Mock Questions 2 Flashcards
Which brain region is thought to be responsible the gut reaction / moral intuition that is experienced when witnessing or considering an event?
Ventromedial prefrontal cortex
A 55 year old lady is brought to hospital by her husband due to a seemingly sudden onset of confusion and forgetfulness. Her husband reports that she has been fine recently but that at around dinner time he found her to be confused and since then she has been asking bizarre and repetitive questions. On review, the lady asks you why she is in hospital and appears disorientated. Her physical examination is entirely normal. She is unable to recall any of the events of the day and preceding few weeks. She is also unable to recall details such as the name of her child and her address. Her husband denies there being any recent stress of note.
The lady remains in hospital overnight. The next morning you assess her again and her memory appears to have returned to normal.
Transient global amnesia
The mother of a young child is finding it difficult to get them to school. Each morning the child screams and cries as they say they are scared of going. The mother starts giving the child a sweet each time they get to school. Gradually the child begins to associate the school with sweets and stops crying when it is time to go.
Counter conditioning
A dog trainer decides to use a type of forward conditioning whereby the unconditioned stimulus is presented after the conditioned stimulus has finished.
Trace conditioning79%
Trace conditioning
According to Thomas and Chess’ formulation and study of temperament, which proportion of children would be described as ‘difficult’?
10%
Bowlby’s ‘clear cut attachment’ phase is generally associated with which time period?
6-8 to 18-24 months
Abnormalities in the dex suppression test have been reported in dementia, true or false
True
What connects the orbital and inferior frontal gyri of the frontal lobe to the anterior temporal lobe?
Uncinate fasciculus
Buprenorphine mechanism of action
Partial agonist at the mu-opioid receptor
Varenicline mechanism of action
Nicotinic receptor partial agonist
What is the General Ability Index in the WAIS based on?
Score from verbal comprehension and perceptual reasoning
The child seeks out and responds to particular caregivers. Also during this stage, separation anxiety (distress, crying etc) manifest when a child is separated from a significant caregiver. This reaction subsides upon the return of and comfort by a significant adult.
6-8 months to 18-24 months
(Clear cut attachment)
At this stage the infant has not yet attached to a caregiver but can recognise his/her mother’s voice and smell. The child displays a variety of behaviours such as smiling, crying and grasping, which usually facilitate adult contact.
Birth to 6-8 weeks
Pre attachment
During this stage the infant begins to respond preferentially and differently to significant caregivers (e.g. smiling and laughing at caregivers, settling more easily from caregivers actions), however does not protest over separation from them.
6-8 weeks to 6-8 months
Attachment in the making
Ainsworth’s ‘strange situation’ procedure is designed to be used in children of what age?
12-18 months
The SSRI with a half-life of up to 4-6 days that has a high propensity to cause drug interactions.
Fluoxetine
The SSRI most likely to be associated with discontinuation symptoms.
Paroxetine
The SSRI most appropriate in an elderly patient who had an myocardial infarction 12 months ago and is prescribed a variety of other medications.
Sertraline
A patient with a suspected metabolic encephalopathy undergoes an EEG. The trace shows predominantly rhythmic activity between 5-8 Hz. What frequency band does this correspond with?
Theta
Antipsychotics least likely to cause sedation
Amisulpride and aripiprazole
A patient known to AIDS is admitted to hospital for treatment for mania. During the admission they begin to complain of a headache and have an associated fever. You request a CT scan which shows multiple contrast-enhancing lesions in the grey matter of the cortex, these are described in the radiologists report as ring enhancing. Which of the following would you suspect?
Toxoplasmosa gondii
Positive symptoms in schizophrenia
Hallucinations
Delusions
Thought disorder
Negative symptoms in schizophrenia
Social withdrawal
Apathy
Lack of energy
Poverty of speech (alogia)
Flattening of affect
Anhedonia
Fear of heights
Towards the end of the first year of life
Fear of the dark
Preschool (3-4)
Fear of bodily injury
6-12
Which test was developed to enable a quick estimate of intellectual functioning?
WASI
The daughter of an elderly female with a long history of schizophrenia complains about her mothers facial appearence. She says that for years her mother has been making chewing movements when there is no food in her mouth. You note that this issue has been addressed previously by discontinuing haloperidol and starting quetiapine. Her daughter is keen to explore other options.
Tetrabenazine
You review a newly admitted patient who was violent and paranoid on admission. You see the man in a seclusion room with four nurses for protection. He is quite hostile and threatens you. During the review he complains that his eyes are rolling up into his head. His eyes appear normal from a distance. You review his drug chart and see that he was given a test dose of an intramuscular antipsychotic earlier in the day.
Oral procyclidine (dystonia)
Hoover’s test is primarily used to detect malingering of what cases?
Leg paresis
A prodrug which is activated by red blood cells following GI absorption
Lisdexamfetamine
A non-stimulant medication that selectively blocks the reuptake of noradrenaline
Atomoxetine
An alpha 2 agonist with relative selectivity of the 2A subtype.
Guanfacine
Difference between clonidine and guanfacine
Both clonidine and guanfacine are α2 agonists. Three α2 subtypes have now been identified, 2A, 2B, and 2C. Guanfacine is more selective for the 2A subtype; clonidine binds equally to all three subtypes.
Desipramine is the active metabolite of which drug
Imipramine
Esyenck personality test is what kind of test?
Quantitative
What proportion of children born to mothers who take valproate during pregnancy would you expect to experience developmental problems such as delays in walking or speech?
30-40%
Genes implicated in ADHD
DAT1
DRD4
DRD5
5HTT
HTR1B
SNAP25
Heritiability of ADHD
74%
Proportion of ADHD youth will have symptoms into adulthood?
2/3
Aripiprazole is thought to exert its therapeutic effect by which mechanisms?
Partial agonist at 5HT1A and D2
Antagonist at 5 HT2A
‘How am I, how are you, you are a doctor, and apple a day keeps the doctor away, you’re a bad apple’.
This presentation is indicative of which of the following?
Flight of ideas
Telegraphic speech is generally observed in children between which ages?
18-36 months
A diencephalic structure located on the inferior and posterior aspect of the hypothalamus, that when damaged can lead to a diencephalic amnesia as seen in Korsakoff’s syndrome.
Mamillary body
An area of the cerebellum consisting of white matter.
Arbor vitae
Almond sized collection of nuclei found in the medial temporal lobe with a key role in processing emotional stimuli.
Amygdala
Half life of flumazenil
1 hour
Type of aphasia is characterised by loss of fluency but with preserved comprehension?
Broca’s
Has synthesised a comprehensive model of aggression called the General Aggression Model which builds on previous theories and models.
Anderson
perception that body parts are absent
Aschemazia
perception that body part is diminished
Hyposchemazia
perception that body part is magnified
Hyperschemazia
imperception for one half of the body
Hemisomatagnosia
described as a feeling that parts of the body are distorted or twisted or that they are separated from the rest of the body. It can occur in association with hallucinagenic use, with an epileptic aura, and with migrane.
Paraschemazia
A 16 item scale used in schizophrenia which assesses for both positive and negative symptoms.
BPRS
A checklist used to assist in differentiating symptoms of withdrawal from antidepressants from symptoms due to relapse.
DESS
A 20 item scale used to assess the severity of depression.
ZSRDS
devised a model of selective attention which includes information processing through a ‘dictionary unit’?
Treisman
Flumazenil acts on
Gaba A
Which of the following of Kohlberg’s stages of moral development is also known as the ‘good boy - nice girl’ orientation?
Interpersonal accord and conformity orientation
A 50-year-old man is brought to clinic by his stepdaughter. She explains that he is not the man he used to be and notes he has been more apathetic of late. She says that he often appears disinterested and easily distracted but appears to have no problem with his memory. Which of the following is most likely to provide additional details to help you approach a diagnosis?
Cognitive estimates
A 15-year-old boy is brought to hospital by his mother who found him smoking cannabis that he’d found in his father’s garage. The boy appears anxious and paranoid and tells you that a spirit is pulling his arm off his body. He also describes feeling like his muscles are being squeezed. Which of the following hallucination is illustrated by this example?
Kinaesthetic
relate to false perceptions of the inner organs.
Visceral hallucinations
relate to false perceptions of fluid (e.g. all my blood has dropped to my legs and I can feel the water level at my chest)
Hygric hallucinations
These refer to false perceptions of touch
Tactile/Haptic hallucination
The average adult can store how many items in their short term memory?
5-9
Which of the following refers to the perception of the physiological condition of the body, including hunger, temperature, and heart rate?
Interoception
Friedreich’s ataxia repeat
GAA
A patient with suspected epilepsy undergoes an EEG. The patient is prescribed lithium for bipolar disorder. Which effects from the lithium would be expected on the EEG?
Increase alpha/beta/delta/theta
Memory impairment and confusion
Muscarinic central M1 blockade
Weight gain and sedation
Histamine H1 blockade
Orthostatic hypotension
Alpha 1 blockade
A male patient with schizophrenia attends the outpatient clinic accompanied by his brother. His brother says that he has read on the internet that the condition is genetic and wants to know what his own risk is. You clarify that the brother is a full sibling. What is his brother’s risk of developing schizophrenia (based on the Gottesman data)?
9%
A patient with schizophrenia is visited in hospital by his cousin. The cousin sees you on his way out and says that he read a hospital leaflet about schizophrenia that suggested the condition was genetic. You confirm that he is the patient’s first cousin. What would you tell him is his risk of schizophrenia considering that his cousin is affected?
2%
A psychiatrist is asked to see a young boy in the community who is displaying features of conduct disorder. Whilst inquiring about family history, the parents explain that the boy’s grandfather was diagnosed with schizophrenia. There is no other history of this in the family. Based solely on his grandfather’s diagnosis, what is the boys lifetime risk of schizophrenia?
5%
A patient with schizophrenia reports an odd experience whereby an exact replica of himself appears. He tells you that it appears identical to him and that it thinks the same thoughts as him. He says that it typically happens each day and that the experience lasts for a few seconds. He thinks the other him is trying to take him over and is expressly suicidal. He says that at times he can see what he considers to be his real self through the eyes of the replica and gets confused about which is the real him. This is an example of which of the following?
Heautoscopy
What is the main type of excitatory neuron in the cerebral cortex?
Pyramidal cells
Pyramidal cells comprise what percentage of cells in the cortex?
60-70%
Compared to the general population, children referred to a gender identity clinic have a higher incidence of
ASD
A patient with schizophrenia is informed by a social worker that their father had been killed in a fire. The patient showed no sign of emotion which was considered to be odd as the two were thought to have had a very close relationship. What is suggested by the patient’s response?
Flattening of affect
What cell cycle stage does DNA replication occur during
Interphase
What percentage of babies born to women prescribed valproate during pregnancy would you expect to have a birth defect?
10%
Class of zopiclone
Cyclopyrolone
The defense mechanism involved when a person consciously forces unwanted information out of their awareness.
Suppression
A child has an estimated vocabulary of 40-50 words but their pronunciation is often unclear. They have started to combine simple words such as ‘more juice’ and are using basic pronouns such as ‘mine’.
18-24 months
A child is noted to babble and to say ‘da-da’ but without meaning. They make an attempt to repeat basic sounds you make.
6-12 months
A child has a vocabulary of approximately 150 words. They are able to answer simple questions and are beginning to make 3 word sentences. Their speech cannot be reliably understood by strangers. They have a poor grasp of tenses.
24-36 months
A band of cortex which surrounds the corpus callosum. It is a component of the limbic system and processes sensory input concerning emotions and regulates aggressive behavior.
Cingulate gyrus
portion of cortex located in the occipital lobe involved in the processing of vision, especially related to letters.
Lingual gyrus
A prominent gyrus on the surface of the posterior frontal lobe of the brain. It is the site of the primary motor cortex.
Precentral gyrus
What is seen in the dex suppression test in depressed patients
In depressed patients cortisol levels often do not decrease
In Mahler’s Separation-Individuation theory of child development, rapprochement is generally observed in which of the following periods?
16-24 months
