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Lets solve Autumn '06 ISQs (over 60 recalled !)

42 posts in this topic

This bright spark Oreta seems to have an amazing memory and recalled these qustions accurately from the exam I sat. Pretty good chance of seeing alot of them in Spring '07.

Lets go !

Memantine is a NMDA agonist.

- According to the receptor profile of Clozapine, it should cause less hypotension than other antipsychotics.  

- Reboxetine is a pre-synaptic alpha-2 antagonist

- Atomoxetine is a Noradrenaline reuptake inhibitor

- People with Aspergers have usually an IQ below 70

- 80% of chlidren with autism will have an IQ below 70.

- 50% of dementias in old age are Lewy Body

- Giving up smoking decreases the efficacy of Clozapine.

- According to the CATIE study, the metabolic syndrome is exagerated in Olanzapine, compared to other atypical antipsychotics

- 60% of children with learning disabilities have Pica

- Pica responds well to antipsychotic medication

- Diminished responsibility is a concept that originates from the McNaughten rules

- Late stages of CJD may show a normal CT  

- Alzheimer's disease can present with normal CT at postmortem (?)

- 5-HT3 effects its action through an ion gated receptor

- Men who abuse alcohol are more likely than women who abuse alcohol to develop Wernicke's encephalopathy.

- In adopted subjects who develop schizophrenia, biological parents are more likely to have a personality disorder than the adoptive parents

- Hypersalivation with Clozapine is caused by interaction with Muscarinic (anticholinergic) M3 receptors

- Lamotrigine is better than Lithium in the prevention of Depression in Bipolar Affective Disorder

- In Bipolar Disorder, depressive episodes become more frequent as the illness progresses

- In ADHD, behavioural + pharmacological treatment is more effective than pharmacological treatment alone

- Open injury affecting the right parietal lobe can cause... (disinhibition?)

- Night terrors occur on phase 3 and 4 of non-REM sleep

- Specific reading difficulty in children is associated with specific writing difficulty

- The incidence of specific reading difficulties in children is 1%

- Fluoxetine increases plasma levels of Clozapine

- Naltrexone is an opioid antagonist

- Naltrexone is effective in the relapse prevention for alcohol dependence

- Acamprosate has a similar action to Glutamate  

- Non-pharmacological treatments in dementia delay institutional care

- Most adults wtih severe Learning Disabilities are in institutional care

- 49/50 is the cut off between mild and moderate Learning Disabilities

- Melatonin is a naturally occurring (imidazole?) derivative.

- Suicide in the elderly is mainly due to suicide

- Studies suggest that response to ECT is long lasting

- Several studies have linked the MMR vaccine to autism

- MMR vaccine is contraindicated in children with autism

- A high frequency EEG is characteristic of Huntington's

- In Huntington's disease there is a similar recreased memory in all decades of life

- A pregnant mother can transmit Mumps to her unborn child, which will cause the child to develop learning disabilities

- ICD-10 has a wider definition of hyperactivity disorder than DSM-IV, which accounts for a higher diagnosis of this condition when using ICD-10.

- Oligoantigenic therapy has been proven to work in children suffereing from ADHD

- Shoplifting is more frequent in women than men

- Shoplifting is associated with OCD

- In girls with Turner's, when the X chromosome originates from the father, the incidence of autism is similar to boys of the same age

- Marfan's syndrome is associated with self-injurious behaviour

- Amenorrhoea is a known effect that accompanies Bulimia

- Studies show that antidepressants are more efficacious in severe than mild depression.

1/4 of elderly in-patients who suffer a mood disorder present with mania.

- Boys who shoplift are often experiencing a mental health problem (?)

- Truancy is often carried out in groups

- If one of the parents has a translocated chromosome, the child has a 50% chance to inherit it.

- Death of either parent in childhood is associated with psychiatric morbidity later life.

- Depression in the elderly is associated with (some gene or another that I can't remember).

- Face recognition of fear is mediated through the amygdala.

- Chromosome 22q is associated with an increase in the development of schizophrenia

- Vascular dementia is associated with Down's syndrome

- Rapid withdrawal of dexamphetamine can cause seizures

- Withdrawal of Diazepam can cause depression

- Visuospatial tests can differentiate pseudodementia from dementia

- Alcohol detox in the community should not happen unless the individual has already had a medically monitored detox (or something along those lines)

- The incidence of Ebstein's anomaly when a mother is being treated with Lithium during pregnancy, is 1 in 500.  

- In myasthenia gravis, anxiety attacks are a known cause of death

- The interaction be

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According to the receptor profile of Clozapine, it should cause less hypotension than other antipsychotics.

false----it cause same risk for hypotension as others i think.

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50% of dementias in old age are Lewy Body

false---i think its 15-20%

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visuospacial tests can differentiate between dementia and pseudo dementia

TRUE (google search)

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CATIE study shows olanzapine causes metabolic syndrome more commonly than others

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giving up smoking increases the efficacy of clozapine and the plasma level

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giving up smoking increases the efficacy of clozapine and the plasma level

false

it increases the level but not efficay i think.

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Memantine is a NMDA agonist. False it is an NMDA antagonist ( glutamate theory of excitotoxicity)

- According to the receptor profile of Clozapine, it should cause less hypotension than other antipsychotics.  False it has more alpha blocking

- Reboxetine is a pre-synaptic alpha-2 antagonist False it is a NARI

- Atomoxetine is a Noradrenaline reuptake inhibitor True

- People with Aspergers have usually an IQ below 70 FALSE

- 80% of chlidren with autism will have an IQ below 70. (Depends on if it is just Autistic disorder or the sperctrum disorder PDD)

- 50% of dementias in old age are Lewy Body False

- Giving up smoking decreases the efficacy of Clozapine. False Smoking induces enzymes. Stopping smoking should technically stop that and the efficacy should increase.

- According to the CATIE study, the metabolic syndrome is exagerated in Olanzapine, compared to other atypical antipsychotics TRUE Olanzapine was associated with the lowest overall drug discontinuation rate, and with the longest duration

of treatment, but also with the highest discontinuation rate due

to unacceptable or intolerable adverse effects, including weight

gain or metabolic effects.

- 60% of children with learning disabilities have Pica False 10% in hospital settings and 1 to 2 % have severe pica.

- Pica responds well to antipsychotic medication False There is no evidence to say that. Only anecdotal reports. Tricyclics like clomipramine also have been found to be useful

- Late stages of CJD may show a normal CT  True

Structural neuroimaging in CJD is usually normal or demonstrates only atrophy or nonspecific signal abnormalities in the basal ganglia on T2-weighted MRI images. Recently, hyperintensity in the basal ganglia and in the cerebral cortex on diffusion-weighted MRI (DWI) has been reported.

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hypersalivation with clozapine is caused by interaction with muscarinic M3 receptors.

(faise)

hypersalivation may be due to agonist activity at M4 receptors outweighing antagonism at M1, M2, M3, and M5 receptors(manchester notes)

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a high frequency EEG is characteristic of huntingtons disease (false) poorly developed flattened trace, loss of alpha

night terrors occur in stage 3 and 4 of non-REM sleep (true)

shoplifting is associated with OCD (false)

vascular dementia associated with down's syndrome (false)

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marfan's syndrome is associated with self injurious behaviour (false)

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specific reading difficulties is associated with specific writing difficulties (false)

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- Lamotrigine is better than Lithium in the prevention of Depression in Bipolar Affective Disorder

true

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- In Bipolar Disorder, depressive episodes become more frequent as the illness progresses

false (is`nt it true for depressive illness?)

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Good stuff folks ! Please include references to answers and clearly indicate if guessing.

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- Alzheimer's disease can present with normal CT at postmortem (?)  It depends... I think the question is non specific. If the patient dies in the early stage, the CT may be normal... and why would anyone  take a CT post mortem???

- 5-HT3 effects its action through an ion gated receptor  True 5HT3 is the only ligand gated cation channel among the serotonin receptors

- Men who abuse alcohol are more likely than women who abuse alcohol to develop Wernicke's encephalopathy.  [highlight]False[/highlight]

Wernicke's per se is more common in men. But this is probably because alcohol problem is more common in men. But... Women are more prone for all physical complications and brain injury... when combined with pregnancy and hyperemesis during pregnancy the risk multiplies

- In adopted subjects who develop schizophrenia, biological parents are more likely to have a personality disorder than the adoptive parents  ??????

Really difficult question. Schizotypal PD is shown to be more in relatives of schizophrenia. As well as SCHizotypal PD is shown to be higher in adoptees with biological mothers having schizophrenia... (Tienari study) but i did not come across any reference for the above statement...

- Hypersalivation with Clozapine is caused by interaction with Muscarinic (anticholinergic) M3 receptors  [highlight]False[/highlight]

M4 agonism and alpha 2 antagonism have been proposed as the mechanism

- Lamotrigine is better than Lithium in the prevention of Depression in Bipolar Affective Disorder  

Lamotrigine has been shown to be good in treating a depressive episode in Bipolar.....

Only a couple of controlled studies have shown that time to recurrence of depression is more in Lamotrigine... But I dont know if the evidence is convincing enough... moreover, Lithium is considered to be the only genuine mood stabiliser....

- In Bipolar Disorder, depressive episodes become more frequent as the illness progresses

[highlight]True[/highlight] especially the fact that Rapid cycling is more common in Bipolar II disorder... as the disease progresses, the frequency increases

- In ADHD, behavioural + pharmacological treatment is more effective than pharmacological treatment alone  [highlight]False[/highlight]

The MTA study (most definitive study to date on ADHD) quotes the following

'For ADHD symptoms, our carefully crafted medication management was superior to behavioral treatment and to routine community care that included medication. Our combined treatment did not yield significantly greater benefits than medication management for core ADHD symptoms, but may have provided modest advantages for non-ADHD symptom and positive functioning outcomes. ' Arch Gen Psychiatry. 1999;56:1073-1086.

- Open injury affecting the right parietal lobe can cause... (disinhibition?) False thought it was frontal lobe which caused disinhibition...  

- Night terrors occur on phase 3 and 4 of non-REM sleep  True

- Specific reading difficulty in children is associated with specific writing difficulty True

 

- The incidence of specific reading difficulties in children is 1% False around 4 %

- Fluoxetine increases plasma levels of Clozapine  

- Naltrexone is an opioid antagonist True

- Naltrexone is effective in the relapse prevention for alcohol dependence  [highlight]True[/highlight]

a number of studies have shown that Naltrexone delays the time to relpse to hazardous drinking

- Acamprosate has a similar action to Glutamate [highlight]False[/highlight]

  Acamprosate enhances [ch947]-aminobutyric acid (GABA) transmission and antagonizes glutamate transmission, probably by antagonizing N-methyl-D-aspartate receptors

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chromosome 22q is associated with increased risk of schizophrenia(false). actually chromosome 22q11 associated with di- georges syndrome 25 - 30% of all those with syndrome develop schizophrenia (Murphy BJPsych 2001)

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in myasthenia gravis anxiety attacks are known cause of death (false). anxiety attacks worsen the prognosis (manchester notes)

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1/4 of elderly inpatients who suffer a mood disorder present with mania(false) 5-10% of elderly suffer from mania. (manchester notes)

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chromosome 22q is associated with increased risk of schizophrenia(false). actually chromosome 22q11  associated with di- georges syndrome 25 - 30% of all those with syndrome develop schizophrenia (Murphy BJPsych 2001)

I dont know Di George syndrome... but Velo cardio facial syndrome has been linked... I dont know if its another name for Di George...

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dear doriannevergreys

In ADHD, behavioural + pharmacological treatment is more effective than pharmacological treatment alone

i would say true because thats what we do most of the time in real practice.

The incidence of specific reading difficulties in children is 1%

this was revealed in a study in japan which was replicated in usa.

where did u get 4%?

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'In ADHD, behavioural + pharmacological treatment is more effective than pharmacological treatment alone.'

I think they're getting at the MTA study - multimodal treatment study of children with ADHD - which showed that medication and behavioural treatment combined was more effective than just medication when both were compared to behavioural treatment alone. However direct comparisons between the combined treatment and the medication alone treatment showed no significant differences. So in answer to the above question, the answer is false if you're comparing combined against pharmacological and true if you're comparing each type of treatment against behavioural treatment.

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PS This doesn't mean you need to know every study in existence, it's just that this one crops up time and again in child psychiatry.

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