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Feedback on Part II ISQ/EMI paper Autumn 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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Superego site is the best site for revision for examination. There is no doubt about it.

Basic Sciences paper nearly 60% was from questions already on superego site.

The EMIs were as follows

1. Drug complications in pregnancy

Lithium - Ebstein anamoly

Sodium valporate - craniofacial abnormalities, bleeding and neural tube defects

Paroxetine - irrtability in the newly born infant

2. Drugs

Cocaine, amphetamine and caffiene causes siezures, hypertension and confusion

LSD and mushrooms cause a bad trip

Volatile sovlents also causes tachycardia etc

3. Phenonmenology

Cotard syndrome

Caouvode syndrome

Capgras syndrome

4. Genetics

Retts disorder

Fragile X

Praidel Willi

5. Clinical vinegettes

Neurosarcoidosis - the clue was the lesions on the shin and respiratory problems - erythema nodosum

Postenecpahhatic psychosis

Huntington disease


1. Statistics

2. EEG

3. Neurobiology in dementias

4. Drug interactions

cimetidine - causes hypotension in patient with clozapine due to enzyme inhibition

flouxetine reduced effect of some drug

metochlorpromide caused dystonia in a patient having lemon juice.


There was only one question on baboons this time - it was already on this site.

Again conduct disorder heritablity 0.1 - 0.2

There was a again a question on mixed states on Kraplein - mania and depression ; is that a mixed state

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This question from today's clinical topics paper must surely rival the baboons for relevance to everyday psychiatry:

CJD is most common in Libyan Jews who emigrate to Israel

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Especially in the basic sciences paper, a lot of the questions were word-for-word copies of those posted on this website. Only one on baboons though.

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A note on the emis...tricky as always..the stems were deceptively simple, but the instruction at the bottom of the choices before the actual questions were crucial to understanding wht they were looking for(not that i found it!  :lol:)

cant resist one emi we laffed over

masturbatory reconditioning is used as part of aversive therapy for fetishism or somthing akin to that

5ht 3 is ionotropic gated

eysencks personality corresponds to fifty percent of some thing

and an emi abt a stupid fuckin budgerigar which i believe is a type of parrot-the point is crucial to the answer as there was a syndrome of misidentification of places and people-guess most got it right anyways

a quote for the occasion-people who drink to drown their sorrows should be told that sorrow knows how to swim...until results good luck all


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Crazy........... that's all I can say.

Totally irrelevant to the practice.

Critical appraisal....... I want to take a random sample of those who set the exam , stratify them and take their cox regression and ask them to do the exam in 90 minutes.......... 'THAT SHOULD GIVE US THE MEAN'

no choice, wait and see....... 3 weeks

Good Luck everyone..

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The Basic Sciences werent too bad,however found it very difficult to sustain attention through the clinical paper-made some major blunders there-

the emi on clinical scenarios and medicn-clozapine,quetiapnie,procyclidine,metoclorpromide etc was it establish side effects of meds or mx of condn -i interpreted it as how woild you manage the clinical scenario with the given options of meds,however an earlier response-by???? states what was causative-


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hi ---> relax

its true, the emi stem had a catch as i mentioned earlier, i e in that particular emi, the choice LED to the clinical situation, and wasnt the solution was it.....sorry, but thot letting u know was better than the torture of speculation

in another stem, the choices had to be fitted to a five year old child with possibility of autism, ie u had to consider comorbidity/family history such as ocd etc..dont remember the half of forgetting at work i guess


CJD question relevance--->It is where the Prp mystery was unravelled! This is just a postmortem, and i had no bloody clue abt it in the exam if thats any comfort! A cut and paste follows

At the time Cuille and Chelle described the transmissionof scrapie in sheep, the high incidence of familial (f) CJD insome families had already been recognized. Some 20 yearslater, transmission of CJD to apes was accomplished by inoculation of brain extracts prepared from patients whohad died from CJD (Gibbs et al., 1968). Epidemiologicalstudies designed to identify the source of the CJD infectionevidenced geographical clusters. For instance, Libyan Jewsliving in Israel developed CJD about 30 times morefrequently than other Israelis (Kahana et al., 1974); someresearchers proposed that the Libyan Jews had become infected with CJD by eating lightly cooked brain fromscrapie-infected sheep before emigration to Israel. How-ever, it was subsequently shown that the Libyan Jewishpatients carry a mutation at codon 200 in PRNP, the geneencoding PrP

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i found the basic sciences ISQ easier than the clinical questions..probably because a lot had been picked up from the question bank here.

still one has to ponder what is the relevance of those absolutely irrelevant questions to us as trainee or practising psychiatrists?

anyways its time now to 'get back to life and start living again'!!!

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ISQs I can remember:

Alexia without agraphia is consistent with lesions in the anterior cerebral artery territory.

Women are better than men at inferring mood from facial expression around the eyes only.

Facial expression conveys more about depressed mood than tone of voice.

Dominant male baboons in a stable group show the most aggression.

Reading disorder is found in 20% of school children in the UK.

Reading disorder is found in 1% of school children in Japan.

Fragile X is caused by a CAG repeat on the X chromosome.

Something about Angelman syndrome and chromosome 15.

Autism is associated with epilepsy in adolescence.

Conduct disorder is associated with mood disorders in adulthood.

Donepezil is an anticholinergic.

Attempted suicide in the elderly is more common in men than women.

School refusal is more common in boys than girls.

The risk of postpartum psychosis is 20% if there is one previous episode of postpartum psychosis.

Maternity blues are present in 50% of mothers.

Carbamazepine is associated with hypothyroidism.

Edinburgh postnatal depression scale is self-completed.

Something about a reparatory grid.

Something about the difference between Hamilton and Beck scales.

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Here are some of ISQs I could remember. Wordings are not exact. Ignore typos.

wdj_abey ;)

In fragile X syndrome fragile site is in the short arm

Autistic adolescents have high incident of fits

Having a relative with the disease is the major risk factor for schizophrenia

In Parkinson’s disease there is increased synuclin in caudate nucleus

Lithium level increases with ACE inhibitors

Lithium level increases with Fluoxetine

Olanzapine causes DM only in doses above 20 mg

5HT3 is an anion channel

D1 and D5 belong to same family

Trail making test is a test for memory functions

Stroop test is for checking attention with interferences

Personality changes before memory changes suggests Picks rather than Alz.

Urinary incontinence suggests vascular dementia rather than Alz.

Having a seizure is more suggestive of Picks than Alz.

There is increased incidence of schizophrenia in LD

1% of Japanese children have dyslexia

Juvenile delinquency reported in More than 10% of British urban teenagers

A typical British 14 year old boy will use solvents in next 6 months

Household survey found 1% of adults had suicidal ideation in the preceding week

Object constancy occur before the onset of stranger anxiety

In negative symptoms there are reduced prefrontal functions

In OCD, there is increased glucose metabolism in caudate nucleus

At least 5% of asparagus have obsessional al ruminations

Admission is essential in an elderly with delusional disorder

No association between late onset schizophrenia with paranoid personality disorder

Implicit memory is preserved in Korsakov’s

Reboxetine blocks alpha 2 receptors

Donepezil is an anticholinergic drug used in dementia

Rivestigmine is a butylcholine esterase inhibitor

Memantin is a NMDA agonist

Acamprosate is an NMDA antagonist

In delusional disorder in elderly there is equal

prevalence of visual and hearing impairment

Planum temporale is in the anterior part of inf. Temporal gyrus

Alexia without agraphia occur in anterior cerebral artery lesions

Amenorrhea is a recognised complication of Bulimia Nervosa

? increases food intake in eating disorders

In autism IQ is less than 70%

Clozapine is expected to cause less post. hypotension when its receptor functions are considered

In ADHD , drugs and behaviour treatment is better than drug treatment alone

Visuo-spatial functions can differentiate depressive pseudo dementia from dementia

DSH more common in elderly men than women

Adolescent girls have more depressive cognitions than boys when they grow up

School refusal is more common in boys

Truancy is commonly associated with anti-social behaviour

There is increased incidence of Alz. In cerebral palsy

One third of women develop blues after normal delivery

There are less depressive symptoms after breast preserving surgery than radical mastectomy for ca breast

Preop. Anxiety worsen the outcome after CABG

Vomiting is a poor prognostic sign in AN

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It was reassuring to see so many familiar ISQs most of which are on this site. There was more time to ponder over the rest.

These two were repeated but with a twist:

Atypical facial pain (odontalgia) is characteristically associated with TMJ problems

TCAs commonly have periferral neuropathy as a

side effect in the elderly

And this appeared to be a very odd question:

A psychiatrist who is instructed by the prosecution to provide a report in a capital (death sentence) case should refuse to do so

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Repertory grid is used to measure attitudes

Angelman syndrome is due to a paternal deletion on chromosome 15

The difference in the results of the Beck Depression Rating Scale and the Hamilton Depression Rating Scale is due to the tests being administered differently (sorry can't remember exact wording)

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mcq's were a bit of a joke, but the emi's must have been the most difficult that i have come across so far - shocker.

my favourite mcq of the exam:

A psychiatrist who is instructed by the prosecution to provide a report in a capital (death sentence) case should refuse to do so.

:o ??? :-X

i would love to meet the moron who put that in, actually i would like to testify in a capital case against him.

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A listener is less likely to interrupt if the speaker re-establishes gaze.

Means of large samples from a skewed distribution will approximate to a normal distribution.

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ESQ were not too bad but the EMI?? What on earth was that about EEG and different condition?

I remember the options of EEG such as normal EEG, alpha changes, beta changes, diffuse slowing, spikes and waves etc but the conditions were not very clear: first one was an elderly chap with recent bereavement, weight loss and a belief of having cancer or something like this. I thought that he is most likely to be depressed and hence could have normal EEG.

The other one was elderly woman who was getting lost and had a nine- month long history of memory impairment. The last one was again elderly man with episodic shoplifting, aggressivenenss and mild memory impairment. I dont even remember what I answered! ???

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Term neurasthenia is retained in ICD10

Relatives of a patient with depression have increased genetic risk for alcoholism

Something about exons and protein synthesis

HIV infects brain through macrophages

In impotence due to organic pathology masturbatory erections are diminished

Mood is better judged by looking at eyes rather than from the sadness in the voice

Eysenk’s personality dimensions have correlation of 50% with something social

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Some of the MCQs were: Statements are not likely to be exact same as in the exam, so please run your imagination wild in modifying / completeing them! :P

1. 12 yr old girl complains of repeated sexual abuse by her father. ______Interview using ‘’anatomically correct’’ dolls would usually be done.

2. 12 yr old girl complains of repeated sexual abuse by her father. You would immediately secure an Child Protection order for her.

3. Specific reading disorder rates in school children in Japan is about 1%.

4. Specific reading disorder rates in school children in England is about 20%

5. Heritibility in Conduct Disorder is about 0.1 – 0.2 %

6. Repetitive self harm happens in ASPD

7. Females are better than males in reading facial expressions of a person just by looking around the eyes only.

8. Amygdala is involved in above-mentioned exercise.

9. Truancy is associated with ASPD

10. Girls with juvenile delinquency have higher rates of psychiatric illnesses than boys.

11. % of 14 years old boys in England who would use volatile substances is about once in 4 months

12. Plenum temporale is situated on anterior part of inferior temporal lobe.

13. Sign test should not be used below 20 observations

14. Visual and auditory deficiencies are similarly distributed in old age patients with delusional disorder.

15. &nbsp:lol:eaths in old age males with delusional disorder are due to alcohol.

16. Seizures in tuberous scleroses.

17. Alien hand sign

18. Keeping in perspective Social power, reward power is seen in family than coercive power.

19. Positive response is more likely to be seen

20. Fahr’s syndrome

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just to add to question 19 above left incompleted:

Being tall is associated with more chances of getting a positive response from others....

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Suffocation alarm theory of anxiety is that some people have hypersensitive suffocation centres

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The ones I scribbled down

1) sign test can be used on small samples

2)sth on facial expression around the eyes and women being better at interpreting it

3) again emotions around the eyes having sth. to do with amygdala

4) dominant baboons show the highest level of aggression in stable hierarchies

5) According to Eysenck's theory, extraverts are more conditionalbe

6) person's perceived tallness creates positive attitude towards him

7)in the absence of autocratic leader, workers act disruptively

8)Krawiecka-Manchester test is self-reporting

9)differences between scores in Becks and Hamiltons are due to the way they are applied?

10)fluoxetine increases clozapine levels

11)according to piaget's theory, experiences are stored as cognitive constructs?

12) low IQ is a recognised risk for schizophrenia

13) poverty doubles depression risk in women (single women?)

14)two questions about in-group/out-group theory-in-group is perceived as more homogenous

15)reboxetine is alpha2 antagonist

16) NA antagonism increases pressure on alpha 2 receptors

17) sth on attitude measures- semantic?


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I have a story:

28/9/2004-I was anxious about a CJD question that made me open up Lishman, then a sentence saying something like 'there is a high incidence of CJD in Jewish Libyan migrants to Israel' caught my eye and I said 'hmmm that's interesting'.

29/9/2004-I was still upset from my critical appraisal paper and essay paper until I saw an exact statement as above-that's the use of my ?£60 Lishman.

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