Manish67

MRPSYCH PAPER A TODAY

28 posts in this topic

How was the paper let's discuss questions 

Gene's for Huntington's disease, lewy body and frontotemporal dementia, metabotropic receptor, two questions on SSRI, delay in gratification, group psychology, group polarization, lewy bodies, ambitendency, extrovert decrease raas, borderline personality paranoid ideation 

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1) Huntington's Gene location

4p16.3

2)Delay gratification in early childhood has been associated with a range of positive outcomes in adolescence and beyond. These include greater academic competence and higher SAT scores, healthier weight, effective coping with stress and frustration, social responsibility and positive relations with peers. 
 

3)  Group polarization refers to the tendency for a group to make decisions that are more extreme than the initial inclination of its members.

4) Hypertension side effect of Venlafaxine 

5) Duloxitine is Serotonin Noradrinaline Reuptake  inhibitor 
6) 
 Both olanzapine and clozapine, drugs with a high risk of weight gain, bind strongly to the histamine H1 and serotonin 5-HT2C receptors.

7) Reward pathway Misolimbic 

8) Lurasidone should be taken with food (at least 350 calories). Administration with food substantially increases the absorption of Lurasidone 

9) Dorso lateral Pre frontal cortex used in Metallisation

10) Introversion with high Reticular activating system 

11) Autism show atrophy of cerebellar vermis on scan 

which is not a type of Familial Frontotemporal Dementia  ?

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I did not know the answer to any of these questions to be honest (except for the Huntington’s one)...

I was wondering where people studied from. I studied from Revision notes in Psychiatry and MRCPsych mentor.

i feel like barely anything came from my studying :(

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I did revise from PsychMentor and SPMM 

you u right exam was really difficult and they asked a lot of questions which has nothing to do with our daily psychiatry practice !

and unfortunately there is no specific text book which we can read to cover all the exam syllabus !

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Highest risk of seizures - Clozapine

LBD - DAT Scan (I think?)

Antipsychotic with the lowest risk of hypotension - Aripiprazole if I'm not mistaken

Commonest dopamine receptor in the brain - D1

Cause of weight gain with antipsychotics - 5HTc antagonism

Ideomotor, ideational apraxia was asked about

Equivalence of 10mg diazepam - 1mg of lorazepam & 25mg chlordiazepoxide

How many times does dopamine receptor cross the cell membrane? 7

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My memory is not very good. These are the questions I could recall:

 

Delay of gratification as measured in childhood is associated with? (my answer: academic achievement)

 

Hypnotic suggestibility is associated with (my answer: personality traits)

 

Glutamate decarboxylase is involved in synthesis of? (my answer: GABA)

 

Disorders of consciousness: Global impairment of consciousness, disturbed sleep-wake cycle (my answer: delirium)

 

Constant, dream-like perceptions (my answer: oneroid state)

 

ADHD associated with which gene (my answer: DRD1)

 

Personality disorders: “Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations.” (my answer: antisocial personality disorder)

 

“Appears indifferent to the praise or criticism of others.” (my answer: schizoid personality disorder)

 

“Transient, stress-related paranoid ideation or severe dissociative symptoms.” (my answer: Borderline personality disorder)

 

There was one which I think was narcissistic personality disorder.

 

Which of the following is most common in human brain (among D1, D2, D3, D4, D5) – I don’t know the answer.

There were questions on “which of the following is a metabotropic receptor?” (I thought the answer was CB1)

 

There were questions on apraxia and agnosia:
- Inability to recognise landmarks (my answer: prosopagnosia)

- Patient unable to demonstrate how to use a hammer when asked to, but reported to be able to use it normally at home (my answer: ideational apraxia – this may have been wrong – maybe ideomotor apraxia)

- patient unable to follow a sequence of tasks, but able to perform each task individually (my answer: ideomotor apraxia – again, my answer here was probably wrong, I think this probably should have been ideational apraxia).

 

Differences in mentalisation between adolescents and adults?

 

Which of these is (?underactive) in autism spectrum disorder (my answer was thalamus – may have been wrong).

 

What type of receptor do corticosteroids act on in the brain?

What type of receptor does (?zopiclone/?zolpidem) act on?

 

Questions on attachment theory


Questions on language developmental milestones

Vocalising alone (?6 to 9 months)

Using two word sentences (?20 – 24 months)

 

Questions on symptoms such as feeling of limbs twisting (?paraschemazia)

When doctors offers a handshake, patient offers a handshake, then withdraws hand, then offers hand, then withdraws it, repeatedly, over 20 times (?ambitendency)

 

Which neurotransmitter is contained in the raphe nuclei (?serotonin)

 

Patient on depot antipsychotic (as well as an antidepressant) complains of back stiffness, takes 10 minutes to get out of bed in the morning (wasn’t sure of the answer).

 

Question on which antipsychotic is least likely to cause postural hypotension?

Which antipsychotic is least metabolised in the liver?

 

Antipsychotic most likely to precipitate epileptic seizures (well, something along those lines)

 

What tests to do before starting methylphenidate (?LFT’s)

What to check before starting atomoxetine (?blood pressure)

 

Which of these is not a variant of frontotemporal dementia? (?progressive supranuclear palsy)

 

Genes linked with FTD, Huntington’s, etc.

 

According to ÆSOP study, what accounts for the nine-fold increased risk of schizophrenia in patients of African-Caribbean descent? (my answer: isolation and exclusion)

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Also questions on EEG findings.

Questions on pharmacology - changes in distribution of drugs in older adults, changes in pregnancy, etc.

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1) What’s screening scale for depression 

EPDS, Hamilton Depression scale, MRDS 

2) what’s Not Bowlby grief stages

protest , Shock and Numbness , Yearning and Searching , Disorganization and Despair, Reorganization and Recovery

3) EEG findings of Delreium Tremens  

increase in fast activity

4) Q sort is used for personality traits ( not sure about answer )

5) Raphi Nuclei (Serotonin)

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Auditory hallucination- dorsolateral prefrontal cortex, depression in elderly-deep white matter hyperintensities, pulvinar nucleus-working memory schizophrenia, least to be affected in old age, person throws stones-deindividuziation, alzeihmer-medial temporal lobe atrophy on MRI, lewy bodies dementia eeg option, least hepatotoxic is it asenapine 

Least hypotension-ziprasidone, seizure risk increased-clozapine,more than 50 hrs-flupenthixol ,wife hitting husband on bed - akathisia, girl with clonus-serotonin syndrome, success of person internal attribute, temperament poorly stable over developmental years, weschlers intellectual ability, gender schema, psychoanalytic, cognitive development theory, social prefrencing, no landmarks- visual agnosia ,daily activities- vineland social maturity scale, person performs well in presence of other ,duration criteria for somatisation, panic disorder, not a icd10 diagnostic criteria for delusion, hpa dysregulation relapse, ghb receptor gaba, zolpidem alpha 1 subunit, diazepam gaba a and b, propranolol beta 2 antagonist 

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Apoe4 increase risk by,percentage of frontal volume, minimum district trial before launching drug, poor parenting leads to ,type of attachment of child, type of conditioning, 

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Damn easy paper pass percentage will be minimum 55 percent 

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Trail making test memory ,linkage analysis, question in which options were rey ostrich test paired learning,one question in which primary motor and secondary motor cortex were in options, hammer question ideomotor apraxia, next question in sequence simultagnosia, child resistance when caregiver goes away, child non responsive type of attachment, moclobemide qtc prolongation, mao inhibitor not to be taken with decongestant 

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Durkeihm suicide more in unmarried lonely couples, learned helplessness animal experiment, man left house feared to go out to cafe publice places ? What type of grief reaction in which son lost his father ,woman seprated from his lover for 2 months is it adjustment disorder 

Linguistic humor- concrete operational

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Utilatrinaism, oxytoxin reduce anxiety, antidepressant and anti emetic substance p,lithium interstitial nephritis shouldn't combine with ace inhibitors, corticosteroids nuclear receptor, zolpicone voltage gated ion channels 

Pregabalin enhance gaba, antiepileptic topiramate, emi muscarinic receptor antagonist,agitated men anticholinergic psychosis

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People pour in more questions and answers so that we can recall complete

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Frontal operculum, inferior temporal region,medial temporal region, anterior temporal region EMI question 

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NMDA AGONIST-ACAMPROSATE, D2 AGONIST-ARIPIPRAZOLE, ATOMEXETINE MONITORING UREA AND ELECTROLYTE, METHYLPHENIDATE MONITORING LIVER FUNCTION TEST

Previous cerebrovascular accident facial weakness 

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For both methylphenidate and atomoxetine blood pressure should be checked before starting drug

Why eeg is used in diagnosis of seizure because of high sensitivity 

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Not a subtype of schizophrenia according to icd or dsm. Options regarding symptoms of borderline personality disorder was given and best statement was asked

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Two EMI on parenting styles and one mcq on characteristic feature of conduct disorder children 

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Attachment style parenting answer is avoidant insecure

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Propanolol n zoplicone  mech of action
Antiepileptics causing aggression


10mg diazepam equivalents = lorazepam = librium 


Qtc prolongation antidepressant


Atomoxetine n methylphenidate wat to monitor


Screening instrument- Edinburgh scale 


Old age rating scale - comprehensive functioning /stroop test


SF36 scale 


healthy parental failure/ brusque or aggressive parenting


Chromosome FTD, lewy, Huntington's


Mri changes in elderly dep, working mem schiz, aud hallucination

Perrsonality disorder specific point

Duration panic n somatisation
Sleep n appetite orexin?
Adverse drug reactions- Muscarinic blockade, male
Case vignettes on Kicking in the night, dystoni, serotonin syndrome, siadh


Pregnancy metabolism gfr increased
Elderly drug met lipophili


Pregabalin- excreted Unchanged 


EEG - hypsarrythmia, absence, juvenile myoclonic seizure


Buprenorphine mech of actio

Li with Ace, hypertension causing agent, interstitial nephritis


Most adults in which kohlberg stage 
Paraschemasia
Dopamine number of times cell mem
Abundant type of dopamine recptor
Metabotropic receptor-cannabinoid
Lurasidone gastric calorie relation
Raphe nuclei
VTA-addiction 
Which is reward pathway 
Locus cerulus-noradrenegic
Minority group decision - consistent
Antipsychotics - seizure causing-clozapine 
Lewy body dementia - imaging finding
Number of words n child age
Secure attachment features 
Delay gratification in children academuc achievements
Phasic fluctuations in mesolimbi-learning curvr+
Rat buzzer fear- classic condition
Reciprocal inhibition is associated with?
Activity of daily living? Vsms? 
Ambitendency/ambivalence in catatonia
Schiz type not in  dsm or icd
Acamprosate mech of action +
Weight gain antipsychotic mech? +
SSRI shortest half life+
Over counter drugs not to b given sith MOAI
fusiform gyrus n new factual memory 
Word finding difficult area of brain? 
Previous CVA - clonus?

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What was the exact question of kohlberg stages in adults. Propranolol beta 2 zopiclone alpha 1 subunit 

Bulesque parenting answer? Qtc prolongation moclobemide 

Not a icd 10 criteria for delusion 

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Was preconventional stage of adult was asked in question on kohler

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healthy parental failure/ brusque or aggressive parenting what's answer of these EMI along with scale for comprehensive assessment in old age and question in which options were key ostrich test,paired unpaired test whats the answers anyone 

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