LocumSHO

Paper A - 19 June 2018

7 posts in this topic

My personal view - today's exam was less difficult than I expected. Not that I'm completely confident that I'm going to pass, but I felt the questions were mostly "straightforward" (compared to Paper B, where questions seem more tricky).

Topics that came up -

  • mechanism of action of various psychotropic drugs - including hypnotic drugs, anti-dementia drugs, what receptors/subtypes do they act at, etc.
  • chemical classification of antipsychotic drugs - which of these is a butyrophenone, which is a dibenzodiazepine, dibenzothiazepine, etc.
  • mechanism(s) underlying various side-effects
  • neuropathology - difference(s) between Alzheimer's, vascular dementia, FTD, etc.
  • genetics - modes of inheritance, chromosomal location of disorders, etc.
  • stages of moral development
  • attachment theory - e.g., what is the stage of development of a child around the age of 2yrs, when the child has accepted that he/she is a separate individual from his/her mother, with his/her own unique identity, and is becoming comfortable with this
  • language development in children - at what age do they start to make vocalisations, what age do they start putting words together, etc.
  • neuroradiology - findings in variant CJD, auditory hallucinations, depression, frontotemporal dementia, etc.
  • changes in volume of distribution of drugs during pregnancy, changes with age, etc.#
  • rat being conditioned to become frightened at sight of a nut by loud noise being played whenever the rat tries to reach for the nut - is that backward conditioning, operant conditioning, or classical, etc.
  • different enzymes involved in synthesis/breakdown of different neurotransmitters.
  • definition of "interoception"
  • 15-yr-old smokes cannabis, experiences feeling of his limbs being stretched and twisted - what's this called? I think it was "paraschemazia".
  • localization of interoception/empathy function in the brain - anterior cingulate cortex?
  • when clinician offers a handshake, patient repeatedly offers and withdraws his own hand - 23 times - what's this called?

I think a lot of this material is covered by MRCPsychMentor.com. I think it's a good resource for Paper A preparation, but perhaps not so much for Paper B - just my personal opinion.

I'd like to hear other people's thoughts. Do share any questions you're able to recollect.

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Some other points I've just remembered:

  • primary vs secondary delusions
  • mechanism of action of atomoxetine
  • what blood tests to do before starting agomelatine
  • ICD-10 criteria - specifically, duration - how long do symptoms need to be present to make a diagnosis of depression, same question for mania, etc.
  • assessment instruments - which one of these is a screening instrument (options given included YBOCS, Edinburgh post-natal depression scale, Hamilton depression scale, etc. I think the answer was the Edinburgh post-natal depression scale, the others are rating scales, i.e., they are used to assess changes in symptom severity, rather than to make the diagnosis in the first place).
  • which one of these is a "precipitating factor" - bereavement, substance misuse, previous birth trauma, genetics, etc. (I think the answer is "bereavement" - the others would generally be regarded as pre-disposing or perpetuating factors)
  • in what stage/phase of sleep do night terrors occur?
  • EMI: what is the diagnosis in these cases: 5-yr-old child repeatedly wakes up agitated and distressed, 20-yr-old wakes up and is able to give vivid account of distressing dreams, 25-year-old has irresistible urges to sleep, etc.
  • conditioning - chemotherapy causes nausea and vomiting, then patient experiences nausea when they see the nurse who administers chemotherapy, then they experience nausea when they see any nurse, then following an inpatient stay of several weeks duration, the conditioned response is no longer present (I thought the first one was an unconditioned stimulus - nausea and vomiting caused by chemotherapy, the next one was a conditioned response - on seeing the nurse who administers the chemotherapy, then generalisation - on seeing any nurse, then extinction - the response is no longer present at the end of an inpatient stay in hospital.
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Hi,

Even though the topics were familiar the options were too close in many questions.Ex: t1/2 of drugs, interoception - cingulate cortex or insula, language development in children with close time frames.. Yes, there were a lot of straight fwd questions. Wonder if  easy questions would have an impact on the final result.. 

spmm material has covered all the topics quite well..

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It was quite tricky in my opinion, similar themes but confusing questions.... what do you think the cut off would be this time ?? 

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17 hours ago, Hats716 said:

It was quite tricky in my opinion, similar themes but confusing questions.... what do you think the cut off would be this time ?? 

I agree with this entirely! A fair amount of straight forward questions however a good few tricky and asked in odd ways. 

Not overly confident. 

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Hi Locum, last of those links is no longer working - would you check? Thanks

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