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MRCPsych Part B > Practice Questions 2 > Flashcards

Practice Questions 2 Flashcards

1
Q

What percentage of elderly patients with delirium will go on to develop dementia?

A

5%

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2
Q

How many elderly patients have delirium on admission?

A

10-15%

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3
Q

How many elderly patients develop delirium in hospital?

A

10-50%

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4
Q

Prevalence of dementtia in >65?

A

5%

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5
Q

Incidence of paraphrenia in >65

A

1-2%

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6
Q

Prevalence of depression >65

A

10-15%

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7
Q

What is late onset schizophrenia?

A

> 40

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8
Q

What is very late onset schizophrenia?

A

> 60

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9
Q

Features of cortical dementia

A

Aphasia
Acalculia
Significant memory loss

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10
Q

Wat does CAMDEX incorporate?

A

Blessed dementia rating scale
MMSE
Haschinki Ischaemia Indiex

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11
Q

Which scale is used to screen for dementia in LD?

A

DMR

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12
Q

Most important risk factor for paraphrenia?

A

Female gender

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13
Q

M:F ratio of paraphrenia?

A

1:4-9

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14
Q

Which antipsychotics is contraindicated in the elderly who are psychotic and have cognitive impairment?

A

Risperidone
Olanzapine

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15
Q

Good prognostic factors of Alzheimers?

A

Later onset
Female
No behavioural sx
Lack of depressive episodes

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16
Q

In which type of dementia is use of antidepressants often poor?

A

Vascular

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17
Q

Most prevalent anxiety disorder in the elderly?

A

Phobias

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18
Q

Risk of alzheimers in general population

A

5%

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19
Q

Which test is frequently used to test executive functioning?

A

Tower of Hanoi

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20
Q

Usual dose of Donepezil

A

10mg OD

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21
Q

Usual dose of Rivastigmine

A

6mg BD

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22
Q

Usual dose of Rivastigmine transdermal patch

A

9.5mg/24 hours

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23
Q

Usual dose of Galantamine

A

12mg BD

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24
Q

Usual dose of Memantine

A

10mg BD

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25
Q

CJD EEG

A

Generalised periodic 1-2 Hz sharp waves

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26
Q

How many people with sporadic CJD show EEG changes?

A

90%

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27
Q

How many people with vCJD show EEG changes?

A

0

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28
Q

EEG changes in HSE

A

Episodic discharges are recurring every 1-3 seconds with variable focal waves over the temporal areas.

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29
Q

EEG changes in Huntingtons

A

Initial loss of alpha; later flattened trace.

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30
Q

EEG changes in hepatic encephelopathy

A

Diffuse generalized slowing. Triphasic waves: 1.5 to 3.0 per second high-voltage slow waves especially in hepatic encephalopathy

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31
Q

Where is Prenisillen Gene 1?

A

Chromosome 14

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32
Q

Where is APOE4 gene?

A

Chromosome 19

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33
Q

Which antidementia drug can cause confusion and hallucinations?

A

Memantine

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34
Q

Which antidementia drug works on Nicotine receptors?

A

Galantamine

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35
Q

Which dementia drug is safest to give in patients with co-morbidities?

A

Rivastigmine

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36
Q

Which antidementia drug is a reversible noncompetitive inhibitor of Ach receptors?

A

Rivastigmine

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37
Q

Duration criteria for Tourettes

A

12 months

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38
Q

How do drugs work for Tourettes?

A

D2 antagonism at basal ganglia

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39
Q

Prevalence of ADHD in the UK?

A

2-5%

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40
Q

1st line medication for Tourettes

A

Clonidine

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41
Q

2nd line medication for Tourettes

A

Topirimate

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42
Q

3rd line medication for Tourettes

A

Haloperidol

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43
Q

M:F for ADHD

A

4:1

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44
Q

Prevalence of MI in adolescents

A

15-20%

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45
Q

Duration criteria for sibling rivalry disorder

A

Within 6/12 of the birth

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46
Q

Which drug is now specifically contraindicated in children and adolescents due to increased risk of suicide?

A

Paroxetine

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47
Q

How many children with CD develop antisocial PD?

A

50%

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48
Q

Most common co-morbid psych disorder in ADHD?

A

ODD

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49
Q

How many children with ADHD have ODD?

A

30-50%

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50
Q

How many children with ADHD have CD?

A

25%

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51
Q

How many children with ADHD have anxiety?

A

15%

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52
Q

First line Rx for bulimia

A

CBT

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53
Q

When is Atomoxetine preferable to Methylphenidate for ADHD in kids?

A

Stimulant abuse
Tics present

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54
Q

Prevalence of depression <18?

A

20%

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55
Q

Best anti-depressant for OCD in kids

A

Sertraline

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56
Q

How many 15-16 year olds admit to DSH?

A

6.9%

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57
Q

What are the PDDs in DSM V?

A

Autism
Retts
Childhood Disintegrative Disorder
PDD-not specified

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58
Q

M:F for Aspergers

A

9:1

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59
Q

M:F for Tourettes

A

3:1

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60
Q

M:F of written disorder

A

3:1

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61
Q

Prevalence of written disorder

A

3-8%

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62
Q

Monitoring for valproate in children

A

6 monthyl height & weight, LFTs and FBCs

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63
Q

Monitoring for methylphenidate in children

A

3 monthyl then 6 monthly height & weight, BP & HR

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64
Q

Prevalence of depression in LD

A

2-4%

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65
Q

How many people with LD have mild lD?

A

85%

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66
Q

How many people with LD have moderate LD?

A

10%

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67
Q

How many people with LD have severe LD?

A

4%

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68
Q

How many people with LD have profound LD?

A

1-2%

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69
Q

Incidence of Downs

A

1 in 700 live births

70
Q

How many Downs fetus’s result in spontaneous abortion?

A

50%

71
Q

How many Downs pregnancies result in stillbirths?

A

20%

72
Q

Risk of autism in second child if first has autism

A

1-10%

73
Q

Risk of child having autism if more than one previous child has had autism?

A

35%

74
Q

MZ vs DZ for autism

A

87% vs 9%

75
Q

Which LD has Attraction to water and laughing at minimal provocation?

A

Angelmann

76
Q

Which LD has pseudomature language abilities and visuospatial motor deficit?

A

Williams

77
Q

How many LDs are from genetic inheritance?

A

5%

78
Q

How many LDs are from environment?

A

15-20%

79
Q

How many LDs are pregnancy-related?

A

10%

80
Q

How many LDS are acquired medical conditions?

A

5%

81
Q

How many LDs have no clear aetiology?

A

30-40%

82
Q

Prevalence of epilepsy in LD?

A

20-25%

83
Q

Prevalence of ADHD in LD?

A

15-20%

84
Q

Prevalence of selfi-inury in LD?

A

15-20%

85
Q

Prevalence of epilepsy in Downs?

A

5-10%

86
Q

Prevalence of epilepsy in Fragile X?

A

20-25%

87
Q

Prevalence of epilepsy in tuberous sclerosis?

A

90%

88
Q

Which LD is associated with OCD?

A

PRader-WIlli

89
Q

Which LD has features in common with Marfans?

A

Homocystinuria

90
Q

Which LD has dwarfism, claw hand, joint stiffness and hepatosplenomegaly?

A

Sanflippo

91
Q

Describe surrogate endpoint

A

Not of direct practical importance but believed to reflect outcomes e.g. reduction in cholesterol level => reduced mortality

92
Q

Calculation for relative benefit increase

A

Absolute benefit increase (EER-CER)/CER

93
Q

Range of cronbachs alpha?

A
  • infinity to 1
94
Q

Importance of CONSORT flowchart

A

Too assess generalisability and validity of results

95
Q

Name of study where exposure is determined at the outset?

A

Cohort

96
Q

How long are methadone reductions usually carried out in the community for opioid detox?

A

3/12

97
Q

How long are buprenorphine reductions usually carried out in the community for opioid detox?

A

14/7 - few weeks

98
Q

How long does postnatal depression usually last for?

A

1/12

99
Q

Peak onset of postnatal depression?

A

3-4 weeks post birth

100
Q

Duration of onset of sx for diagnosis of postnatal depressoin?

A

Onset of sx within 6/12 of birth

101
Q

RFs for PTSD

A

External locus of control
Female
Neuroticism
Low sense of security

102
Q

Risk of suicide with those with epilepsy compared with those without

A

x25 greater

103
Q

Prevalence of psychiatric sx at first presentation of Huntingtons Disease?

A

30%

104
Q

Prevalence of somatoform pain disorder?

A

8-10%

105
Q

What does SF-36 measure?

A

Health related QoL

106
Q

How many patients with schizophrenia discontinue antipsychotics by 18 months?

A

70-75%

107
Q

NICE requirement for clozapine to be started?

A

Patients with schizophrenia who are unresponsive to 2 or more antipsychotics, of which at least one must be atypical or who are intolerant of their SEs

108
Q

Best developed treatment for conduct disorder?

A

Multisystemic therapy

109
Q

How long is multisystemic therapy?

A

3/12

110
Q

How is a person assessed in multisystemic therapy?

A

At home, in relationships with other systems e.g. peers, school

111
Q

Underlying goal in multisystemic therapy?

A

Assessing and promoting strengths of the person

112
Q

Which therapy uses reciprocal role reversal?

A

Psychodrama

113
Q

Which 2 antipsychotics increase the risk of CVE in the elderly?

A

Risperidone
Olanzapine

114
Q

Recurrence rate of siblings in children with autism?

A

2-8%

115
Q

in which social classes is subcultural LD more common in?

A

Lower social classes

116
Q

RFs for infanticide

A

DV and hx of childhood maltreatment
Suicidal ideation in pregnancy and previous suicide attempts
Concealed or denial of pregnancy
Unintended pregnancy in young women

117
Q

Calculation for false +ve?

A

1-specificity or
False positives/total non-diseased

118
Q

Calculation for false -ve?

A

1- sensitivity or

False negatives/total diseased

119
Q

Calculation for sensitivity

A

True +ve/total diseased

120
Q

Calculation for specificity

A

True -ve/total non diseased

121
Q

Calculation for PPV

A

True positive/total positive

122
Q

Calculation for NPV

A

True -ve/total -ve

123
Q

What are random errors?

A

Caused by unknown and unpredictable changes in the experiment, including the measuring instruments

124
Q

What type of error is recall bias?

A

Systematic error

125
Q

What type of error is normally distributed?

A

Random error

126
Q

Define minimisation

A

Allocation of each participant is done methodically to ensure balance of confounding factors between groups

127
Q

Define allocation concealment

A

Maintaining secrecy with regard to the allocation itself at the start of the study

128
Q

Define blinding

A

Maintaining secrecy about the status of a patient as to which arm he or she belongs, once the allocation is complete

129
Q

What measurement can tell us the burden of a disease?

A

Prevalence

130
Q

What is the denominator of incidence density?

A

Person-years

131
Q

Denominator of incidence calculation?

A

Total number of people at risk in population per unit time

132
Q

What does incidence density account for that incidence doesnt?

A

Varying time periods of follow-up

133
Q

Which 2 antipsychotics are least likely to cause sexual SEs?

A

Aripirazole
Quetiapine

134
Q

Which 2 antipsychotics are least likely to cause high prolactin?

A

Aripiprazole
Quetipine

135
Q

Which neurodegenerative disorder affects the striatum?

A

Huntingtons

136
Q

Which neurodegenerative disorder shows box-car shaped ventricles on MRI?

A

Huntingtons

137
Q

What parts of the brain does corticobasal degeneration affect?

A

Cerebral cortex
Basal ganglia

138
Q

Sx of corticobasal degeneration?

A

Disorder of movement
Cognitive dysfunction

139
Q

Which scale measures aggression and conduct problems in kids 7-17 years?

A

Child & Adolescent functional assessment scale

140
Q

Which scale helps to obtain information from school regarding psych problems?

A

Strengths and difficulties questionnaire

141
Q

Which scale tests for TD?

A

AIMs

142
Q

Which scale tests for EPSEs?

A

Simpson-Angus

143
Q

Which antidepressants should not be px with Tamoxifen?

A

Fluoxetine
Paroxetine
Bupropion
Duloxetine

144
Q

What does Giant Panda Sign on MRI suggest?

A

Wilsons Disease

145
Q

What does sparing of medial temporal lobe suggest?

A

LBD

146
Q

Which LD has Salaam attacks?

A

TS

147
Q

What percentage of patients taking benzodiazepines for nearly a year develop dependence syndrome?

A

40%

148
Q

Which guidelines give guidance on reporting of meta-analyses and systematic reviews?

A

PRISMA

149
Q

Which guidelines give guidance on meta-analyses reporting on RCTs?

A

QUORUM

150
Q

The number that will repeat DSH (deliberate self harm) within one year

A

30%

151
Q

The percentage of patients in contact with mental health services within a year of death

A

25%

152
Q

EEG of grand mal seizure

A

EEG shows multispikes followed by multispikes and slow waves

153
Q

EEG of absence seizure

A

EEG shows generalised 3 Hz spike and slow wave activity

154
Q

Prevalence of any PD in the community

A

5%

155
Q

SMR for antisocial PD?

A

8-9

156
Q

RR of psychosis in prisons compared to general population?

A

20

157
Q

How many homicide offenders are women?

A

11%

158
Q

Which age group in females is at highest risk of committing a homicide?

A

30-39

159
Q

Cause of Cornelia de Lange?

A

Lack of pregnancy-associated plasma protein A (PAPPA) linked to chromosome 9q33.

160
Q

Incidence of fetal alcohol syndrome?

A

1.9 per 1000 live births

161
Q

Which type of dementia has impaired executive function and apathy?

A

Subcortical dementia

162
Q

Which type of dementia has normal alertness?

A

Cortical dementia

163
Q

Which type of dementia has apraxia?

A

Cortical

164
Q

Most common behavioural and psychological symptom of dementia?

A

Apathy - 59%

165
Q

Name the behavioural and psychological symptoms of dementia

A

Apathy - 59%
Depression - 58%
Irritability - 44%
Anxiety - 44%
Agitation - 41%

166
Q

What does the therapist use in Rational Emotive therapy to guide the discussion?

A

Humour
Guided discussion
Logic
Real-life challenges

167
Q

Which genetic disease is due to deficiency in L-iduronidase activity?

A

Hurler

168
Q

Which genetic disease is due to deficiency of iduronate sulfatase?

A

Hunter

169
Q

What is the mode of transmission of Hunters?

A

X-linked recessive

170
Q

SPECT finding in older depressed patients

A

Reduced cerebral blood flow sparing the posterior parietal cortex

171
Q

MRS findings of Alzheimers

A

Abnormal synthesis of membrane phospholipids

MRCPsych Part B (64 decks)

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