June 2023 Flashcards
What is a core feature of Probable Dementia with Lewy Bodies (DLB)?
REM sleep behavior disorder.
Explain DLB core clinical features.
Fluctuating cognition, visual hallucinations, REM sleep disorder, parkinsonism.
List supportive clinical features of DLB.
- Neuroleptic sensitivity
- Postural instability
- Falls
- Syncope
- Autonomic issues
- Hypersomnia
- Hyposmia
- Delusions
- Other hallucinations
- Apathy
- Anxiety
- Depression
What is sane automatism in forensic terms?
Loss of consciousness for a short duration caused by an external factor.
Give examples of sane automatism.
- Sleep terrors
- Confusional states
- Concussion
- Reflexes after bee stings
- Dissociative states
- Hypoglycemia
What is the legal consequence of sane automatism?
Complete acquittal.
Describe insane automatism legally.
Due to an intrinsic cause; results in acquittal on grounds of insanity.
Give examples of insane automatism.
- Sleepwalking
- Brain tumors
- Epilepsy
Order forensic terms: remand, conviction, sentence, trial.
Remand, trial, conviction, sentence.
Define ‘remand.’
Detaining an accused person in custody pre-trial, or a case sent back for further consideration.
Define ‘trial.’
Formal legal proceeding to examine facts, hear witnesses, decide guilt.
Define ‘conviction.’
Court’s formal declaration of guilt after trial or guilty plea.
Define ‘sentence.’
Court-imposed punishment after conviction (fine, prison, probation, etc.).
Are released prisoners or patients from hospitals more likely to reoffend?
Neither is inherently more likely, but both can have risk factors.
Is suicide risk higher in prisoners compared to the general population?
Yes, rates of suicide are higher in prisons than the general population.
What are risk factors for suicide in prison?
- Psychiatric illness
- Substance misuse
- Repetitive self-harm
What is the most common method of suicide in prisons?
Hanging.
What is the association between overcrowding and prison suicide?
Inconsistent evidence; may sometimes reduce risk.
Which disorder is common in arsonists?
Substance use disorder, especially alcohol, and personality disorders.
Describe arson characteristics.
Usually male, late teens/early 20s, unmarried, poorly educated.
What age group is most likely to be victims of female homicide perpetrators with psychosis?
Children under 16 years of age.
What age group of women has the highest risk of committing homicide?
Women aged 30-39.
What is a key factor in being deemed unfit to plead?
Inability to understand trial proceedings or instruct counsel.
Is amnesia for the event likely to cause unfitness to plead?
No. Amnesia of the event alone does not make someone unfit to plead.
Which condition most often causes ‘unfit to plead’?
Schizophrenia.
Define Type 1 Error.
Rejecting a true null hypothesis, a false positive.
What is the consequence of mean imputation in intention to treat?
It increases the risk of Type 1 error.
How can effect modifiers and confounders be evaluated?
By stratification.
What can control known and unknown confounders?
Randomization.
When to use Mann-Whitney U test?
When comparing two independent groups with non-parametric data.
When are risk ratio and hazard ratio similar?
When the prevalence of the outcome is low.
What assumption must be met before using a Cox regression?
Hazard ratio remains constant over time.
What does hazard ratio assess?
Average risk, weighted for at-risk patients over a follow-up.
Define ‘indirect costs’ in economic evaluation.
Costs due to reduced productivity of the patient or caregiver.
What effect do outliers have on study validity?
They can reduce study validity.
What is per-protocol analysis?
Analysis that only includes participants that sufficiently complied with the trial’s protocol.
What is ‘intention-to-treat’ (ITT) analysis?
Analysis includes all randomized patients regardless of compliance.
What is the main goal of ITT analysis in RCTs?
Assess treatment effects as randomized despite patient non-adherence.
In research, what does ‘SEM’ mean?
Standard Error of the Mean, a measure of the dispersion of sample means.
How do you calculate SEM?
SEM = SD divided by the square root of the sample size.
If variance is 36, what is the Standard deviation?
The Standard deviation is 6 (square root of the variance).
Define standard error of the mean.
Dispersion of sample means around the true population mean.
How do you calculate LR-?
LR- = (1-sensitivity) / specificity.
How do you calculate NNT?
NNT = 1 / Absolute Benefit Increase (ABI).
How do you calculate NNH?
NNH = 1 / Absolute risk increase.
What is the effect of an increase in sample size on statistical non-significance?
It may help detect smaller effects, increasing statistical power.
When to consider starting treatment despite no statistical significance?
If results are clinically significant or may have a clinical impact.
What is the primary use of qualitative research?
Exploration of experiences, perspectives, in-depth understanding.
What can be used to transform skewed data?
- Log
- Square root
- Reciprocal transformations
Name an agreed reporting standard for meta-analyses and reviews.
QUORUM/PRISMA.
How is causation shown in path analysis?
P-value.
Define dichotomous data.
Data with two possible values (e.g., yes/no, present/absent).
What differentiates dichotomous data?
- Easier to represent
- Easier to interpret
- Different testing methods
Which is categorical data?
Gender.
What is the appropriate test to use for 2x2 data?
Chi Square.
What measure cannot be calculated if there are zero events in a group?
Risk Ratio.
Which study uses odds ratio?
Case control.
Which study uses relative risk?
Cohort study.
If the SD is 16, what is the SEM if the sample size is 12?
4.624 (16/sqrt(12)).
What does a higher SEM suggest?
Lower accuracy of the sample mean to represent the true population mean.
What is the point of confidence interval becoming non-significant?
Zero.
What’s the first-line medication for ADHD?
Methylphenidate.
When is clonidine indicated in ADHD?
If tics worsen with stimulants.
What medication is useful for both depression and ADHD?
Tricyclics.
For ADHD with aggression, which medication is less beneficial?
Atomoxetine.
What is first-line treatment for acute mania in adolescents?
Aripiprazole or alternative antipsychotics like olanzapine or quetiapine.
What is a commonly used antipsychotic in the first trimester of pregnancy?
Quetiapine.
If a patient is on lithium with good serum levels and has severe depression, what can be added?
Lamotrigine.
A bipolar patient presents with mania, which antipsychotic is recommended in the first instance?
Haloperidol, olanzapine, quetiapine, or risperidone.
What is a diagnostic feature of Binswanger’s disease?
Subcortical dementia with vascular risk factors, small infarcts on MRI.
When should Parkinson’s Disease Dementia be diagnosed?
When parkinsonian symptoms precede dementia by > 12 months.
What is characteristic of Alzheimer’s dementia?
Progressive cognitive decline, temporoparietal dysfunction.
What are the features of Friedreich’s ataxia?
- Clumsy gait
- Repeated falls
- Heart issues
- Intact cognition
What brain issue is most linked to HIV?
Progressive multifocal leukoencephalopathy (PML).
Describe paradoxical injunction.
A strategic technique used to overcome resistance.
What type of therapy uses ‘unspoken rules’?
Structural family therapy.
Which family therapy emphasizes past experiences?
Psychodynamic therapy.
What can anorexia with binge eating cause?
- Hypokalemia
- U waves
- PR prolongation on ECG
What ECG change can clozapine cause?
Saddle T inversion.
What ECG change can citalopram and diphenhydramine cause?
QTc prolongation.
What ECG change can Donepezil cause?
Sinus bradycardia.
What does low mood with obesity in the face, neck, abdomen, back suggest?
Cushing’s syndrome.
What does depression with red tongue, mouth ulcers, and decreased taste in someone on phenytoin suggest?
Folate deficiency.
What does memory loss, tingling, numbness, and a smooth tongue suggest?
Vitamin B12 deficiency.
Low mood, emotional dysregulation, dry skin, nail changes suggest what?
Hypoparathyroidism.
What is ‘diagnostic overshadowing’?
Attributing symptoms to a known condition, overlooking other problems.
What is a key aim of normalization of care for people with ID?
Social roles and life circumstances that are not too different from others.
What kind of data is ‘1-5 scale with mild to severe’?
Ordinal.
What is the study type where cases and controls are recruited at the same time?
Case control.
What is the study type where individuals are followed up from a baseline for future outcomes?
Cohort.
What is the best study type to find the efficacy of ECT?
RCT.
What is represented by a funnel plot?
Publication bias in meta-analyses.
What is the chart that represents decreasing survival with time?
Kaplan-Meier survival plot.
What plot categorizes continuous data into a number of categories?
Histogram.
What chart can show comparison between categories?
Bar chart.
What does a scatter plot show?
The association or relationship between two continuous variables.
What chart can represent 3 categories across 4 wards?
Frequency Curve.
What is the validity of a tool when its result correlates with a future outcome?
Predictive validity.
What does concurrent validity measure?
The agreement of a new instrument with a currently valid scale.
What does content validity measure?
Whether the contents of an instrument align with its intended purpose.
What’s a common medication for child depression?
Fluoxetine.
12-year-old with 12-month tics + ADHD?
Clonidine.
Child on methylphenidate develops tics; consider what?
Atomoxetine.
Tourette’s, no ADHD/OCD, first-line treatment?
CBIT (Comprehensive Behavioural Intervention for Tics).
Tourette’s + ADHD, second-line medication?
Alpha-2 agonists (e.g., clonidine or guanfacine).
Tourette’s + OCD, first-line treatment?
CBT (Cognitive Behavioural Therapy).
Best first step for aggressive behaviour in intellectual disability (ID)?
Functional behaviour assessment/analysis.
What does functional assessment assess?
Behavior, situations, consequences, and reinforcers.
Male to female ratio for Tourette’s?
3:1.
ICD-11/DSM-5, ADHD symptoms must be before what age?
12 years old.
First-line OCD med for child if sertraline not an option?
Fluvoxamine.
16-year-old OCD + depression, first-line medication?
Fluoxetine.
UK-licensed SSRIs for child OCD?
- Sertraline (from 6yo)
- Fluvoxamine (from 8yo)
Why not paroxetine for children with OCD?
Not recommended for this age group.
First-line treatment for paraphilia with compulsive sexual preoccupation, OCD?
SSRI.
What to do after SSRI + CBT for OCD ineffective?
Switch SSRI or try Clomipramine.
NICE guideline for severe, refractory OCD?
Anterior Cingulotomy.
What if anterior cingulotomy not an option?
Consider DBS.
Besides OCD, what else can DBS treat?
- Tourette’s
- Dystonia
- Parkinson’s
Vivid dreams, increased appetite, dysphoria suggest withdrawal from what?
Cocaine.
What are the symptoms of amphetamine withdrawal?
- Fatigue
- Hypersomnia
- Psychomotor changes
- Increased appetite
- Vivid dreams
What is the first-line medication for ADHD?
Methylphenidate.
What is considered when ingulotomy is not an option?
Consider DBS.
DBS stands for Deep Brain Stimulation.
Besides OCD, what else can DBS treat?
Tourette’s, dystonia, Parkinson’s.
What withdrawal symptoms suggest withdrawal from cocaine?
Vivid dreams, increased appetite, dysphoria.
What are the symptoms of amphetamine withdrawal?
Fatigue, hypersomnia, psychomotor changes, increased appetite, vivid dreams.
Psychosis is possible in withdrawal from which drugs?
Alcohol, benzodiazepines.
Which substance has the least risk of dependence?
LSD.
What do tactile hallucinations and jaw rigidity suggest?
Abuse of ketamine.
What are common features of amphetamine-induced psychosis?
Paranoia, visual, auditory, and tactile hallucinations.
What substance causes long-term cognitive deficits, specifically sustained attention?
Cocaine.
What is Mephedrone chemically?
Synthetic cathinone drug.
What is the best predictor of gaming addiction in youth?
Novelty-seeking behaviour.
What is important before starting detoxification?
Take detailed history.
Which brain imaging finding is typical in chronic alcohol abuse?
Enlargement of the lateral ventricles.
What is the common radiological finding in alcohol-related dementia?
Generalised cortical atrophy.
What condition is linked to homemade red wine and damages the corpus callosum?
Marchiafava-Bignami syndrome.
What is an antecedent in behavioral terms?
A stimulus that cues a learned behavior.
What are the key characteristics of Cri du Chat Syndrome?
Noisy infant with hypertelorism, microcephaly, hypotonia, moderate ID.
What is hypertelorism?
Increased distance between eyes.
What common behavioral issue is seen in Fragile X syndrome?
Hyperactivity and cluttering speech.
What mutation is seen in Rett Syndrome?
Mutation in MECP2 gene.
What is the usual progression for Rett syndrome?
Regression of speech and motor skills, seizures, growth issues.
What is the age of the child with epilepsy and language of 6 years in Landau Kleffner Syndrome?
11 years.
What is the gender distribution for Prader Willi syndrome?
1:1.
What other disorder shares the same gender distribution as Prader Willi syndrome?
Child OCD and Bipolar disorder.
What is the first step for aggressive behavior in ID?
Functional behavior assessment/analysis.
What is the initial medication for ID girl hitting stomach during menstruation?
Ibuprofen.
What is the most appropriate option if an ID patient refuses a blood test?
Benzodiazepines or distraction.
What is the principle of moving patients from institution to community?
Normalization.
What does DBT comprise?
A hierarchy of goals.
How should you ask a child about trauma?
Ask the child directly.
What does behavioral activation assess in depression?
Degree of avoidance.
Which therapy focuses on interpersonal relationships/social milieu?
Interpersonal Therapy (IPT).
What is an element of motivational interviewing?
Cognitive dissonance amplification.
What is a correct statement about transference?
Explained by the mechanism of sublimation.
Which antipsychotic is best for eGFR < 5?
Olanzapine.
Which antipsychotics should be avoided in renal impairment?
Sulpiride and Amisulpride.
When should you use Memantine with caution?
eGFR 53, history of epilepsy.
What is the first-line antipsychotic for psychosis in epilepsy?
Haloperidol.
Which antidepressants should be avoided with Tamoxifen?
Paroxetine and Fluoxetine.
What are CYP2D6 inhibitors?
Bupropion, Amitriptyline, Nortriptyline, Paroxetine, Duloxetine, Fluoxetine.
What should be done if QTc is over 500 ms?
Reduce the dose and consider referral to cardiology.
What favors psychogenic non-epileptic seizures (PNES)?
Side-to-side head movements.
What is a predictor of long-term cognitive impairment after TBI?
Duration of post-traumatic amnesia (PTA).
What common psychiatric issue follows TBI?
ADHD.
What differs Bulimia from Anorexia?
Poor impulse control.
What is the first-line treatment for bulimia?
Guided self-help.
What should be the next step for BDD if Sertraline 200mg has no effect?
Augment sertraline with buspirone.
What disorder involves sudden aphonia after stress?
Motor dissociative disorder.
How does Bipolar I differ between sexes?
Men have higher suicide rates.
What is the worst prognostic factor in psychosis?
Insidious onset.
What is an early symptom in young-onset schizophrenia?
Disorganized behavior, increased negative symptoms.
What is the best predictor for response to ECT?
Psychotic depression.
What is the first-line treatment for affective stupor?
Lorazepam.
What is an absolute contraindication for rTMS?
Cochlear implant.
What is the most common comorbidity in gender dysphoria?
Mood disorders.
What is the duration of cyclothymia?
2 years.
What is true about treating first episode psychosis?
Lower antipsychotic doses are effective.
What is the usual first-line medication for first episode psychosis?
Antipsychotic monotherapy.
What is the best universal prevention against alcohol dependence?
Increase price.
What is one of Nolan’s key QI questions?
What are we trying to accomplish?
What is the minimum time to withdraw mood stabilizer?
4 weeks/1 month.
What is the prevalence of postnatal depression in developed countries?
11-15%.
What is Tay-Sachs?
Rare autosomal recessive disorder; deficiency of Beta-N-acetylhexosaminidase A.
What kind of disorder is PKU?
Autosomal recessive disorder.
What causes PKU?
Deficiency of phenylalanine hydroxylase (PAH).
What are key features of untreated PKU?
Microcephaly, language delay, hypopigmentation, hyperactivity, severe LD, self-injury, musty odour.
What symptoms are seen in a four-year-old Indian boy with PKU?
Epilepsy, severe mental retardation, behavioral problems, lack of pigment in skin and hair.
What is a key clinical triad of Korsakoff’s syndrome?
Ophthalmoplegia, ataxia, and confusion.
Which test is useful for identifying Korsakoff’s?
Address and recall test.
What type of memory is most affected by ECT?
Retrograde (explicit) memory.
What causes fluctuating memory loss typical for which type of dementia?
Lewy Body Dementia (LBD).
What cardiac malformations are linked to paroxetine use in pregnancy?
ASD and VSD.
What is the recommendation for lithium dosage before delivery?
Suspend 24-48 hours before, check level 12 hours after last dose.
How often should lithium be monitored during pregnancy if continued?
Every 4 weeks until 34 weeks, then weekly until 2 weeks post-partum.
What is ‘healthy entrant bias’?
Study participants are healthier than the general population, affecting findings.
What is characterized by acts of threats, humiliation, and intimidation to harm?
Coercive control.
What is the gender ratio for OCD?
1:1.
What is an example of an immature defense mechanism?
Identification.
What is the first-line treatment for ODD?
Parenting skills training.
What is a key difference between PTSD and malingered PTSD with nightmares?
Malingered PTSD: exact same dream nightly; PTSD: varying dreams.
What is the term for pathological lying with a mix of truth and lies?
Pseudologia fantastica.
What type of treatment should be offered to a young person with mild depression after a period of watchful waiting?
Group CBT.
What should be the first-line antidepressant for a 13-year-old?
Fluoxetine.
What is the incremental cost formula for QALY?
Difference in cost x 52 weeks for 1 year of placement.
Which economic analysis uses QALYs?
Cost-utility analysis.
What is the first phase of CAT?
Exploration of traps, dilemmas, and snags.
What should be the first line antidepressant for a 13-year-old?
Fluoxetine
What is the incremental cost formula for QALY?
Difference in cost x 52 weeks for 1 year of placement
Which economic analysis uses QALYs?
Cost-utility analysis
What is the first phase of CAT (Cognitive Analytic Therapy)?
Exploration of traps, dilemmas, and snags
What is the ethical document guiding human research?
Helsinki Declaration or Belmont Report
In qualitative research, what is bracketing?
Setting aside researcher preconceptions
What is ‘member checking’ or respondent validation?
Comparing researcher’s account with research participants
What statistical measure is used to assess heterogeneity in a meta-analysis?
I-squared (I²) statistic
Which method of randomization ensures more or less equal sample sizes in a study?
Block randomization
What is the purpose of stratification in a study?
To control for confounding factors
What analysis technique reduces the impact of dropouts?
Intention-to-treat (ITT) analysis
What is the method of qualitative data collection that explores subjective experiences?
Phenomenological research
In family therapy, which approach uses the concept of circular questioning?
Systemic family therapy
What medication worsens hallucinations in Parkinson’s?
Levodopa
What medication is indicated to treat psychosis in LBD?
Rivastigmine
What does paroxetine cause in late pregnancy?
Irritability in the neonate
What medication is associated with pancreatitis?
Sodium valproate
What medication can cause hypercalcemia?
Lithium
What drug reduces seizure duration in ECT?
Chlordiazepoxide
Which antidepressant is usually used first line in adolescent depression?
Fluoxetine
What is the choice of medication for alcohol withdrawal in a patient taking tramadol?
Acamprosate
What syndrome is associated with self-hugging, self-injury, and sleep disturbance with moderate LD?
Smith-Magenis syndrome
What syndrome presents with self-harm, spasticity, choreiform movements, and microcephaly?
Lesch-Nyhan syndrome
What is the term for increased sensibility to stimuli?
Hyperesthesia
What is the term for pain due to a normally non-painful stimulus?
Allodynia
What is the term for decreased sensibility to stimuli?
Hypoesthesia
What is the first step in DBT treatment after pre-preparation?
Reducing life-threatening behaviors
What do you do for a patient on flupentixol and procyclidine for 20 years?
Consider reducing flupentixol, then consider tetrabenazine. Stop procyclidine if not needed
What is a feature of drug-induced Parkinsonism vs. Parkinson’s disease?
Drug-induced parkinsonism is usually symmetrical
What is the most significant risk factor for vascular dementia?
Hypertension
What is a difference in development between autism and schizophrenia?
In autism, development is never normal. In schizophrenia, it is normal or near-normal
What stimulant use by the mother can cause a newborn to be jittery?
Cocaine
What is catamenial epilepsy?
Worsening of seizures related to the menstrual cycle
The most common cause of mild learning disability is?
Unknown cause
What is the risk of social anxiety in childhood?
Increased risk of substance misuse in adulthood
How to differentiate MCI and Dementia?
Informant assessment of ADLs (activities of daily living)
What is the most likely electrolyte abnormality in a refeeding anorexic patient?
Hypophosphatemia
A patient with a non-dominant parietal stroke, what are the symptoms?
Contralateral hemi-spatial neglect, dressing apraxia, construction apraxia, and anosognosia
Which is the least psychologically addictive substance?
LSD
What are the most common causes of drug-induced pancreatitis?
Antipsychotics and mood stabilizers
What symptoms do you see in a patient using PCP?
Violent behavior, dysarthria, nystagmus, tachycardia, hypertension, anesthesia, and analgesia
What are the key symptoms of opioid toxicity and withdrawal?
Respiratory depression, use of accessory muscles, tachycardia, hypotension. Use naloxone
What technique is used when a therapist confronts a client about missing details in a conversation?
Confrontation
What technique is used when a therapist seeks clarification on a client’s statements?
Clarification
What is the diagnosis for an 8-year-old with 6-month eye blinking, grimacing, obscene words/gestures, resolved after 3 months?
Transient tic disorder
How long should tics persist to be considered a transient tic disorder?
Symptoms must be present for less than 12 months
What is most likely to prevent an adult shoplifter from reoffending?
Appearance in court is the most effective deterrent
Which disorder is least likely associated with shoplifting?
Obsessive-compulsive disorder is the least common comorbid condition
What are some common comorbidities with shoplifting?
- Depression
- Substance misuse
- Personality disorders
What is kleptomania?
Kleptomania is an impulse control disorder marked by compulsive stealing
What is the suicide risk within 1 year after a self-harm attempt?
0.7% (0.5% in females, 1.1% in males)
What is the increased risk of suicide following a self-harm attempt?
Suicide risk increases 66x compared to the general population
In an eating disorder, what is the most immediately life-threatening sign?
Severe dehydration is the most critical
What is the risk associated with a heart rate of 50 bpm in eating disorders?
Heart rate 50 bpm in eating disorders is considered amber risk
How much does Alzheimer’s risk increase from age 65 to 85?
The risk increases approximately 16 times
How much is the risk of dementia higher at age 85 than at 65?
Dementia risk is 4x higher at age 85 compared to age 65
How long is amphetamine detectable in urine?
Amphetamine is detectable up to 48 hours
What is a common symptom of ketamine abuse?
Urinary frequency, urgency, and hematuria can occur
What are common symptoms of cocaine intoxication?
- Ischemic changes
- Tachycardia
- Tachypnea
What effect does long-term cocaine use have on attention?
Long-term cocaine use can impair sustained attention
What is the purpose of a urine drug screen (UDS) in treatment?
UDS monitors treatment compliance and detects relapses
What is a common cause of neonatal jitteriness related to substance use?
Heroin use is a common cause of substance-related jitteriness in babies
What psychiatric disorder is most associated with DiGeorge syndrome?
Schizophrenia is the most commonly associated condition
What can lead to cleft palate and developmental delay in babies?
Antenatal sodium valproate exposure is a strong risk factor
What are the signs of fetal alcohol syndrome?
- Microcephaly
- Growth deficits
- Developmental delay
What are the genetic inheritance mechanisms for Down’s syndrome?
- Trisomy 21
- Mosaicism
- Robertsonian translocation
What inheritance type does Lesch-Nyhan follow?
Lesch-Nyhan follows an X-linked recessive inheritance pattern
What correlation is used for two binary variables?
Phi coefficient is used for two binary variables
What statistical test compares weight before and after in the same people?
A paired t-test is used for within-subject comparisons
What tests are used for comparing cholesterol levels in three groups?
- ANOVA if no adjustment
- ANCOVA with adjustment
What does the likelihood ratio for a negative test (LR-) indicate?
Probability of a negative test in those with vs. without the disease
What is the formula for calculating the likelihood ratio for a negative test?
(1 - Sensitivity) / Specificity
What is the likelihood ratio of a negative test if sensitivity is 60% and specificity is 80%?
0.5
What does a high beta value in path analysis indicate?
A high beta suggests a strong association between the variables
What type of bias does Intention-To-Treat control?
ITT analysis controls for attrition bias
What is the most conservative approach in ITT when handling missing data?
Worst-case scenario is the most conservative approach
What is statistical power used to determine?
Power is used to determine sample size
Which analysis measures results in monetary terms?
Cost-benefit analysis measures results in monetary terms
What does a forest plot arrowhead indicate?
An arrowhead on a forest plot indicates point estimate imprecision
What does a ROC curve show?
A ROC curve shows the balance between sensitivity and specificity
Which test has the best specificity in SCQ, SRS, CCQ?
SCQ has more specificity than SRS and CCQ
What does a high correlation coefficient indicate?
A high correlation indicates a strong linear association
What statistical method is used to fill in missing values using observed data?
Multiple Imputation fills missing data by using observed data
What is the likely cause of 6th nerve palsy and fluctuating consciousness in an elderly patient?
Wernicke’s encephalopathy is a possibility
What part of the brain is implicated in snout reflex/frontal release signs?
The frontal lobe is implicated in frontal release signs
What is the term for pain with light touch?
Allodynia is pain with non-painful stimuli
What is the strongest link of clozapine?
Sedation & motivation are associated with clozapine use
A patient on clozapine still has hallucinations, what is the next step?
Assess medication adherence first
What type of drug lowers seizure duration during ECT?
Benzodiazepines and anticonvulsants lower seizure duration
Which medication is contraindicated for community initiation due to risk?
Clozapine has caution in initiation due to risks
What is the risk of citalopram in a person with a history of seizures?
Citalopram can lower the seizure threshold in patients
What is a common side effect of mirtazapine that could cause patients to leave a study?
Mirtazapine can cause adverse effects leading to study withdrawal
Which medication can cause Torsades de Pointes?
Some medications can cause Torsades de Pointes; check BNF/local policy
Which dementia has REM sleep behavior disorder as a core feature?
Lewy body dementia includes REM sleep behavior disorder
What increases the risk of developing depression in epilepsy?
Complex partial seizures increase the risk of depression
Which mental health condition was statistically significant in COVID and mental health outcome studies?
Schizophrenia was the only significant mental health outcome
What predicts first episode psychosis (FEP)?
Frequency of cannabis use is the most significant predictor of FEP
Which religious group has the lowest rates of suicide?
Roman Catholics aged 55-74 had lower suicide rates in a specific study
What is the most common condition seen in mental health rehabilitation services?
Psychotic disorder is the most common diagnosis
Which is the best antidepressant for narcolepsy to help with cataplexy?
Antidepressants are used to treat cataplexy in narcolepsy
What is the first-line medication for a child with aggression not responding to non-pharmacological measures?
Risperidone can be considered for aggression if first-line measures fail
Which factor distinguishes prolonged grief from depression?
Excessive guilt is more common in depression than grief
What is blinding used to prevent?
Blinding is used to minimize measurement bias
Which randomization strategy aims for balanced groups?
Block randomization is used to balance groups in studies
What is minimization used for in randomization?
Minimization aims to balance confounders between groups
When does selection bias occur?
Selection bias occurs when the sample is not representative
When does information bias occur?
Information bias happens with flawed data collection
What are types of sampling methods in qualitative studies?
- Purposive
- Snowball
- Case studies
What is the primary purpose of a clinical audit?
Clinical audit is used to check a service’s performance
What step is omitted in an audit if change is not implemented after the initial audit?
Implementing a change
What occurs when the sample is not representative?
Selection bias occurs when the sample is not representative.
Selection bias can lead to inaccurate conclusions in research.
When does _______ occur?
Information bias happens with flawed data collection.
Information bias can result from poor survey design or data entry errors.
What are types of _______ methods in qualitative studies?
Purposive, snowball, and case studies are used in qualitative studies.
These methods help researchers gather in-depth insights from specific populations.
What is the primary purpose of a _______ audit?
Clinical audit is used to check a service’s performance.
Clinical audits help in maintaining and improving quality in healthcare services.
What step is omitted in an audit if change is not _______ after the initial audit?
Implementing a change after the initial cycle is important.
Without implementation, the audit process becomes ineffective.
Which type of validity uses a _______ validated measure?
Concurrent validity correlates to a previously validated measure.
This type of validity helps establish the reliability of new instruments.
Which type of validity measures a prediction of _______ difference?
Predictive validity looks at future group differences in a study.
It assesses the effectiveness of tests in predicting outcomes.
Which type of validity is measured when testing a score against itself over _______?
Test-retest validity assesses the stability of the test over time.
This type of validity is crucial for ensuring consistency in measurements.
Which sampling allocates participants based on _______?
Stratification sampling allocates based on group characteristics.
This method ensures representation from various subgroups within the population.
What is most important in _______ risk assessment?
Dynamic risk factors are most important in short-term assessment.
These factors can change rapidly and influence immediate risk levels.
What increases the risk of _______ in prison?
Being on remand increases suicide risk in prison.
Remand prisoners often experience higher levels of distress and uncertainty.
What is the first-line treatment for an opioid overdose with _______ depression?
Naloxone is the first-line treatment.
Naloxone quickly reverses the effects of opioid overdoses.
What is a goal of _______ psychotherapy?
Hypothesizing is a goal of systemic therapy.
This approach encourages understanding the dynamics within relationships.
What is considered to be a primary _______ mechanism?
Repression is considered to be a primary defense mechanism.
Repression involves unconsciously blocking out painful or distressing thoughts.
