word, even when you ask him a different question he still replies the word eg: Ice she wants to know what this is called so she could look it up on the internet. What is this called:

    1- Echolalia
    5- paragramatism

    Ans -Perseveration -refers to the uncontrollable repetition of a word, phrase, or movement.
  40. upen

    upen Guest

    A Extensor plantar reflex
    B Flapping tremor
    C Intention tremor
    D Neck stiffness
    E Nystagmus
    F Optic atrophy
    G Perseveration
    H Petechial rash
    I Resting tremor
    J Urinary hesitancy
    For each of the following conditions, choose the most appropriate symptom/sign from the list above. The number of answers required for each condition is indicated in parentheses. Each option may be used once, more than once or not at all.
    Q134 A 45-year-old man with Wernicke’s encephalopathy.
    Q135 Following an attack of mastoiditis, a 16-year-old boy develops pyrexia, headache, vomiting and impaired consciousness.
    Q136 A60-year-old man suffering from hepatic encephalopathy.
    Q137 A 70-year-old man with Parkinson’s disease.
  41. upen

    upen Guest

    EMI 2
    A Bradycardia
    B Bronchospasm
    C Confusion
    D Hair loss
    E Influenza-like symptoms
    F Microcytosis
    G Myoclonus
    H Osteomalacia
    I Rash
    J Significant weight gain
    K Tachycardia
    From the above list, choose the two most likely side-effects of the medications below. Each option can be used once, more than once or not at all.
    Q138 A young woman taking lamotrigine as a mood stabiliser.
    Q139 A middle-aged man uses propranolol for his symptoms of anxiety.
    Q140 A30-year-oldwomantakes sodiumvalproate andolanzapine concomitantly.
    Q141 A 40-year-old man is prescribed tranylcypromine concurrently with clomipramine.
  42. upen

    upen Guest

    Anti Depressants end other Drugs

    An antidepressant is a medication used primarily in the treatment of depression.
    Depression can occur if some of the chemicals called neurotransmitters in the brain are not functioning effectively.
    There are three specific chemicals that can affect a person's mood
    Antidepressants affect one or more of these chemicals in different ways to help stabilize the chemical imbalance often seen in depression.
  43. upen

    upen Guest

    Which one of the following statements is correct concerning opiate abuse?

    (Please select 1 option)

    An amotivational state occurs

    Clinical effects of opiates include restlessness, abdominal pain and piloerection

    Heroin is often used to replace Naltrexone

    Opiates are also known as "Ice"

    Withdrawal symptoms rarely threaten the life of someone who is in reasonable health This is the correct answer

    Opiate withdrawal is not usually life threatening. The classic withdrawal syndrome for heroin appears within 4 to 12 hours, peaks at 48 to 72 hours, and subsides by the end of 7 to 10 days. There is often a period of several hours before frank withdrawal symptoms begin, during which the addict becomes agitated and anxious. Characteristic withdrawal symptoms include aching muscles and joints, dysphoria, insomnia, agitation, diarrhoea, shivering, yawning, and fatigue. More objective measures include tachycardia and hypertension, lacrimation, rhinorrhoea, dilated pupils, and 'goosefleshing' (piloerection) of the skin (hence 'cold turkey' or 'clucking'). Insomnia (with increase in REM sleep) and craving for the drug may persist for weeks.

    Methadone is a synthetic orally effective opiate with a longer half-life than heroin (24 to 36 hours), making it suitable for daily administration. It is the mainstay of treatment for heroin dependency in the Western world. Methadone may be used as substitute opiate drug, prescribed long term with the aim of achieving stable (non-injecting) opiate dependence (methadone maintenance) or it may be prescribed in the short term to aid withdrawal. Withdrawal may also be hastened by administering the long-acting opiate antagonist Naltrexone, which 'kicks' the addict into intense but shorter-lived withdrawal during which symptomatic relief may be given with clonidine and benzodiazepines. Opiate withdrawal is not usually considered to be life threatening.

    Cannabis abuse is associated with an amotivational state.

    Cocaine is also known as "Ice".

    Street names of heroin include brown, china white, whack, brown sugar, and smack.
  44. upen

    upen Guest

    Defence Mechanism

    A Conversion
    B Isolation
    C Rationalisation
    D Identification with the aggressor
    E Intellectualisation
    F Projective identification
    G Magical undoing
    H Splitting
    I Denial
    J Displacement

    From the option list, select the most likely relating to the following examples.

    A 40-year-old man is unable to post letter in the letter box until he has walked round the box four times.

    - The answer is Magical undoing

    Magical undoing is a term used in psychoanalysis. It is a defence mechanism whereby an emotional conflict associated with an action is dealt with by negating the action or attempting 'magically' to cause it not have occurred by substituting an approximately opposite action.


    An 18-year-old woman tells the duty psychiatrist in a matter of fact way that she took 20 Paracetamol tablets two hours ago.

    - The answer is Isolation

    Isolation is a defence mechanism involving the act or process of separating or placing apart, emotions or feelings.


    A boss gets migraines after her secretary has made a mistake in double booking her.

    - The answer is Conversion

    Conversion is a defence mechanism in which an unconscious conflict that would otherwise arouse anxiety is expressed symbolically. The repressed emotion is transformed into a physical symptom, which can vary from a headache to paralysis or loss of sensation.
  45. durgesh2011

    durgesh2011 Guest

    Q . Theme:psychopathology

    A Palinopsia
    B Hypnagogic hallucination
    C Extra campine hallucination
    D Visual hallucination
    E Haptic hallucination
    F Reflex hallucination
    G Autoscopy
    H Illusion
    I Synaesthesia
    J Charles Bonnet syndrome

    For each of the following cases, choose the most likely option from the above list.

    A 45-year-old woman who claims to see the trace of objects as they move around.

    Incorrect - The answer is Palinopsia

    Palinopsia is a phenomenon in which there is perseveration of a visual sensation. Palinacousis is ictal phenomenon with perseveration of an auditory sensation.


    A 37-year-old woman who claims that she hears the colour red when she sees it
    - The answer is Synaesthesia

    In synaesthesia the sensory stimulus in one modality is perceived as a sensation in another modality.


    A 60-year-old man with bilateral cataracts, otherwise healthy, says he sees things that he could not explain.

    - The answer is Charles Bonnet syndrome

    Sometimes visual hallucinations do not appear to be associated with other psychiatric abnormality. Phantom visual images is a condition in which individuals experience complex visual hallucinations with a demonstrable psychopathology. This is known as Charles Bonnet syndrome.
  46. durgesh2011

    durgesh2011 Guest

    Q. A 52-year-old male is admitted after taking an overdose. Which single feature best suggests a high risk of future suicide?

    (Please select 1 option)

    Ingestion of alcohol with the overdose drug
    Ingestion of more than 100 tablets
    Ingestion of more than one drug
    Making plans before the overdose to avoid discovery
    Previous history of overdose

    Making plans before the overdose to avoid discovery This is the answer

    The effort to conceal the overdose suggests a serious intent to commit suicide more so than the other options given. Previous history of overdoses does not necessarily imply a more serious intent. Other factors that would imply a more sinister intent would be male, elderly with mental illness.
  47. guest2011

    guest2011 Moderator


    1. Overdose lady - assess the circumstances of overdose and assess if compulsory detention is required

    2. Agoraphobia - Discuss desensitisation treatment with a woman who suffers from agoraphobia and is scared of leaving her house. She has heard about desensitisation and is worried that she will be forced to go out of her house which makes her very anxious.

    3. Manic/ hypo manic patient - Assess this young man who has been referred by GP for an urgent assessment. He has a past history of depression. Take history and establish etiological factors.

    4. Alzheimer's Medication - Explain Alzheimer's medication to the daughter of a lady suffering from mild to moderate Alzheimer's. Discuss benefits and side effects.

    5. BDD - Assess young lady who believes that her eyes are too wide apart and feels that she looks like a fish.

    6. Psychotic old woman - Elderly woman who is very frightened as she believes that she had committed a war crime in 1970s and now watched the TV programme where she heard about the war crimes and believes that she will be arrested and appeared very frightened and kept on asking if you are from Police department there to arrest her.

    7. Cognitive assessment focusing on the Frontal Lobe tests

    8. Assess an inpatient with Schizophrenia who has become very distressed. Assess why she has become distressed. This lady believed that the secret services were sending her messages by waves and telling her that she was an al-qeida member.


    1. (a) Erotomanic patient: Wanting to see a nurse who he believes that is in love with him. He was seen by this nurse in A&E a month ago. Assess his beliefs and dangerousness. - he was carrying handcuffs in his bag and ? a knife) In the next station you will be talking to the nurse about the risks.

    1. (b) Talk to the nurse who is very scared of this man. He was arrested by police, he took a knife out in the casualty after he was not allowed to see this nurse. He unfortunately managed to escape from the prison and the police is now looking for him.

    2. (a) 15 year old girl took and overdose of 40 Paracetamol and left a note. Also has a history of bullying in school, recently moved to new school. Assess the circumstances and risk. In the next station you will be required to discuss the management with the consultant.

    2. (b) Talk to the consultant and discuss the management plan.

    3. (a) Take a collateral history from the carer of this man with dementia who lives in a nursing home. He has in last 3 months become very aggressive and also hit other patient. Take history to find out more about the change in behaviour and risks. In the next station you will be taking to his son about the management.

    3. (b) Talk to this man's son who is very angry that his dad was prescribed Olanzapine and he has read on the Internet that this is a medication for Schizophrenia and is a sedative and can cause stroke etc. Also discuss with him other ways of managing aggression and difficult behaviour in dementia.

    4. (a) Take history of presenting complaint and medical history from this man with headache who is convinced that he has a brain tumor in spite of normal investigations and normal CT Scan. Do not take any other history. 9only presenting complaint and past medical history). In next station you will be required to talk to his partner to explain diagnosis and management.

    4. (b) Talk to this man's partner and explain to her the the diagnosis, etiology and management. Also address any concerns she may have.
  48. guest2011

    guest2011 Moderator

    Q. Forming hypothesis and ability to do deductive reasoning is a feature of
    A. Preoperational stage
    B. Sensorimotor stage
    C. Concrete operational stage
    D. Formal operational stage
    E. None of the above
  49. guest2011

    guest2011 Moderator

    Q. In Piaget’s theory of cognitive development, the process of solving new problems using existing schemata is termed as
    A. Accommodation
    B. Schema
    C. Assimilation
    D. Maturation
    E. Adaptation
  50. guest2011

    guest2011 Moderator

    Q. In Piaget’s theory of cognitive development, the concrete operational stage lasts from

    Birth to 2 years
    2 to 7 years
    7-12 years
    12 years and above
    18 years and above

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