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Gurpal

Part II ISQ Club - Organic Psychiatry

17 posts in this topic

Starting from today, 10 ISQs on each of two topics will be posted twice a week, on Monday and Thursday. You are encouraged to post a reply in the thread, stating whether you think an ISQ is true or false and why (eg. a short explanation, with reference to the textbook you used). Please only deal with one ISQ in each post amd try not to dominate a thread. All ISQs are taken from previous posts by Forum members. By the time of the exam, we should have got through 500 ISQs.

1 The negative symptoms of schizophrenia are thought to be related to hypofunction of the pre-frontal cortex.

2 The anterior thalamus is affected in Huntington’s disease.

3 Lesch-Nyan syndrome can be successfully treated by diet.

4 Patients with Parkinson’s disease are impaired in set-shifting tasks.

5 Lewy bodies are found in 40% of patients with dementia.

6 Lewy bodies are found in Parkinson’s disease.

7 There is usually a greater fall of cortisol following dexamethasone in depressed individuals than in normal volunteers.

8 An inter-ictal EEG in automatisms typically shows 8Hz and 14Hz spikes.

9 In Alzheimer’s disease there is decreased latency in the evoked responses on EEG.

10 OCD is associated with increased blood flow in the prefrontal cortex and basal ganglia.

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Great idea.

1 The negative symptoms of schizophrenia are thought to be related to hypofunction of the pre-frontal cortex.

TRUE

Revision notes in psychiatry, Puri and Hall p259-260

- Functional brain abnormalities in schizophrenia - studies have found hypofrontality: associated with the presence of negative symptoms and autism.

- Combining functional imaging with task activation: impaired performance by schizophrenics was mirrored by smaller increase in blood flow to prefrontal cortex.

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2 false The main histological abnormality is found in the caudate and putamen, where there is extensive loss of small neurones, leading to shrinkage, and a false impression of gliosis, although such changes are found elsewhere. ( oxford textbk of medicine) 8)

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3 false ::)Most children affected by Lesch–Nyhan syndrome show verbal and physical aggression. However, more characteristic problems, which are resistant to management, are self-injurious behaviours which affect over 85 per cent of these children( ox TxBk of psy)

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8)web-guruji , xmas has improved your cortical flow, this is a splendid idea, my concern as always are the free loaders, any way of making sure everyone contributes :-/ :-/ :-*

:-[oops did not see your post about making it exclusive .

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6-true

lewy bodies presence is one of the pathological hallmarks in parkinson's disease.

ref,shorter oxford textbook of psychiatry page 421.

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Q 4 True re Impaired set shifting in parkinsons

read from the web

Contrasting mechanisms of impaired attentional set-shifting in patients with frontal lobe damage or Parkinson's disease.

Owen AM, Roberts AC, Hodges JR, Summers BA, Polkey CE, Robbins TW.

Department of Experimental Psychology, University of Cambridge, UK.

Tests which assess the ability to shift cognitive set modelled after the Wisconsin Card Sorting Test are particularly sensitive to impairments in patients with Parkinson's disease as well as in patients with frontal lobe damage. However, the underlying mechanisms responsible for the similar deficits observed in the two patient groups are not well understood and may not be identical. For example, an apparent deficit in set-shifting ability may reflect either an impairment in the ability to shift from a perceptual dimension which has previously commanded attention (i.e. 'perseveration'), or in the ability to shift to an alternative perceptual dimension which has previously been irrelevant (i.e. 'learned irrelevance'). In this study, the performance of both medicated and non-medicated patients with Parkinson's disease were compared with a group of neurosurgical patients with localized excisions of the frontal lobes on a novel task designed to assess the relative contribution of 'perseveration' and 'learned irrelevance' to impaired set-shifting ability. Patients with frontal lobe damage were worse than controls in their ability to shift attention from a previously relevant stimulus dimension. Medicated patients with Parkinson's disease were worse at shifting to a previously irrelevant dimension. In contrast to both groups, nonmedicated patients with Parkinson's disease were impaired in both conditions. These results suggest that the gross set-shifting deficits reported in both frontal lobe patients and patients with Parkinson's disease may involve fundamentally different, though related, cognitive processes, and that these may be differentially affected by medication. Specifically, L-dopa therapy may protect Parkinson's disease patients from preservation of attention to a formerly relevant stimulus dimension.

PMID: 8221053 [PubMed - indexed for MEDLINE]

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q.9- F- P300 abnormalities have been reported in patients with dementia (delayed response and reduced amplitude).

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the above-ref-core psychiatry

q.10- T- FUNCTIONAL NEUROIMAGING STUDIES SHOW INCREASED BLOOD FLOW IN THE BASAL GANGLIA ,ORBITAL,PREFRONTAL AND ANTIRIOR CINGULATE CORTEX.-PURI/HALL

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8 An inter-ictal EEG in automatisms typically shows 8Hz and 14Hz spikes.

DOES ANYONE KNOW THE ANSWER TO THIS QUESTION (with references?)

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There is usually a greater fall of cortisol following dexamethasone in depressed individuals than in normal volunteers

ans- F- a proportion of depressed pts -non suppression of cortisol with dxmethasone (positive test-nonspecific)

ref-core psychiatry

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dear dk since u have worked so :-*hard look at page 205 in weller /eysenck book, is the question asking if the EEg is normal as 8- 13 is the normal dominant rhytmn ???

the book says bilateral delta waves that have a fronto temporal distribution :-/

this is the only reference i can find after 2 hours and hence i will go with true

we will discuss again once you have looked it up.

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??? dear Satya, thanks for your help. unfortunately, I'm still in the dark,as I am not conversant with the book you referred to. Please post the full reference.

Many thanks,

DK

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scientific basis of psychiatry by weller and eysenck, 2nd ed saunders

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;)Q8 an interictal eeg in automatisms typically shows 8 and 14 HZ spikes?

False ref: Core Psychiatry: automatisms are associated with initial unilateral low voltage theta (4-8Hz waves) and subsequent bilateral delta(<4Hz waves) waves on the EED. Also question refers to spikes! :D:lol:

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