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Feedback: MRCPsych Paper A - June 2016

28 posts in this topic

On 7/28/2016 at 08:42, pankaj sheoran said:

Utilitarian moral theory

... is correct :)

Many thanks to this.

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On 6/24/2016 at 11:09, MONA NAZ said:

hi, these are the questions i remember. there were pretty similar to these.  

 

1, The annual incidence of tardive dyskinesia in patients with chronic schizophrenia who are on any antipsychotic treatment is

 

 

 

Select one:

 

1%

 

3%

5% 10%

The correct answer is: 0.03

 

According to the CATIE study of patients with schizophrenia, the number of patients meeting criteria for metabolic syndrome ranges between what percentages?

 

2, Select one:

 

10-20%

 

31-40%

 

51-60%

 

21-30%

 

41-50% 

 

3, The upper normal QTc level in female subjects is

 

Select one:

 

440 ms

 

450 ms

 

500 ms

 

 

 

420 ms

 

4, Which of the following drugs have a half-life of 3 days?

 

Select one:

 

Carbamazepine

 

Aripiprazole 

 

Quetipaine

 

Reboxetine

 

Fluoxetine

 

5, Which of the following is a localising sign for frontal lesions?

 

Select one:

 

Postural headache

 

Ptosis

 

Nystagmus

 

Olfactory disturbances 

 

Myoclonus

 

6, National adult reading test is used to assess

 

Select one:

 

Visuospatial ability

 

Premorbid intelligence 

 

Attentional bias

 

Nonverbal intelligence

 

Frontal lobe functions

 

7, On routine examination of eyes, accommodation reflexes were present but pupils were small irregular with absent light reflexes. This type of pupil is called 

 

Select one:

 

Marcus Gunn pupil

 

Senile pupil

 

Anosognosia

 

Kayser-Fleischer pupil

 

Argyll Robertson pupils 

 

8, The gene implicated in Huntington's disease is present on the chromosome

 

More than 35 repeats

 

Less than 35 repast

 

 Which of the following is associated with narcolepsy?

 

9.  callous-unemotional traits

 

A, schizoid personality

 

B, schizotypal

 

C, pwersonality

 

10, Huntingtonis causedby

 

A,  AD

 

B, AR,

 

C, x link recessive

 

D, x link dominant

 

11, 3RD NERVE SUPPLY

 

? SUP RECTUS MUSCLE

 

6th nerve pelsy

 

5th nerve

 

7th nerve

 

12, The somatodendritic inhibition of 5-HT release is regulated by

 

Select one:

 

5-HT1A receptors 

 

5-HT3 receptors

 

5-HT4 receptors

 

5-HT5 receptors

 

5-HT2 receptors

 

13, Which of the following is the precursor of Dopamine

 

L tyrosine

 

L tryphtophane

 

Acetyal co

 

Dopamine

 

5 hydroxybyt

 

14, patient admitted to hospital he had previous stroke 2 years ago . How will we differentiate

 

A, Bilateral weakness in both limbs

 

B, Muscle wasting in left limb.

 

C, Facial droop.

 

 

 

15, Prion protein found I prion nucleus

 

Venlafaxine to mirtazapine in a patient who has developed severe gastrointestinal intolerance.

 

..Withdraw, wait for five weeks and then start the second drugWithdraw,

Fluoxetine to tranylcypromine due to the inefficacy of the former.

 

.Withdraw, wait for five weeks 

 

An investigator is interested in calculating the risk of illness within families among first, second and third degree relatives and compare the rates with the established risk in the general population.

 

 

 

 

 

16, Rey-Osterrieth complex figure test is one of the non verbal memory tests. Here the subject is first asked to copy a complex geometric figure and then to draw from memory after an interval of 30 minutes. The recall is impaired in patients with dementia and amnesic syndrome. 

 

17, Stroop test, inhibition

 

18, Neuroleptic malignant syndrome (NMS) is associated with a mortality rate of

 

Select one:

 

15-20%. 

 

5-10%

 

25-50%

 

1-2%

 

2-5%

 

19, Mr.Z is a 25 year old gentleman being treated for first episode schizophrenia. He was initially started on Risperidone 2mgs daily which was subsequently increased to 4mgs by week 4. Difficulty in breating and saying that he will swallow his tongue.

 

Select one:

 

acute dystonia

 

 

 

20, The antidepressant most associated with QTc prolongation is

 

Select one:

 

Venlafaxine

 

Paroxetine

 

Mirtazapine

 

Amitriptyline 

 

Moclobemide

 

21, inpatient on a psychiatric ward. He has a history of psychotic depression and is on combination treatment with antipsychotics and antidepressants. He appears slightly flushed, with dry mouth, dry skin, feeling hot, and confused. He is exhibiting features of

 

Select one:

 

SSRI discontinuation syndrome

 

Neuroleptic malignant syndrome

 

Idiopathic parkinsonism

 

Anticholinergic syndrome 

 

Serotonin syndrome

 

22, Which drug increases the risk of bleeding in patients on SSRIs?

 

Select one:

 

Paracetamol

 

 

 

Naproxen

 

Ibuprofen

 

Diclofenac

 

23, The mechanism of action of Varenicline is

 

Select one:

 

Alpha-2, beta-4, nicotinic acetylcholine receptor partial agonist

 

Alpha-2, beta-2, nicotinic acetylcholine receptor partial agonist

 

Alpha-4, beta-2, nicotinic acetylcholine receptor partial antagonist

 

Alpha-4, beta-2, nicotinic acetylcholine receptor partial agonist 

 

Alpha-2, beta-4, nicotinic acetylcholine receptor partial antagonist

 

24, Aripiprazole has an elimination half life of

 

Select one:

 

3.5 hours

 

2 hours

 

12 hours

 

24 hours

 

75 hours 

 

25. Drugs not effected by P450

 

26, In pregnancy effect of

 

Reduce  kidney function

 

reduce liver function

 

reduce fat

 

reduce Gut absorption

 

need more dose of iv medication

 

26, D2 receptors

 

Ans , pre and post receptor

 

27, Transcriptome is a

 

Select one:

 

Statistical test

 

Type of plasmid

 

Collection of expressed m-RNA

 

Positional cloning

 

Stretch of DNA 

 

28, Which of the following areas of the brain does not lack blood brain barrier?

 

Select one:

 

Median eminence

 

Posterior pituitary

 

Area postrema

 

Subfornical organ

 

Anterior pituitary 

 

29, Phencyclidine –

 

NON COMPETETIVE  NMDA

 

30, chose most relevant

 

Ans, Glycine most distributed in brain

 

31, Which area of the brain is implicated with recognition of faces?

 

Select one:

 

Amygdala

 

Fusiform gyrus 

 

31, The receptors which have both pre and postsynaptic presence are

 

Select one:

 

5-HT2C receptors

 

D2 receptors 

 

D1 receptors

 

D5 receptors

 

5-HT1A receptors

 

Feedback

 

Your answer is correct.

 

D2-like receptors (D-2, D-3 and D-4) have both pre-synaptic and post-synaptic inhibitory effect. 

 

D1 like receptors (D1 and D5) have only postsynaptic inhibition effect.

 

 

 

32, EEG  4-8 = theta

 

33, A patient has chronic schizophrenia and is on clozapine therapy. If you want to try augmentation, which one should be avoided?

 

Select one:

 

Carbamazepine 

 

Sodium valproate

 

Aripiprazole

 

Fluoxetine

 

Lithium

 

33, Pt have risk of congenital disease more  ?

 

Mother using Smoking,

 

alcohol

 

34, In WAIS, hold tests are vocabulary, can relatively

 

information,

 

object assembly

 

picture completion.

 

35, The term used for purpose to identify locus of a gene on the chromosome by studying the extent to which it, co-segregates with a marker gene is called as;

 

Select one:

 

Mutagenesis

 

Physical mapping

 

Association studies

 

Linkage analysis 

 

Polymerase chain reaction

 

36, The metabotropic receptors are coupled to

 

Select one:

 

Ligand non-dependent regulators of nuclear transcription

 

G proteins 

 

Ligand dependent regulators of nuclear transcription

 

Proteins that have intrinsic enzyme activity

 

Ligand gated channels

 

37, The neurotransmitter which is most widely distributed in the brain is

 

Select one:

 

Dopamine

 

Glutamate 

 

Acetylcholine

 

Norepinephrine

 

Serotonin

 

38, Which of the following neuroimaging finding is most suggestive of new variant CJD?

 

Select one:

 

Occipital hypoperfusion on HMPAO- SPECT

 

Activation of primary auditory cortex on functional MRI

 

Impaired dorsolateral cortex function

 

Medial temporal atrophy on structural MRI scan

 

Increased signal in the pulvinar nucleus of thalamus bilaterally 

 

39, Wife started on Risperidone now she is Kicking in bed

 

Akathisia

 

TD

 

MYOCLONUS

 

 

 

40, shock-like sensations are seen in SSRI discontinuation syndrome.

 

One among the following is not a feature of serotonin syndrome

 

Select one:

 

Hyperreflexia

 

Confusion

 

Myoclonic Jerks

 

Electric shock like sensations 

 

Autonomic instability

 

41, A 67-year-old gentleman has been on treatment for depression. He went to the local beach for sunbathing on a summer day afternoon and presented to A and E complaining of nausea, dizziness and leg cramps.

 

Select one:

 

Hypoglycemia

 

Hyponatraemia 

 

Hyperkalemia

 

Hypokalemia

 

Hypernatraemia

 

42, What is the main risk involved in treating a patient with combination of clozapine and carbamazepine?

 

Select one:

 

Neuroleptic malignant syndrome

 

Diabetes mellitus

 

Seizures

 

Leucopenia 

 

Weight gain

 

43, With Agomalation check

 

Lfts

 

Tfts

 

Fbs

 

44, Which of the following agents exert an allosteric action on the nicotinic receptors?

 

Select one:

 

Memantine

 

Gallantamine 

 

Rivastigmine

 

Tacrine

 

Donepezil

 

45, It does not affect hepatic cytochrome P450 enzymes.

 

Reboxetine i

 

Fluoxetine

 

 

46, Which of the following is hydroxylated as one of the steps in dopamine synthesis?

 

 L-tyrosine

 

In Huntington's disease, there are increased CAG repeats. Normal repeat lengths range from about 7 to 28 triplets. Individuals with 29-35 triplets will not develop HD but may pass an expanded allele to an offspring, while individuals with 40 or more triplets will develop HD

wrong question as option were repeated twice

 

47, The technique used to assemble correct DNA fragments from a gene library into a continuous overlapping stretch, which will contain genes of interests is;

 

Select one:

 

Physical mapping 

 

Polymerase chain reaction

 

Association studies

 

Mutagenesis

 

Linkage analysis

 

48, Which neuroglial cells act as scavenger cells at the sites of CNS injury?

 

Select one:

 

Schwann cells

 

Microglia 

 

Satellite cells

 

Astrocytes

 

Ependymal cells

 

 

 

49, SINGLE RISK FACTOR FOR SUCCIDE

 

MALE

 

OLD

 

LIVING ALONE

 

BAD CONDIONS AROUND

 

50, The mechanism of action of Memantine is

 

Select one:

 

Non competitive NMDA receptor agonist

 

Non competitive NMDA receptor antagonist 

 

Competitive NMDA receptor antagonist

 

Competitive NMDA receptor agonist

 

Acetylcholinesterase inhibitor

 

51, When swapping MAOIs to SSRIs, what is the optimum wash out period?

 

Select one:

 

Minimum 2 days is essential

 

Minimum 5 days is essential

 

Minimum 2 months is essential

 

Minimum 2 weeks is essential 

 

Minimum 5 weeks is essential

 

52, A psychologist is performing neuropsychological testing in a 45 year old man. Which one of the following is a test of set shifting?

 

Select one:

 

Wechsler memory scale

 

Ravens progressive matrices

 

Boston naming test

 

Wisconsin Card sorting test

 

 

 

53, Copying intersecting pentagons  which test is used

 

constructional praxis

 

54, Which of the following accounts for spongiform appearance in CJD?

 

Select one:

 

Accumulation of prion proteins

 

Neuronal vacuolation 

 

Trapped air in parenchymal cells

 

Neuronal loss

 

Neurophil loss

 

 54, Korsakoff's syndrome correlates best with the presence of lesions in the dorsomedial thalamus. But lesions in the mammillary bodies, the mammillothalamic tract and the anterior thalamus may be more relevant to memory dysfunction than lesions in the medial dorsal nucleus of the thalamus. 

 

55, Prosopagnosics cannot recognise familiar faces.  (fusiform gyrus). 

 

56, Astrocytes are the most numerous of all three types of glial cells. These are star-shaped cells that enable nutrition of neurons, breakdown of some neurotransmitters, and maintaining the blood-brain barrier

 

57, Ependymal cells are a particular type of glia that cover the ventricles and enable CSF circulation.

 

58, A 27-year-old woman suffers from depression and is on Amitriptyline. She develops infectious diarrhoea and collapses. ECG shows polymorphic ventricular tachycardia. What feature could be seen in her ECG recorded prior to developing tachycardia?

 

Answer 2Choose...P waves absent before every QRSP-R interval of 100 msP-R interval of 280 msP-R interval of 500 msCorrected QT of 510 msDiffuse ST elevation with saddle formationR-R interval of 500 msProlonged QRS intervalR-R interval of 1500msCorrected QT of 440 ms

 

60, Saddle shape in pericarditis and other option ?

 

61,

 

 

A 33-year-old gentleman was started on trifluoperazine five days ago. He is now complaining of tremors, stiffness and inability to initiate body movement.

 

Answer 3Choose...AkathisiaCerebellar ataxiaHyponatraemiaSerotonin syndromeSIADHNeuroleptic malignant syndromeParkinsonismTardive dyskinesiaAcute dystoniaCholinergic rebound syndrome

 

62, A 36-year-old woman treated on fluoxetine and phenelzine for her depression has now developed diarrhoea, excessive sweating and myoclonus.

 

Answer 1Choose...HyponatraemiaParkinsonismAcute dystoniaSerotonin syndromeAntidepressant discontinuation syndromeNeuroleptic malignant syndromeCholinergic rebound syndromeCerebellar ataxiaTardive dyskinesia

 

A 76-year-old gentleman admitted to hospital is on paroxetine for more than five years. He has not taken his antidepressant medication for last five days. He has developed flu-like symptoms, paresthesias and complains of electric shock-like sensations

 

Answer 2Choose...Hyponatraemia

 

 

 

 

A 25-year-old gentleman with an acute episode of psychosis was started on trifluoperazine 3 days ago. He has now developed a high fever, rigidity, profuse sweating and confusion.

 

Answer 1Choose...ParkinsonismTardive dyskinesiaCerebellar ataxiaSerotonin syndromeSIADHHyponatraemiaCholinergic rebound syndromeAcute dystoniaNeuroleptic malignant syndromeAkathisia

 

 

 

 

 

63, associated with Gamblers

 

Agomalatine

 

 

 

64,  Cause of nausea

 

Answer 3Choose...Serotonin 5HT3 activation

 

 

 

 

 

 

65, X link reassess picture

 

 

 

66, Hardy-Weinberg equilibrium? 

 

 

67, Which of the following conditions is an example of aneuploidy?

 

Select one:

 

Thalassemia

 

Huntington's disease

 

Absence seizures

 

Phenylketonuria

 

Down's syndrome 

 

 

 

 

 

 

 

68, enome-wide association studies are based on linkage disequilibrium (LD), using several hundred thousand marker single nucleotide polymorphisms or SNPs.

 

The correct answer is: Single nucleotide polymorphisms

 

 

 

70, Unfavourable lyonisation of X chromosome

 

 

 

 

 

71, Which memory is independent of time and place

 

Sementic

 

Declarative

 

 

 

Episodic memory is

 

Episodic memory 

 

72, Only see some things area of brain affected

 

Tunnel vision effected brain

 

? post cerebral region 

 

73, A 25-year-old man sustains a severe head injury in a motor cycle race event. On recovery, he is noted to have grasp reflex, poor judgement and impaired reasoning with impulsivity. Which of the following tests is highly likely to be abnormal?

 

Select one:

 

Wisconsin card sorting test 

 

Wechsler adult intelligence scale IQ score

 

Paragraph retention test

 

Wechsler memory scale

 

National adult reading test

 

74, Which of the following is a true statement concerning human HIV disease?

 

Select one:

 

Psychosis is the most common HIV related psychiatric problem.

 

CSF viral load is the best predictor of HIV related CNS disease.

 

HIV cross the blood brain barrier using macrophages 

 

CD4 count is the better indicator for severity than viral load

 

HIV does not cause programmed cell death of neurons

 

 

 

I75, n which of the following conditions both balloon cells and Hirano bodies are seen?

 

Select one:

 

Alzheimer's disease

 

HSE encephalitis

 

Neurosyphilis

 

CJD

 

Pick's disease 

 

76, Mr. Y presents to the emergency department with a history of apathy and weight loss. On further investigations, he has hyponatraemia and hyperkalemia. What is his possible diagnosis?

 

Select one:

 

Acute porphyria

 

Cushing's syndrome

 

Cohn's syndrome

 

Diabetes insipidus

 

Addison's disease 

 

77,  Mrs. X is an 83-year-old lady who has been diagnosed with early stages of Alzheimer's disease. The brain region, which could show prominent changes, is;

 

Select one:

 

Prefrontal cortex

 

Entorhinal cortex 

 

Superior temporal gyrus

 

Caudate nucleus

 

Prefrontal cortex

 

78, Which one of the following structures is involved in the visual pathway? Chose 2 options

 

Select one:

 

Medial geniculate body

 

Heschl's gyrus

 

Inferior Colliculus

 

Lateral geniculate body 

 

Tegmentum

 

 

 

79, Which of the following disorders is characterised by a predominant presence of triphasic waves in EEG?

 

 Hepatic encephalopathy

 

 

 

 

 

80,  deficits in new learning  area of brain involve

 

 

 

81, EEG IN DELIRIUM TREMORSip

 

Drugs worse the schizoprinic hallocinations ? LSD

 

 

 

Pregabalin is a 3-isobutyl derivative of the inhibitory neurotransmitter γ-aminobutyric acid (GABA) that functions as a calcium channel blocker.[1

 

 

 

Clozapine don’t work on

 

? Glutamte receptor

 

Risk factors for TD-Older patients, females, patients with organic brain damage and patients with affective disorders, and those who have had acute EPSEs (Extra pyramidal side effects) early on treatment.

 

 

 

 

 

82, Bipolar time

 

A, 2 days

 

2, week

 

3 months

 

4, 6 months

 

 

 

83, Which of the following is not a feature of Kubler-Ross model of grief?

 

 

 

Select one:

 

Agitation Correct

 

Bargaining

 

Denial

 

Depression

 

Acceptance

 

84, Which of the following is a characteristic feature of schizoid personality disorder?

 

Select one:

 

Labile affect

 

Insensitivity to prevailing social norms 

 

Highly sensitive and intolerability to setbacks

 

Poor frustration tolerance

 

Rigidity and stubbornness

 

85, fECG shown 

 

Ant MI

 

 

 

85,  mode of retrieval after showing 2 list to patient to identify similar

 

Flow recall

 

Recognition

 

 

 

86, Select one: child burn hand and never went near to stove

 

Positive reinforcement

 

Classical conditioning 

 

Modeling

 

Negative reinforcement

 

Habituation

 

 

 

87, Autonomy, beneficience, non-maleficinece in medical ethics are described as

 

Select one:

 

Utilitarianism

 

Teleology

 

Enshrinement

 

Principlism 

 

Deontology

 

88, A 4-year-old child , my teddy is sleeping , got pain, Which of the following features is she exhibiting?

 

Select one:

 

Semiotic thinking

 

Lack of conservation

 

Animism 

 

Conservation

 

Egocentricity

 

89, achieving 'conservation'.

 

Select one:

 

Formal operational

 

Operational stage

 

Sensorimotor

 

Pre-operational

 

Concrete operational 

 

99, According to Erik Erikson, between the ages of 8, the crisis to be resolved is

 

Select one:

 

Autonomy vs shame

 

Initiative vs guilt

 

Industry vs inferiority 

 

Trust vs mistrust

 

Identity vs role confusion

 

100, A psychologist takes a 31 year old patient with significant fear of heights to the top of a 21 storey-building. Which of the following behavioural technique is he employing?

 

 

 

Select one:

 

Relaxation training

 

Desensitisation

 

Flooding Correct

 

Implosion

 

In vitro flooding

 

 

 

101, Star chart is based on the principles of

 

Select one:

 

Avoidance conditioning

 

Classical conditioning

 

Operant conditioning 

 

Higher order conditioning

 

Trace conditioning

 

102, LSD also produces visual hallucinations in pt with schizophrenia

 

103, In MMSE, intersecting pentagons primarily assesses which of the following functions?

 

Select one:

 

Orientation

 

Constructional praxis 

 

Language

 

Copying skills

 

Visual retention

 

104, A child was told to finish homework tasks before he can play outside. This is based on

 

Select one:

 

Reciprocal inhibition

 

Classical conditioning

 

Cognitive mapping

 

Premack's principle 

 

Operant conditioning

 

105, A family has got a new dog. A 3 year old child in the family is afraid of dogs and would stay in the same room with the dog only if he could sit on his mother's lap and had his favourite ice cream. Select the learning theory principle employed here

 

Select one:

 

Avoidance learning

 

Extinction

 

Operant conditioning

 

Reciprocal inhibition 

 

Classical conditioning

 

106, A 40 year old man has chest pain and dizziness. His bloods and ECG are normal. He is advised to take medications, fat restricted diet, exercise. This is called 

 

Select one:

 

Illness behaviour 

 

Illness

 

Sick role

 

Worried well

 

Depression

 

107, Semantic memory is not tagged to the time of learning but involves factual recalls.

 

 

 

108, The modification of memories in terms of one's general attitude is called 

 

Select one:

 

False memory syndrome

 

Semantic memory

 

Repressed memory

 

Flashbulb memory

 

Retrospective falsification 

 

108, A 59-year-old man played Lotto consistently with the desire to win big one day. He has won small amounts of money on certain occasions. What is the reinforcement schedule demonstrated by his behaviour?

 

 

 

Variable ratio

 

 

 

 

 

109, hich of the following increases the effectiveness of a persuasive communication?

 

Select one:

 

Mass media communication

 

High intensity urging

 

A credible communicator 

 

High receiver intelligence

 

High cognitive dissonance

 

 

 

110, "The individual behaviour of group members is less important than that of the whole group". What is this concept called?

 

Select one:

 

Group think

 

Sociogram

 

Deindividuation 

 

Risky shift phenomenon

 

Polarization

 

 

 

111, Which of the following can reduce groupthink?

 

To tell members to keep information secret and hide from other group members.

 

 

 

112, A 12-year-old girl is called by names at her school after her dad's admission at the local psychiatric hospital. This is called

 

Select one:

 

NIMBY opposition

 

Self stigma

 

Nosophobia

 

Courtesy stigma 

 

Stereotyping

 

113, The right action is the one that has the best foreseeable consequences and not duty. This is called;

 

Select one:

 

Engel's model

 

Utilitarian moral theory 

 

Paternalistic model

 

Hammurabi code

 

Oath of Hippocrates

 

 

 

114, NHS employees are paid every month irrespective of targets achieved or competitive performance.

 

 Fixed interval reinforcement

 

115,

 

Mr. Z is shown a list of words. He is then shown an another list of words and asked which of those appeared on the first list

 

 

116, Language is slower to develop in

 

Select one:

 

Both parent is deaf and not communicating

 

 

 

Big thanks

 

 

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