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Part II ISQ Club - Organic

24 posts in this topic

Part II ISQs on one topic 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 and include the question as the first line of your post.

In a few days this ISQ Club thread will be moved to the Question Bank board. If you submit an answer, your status will be changed to 'Question Bank member' and you will be able to see the Question Bank board. Please allow up to 48 hours for this change to happen.

1. An inter-ictal EEG in automatisms is of limited value

2. Korsakoff’s syndrome affects implicit memory

3. New variant CJD is characterised by positive tonsillar biopsy of prion protein

4. Met-Val allele in new variant CJD is present on region 129

5. The EEG in Huntington's disease is characteristic

6. Broca’s aphasia includes brief, short phrases

7. Stimulation of 5HT receptors in ventromedial hypothalamus leads to satiety(?correct)

8. Genes consist of introns, extrons & tRNA

9. Myasthenia Gravis is associated with panic disorder leads to increased mortality

10. In dementia associated with Huntington’s disease, the amnesia is similar for all decades of life

11. In dementia associated with Alzheimer’s disease, the amnesia is similar for all decades of life

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OK - here goes

please comment guys

1. An inter-ictal EEG in automatisms is of limited value

FALSE - it is a generalized seizure

2. Korsakoff’s syndrome affects implicit memory

FALSE - Explicit

3. New variant CJD is characterised by positive tonsillar biopsy of prion protein

FALSE - wouldn't say characterised, i think it can help though

4. Met-Val allele in new variant CJD is present on region 129

TRUE ??

5. The EEG in Huntington's disease is characteristic

TRUE - Triphasic peak

6. Broca’s aphasia includes brief, short phrases

FALSE - I think, i don't think they can say short phrases

7. Stimulation of 5HT receptors in ventromedial

hypothalamus leads to satiety(?correct)

TRUE -VoM centre!

8. Genes consist of introns, extrons & tRNA

FALSE

9. Myasthenia Gravis is associated with panic disorder leads to increased mortality

TRUE - why not, panic - hyperventilate - tired chest - can't breathe!!!!!!!!!!!!!!!!!

10. In dementia associated with Huntington’s disease, the amnesia is similar for all decades of life

TRUE ????

11. In dementia associated with Alzheimer’s disease, the amnesia is similar for all decades of life

FALSE????

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6. Broca's aphasia includes brief, short phrases.

TRUE.

(I reckon anyway as disruption to Wernicke's area results in a fluent receptive dysphasia and to Broca's results in a DSYFLUENT expressive dysphasia.)

'Speech is slow and hesitant, often lacking the connecting words. Speech sounds agrammatical and articulation may be crude.' Puri and Hall p19.

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2. Korsakoff’s syndrome affects implicit memory

FALSE

working memory and long-term memory, (implicit) are intact - transfer and therefore memory acquisiton is impaired

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reply to omniol

I don't understand your reason for answer 1, although I would agree that interictal EEG in automatism is of value.

According to www.epilepsy.com, automatism can occur as absence, as complex partial seizure and after tonic clonic seizures, i.e. it is not necessarily a generelised seizure.

An interictal EEG is useful also because epileptiform activity could be provoked, e.g. by hyperventilation.

Regarding the formulation of the question I feel it can be understood in both ways, i.e it is of some value or it is not of much value.

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1. True

20-30% of inter-ictal EEG's are normal in epileptic subjects (Lishman, p129) - though it also says they are useful in establishing epileptic focus, seems fair to say they have limitations.

2. False

affects explicit memory

3. Maybe False? Seems to be quite specific test (Lancet Jan.16th 1999) but I think probably not 'characteristic' - not sure :-/

4. True

and val/val allele with younger onset and slower course, neurology 25th April 2000

5. True

loss of alpha rhythms, generalised low voltage fast activity which may disappear as the disease progresses, though a normal EEG can be obtained (Lishman p 470)

6. True

expressive dysphasia

7. True

satiety centre

8. False

don't think tRNA counts as gene

9. True

Lishman p 712 - says that anxiety attacks appear to be of particularly grave significance (in myasthaenia gravis) and increases the mortality to almost 50% in 14years (39% with emotional or psychiatric disturbance vs 17% without)

10./11. I don't understand the questions! does this mean early onset cases have different severity than late onset? ???

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6. Broca’s aphasia includes brief, short phrases

True.

Broca's aphasia is characterised by brief short phrases, refer to SIMS.

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5. Huntington's EEG

TRUE

Characteristic diffuse flattening with low amolitude theta and delta waves

(Examination notes in psych- Basic sciences p141

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10. In dementia associated with Huntington’s disease, the amnesia is similar for all decades of life

Answer:

FALSE in early Huntington's disease recall of important dates is affected( hence I assume long-term or autobiographical memory), in well established Huntington's word recall is affected on distraction( hence I assume short-term memory)

reference from chapter -'Huntinton's Dementia' in Oxford texbook of Psychiatry

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Thanks Borracho :) - do you think that makes the answer to the Alzheimers question False then? (ie. its not necessarily qualatively different) :-/

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2. Korsakoff’s syndrome affects implicit memory FALSE

The existence of intact implicit recollection in the absence of explicit memory is found in various conditions including surgical anesthesia, hypnotic amnesia, the adverse effects of some benzodiazepines, neurological conditions such as Korsakoff's syndrome (Kaplan and Saddock CTP)

3. New variant CJD is characterised by positive tonsillar biopsy of prion protein FALSE

• There are no available, completely reliable diagnostic tests for use before the onset of clinical symptoms. However, magnetic resonance scans, tonsillar biopsy and cerebrospinal fluid tests are useful diagnostic tests. –WHO website

6. Broca’s aphasia includes brief, short phrases TRUE

Patients may produce one-word replies or very short phrases. (Kaplan and Saddock CTP)

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1. True - the EEG is insensitive: a single interictal EEG will only detect clearly epileptiform abnormalities in about 30% of patients with epilepsy.

Companion to Psychiatric Studies (p.353)

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2. False - Korsakoff's is characterised by impairment of STM with a tendency to confabulate.

Companion to Psychiatric Studies (p. 370)

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3. True - tonsillar tissue and gut-associated lymphoid tissue probably contain detectable prion protein before the onset of symptoms, but biopsy of these tissues is not a practicable option in all young people with new onset of psychiatric symptoms.

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4. True - Mutations in the PrP gene, best known at codons 102, 178 and 210, are important factors in inherited prion diseases, but no mutation is present in sporadic or variant CJD.  The natural val/met polymorphism at codon 129 influences the phenotype of the disease as well as having an apparent effect on vulnerability.  All patients with vCJD have been met homozygotes up to the present time.

Companion to Psychiatric Studies (p.79)

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6. True - In 1861 Broca published his paper about production aphasia, describing 'Tan' who could barely produce more than a few words, and who on post-mortem was shown to have sustained damage to the 3rd convolution of the left frontal lobe.

Companion to Psychiatric Studies (p.133)

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7. True - Stimulation of VM hypothalamus results in satiety. SSRIs which increase available 5HT can have anorexia as a side-effect.

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8. False - Genes consist of DNA

Companion to Psychiatric Studies (p.152)

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11. False - Ribot's Law of Memory Regression states that recent memories are lost first, with long-term memory relatively intact until latter stages of illness.

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10. In dementia associated with Huntington’s disease, the amnesia is similar for all decades of life

TRUE according to Lishman ' the retrograde amnesia is usually severe and generalised, being equally impaired across the decades and not showing the temporal gradient of Korsakoff's syndrome.' p 469

11. In dementia associated with Alzheimer’s disease, the amnesia is similar for all decades of life

FALSE

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EEG in huntington's disease is characteristic.

TRUE

There is characteristic(not specific) diffuse flattening of EEG with low amplitude theta and delta waves.

Please note-Triphasic waves and widespread slowing occur in hepatic encephalopathy.(Exam. Note in Psych.- Gin Malhi)

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7. Stimulation of VM hypo 5HT results in satiety.

True.

Kaplan Saddock.

Also antagonism of 5HT1A and 5HT2C increases appaetite.

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Met-Val allele in new variant CJD is present on region 129

false.. met/met in new variant

met/val in sporadic

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