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Gurpal

July 2014 - MRCPsych Paper 1 Feedback

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just remembered-one more question. violence inflicted by people with hoods and balaclava and another group without them so who caused what, something weird like that.

asbo in school

stigma and school children. does anyone remember these questions?

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Yeah I remember them. Total guess for all!

I put that the men in hoods would cause more pain

For the children and stigma I just put that no change in attitude would be see !

No idea though

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I wonder if all the questions are marked or some of them (at least those weird ones) are kind of pilot?

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you are an optimist naturallycrazy! They are going to be marked for sure.

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HI All,

Here are some of the questions that I can remember.  

Multiple choice questions

 

1.       Inflicting pain by a person wearing a mask and not wearing a mask. What is more painful?

2.       The name of the author who wrote a book about ‘ ....... mind’

3.       The name of another author who wrote about a book about depression.

4.       Risk of fatality with ECG – 10/10000 given as an option

5.       Prevalence of Schizophrenia  an option given as 2%

6.       How to differentiate Lewy Body Dementia and Alzheimer’s dementia by radiology findings?  Options given ?SPECT

7.       A patient with a lung CA. Not tell the patient about this but repeating X – days to monitor that? What is the ethical principal? Beneficence, non – maleficiance , utilitarian

8.        A manage makes a decision about what service to continue what serve to close? What is the ethical principal?

9.       What is not in Big Five? Introversion and Extroversion given

10.   The upper limit of adult female QTc  - options are 440, 450, 460, 470, 480

11.   How many episodes per year in Rapid Cycling BPAD?  4 episodes per year

12.   Bullimia Nervosa – what is the endocrine abnormality – Low ACTH  or something to do with less insulin secretion?

13.   Two candidates sitting for MRCPsych exam. One read books and have lot of knowledge but fail the exam. Other person do past papers and pass the exam.  What is the learning process of the latter person? Can’t remember the options.

14.   Which medication least likely to affect QTc? – options

Clozapine, Rispridone Olanzapine, Aripiprazole, Quetiapine

15.   Constipation is a side effect of which antipsychotic medication?

16.   A person with L? Sided stiffness and Rigidity (some more information) – what is the likely course?   Parkinsonism??

17.   Person comes to GP surgery with hand and neck jerky movements and at the reception he swears at the receptionist.     ? Tourett’s Sx

18.   What stage one develops linguistic humour?  ? Formal operation stage??

19.   Stage when the baby is not separate from the mother?   Symbiosis

20.   The question about Monotrophy as described by Bolby. The two possible options that I can remember are:

  • Innate need for the baby to attach to a female figure
  • The time period when a baby is attaché to the mother

21.   In a group cohesiveness is more likely when:

  • When given an ambivalent task
  • Depends on the number of individuals in the group

22.       Which medication has the longest half life:

Nitrazepam, Temazepam, Paroxetine, .................................................

23.   Most anticholinergic SSRI ?  Fluoxetine, Paroxetine, Fluvoxamine, .......................

24.   SSRI that has least drug interactions? Citalopram, Fluxetine, Mertazepam, Sertraine, Paroxetine.

25.   Use of Lithium in Mania. Five options given. Two options that I can remember are,

  • Combined therapy is better than monotherapy
  • No use in acute mania

26.   Most teratogenic medication:  Sodium Valpoate, Carbamazepine, Lamotrigine, ...................

27.   Which 5HT receptor is involved in nausea? 5HT3

28.   What type of condition is Couvarde ? psychosomatic, culture bound disease, biological

29.   A university girl thinks that her lecturer is in love with her and planning to kill HIS wife. What is the condition? De Cleranbault’s Syndrome

30.   EEG >13 Hz – Beta waves

31.   ECG tracing – Gradually prolonging P waves and then drop of P wave. -  Morbitz type 1

32.   A girl with 165cm and weight 50kg. What is her BMI – 18 – 19?

33.   Answer as post natal depression

34.   Question about child abuse:

  • Boys are more physically abused than girls
  • Girls more sexually abused than boys
  • Mothers sexually abuse children as same as fathers

35.   Neurasthenia under what category? Somatoform disorders, neurotic disorders, ..............................

36.   Birth trauma ? whether it increase the risk of mania?

37.   A mother with schizophrenia. The risk of her chid developing schizophrenia:

  • 1%, 5 – 10%, 10 – 20%, ............................

38.   Death from delirium tremens : 1%. 10%, 20%, 30%, 40%

39.   What is Sally- Anne test used for: To identify Theory of mind

40.   What is the principle of DBT?

  • based on  attachment theory
  • Higheracheal
  • Social adjustment is limited ?

 

41.   Question on cognitive distortion of a depressed person?  A scenario and asking what the distortion is. Number of good aspect of his life. But he thinks that ‘what is the point if I have to take a pill everyday!’ - ? Overgeneralization?

42.   What is not right about CBT – options given.   ? Socratic questioning

43.   Who’s terms are Demetia precox and psychotic depression?

44.   A scenario about an elderly person who has nightmares, increased excitability and .....................

  • PTSD
  • Vascular Dementia

45.   Radiological finding in Schizophrenia. What is INCREASED? –

  • Ventrical/cortical ratio
  • Hypocampal volume
  • Frontal ...........

46.   Something like, what part of the brain involved in the treatment of Alcohol ......=

? Tegmental area

47.   A professional worker had attended number of times to A & E with abdominal pain. Later she admitted that she had injected faeces???  

  • Malingering
  • Factitious Disorder
  • Dissociation

 

48.   What enzyme deficiency likely to cause brain damage in Alcoholics?

  • Aldehyde Dehydrogenase
  • Alcohol Dehydrogenase

49.   Questions o n defence mechanisms -  few questions on mature, primitive defence mechanisms, and about projections.

50.   Patient treated for a malignancy at the hospital.  When he goes out gets anxious when he see someone with white court, he becomes distressed.  What is it?

  • Conditional Stimulus
  • Unconditional Stimulus
  • Conditional Response
  • Unconditional Response

51.   However, 6 months after stopping the treatment this stops. What is the option? Extinction

52.  

53.   Which scale is self rated?

  • Brief Psychiatric Rating Scale
  • Hammilton Rating Scale
  • Minnesota Multiphasic Personality Inventory (MMPI)

54.   What is targeted in DBT ?    Emotional Regulation?

55.   Stored memory when recalled what is it called? Recall or Retrieval?

56.   Criteria for Manic episode, duration?

  • 1 week
  • 2 weeks
  • 3 days

57.   Steady state of Lithium how many t1/2= 5

58.   Scenario on delusional mood.

59.   Question on thought echo.

60.   Question on somatic hallucinations.

61.   See himself –Autoscopy,  Doppelganger phenomenon

62.   Jungian concepts – Something like innate qualities developed from past? 

OPTIONS - Archetypes, collective unconsciousness

63.   Aprosodia, what part of the brain involved?

Non dominant hemisphere. (perisylvan region of the right hemisphere) 

64.   What is the bedside question to ask to check orientation?

  • Address
  • Date of birth
  • Counting backwords

65.   In moderate Alzheimer’s, which is preserved?

  • Drawing crossing pentagons
  • Short term memory

66.   In darkness a spot of light appears to be moving. What is this phenomena?

Autokinesis,  Pie phenomenon, ..................................

67.   Question about educating schools about mental illness and the outcome.

  • One options is that the fear of mental illness has reduced
  • No change

68.   The Hawthorne effect is a term referring to the tendency of some people to work harder and perform better when they are participants in an experiment.

69.   What is true as Adanbrookes  cognitive examination-

  • If >80% it is sensitive for dementia
  • If > 80% it is specific for Dementia

70.   Sudden left arm and Trunk jerks? Hemiballismus, Myoclonus

71.   Slow movements and predominantly in limbs? Athetoid movements, Huntington’s Choria

72.   What is the best strategy to prevent mental illness?

  • Preventative factors
  • Precipitating factors
  • Maintaining factors
  • Both Preventative and precipitating factors have same effects

73.   Patient believes that her bladder is rotting. She is also dehydrated. She think that the world is going to end.   ? Cotards syndrome??

74.   Scenario to indicate Capgras syndrome.

75.   HIV patient with headache and flu symptoms. Histology findings? Toxoplasmosis

76.   Question about stigma with options. One option is that the stigma about different mental health conditions is different.

77.   Question about nicotinic receptors –  what is true

  • Always excitatory receptors
  • Slow acting receptors
  • Has cholinergic activity

78.   Midlife crisis – what is the social developmental stage

  • Generation – stagnation

 

79.   A child feels embarrassed about parents and teachers about performance?

?? Industry vs inferiority (because if in front of the teachers, it is likely school going age which is after 5 years!)

80.   Who is associated with object relations theory?

  • Melanie Klein
  • Winnicott

81.   Neurasthenia. Classified under-

  • Somatoform Disorder
  • Neurotic disorder
  • .......................................

82.   Elderly person with memory intact but change in behaviour? What is the appropriate test?

Wisconsin card sorting test

 

EMQs

 

1.       Speech difficulties

  • Someone with high pitch sound and ..................    –
  • Hoarse voice, weak tongue wasting  etc ......................
  • Staccato speech , ....................................

POTIONS – Upper motor neurone lesion, Lower motor neurone lesion, Myasthenia Gravis, Vocal Cord paralysis

 

2.       EMI on defence mechanisms. Three questions.

 

3.       Scenarios about ethics. Five questions???

 

4.       Neurological signs and given. Asking about the neurological signs of the conditions.

  • Acute encephalitis - asterexis
  • Wernke’s  Encephalopathy - Nistagmus-
  • ?? menigo encephalitis – petechial rash

5.       Question on learning theories –

  • A scenario to indicate classical conditioning
  • Star chart – operant conditioning
  • Shows a spider  whilst relaxation – counter conditioning

6.       Choose options for  the three conditions –

 

Hebaphrenic Schizophrenia (Three options) –  negativities, ........................................

Delusional disorder- Systematised delutions, Old age ??

Paranoid Disorder(one option)– Prominent delusions

OTHER  OPTIONS – Adolescent age?,

 

7.       Personality disorders –

Options – histrionic, borderline personality, schizoid, anankastic

  1. Self centred person?
  2. Person who finds it difficult to make decisions
  3. ???

8.       Study and measures –

 

Options – Inter rater reliability, test retest validity, predictive validity

  • You ask a group of doctors and group of patients about your assessment of patient response to  treatment – Inter rater reliability?
  • You ask the same questionnaire in 1 years time – Test –retest validity?
  • Initial risk assessment to current level of risk – Predictive validity?

9.       Scales and tests –

  • Rapid bedside test to assess cognitive functions- MMSE
  • Test to assess premobid IQ – National Adult Reading test

10.   Symptoms on drug withdrawal  (number of symptoms given )–

  • Runny nose, yawning, pilloerection – Heroin?
  • Irritable etc – Cannabis?
  • Constipations ect?  -   Cocaine or Amphetamine?

11.   Catatonic symptoms –

  • Pt saluting – manarism
  • Walking in the corridor with L hand moving inwards and outwards? – Stereotypes
  • Doctor raise his hands over his head and patient keep the hadn in that position for  some time –  Mitmchen or Mitgehen ?
  •   

12.   Symptoms of drug abuse – symptoms

  • Vivid images -    LSD, Phencyclidine
  • ................................
     

Let me know your answers to these questions.

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Hi All,

 

Few more MCQs I can remember.

 

  1. A scenario to show thought flight.  A few sentences with the theme constantly moving starting with the end of the sentence before. – Thought flight,  
  2. The scenario about defence mechanisms and asking the mechanism when the information is consciously delayed. – Suppression
  3. The scenario about defence mechanisms and asking the mechanism when the information is un- consciously delayed (similar meaning). – Repression
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So, I passed that bloody weird exam! I am sure there was a big element of luck in there.

Congratulations to all who passed. And those who couldn't make it, hang in there guys and all the best next time.Cheers

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I passed too,got my letter as well and surprised to know i have got  82.3%.Horray.....

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hi all. i passed too got 82%. i dont know how . congrats to all. its a weird exam . no one can predict.

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yes, nc. now to start for paper 3. I started with paper 2 with my exams. are you going to do both the papers together? or you done them? congratulations for passing paperone. 67 percent pass mark makes me wonder what are the standards of the exam?

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I know! I have already started preparing for paper 2. wanna get rid of them one by one. I believe paper1 and 2 kind of overlap some topics.

GL for paper 3

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