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DK14

BEGIN THE BATTLE

138 posts in this topic

I am planning to appear for the part 2 in september

Is there anyone interested in making a group in this forum.

I would like to make an informal beginning by

solving 10 ISQs per week(that is all I can cope with, right now)

With time, increasing the number.

Also, would like to begin looking at critical appraisal

but not sure how, especially in the forum.

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Hello there

I am beginning with the past papers in this website.

AUTUMN 2004

first 10 questions for 20-4-05 to 27-4-05

1. The plenum temporale is situated on the anterior part of inferior temporal lobe

2. HIV enters the brain via infected macrophages

3. seizures are seen in tuberous sclerosis

4. Atypical facial pain (odontalgia) is characteristically associated with temporo-mandibular joint problems

5. In impotence due to organic pathology, masturbatory erections are diminished

6. Alexia without agraphia occurs in anterior cerebral artery lesions

7. In alexia with agraphia naming errors occur

8. Broca's aphasia results in short phrase sentences

9. Complications of Tay-sachs disease can be prevented by diet restriction

10. CJD is most common in Libyan Jews who emigrate to Israel

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3. seizures are seen in tuberous sclerosis

TRUE

also called EPILOIA

autosomal dominant

genes, TSC1 & TSC2

cli.fea: epilepsy......

LD in about 70%. more with TSC2

Ref: shorter ox.te.psy. page 879

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Hello again,

I am slightly worried to see no posts.

Is it too late to say 'I am beginning to study for

part 2'?

anyway,

7) In alexia with agraphia naming errors occur

TRUE

In alexia with agraphia, person cannot read or write.

usually accompanied by some degree of nominal dysphasia, dyscalculia, spatial disorganisation or visual object agnosia.

lesion is in the ANGULAR GYRUS and adjacent SUPRAMARGINAL GYRUS of the DOMINANAT PARIETAL LOBE

ref: ORGANIC PSYCHIATRY - LISHMAN

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uh. at last some one did reply

thank u very much.

next 10 questions will come on Thursday from

one of the past papers.

Feel free to suggest and change plans.

Feels really positive to have company to prepare

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i would like to join as well. I will try and solve some of the questions which came this spring ,would that be ok?

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That is perfectly fine I think.

Perhaps what we could do is to fix THURSDAY of the

week as the day to post questions or exercises or whatever u want to call it and give ourselves a week until the next Thursday to solve them with references please.

In a couple of weeks or so, we will be able to increase either the amount of questions or the frequency of it.

I feel it is important to keep it uniform so that we know which day new exercises come. otherwise it can get overwhelming and fall apart.

It is possible that all those people who want to join the group might want to post some questions and this can effectively increase the number of questions that need to be answered in that week. Hence, it is important to structure the time when we can expect new questions.

are u both happy with the above and agreeable to fixing THURSDAY as the new set of questions day.

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yeah,but i will be posting questions late at night and the a wk to solve them sound fine to me

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great.

would anyone of you post answers to some more questions that were posted last thursday please.

with references is important

I shall post some more questions tonight.

feel free to post what u want to be solved this week. we shall try and do all of them by next week.

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.4) Atypical facial pain (odontalgia) is characteristically associated with temporo-mandibular joint problems

FALSE

Atypical odontalgia: a review of the literature.

Melis M, Lobo SL, Ceneviz C, Zawawi K, Al-Badawi E, Maloney G, Mehta N.

Atypical odontalgia is one of many painful conditions that affect the oral cavity and is often overlooked in the differential diagnosis.

The typical clinical presentation of atypical odontalgia that has been reported involves pain in a tooth in the absence of any sign of pathology; the pain may spread to areas of the face, neck, and shoulder. The existing literature suggests that this condition occurs in 3% to 6% of the patients who undergo endodontic treatment, with high female preponderance and a concentration of cases in the fourth decade of life. Deafferentation seems to be the most likely mechanism to initiate the pain, but psychological factors, alteration of neural mechanisms, and even an idiopathic mechanism have been implicated.

The treatment of choice is a tricyclic antidepressant, alone or in combination with a phenothiazine. The outcome is usually fair, with many patients obtaining complete relief from pain. Especially in the absence of overt pathology, particular attention should be paid to avoiding any unnecessary and potentially dangerous dental intervention on the teeth.

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10. CJD is most common in Libyan Jews who emigrate to Israel

TRUE

The majority of cases are sporadic (85%), between 10-15% are familial and the remainder are iatrogenic.

CJD occurs worldwide with a roughly even incidence of between 0.5-1.0 cases per million per year.

Higher rates (upto 100-fold) have reported in Slovakia and Libyan-born Israelis but this is explained by the high incidence of a certain mutation of the PrP gene in these groups.

The geographical distribution of CJD in the United Kingdom over the past 25 years demonstrates no overall evidence of spatio-temporal aggregation of cases, despite the occurrence of local areas of relatively high incidence over short periods. There is no evidence of case to case transmission and spouses of sporadic cases do not have an increased incidence of the disease.

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8. Broca's aphasia results in short phrase sentences  

TRUE

The phrase length is short, and the style may be abbreviated and telegraphic with omissions of words, but the speech that does emerge is meaningful.

In most severe examples the patient may have only one or two words at his command. Total loss of ability to speak is not seen however, and the occasional speech sound can usually be discerned.

Ref: ORGANIC PSYCHIATRY - LISHMAN

Sentence length is short. Average utterance length (MLU) is typically about 2.

Ref:The Neuroscience on the Web Series:

CMSD 336 Neuropathologies of Language and Cognition

CSU, Chico, Patrick McCaffrey, Ph.D

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Will join you brave souls revising in public :-[

Question 7 Complications of Tay-Sach disease can be prevented by diet restriction.

Autosomal recessive defect in hexosaminidase A causes increased lipid storage. This leads to progressive loss of vision& hearing, spastic paralysis, myoclonus,cherry red spot at macula, epilepsy, death by age 2-4. More common in Ashkenazi Jews. Can't find answer to question but would speculate lipid restriction might delay onset but not prevent complications. Source shorter oxford textbook of psych, synopsis of psychiatry Kaplan and Sadock. Neurology and neurosurgey illustrated.

Could we maybe theme questions? So we're reading generally within same subject rather than random fact gathering.

Question 1 Haven't a clue where plenum temporale is can some one enlighten me?

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5. In impotence due to organic pathology, masturbatory erections are diminished?

True

Erectile dysfunction, generally defined as failure to achieve and maintain an erection satisfactory for intercourse, is the most common complaint. The incidence increases with age, such that nearly 25% of men at age 65 are affected. There are many potential causes, and a careful history provides essential clues to the diagnosis. The manner of onset of erectile dysfunction, the degree of difficulty in attaining erection during masturbation versus with a sexual partner, a progression in the degree of dysfunction over time, and the presence or absence of nocturnal erections often distinguish an organic versus a psychogenic etiology. Typically, an organic etiology shows a gradual onset with progressive dysfunction over time, equal difficulty with a partner or during masturbation, and a loss of nocturnal erection. Psychogenic impotence more typically shows an abrupt or stuttering pattern of erectile dysfunction without a gradually progressive pattern, a situational pattern of erectile dysfunction, or maintenance of nocturnal erections.

Adult & Pediatric Urology

Editor(s): Gillenwater, Jay Y., Grayhack, John T., Howards, Stuart S., Mitchell, Michael E.

4th Edition © 2002 Lippincott Williams & Wilkins

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1. The plenum temporale is situated on the anterior part of inferior temporal lobe

False

Certain brain functions, such as language, are localized to one hemisphere . The structural bases for the lateralization of function have not been determined, but some anatomical differences between the cerebral hemispheres have been observed. For example, a portion of the superior temporal cortex, called the planum temporale (infolded cortex in the posterior portion of the sylvian fissure) , is generally larger in the left hemisphere than in the right hemisphere. That cortical area, which is located close to the primary auditory cortex and includes the region known as Wernicke's area appears to be involved in receptive language functions that are localized to the left hemisphere. In addition, Brodmann's area 44 in the left inferior frontal cortex contains larger pyramidal neurons than the homotopic region of the right hemisphere, a difference that may contribute to the specialization of Broca's area for motor speech function.

Kaplan & Sadock's Comprehensive Textbook of Psychiatry

Editor(s): Sadock, Benjamin J., Sadock, Virginia A.

8th Edition © 2005 Lippincott Williams & Wilkins

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2. HIV enters the brain via infected macrophages

False?

This virus primarily infects cells with a CD4+ cell membrane glycoprotein but may infect other cells that do not express CD4+. Two recently described coreceptors, CCR5 and CXCR4, appear to be necessary for HIV-1 entry into macrophage-tropic, non–syncytium-inducing strains and lymphocyte-tropic, syncytium-inducing strains, respectively. Once the virus enters the cells, uncoating occurs. A reverse transcriptase enzyme transcribes viral RNA into double-stranded DNA, which is inserted into the host cell chromosome. With activation of the cell by antigenic or viral stimulation, DNA transcription occurs and new viral particles are assembled at the cell surface. The infected cell then dies by mechanisms that are not clearly understood. Potential mechanisms for CD4+ cell destruction may include direct lysis, killing of progenitor cells in the thymus and bone marrow, syncytium formation between uninfected and infected cells, apoptosis (programmed cell death), and/or immune-mediated lysis.

Following the initial infection of monocytes, macrophages, and dendritic cells, virus disseminates through the bloodstream and lymphatics to the germinal center of lymph nodes. Most of the virus in the lymph nodes is extracellular and in the form of virus–antibody immune complexes. In lymphoid tissues, the frequency of HIV-infected CD4+ cells is approximately tenfold higher than in peripheral blood.

Kelley's Textbook of Internal Medicine

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6) Alexia without agraphia occurs in anterior cerebral artery lesions

FALSE

Also known as pure word blindness/agnosic alexia

the patient can speak normally and has no difficulty with comprehension of the spoken word. His difficulties with language are entirely restricted to his understanding of what he reads.

The lesion is of the LEFT VISUAL CORTEX WITH SPLENIUM OF THE CORPUS CALLOSUM

usual cause is occlusion of

LEFT POSTERIOR CEREBRAL ARTERY

Ref: lishman, organic psychiatry

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Slightly late but atlast there.

solved all 10.

Here is the next set.

FORENSIC (AUTUMN 2004)

1. The means of large samples from a skewed distribution will approximate to a normal distribution

2. The sign test can be used on small samples  

3. The sign test should not be used below 20 observations  

4. Krawiecka-Manchester test is self-reporting  

5. Shoplifting is highly likely to recur if associated with mental illness  

6. Rate of recurrence of exhibitionism is lower after the first conviction  

7. There is an increase chance of sexual assault if an exhibitionist touches the victim  

8. 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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hi Paul12

thanks for the answers

could u try and give the references please

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6. Rate of recurrence of exhibitionism is lower after the first conviction

False

Exhibitionism is the term commonly used to describe the sexual disorder that is characterised by an overwhelming desire to expose ones genitals or, less frequently, other parts of the body (Marshall, Laws, & Barbaree, 1990), to unsuspecting onlookers from a distance. Because of its non-consenting nature, such sexual deviation is classed as a form of paraphilia (Lefton, 1997).

Such individuals constitute about one third of all sex offenders, and show the highest rate of recidivism, estimated at 35%. As ironic as it may seem, studies have shown that such individuals have a tendency to commit even more deviation after conviction (Appendix 1).

http://www.uplink.com.au/lawlibrary/Documents/Docs/Doc81.html

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7. There is an increase chance of sexual assault if an exhibitionist touches the victim

False

Exhibitionism involves nonconsenting persons. Sometimes the exhibitionist masturbates while exposing himself or herself, but makes no further attempt at sexual activity with the stranger. An exhibitionist is not seeking physical contact and will not commit rape, although some rapists may show signs of exhibitionism as well. An exhibitionist is sexually aroused by the shock or surprise of the victim. Exhibitionist behavior frequently will occur around times of stress or when the patient has free time (Morrison, 1995).

http://cms.psychologytoday.com/conditions/exhibitionism.html

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5. Shoplifting is highly likely to recur if associated with mental illness

False

A survey of 1,649 shoplifting convictions at a Montreal area municipal court found that a relatively low percentage (3.2%) of the cases involved mentally ill patients and that there is a comparatively closer link between shoplifting and affective disorders, alcoholism and drug addiction. The survey also showed that shoplifting is related more to mental illness than to the use of psychotropic drugs. The authors therefore reject the hypothesis of pharmacogenic shoplifting which has been reported in some studies on small numbers of shoplifters.

PMID: 8044748 [PubMed - indexed for MEDLINE]

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