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Feedback on Part II ISQ/EMI paper Spring 2004

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After the Part II ISQ/EMI papers, please post an account of your experience, good or bad. If you remember any questions, please post them, even if you then you're repeating someone else's post. Thanks and good luck on results day!

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i cant understant whats the use of asking questions which we are never going to use again or read again. no use in clinical practice at all.

basic science paper imtalking about.

even the clinical paper was more like basic science.

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quite a ridiculous set of papers - basic interspersed amongst clinical and vice versa

usual rubbish about baboons, apes, primates and other attractions at London Zoo

by all accounts, an entirely usual RCPsych production

will post some questions as soon as I recover

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For the first time, I came out of an exam not cursing myself for not having started revision earlier or worked harder. I dont think I could have done any better even if I had worked double. The questions were about niggly detail about diagnoses that many of us would never even see once in our lifetimes - I mean, who can be expected to know whether epilepsy diagnosis increases the chance of reoffending in someone convicted of arson!!


As for the basic sciences - the less said the better! The only redeeming feature for me, thanks to this forum!!, were the baboon questions!

Good luck everyone!

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As for the basic sciences most was guess work . :o

A lot of old age questions in clinical isqs

EMIs - prescribing in pregnancy - lithium ,valproate , paroxetine on newborn .

EEG changes. Neurotransmitters NMDA, reuptake inhibitors, 5ht3 and drugs.

Chromosomal abn/ mutation in TAU etc and cases.

etc ???

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for some strange reason, the isq which i remember is

' during a conversation, one is more likely to have longer utterances during a phone conversation than while talking to someone face to face'! :: ::)

EMIS abt treating opiod dep diff lead in

1.addict wants to give up, but cant stand withdrawal symptoms

2.wants to give up, but doesnt want methadone

3.a known pt given his daily dose of methadone found to have collapsed with pinpoint pupils.

some options were





lots of other, but cant remeber

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In atypical facial pain TMJ dysfunction if usually found (not sure about wording)

Messages are received better from people who are perceived as tall

Utterances are longer during telephone conversations than face to face conversations

Imipramine and ECT work synergistically

In psychoanalysis interpretations are given tentatively

Incomplete memory of the trauma is characteristic in PTSD

Procedural memory is not affected in Korsikoff’s

Episodic memory is usually impaired in semantic dementia

NMDA channels are blocked by Mg ions

An infant will cross a visual cliff irrespective of the mother’s facial expression

Exit life events have been shown to be more common than enter life events in depression

Children of parents with PD are more likely to have mental disorder than children of parents with schizophrenia

Genes are as important as relationships are determining adjustment in children (not sure of wording)

30% of homicides are committed by people with mental illness

People with learning difficulties are more likely to commit acts of serious violence

25% of prisoners have epilepsy

Clonidine and methamphetamine are more affective than either alone in ADHD

Primacy effect is retained in (?type) dementia

Theory of mind develops around the age of 4

If a child of six can read 6 words or less this predicts he/ she is more likely to develop mod/severe LD

If a child of 6 has not developed clear right/left dominance he/ she is more likely to develop mod/severe LD

The difference between the protein in CJD and nvCJD is a disulphide bond


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Where does one start.....well, at least the baboons are becoming a standard and therefore reassuring....overall, the college seems to like to set an unfair paper in that it will pick a few areas and if you are up to date on it great but if not, well tough....surely they should be aiming for an all round picture!!!???

At least there was enough time to do the ISQ papers (compared to the critical review or am I the only dense one out there??)

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Basic sciences was pretty much an amusing guessathon as expected. Clinical was better but still plenty of uneducated guesses.

Some questions I remember but everything is a bit hazy just now

Amnesia for traumatic event is characteristic of PTSD

Emotional blunting is characteristic of PTSD

Baby experiences visual cliff regardless of mother's facial expression

Clonidine and methylphenidate combination is more effective than either alone in treatment of ADHD with associated tics

Aripiprazole is a D2 partial agonist

Aripiprazole is a 5HT2 antagonist

Repitition of self harm is more likely in antisocial PD

Partner abuse is more common in family with teenage children

In divorce, adjustment difficulties are seen in children before the event even if lack of parental conflict

In spousal violence the women hits first in 20%

Old age and Alzheimers both show neuronal degeneration in layer 2 of entorhinal cortex

Exons are excluded in transcription

Physical dependence can develop in long term procyclidine use

Serotonin receptors are all metabotropic

Glutamate receptors are unchanged in number in post mortems of schizophrenics brains

Magnesium inhibits glutamate receptors

Imipramine and MAOIs are equally effective in treating severe depression

Imipramine and CBT are equally effective in treating moderately severe depression

Amitriptyline in old age depression is associated with decreased REM sleep

There is decreased short wave sleep in elderly

Will put some more up in a bit if my brain permits

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I think the College spied on superegocafe question bank, hence the drastic reduction in repeat questions this time around.Webmaster could you deny the college access please.

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Some more ISQs

Ethology field studies show that populations of the same species in different areas show different skills

Shoplifting is likely to be repeated if associated with mental illness

25% of prisoners have epilepsy

Arson is likely to be repeated if associated with epilepsy

Platelet 5HT binding is decreased in depression

Lower social classes are more likely than middle social classes to develop depression following a life event

In schizophrenic adoptees the biological parents have a higher frequency of delusional disorder than adoptive parents

Heritability for bipolar disorder is 65%

Impulsivity is not associated with Prader-Willi

Lesch-Nyan is a sex linked disorder

Fragile X is associated with repeats on the short arm of the X chromosome

EEG shows exaggerated spikes in Huntingtons

One third of old age depression becomes chronic and unremitting in nature

Early onset is a bad prognostic factor for anorexia

Short time from onset to presentation is a good prognostic factor for anorexia nervosa

Family therapy is more effective than individual CBT for anorexia nervosa in under 18s

A binomial distribution will approximate to a normal distribution if the sample size is large enough

A binomial distribution will be more symmetrical if p is much greater than 1-p

Deliberate self harm in an adolescent girl usually occurs immediately after an episode of parental criticism

Pindolol blocks pre and post synaptic 5HT receptors

Restriction of sexual contact is part of sensate focus

Social judgement decision making is spared in lesions to the ventromedial frontal cortex

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Gaze avoidance is characteristic of fragile x

concrete operational thinking is protective against depression in children

Lack of empathy is characteristic of Asperger's

Partner abuse is more common in family with teenage children than a family with young children

In domestic violence the women hits first 20% of the time

Amitriptyline in old age depression is associated with decreased nonREM sleep

if food is provided by an outside agent baboons will become less aggressive with time

dominant male baboons do not demonstrate submissive behaviour before they become dominant

In schizophrenic adoptees the biological parents have a higher frequency of delusional disorder (delusional psychosis) than adoptive parents

As a sample size increases the standard error will decrease

Restriction of sexual contact is used in behavioural sexual therapy


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Reduced fertility is seen in late onset paraphrenia

?type of EEG change is still apparent 2 months after ECT


Psychotherapy question

Match techniques to type of therapy (IPT, CAT, psychoanalysis)


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adversarial system is used in common law jurisdiction.

infanticide, on conviction, leads to sentence fixed by law.

leptin level increases in proportion to body mass index.

when mother remarries, girls are more likely to be distressed than boys.

2 stems on semantic demantia.

lots of stems on findings of first british psychiatric morbidity survey; sorry cant remember. old one about suicidal ideation was repeated and thats the only one retained in my mind :D

EMIs : one on EEG in old age

one on choice of antipsychotics ac/to clinical


i wish i could recall more. will come back later if managed to.

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globus pallidus is part of the limbic system

i am so dazed i can't remember any questions.

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I work in Birmingham where Prof. Oyebode, the Chief Examiner, also works - I have been told that he is very aware of the fact that many of the questions are on the net - however, the philosophy of the college is that this does not really matter, as those who are likely to get them right will get them right any way and those who are likely to get them wrong will get them wrong any way!??

Apparently, they also have quite a detailed algorithm for marking the ISQs - questions that most people get either wrong or right are excluded from their analysis. Questions that good candidates get wrong but bad candidates get right are also excluded and vice versa.

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I went to a talk given by Prof Oyebode and he was asked about the fact that a lot of the mcqs were circulating. He said it was irrelevant if you have a big enough bank of questions and that only the good candidates will be able to learn the right answers and remember them!


Other isqs about the first british psychiatric morbidity survey as best as I can remember:

It found that 60% of people with psychosis had not had their quality of life impaired in the last 1yr (or something like that)

It found that (?%) of people with mental health problems were in contact with psychiatric services

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Please change if I am wrong

1.EEG changes

Slowing of ' @ rhythm

Fast delta rhythm

Fast beta rhythm

Match the following conditions withthe EEG changes

A 72 year woman with loss of memory for the last 9 months







The following receptors are involved with the above medication

5HT3 antagonist

Dopaminergic agonist ?




Flupenthixol depot

Haloperidol depot

Olanzapine tablets

A 25 year old patient has already been tried on risperidone and olanzapine with no effect

A35 year old patient has been non compliant with medication...........

A 72 year old woman has assaulted staff at night....



Urinary drug screen


A 25 year old regular herion user comes to your clinic and says that he wants to stop taking it and start on methadone

A regular methadone clinic patient during the clinic toime slumps on the chair and becomes unconscious

A regular heroin user says that he is going to abstain from taking heroin from now

5A strange question on

Chi squared test

Mann Whitney U test

Fishers test

Paired t test

t test

A child calculation of IQ and height ? Does anyone remember this ques

6Paternal deletion of chromosome 15q....

Maternal deletion of 15q...

Normal tau protein

A young man eating excessively and has mild learning disability


Adolescents have a diasagreement with parents immediately before an overdose

Persuasive communication increases if person stands close

Anorexia has a good prognosis if less time between onset and treatment

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People with learning disabilities have higher conviction rate than general population

Exhibitionists who touch or harass their victims have higher reconviction rate

In MET action phase is the righ ttimre to start detox /acamprosate

Heritability of conduct disorderis.1-.2

Waxy flexibility ( flexibilitas cerea) occurs in encephalitis

Akathisia is a side effect of amphetamines


Pregnancy and medication

Ebsteins anomaly

Neural tube defects

facial abnormalities

Renal abnormalities

A woman on lithium comes for prepregnancy counselling

A woman on valproate

A woman on fluoxetin

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Basic sciences:

Can anyone tell me where you could find a comprehensive book to cover the stuff they asked?

Clinical topics:

I'm looking forward to treating baboons......... ???

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i dont think the type of questions asked would be avilable in any book (esp. in the basic sceinces paper).

some of the questions were repeats but still couldnt find the answers in spite of going through psychology/social psychology books.

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another option in EMI on pregnancy and medication:

floppy baby syndrome

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ISQ's on caffein and clozapine interacting.

Caffeine and false positive dexamethasone suppression test.

Caffeine and benzo's.

Angelmans and the age that definitive EEG changes happen (something like ; at birth EEG is normal but by age 1 there are definite EEG's changes).

Tuberous sclerosis came up.

Prader Willi and self mutilation.

Something to do with Williams syndrome.

Screening for galactosamia can decrease the amount of mental retardation.

There was a question about PCR needing thermostable ENDONUCLEASES (i.e. False).

In transcribing mRNA the exons are spliced out.

Alpha babboon males use more appeasement than non dominant ones.

Was so exhausted, demoralised, and upset by ISQ's couldn't remember that many.

Even the DST and caffeine - looked up papers - apparantly acute large doses in non-caffeine users can cause non-suppression but chronic use doesn't... so even armed with this fact wouldn't be sure how to answer it.

The only thing I can say is that I don't feel guilty about inadequate preparation because I could have studied twice as much and not made much difference!

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I so hated the isq s. In the middle of the basic sciences paper I felt whats the use of even trying to guess-I probably would have been better off putting all trues or something..........anyway some of the isqs that came up are---(please feel free to correct them)----

1.head of the babbons being more agressive ???

2.apparently in a 15mnth old baby, according to AAI,a child who refuses to open their arms to their primary caregiver when she comes back is a sign of insecure attachment..they had two questions onthe same topic

3.some sort of association with piagets formal thought disorder

4.kraeplins mixed state includes depression with flight of ideas

5.a third of late onset depresson in the elderly follow a nonremitent and poor prognosis.

6.cognitive consonance is imperative for problem solving a minority group an allel of two(one agreeing and the other disagreeing)are important to change the group thinking

8.they asked about one of the yaolms factors

9.there was a question about transference that it had to resolved before starting a therapy...something like that

10.interaction of st johns wort and contraceptions :)

.....this is all for now...will get back with a few more later...have fun....

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