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Gurpal

Feedback on the Part 1 ISQ/EMI papers autumn 2007

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After the Part 1 ISQ/EMI paper, please post an account of your experience, good or bad. If you remember any questions, please post them, even if you think you're repeating someone else's post. Please do not discuss answers in this thread.

Thanks and good luck on results day!

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* most common cause of maternal dealth in UK is psychiatric disorders

* according to Beck a depressed person is less likely to make arbitary references

* dysthymia affects makes more than females

* rapid cycling bipolar is commoner in males

* fear of loud noises is regularly present in first year of life

* people who suffer from depression commonly experience personalisation

* short term memory has a span of only seven seconds

* anosgnosia is a feature of dominant parietal lobe lesion

* in Huntington's disease memory loss occurs late

* elementary hallunications occur more in visual modality

* margaret mehlar described separation individuation with practicing period

* syndromal classification occurs with criteria of continuity ( something like that )

* bleuler's 4A's of schizophrenia include mutism

* essential feature of erickson's development in old age is conflict of integrity

* olfactory hallucinations are more common than auditory in severe depression

* night terros occur in PTSD

* stroop test is specific for frontal lobe functions

* it is always necessary to make other people aware of when you go for a community visit

* escape training is helpful in dealing with punishment when punishment is not contingent on behaviour

* risperidone causes gynaecomastia

* memantine is NMDA agonist

* patients on TCA are more likely to stop drug due to side effects compared to patients on SSRI

* schizoid personality is associated with developement of schizophrenia

* dissocial personality disorder is the preferred term in DSM 4 for antisocial personality disorder in ICD 10

* emotionally unstable personality disorder in ICD 10 is the same as narcissictic personality disorder in DSM 4

* acute stress reaction according to ICD 10 lasts for 7 days

* adjustment disorder can result in severe dramatic and violent behavior

* dressing dyspraxia is associated with dominant temporal lobe lesions

* family with more than four children is more cohesive

* projective identification is a primitive defence mechanism

* months of year backwards helps in eliciting perseveration

* people with alexithymia have difficulty in expressing emotions

* in pseudobulbar palsy tongue is small with fasciculations

* factitious disorder is when someone believes that he has some specific disease

* DSM 4. the third axis is psychosocial factors

* buspirone can cause tolerance

* tricyclic antidepressants may cause hypotension

well as much as i can remember as of now

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* most common cause of maternal dealth in UK is psychiatric disorders

* according to Beck a depressed person is less likely to make arbitary references

* dysthymia affects makes more than females

* rapid cycling bipolar is commoner in males

* fear of loud noises is regularly present in first year of life

* people who suffer from depression commonly experience personalisation

* short term memory has a span of only seven seconds

* anosgnosia is a feature of dominant parietal lobe lesion

* in Huntington's disease memory loss occurs late

* elementary hallunications occur more in visual modality

* margaret mehlar described separation individuation with practicing period

* syndromal classification occurs with criteria of continuity ( something like that )

* bleuler's 4A's of schizophrenia include mutism

* essential feature of erickson's development in old age is conflict of integrity

* olfactory hallucinations are more common than auditory in severe depression

* night terros occur in PTSD

* stroop test is specific for frontal lobe functions

* it is always necessary to make other people aware of when you go for a community visit

* escape training is helpful in dealing with punishment when punishment is not contingent on behaviour

* risperidone causes gynaecomastia

* memantine is NMDA agonist

* patients on TCA are more likely to stop drug due to side effects compared to patients on SSRI

* schizoid personality is associated with developement of schizophrenia

* dissocial personality disorder is the preferred term in DSM 4 for antisocial personality disorder in ICD 10

* emotionally unstable personality disorder in ICD 10 is the same as narcissictic personality disorder in DSM 4

* acute stress reaction according to ICD 10 lasts for 7 days

* adjustment disorder can result in severe dramatic and violent behavior

* dressing dyspraxia is associated with dominant temporal lobe lesions

* family with more than four children is more cohesive

* projective identification is a primitive defence mechanism

* months of year backwards helps in eliciting perseveration

* people with alexithymia have difficulty in expressing emotions

* in pseudobulbar palsy tongue is small with fasciculations

* factitious disorder is when someone believes that he has some specific disease

* DSM 4. the third axis is psychosocial factors

* buspirone can cause tolerance

* tricyclic antidepressants may cause hypotension

well as much as i can remember as of now

Few suggestions i have about above questions

* fear of loud noises is regularly present in first year of life-I cant remember the word regularly in this question

* bleuler's 4A's of schizophrenia include mutismit was autism not mutism and there was no mention of 4As as if i remember correctly

* tricyclic antidepressants may cause hypotensionit was postural hypotension

* in pseudobulbar palsy tongue is small with fasciculationsi dont remember the word small in this

* adjustment disorder can result in severe dramatic and violent behavior i think the word commonly or something which denoted >50% was there in this

* dissocial personality disorder is the preferred term in DSM 4 for antisocial personality disorder in ICD 10the question was different cannot remember exactly

could others clarify on this please cheers. :)

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significant weight loss is caused by Fluoxetine

According to Margaret Mahler separation - individuation occurs in practising period

According to WAIS - R, 10 % of people have an IQ > 125

NART is used to test premorbid IQ

Mania can occur in Grief reaction

In persisitent delusional disorder, symptoms should be present for a month

Erikson's stage of industry v inferiority occurs in ages 6 - 11 yrs

I apologise that wording may not be as in the exam paper

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EMI - vaguely remebered.

EMI 1.

Lithium

Methadone

Lorazepam

Phenytoin

1. Which of the above is approximately 95% excreted in the urine

2. Which causes respiratory depression and heart failure in OD?

3. Which reduces the seizure duration

EMI 2.

Dissociative amnesia

Dissociative fugue

Dissociative motor

Head Injury

Korsokoffs

1. A man who appears in A and E saying he was mugged and hit his head 2 days ago in a town 50 miles away. he does not know his name or how he got here - but knows the date (list 2)

2. A soilder's arm does not move when in battle (list 1)

3 can't rember 3rd Q

EMI 3

Grief reaction

Pathological grief

severe Depressive without psychotic

severe depressive episode with psychotic

postnatal depression

Puerpial psychosis

a 65 yo widow who presents 5 months after the death of husband with low mood and poor sleep who has kept all husbands things and hears his voice calling her to join him

b. a young lady 2 weeks after baby is low in mood. Husband is worried as she appears connfused at times and appears to be picking things off the floor (???)

Anterograde amnesia

retrograde ammnesia

Confabulation

1. seen in a man during delirium

2. Seen in korsokoffs (list 2)

EMI 5

ABGs

CK

TFT

LFT

1. Young man with rigidity and fluctuating BP after being given ....

2. 65 yo healthy male who has smoked develops SOB

EMI - old repeat

cocaine intoxication

Cannabis dependency

LSD intox

Amphetamine

heroin intoxication

heroin withdrawal

1. starlet who is grandiose with nasal cogestion and dilated pupils

2. young man with persecutory ideas, blood shot eyes and cough

3. young man seeing colours in music

ISQ

1. Spirits are more likely to cause dependence than beer

2. about 5% of over 65s will develop TD after one year when commenced on a atypical

3. Closure and difference laws are found in gestalt psychology

4. 80% of patients with alcohol dependency have raised GGT

5. Acalculia is a feature of dominant parietal lesions

6. In Huntingdons, memory loss does not accur till late in the disease

7. Adjustment disorder is usually the result of of a severedramatic or violent event.

8. Elementary hallucinations commonly occur in the visual modality.

9. Hypermetamorphosis is seen in Kluver bucy syndrome

10 Hyperphagia is seen in Klein levin syndrome

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increased glutamayl transpeptidase has a diagnotic specificity in 70% of people with alcohol depence

(is this the same as gamma glutamyl transferase?)

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I recognised a lot of the questions but annoyed that there were some that I second guessed myself and got wrong!!

Among the questions that I can recall are-

Aripiprazole causes QT prolongation

Operant conditioning is involved in Reciprocal inhibition

TCAs can cause postural hypotension

Rapid cycling bipolar is more common in men

Dyspraxia is a feature of dominant temporal lobe

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EMI - vaguely remebered.

EMI 1.

Lithium

Methadone

Lorazepam

Phenytoin

[highlight]Haloperidol[/highlight]

1. Which of the above is approximately 95% excreted in the urine

2. Which causes respiratory depression and heart failure in OD?

3. Which reduces the seizure duration

EMI 2.  

Dissociative amnesia

Dissociative fugue

Dissociative motor  

Head Injury

Korsokoffs

[highlight]Briquett's (spelling might be wrong)[/highlight]

1. A man who appears in A and E saying he was mugged and hit his head 2 days ago in a town 50 miles away. he does not know his name or how he got here - but knows the date (list 2)

2. A soilder's arm does not move when in battle (list 1)

3 can't rember 3rd Q

[highlight](it was about a midle aged lady with a lot of physical complaints and normal investigations----suggesting Munchaussen's)[/highlight]

EMI 3

Grief reaction

Pathological grief  

severe Depressive without psychotic

severe depressive episode with psychotic

postnatal depression

Puerpial psychosis

[highlight]Mild depressive episode with somatic symptoms[/highlight]

[highlight]Moderate depressive disorder with Psychoatic / Somatic symptoms ?!?![/highlight]

a 65 yo widow who presents 5 months after the death of husband with low mood and poor sleep who has kept all husbands things and hears his voice calling her to join him

b. a young lady 2 weeks after baby is low in mood. Husband is worried as she appears connfused at times and appears to be picking things off the floor (???)

[highlight]c.a guy who has lost 1 stone in weight and loss of intrest in golf,heard boss telling him that he is worthless and does not deserve to live .... and some other features also [/highlight]

Anterograde amnesia

retrograde ammnesia

Confabulation

[highlight]Post concussion[/highlight]

1. seen in a man during delirium

2Seen in korsokoffs (list 2)

[highlight]3.Man with injury to head 50 miles away in another town,cant remeber his identity or the name of the town but can recall the date today[/highlight]

EMI 5

ABGs

CK

TFT

LFT  

[highlight]Prolactin levels[/highlight]

1. Young man with rigidity and fluctuating BP after being given ....

2. 65 yo healthy male who has smoked develops SOB

[highlight]3.Lady on antipsychotics complaining of ammenhorea [/highlight]

ummmmm dats about all i can remeber at present...would update once am more orriented  :P

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These are some of the questions (all of them are repeats from previous papers- slightly twisted).

Please accept my apologies if the wordings are different (also some might be my 'confabulatory' questions- nevertheless they will be good practice)

1. Chlorpromazine levels are increased by tricyclic antidepressants.

2. According to Becks, a depressed person is less likely to make arbitrary inferences.

3. &nbsp:lol:ysthymia affects more men than women.

4. Fear of loud noises usually is present in one year olds.

5. NART is used to test Pre-morbid IQ.

6. A syndromal classification comprises of criteria of discontinuity.

7. &nbsp:lol:yscalculia is seen in dominant parietal lobe lesions.

8. &nbsp:lol:epersonalisation is often associated with a distortion of time.

9. Adjustment disorder is characterised by persons who are dramatic and show violent behaviour.

10. Cotard syndrome is causally related to schizophrenia.

11. Protein bound drugs can more easily pass the BBB.

12. Psedobulbar palsy is associated with labile emotions.

13. In the UK, most causes of maternal perinatal deaths are associated with psychiatric illnesses.

14. The law of proximity and difference is involved in Gestalt theory.

15. Alcohol dependency is more likely with spirits than beer.

16. Hypnagogic hallucinations is a normal phenomenon.

17. Gait seen in cerebellar dysfunction is short, shuffling and slow

Parkinsons- small stepping + shuffling + less arm swing

Cerebellar- broad based + unsteady

UMNL- spastic + scissoring

Huntingtons- lurching + chaotic

Foot drop- High stepping

18. The active metabolite of psychotropic drug can cross BBB

19. Attribution theory says that people attribute their behaviour to their personality traits.

20. Sleep walking is an automatism.

21. One of Bleuler's symptoms of schizophrenia is autism

22. Habituation underpins generalization

23. According to Winnicott transitional object is the same as the good enough mother

24. The stroop test is a specific test for frontal lobe function.

25. Imipramine causes dry mouth due to blocking of peripheral muscarinic receptors

26. pre-operational is characterised by transductive thinking

27. At an initial interview with a psychiatric patient it is only appropriate to use open ended questions.

28. Personalisation is a cognitive distortion involved in depression

29. Insomnia is commonly associated with minor head injury.

30. Habituation is based on generalisation

31. Capgras syndrome has an organic cause in 50% of cases

32. Stressful life events precipitate a relapse in bipolar disorders rather than the first episode of the disorder

33. In interviewing, counter-transference can give some indications about patient's emotional experiences

34. Projective identification is a defence mechanism in paranoid-schizoid position

35. Trazodone has clinically significant antimuscarinic effects

36. &nbsp:lol:eveloping a warm relationship with the subject is part of functional analysis / assessment

37. Axis 3 of DSM-IV is concerned with Psychosocial factors

38. Alexithymia makes assessment of mood more difficult

39. In confabulation there are fragments of preserved memory

40. Self-Reference delusions are common in paranoid personality disorder

41. 10% of people will have an IQ greater than 125 on the WAIS-R

42. Parents of large family have good communication

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:-/ just recalled a few more,thought would post it here but remeber sum words mite not be right --- as am old  :P

1. Stressful life events are more important in the first episode of BPAD than relapses.

2. Patients with psudobulbar palsy show emotional lability.

3. Bleuler’s fundamental symptoms of schizophrenia include autism.

4. Personalisation is a cognitive distortion in depression.

5. According to Margaret Mehler,in the separation individuation period identity diffusion occurs.

6. According to Winnicot the transitional object is the good enough mother.

7. Attachment behaviour increases ieven if the mother is abusive.

8. According to Erickson’s stages,between the ages of 6-11 the crisis to resolve is Industry vs Inferiority.

9. &nbsp:lol:elusional perception may be preceeded by delusional mood.

10. Psychological deficits seen in Non-Dominent temporal lobe lesion include not being able to learn new words.

11. Insomnia is seen in mild head injury.

12. Sleep walking is a type of automatism.

13. Hyperphagia is a feature of Klien Levin syndrome.

14. Closed questions can be used in history taking.

15. A family with 4 or more children is cohesive.

16. &nbsp:lol:iplopia is a feature of Wernicke’s Syndrome.

17. The Stroop test is specific for frontal lobe syndrome.

18. Buspirone can cause tolerance.

19. Intentional tremor is a side effect of antipsychotics.

20. Highly ionized drugs pass the BBB easily.

21. Most children develop fear of starnagers in the first year.

22. &nbsp:lol:eveloping a warm relationship with the subject is part if the functional anylisis.

23. Therapists use introjection in family therapy.

24. In Confabulation there are fragments of preserved memory.

25. Alexithymia makes assessment of mood more difficult.

26. Lous noises induce fear in infants upto the age of 1 yr.

27. IQ>125 is found in atleast 10%.

28. A discripency of more than 15 points in the WAIS test between verbal and visual score indicates organic pathology.

29. Working memory if of 7seconds duration.

30. Egocentrism means the child keeps his needs before needs of others.

31. A patient can be safely advised to eat cheese two weeks following discontinuation of Phenalzine.

32. In DSM IV axis 3 is based on global scores of functioning.

33. Acoording to ICD10 acute stress reaction should be over by 7 days.

34. Attachment happens to provider of food only.

35. Mirtazapine inhibits Serotonin reuptake.

36. Hypnagogic hallucinations are a normal phenomena.

37. Increased jaw reflex is associated with psudobulbar palsy.

38. Weight loss is a recognized side effect of Fluoxetine.

39. Mementine is NMDA antagonist.

40. Acording to Erickson,old age is  associated with the crisis of integrity.

41. Perinatal Psycholocical problems are the cause of maximum peri-natal maternal deaths in UK / Europe.

42. Autoctonous delusion and delusional perception can be used interchangeably.

43. According to James Lange,emotions are interpreted from autonomic symptoms.

44. Most of the psychotropic drugs have metabolites that are inonized.

45. Smoking is a known risk factor for Alzeimers’s.

46. Capgras syndrome is (commonly ?!) associated with Shizophrenia.

47. Gestalt’s principle is associated with proximity and difference.

48. Alcohol dependency is more with spirits then beers.

49. Persistant delusional disorder is diagnosed when bizarre delusions are present for more than 1 month.

50. NART measures pre-morbid IQ.

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just a few more.........

51. Procedural memory is explicit.

52. Adoptive children do well if the information about their biological parenst is withheld until adulthood.

53. Vissual hallucinations are more common than auditory in alcoholic hallucinosis.

54. Frontal lobe syndrome is associated with topographic memory loss.

55. Paranoid personality disorder is characterized by excessive self importance.

56. Risperidone causes gynaecomastia.

57. Chlorpromazine levels are increased by tricyclics.

58. Olfactory hallucinations are more common than auditory ones in depression.

59. Rate of depression increases with age.

60. Escape training is helpful in dealing with punishment when it is not contingent on behaviour.

61. Its always important when doing assessments in community to let someone know where you are.

62. Acalculia is seen in Dominent parietal lobe lesions.

:-/

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