141 questions Flashcards
strongest risk factor for suicide
substance use + indigenous
if a person has both ovaries and testes.
Hermaphroditism.
This scale has sections on symptoms, behaviour, social and functioning.
Answer: Brief psychiatric rating scale.
This scale detects psychiatric caseness. Choices, BPRS, GHQ, HoNOS
GHQ, general health questionnaire.
Erik Erikson, which one of the following is mentioned in a psychosocial theory
Answer: Generativity. This is the stage of generativity versus stagnation.
In which phase is one happy or relieved to have learnt a new skill?
Answer: Industry versus inferiority.
Female child seems normal then has learning problems after six months and appears like she has acquired microcephaly.
Answer: Rett syndrome.
Male child with hand biting and other self-injurious behaviours.
Lesch-Nyhan syndrome.
What differentiates normal age-related cognitive decline from dementia?
Progressive cognitive decline.
Other than age, which factor is associated with higher seizure thresholds?
Bilateral ECT
Male patient was admitted for detoxification, has had IV heroin 10 times a day, want substitution therapy.
Methadone high dose
This will be diagnostic in 70% of patients with sporadic CJD.
Answer EEG. The variant CJD shows pulvinar sign on regular MRI not fMRI.
My boss looks at me a certain way. He must hate me.
jumping to conclusions
A homosexual man thinks that the community will not accept him so he enters a heterosexual relationship.
Denial.
Which of the following would be most appropriately detected by diffusion tensor imaging in schizophrenia.
• Lateral ventricular enlargement.
• Enlarged parahippocampal gyrus.
• Parietal lobe blood flow abnormalities.
• Frontal and temporal white matter abnormality.
Frontal and temporal white matter. Schizophrenia has frontal and temporal involvement. Parietal lobe involvement indicates Alzheimer’s.
Decreased ability to concentrate urine.
Lithium.
A 17-year-old female reports hearing her friend say bad things about her.
Delusional perception
Mother leaves the child. Upon returning, he cries. She says, I’m back now and he freezes. Insecure avoidant, insecure resistant or disorganised.
Insecure resistant.
Child can play next to mother.
Mahler practicing
Lowest risk mood stabiliser in pregnancy.
Lamotrigine.
Overdose of benztropine amongst bradycardia, hypertension, miosis, tachycardia, tachypnoea, tremor and mydriasis.
Mydriasis
Mother who suffered from childhood sexual abuse previously finds a man who is attempting to sexually abuse her 6-year-old son. She defends her son by attacking the man and killing him.
provocation
Which childhood disorder can lead to panic disorder without agoraphobia. Choices, separation anxiety, major depression of adolescence and reactive attachment disorder of infancy
Separation anxiety.
Patient wants to kill his partner. Select the most relevant forensic concept.
Tarasoff Rule. Other choices were Durham rule not used.
Jacksonian seizures area of the brain.
Choices:
• Uncus which gives olfactory hallucinations
• medial basal temporal lobe - complex partial seizure symptoms
• postcentral gyrus
• occipital lobe.
Precentral motor area.
Which treatment shows best evidence in Tourette’s.
Answer: Amongst the choices, haloperidol would be first to risperidone. If tetrabenazine or risperidone given, then choose risperidone. D2 blockers should be considered.
Which neurotransmitter is related to pain - noradrenaline, dopamine, sertraline or substance P.
Substance P
Which is the most important step in assessing hoarding disorder?
home visit
Congenital amusia lesion
Left auditory cortex, right superior temporal gyrus, potentially right in congenital amusics. Right superior temporal gyrus is the most likely answer.
confused male enters the emergency department with gaze palsy and clear psychotic symptoms.
Thiamine
Patient with melancholic depression has had partial response to three different SSRIs. Next best step in management.
snri
Which drug interferes with alcohol enzyme breakdown.
Disulfiram - acetaldehyde dehydrogenase inhibitor.
An 8-year-old girl refuses to go to school, do her homework or read aloud in class when instructed by her teacher. She enjoys spending time overnight at her friends’ homes and staying with her grandparents. She has a normal IQ.
ODD
After which age is daytime enuresis considered normal.
After 4 years of age. Nocturnal enuresis by 5 to 7 should be achieved continence.
Apart from bifrontal ECT, which of the following is associated with increased cognitive problems following the procedure.
Bitemporal ECT is an option, age is another option.
A woman lost her husband suddenly in a car accident three weeks ago. She is tearful, agitated and has poor sleep. Amongst the choices, antidepressants, supportive care and regular monitoring, low-dose benzodiazepines.
Supportive care and regular monitoring.
A previously confident 27-year-old witnessed his best friend die in an accident two weeks ago. He is now constantly on edge and full of apprehension when he is anywhere near cars. He has difficulty concentrating.
acute stress disorder
A Sudanese refugee discharged from hospital, which is the most important risk factor for suicide.
recent admission
Middle-aged indigenous male with a history of substance use, not current, has a court hearing. Most important risk factor for suicide.
Answer: Likely the impending court hearing - risk to reputation.
Patient with diabetes on metformin dieting for two days attends emergency department cold and tremulous.
hypoglycemia
An 86-year-old man in hospital for two weeks develops confusion and tachypnoea, normal temperature.
PE
Young male admitted with mania on sodium valproate and chlorpromazine as prn continues to present in an irritable elevated state despite increasing the dose of chlorpromazine.
Anticholinergic intoxication.
businessman has continued sobriety now for four months, has a business trip coming and has decided to see GP about medication options and considering ways he can negotiate business catch-ups, which would usually be associated with alcohol.
maintenence
Young man goes to see the general practitioner. He wants to give up alcohol but is unsure.
contemplation
Female aged 22 admits to binging on cereals when feeling low. Afterwards she suffers some transient depressed feelings.
BED
Two symptoms of anorexia nervosa.
LANUGO, AMENORRHHOEA
This treatment works better with bulimia nervosa.
CBT
This treatment works better with anorexia.
FBT
Patient refuses any therapeutic intervention.
: Inpatient treatment - indicates a poor prognosis
Three weeks after being injured in a motor vehicle accident, a young man still has nightmares and intrusive memories, poor sleep, panic of the crash in which his friend was killed.
acute stress disorder
A 17-year-old from a Fundamentalist Christian household admitted for weight loss says she cannot eat as demons say they are spitting in my food.
schizophrenia
I am being followed. I have notes of all the car registrations and there is a clear pattern plus all the cars are white. A choice of delusional disorder versus schizophrenia.
schizophrenia
A 17-year-old man with fever and confusion along with neck stiffness.
meningitis
A lady with HIV gets sudden-onset headache, confusion, CSF shows high protein.
meningitis
A man with unilateral headaches with noise sensitivity.
migraine
