• Announcements

    • Gurpal

      New question bank for paper B   05/11/18

      Please see the link below for a new question bank: http://www.superegocafe.com/online-courses/mrcpsych-paper-b-multiple-choice-question-bank/  
Sign in to follow this  
Followers 0
Gurpal

Part 2 ISQ Club - Addiction psychiatry

33 posts in this topic

MRCPsych Part 2 ISQs will be posted regularly. 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. Posts not following this rule may be removed without warning.

You can download these questions and others on the same topic by clicking here.

1. People give up smoking more for the perceived health benefits than confidence in their ability to give up.

2. Caffeine consumption can be accurately calculated by counting the daily intake of cups of tea and coffee.

3. Alcohol intoxication increases plasma endorphins.

4. People with low levels of alcohol dehydrogenase are at increased risk of alcohol dependence.

5. Bus drivers are at increased risk of liver cirrhosis.

6. There is an increased rate of alcoholism in first born children.

7. There are specific histological changes to the brain in alcohol abuse.

8. Alcoholic dementia can be demonstrated histologically at post mortem.

9. One of the questions in the CAGE screen is “do you crave alcohol?”

10. The Halstead Reitan Battery can be used to help identify problem drinking in medical inpatients.

11. Plasma viscosity measurements can be used to identify problem drinking in medical inpatients.

12. Motivational interviewing in alcohol dependence can increase the awareness of cognitive dissonance.

13. Disulfiram works by negative reinforcement.

14. Acamprosate is particularly suited to use in the elderly.

15. Wernike's encephalopathy should be treated with high doses of oral thiamine.

16. LSD intoxication can lead to a transient psychotic state with paranoid delusions and auditory hallucinations.

17. LSD intoxication causes papillary constriction.

18. LSD intoxication can cause severe anxiety.

19. NMDA is blocked by ionic magnesium.

20. NDMA is associated with physical addiction.

21. Cocaine enhances the release of 5-HT.

22. Intoxication with crack cocaine can mimic mania.

23. Heroin during pregnancy is associated with a higher incidence of cleft palate.

24. Heroin can cause a schizophreniform psychosis.

25. Heroin use can cause an increase in libido in women.

Share this post


Link to post
Share on other sites

Q9: False.

C - Have you felt you should Cut down your alcohol intake?

A - Have cricisms of your drinking Annoyed you?

G - Have you felt Guilty about your drinking?

E - Have you ever needed an Eyeopener?

Share this post


Link to post
Share on other sites

Q15: False.

Wernicke's Encephalopathy should be treated with high dose thiamine, but not orally.

Share this post


Link to post
Share on other sites

Q5 Bus drivers and cirrhosis...? I'd say False, as I would expect bus drivers to be sacked if they are drinking that heavily, otherwise they might be hungover/drunk and crash their bus. Perhaps unemployed former bus drivers have high rates of cirrhosis...? I haven't found a referrence for this yet!

Share this post


Link to post
Share on other sites

Q2: Caffeine intake by asking about cups of coffee and tea...

FALSE.

You'd maybe also ask if it was decaf, or a super-double grande espresso in each cup. Also if they drink coke, pepsi, red bull, etc. Or if they take ProPlus tablets.

Share this post


Link to post
Share on other sites

14. Acamprosate is particularly suited to use in the elderly.

False.............may be helpful but not PARTICULARLY

Share this post


Link to post
Share on other sites

17. LSD intoxication causes papillary constriction.

False........Pupillary Dilation

Share this post


Link to post
Share on other sites

16. LSD intoxication can lead to a transient psychotic state with paranoid delusions and auditory hallucinations.

17. LSD intoxication causes papillary constriction.

18. LSD intoxication can cause severe anxiety.

16. T. (ref OTP pg577, but it says the associtaion is dubious, can somebody clarify?)

17.F

18.T (same ref)

Share this post


Link to post
Share on other sites

Hi

My GO:

1. People give up smoking more for the perceived health benefits than confidence in their ability to give up.   TRUE

2. Caffeine consumption can be accurately calculated by counting the daily intake of cups of tea and coffee. FALSE

4. People with low levels of alcohol dehydrogenase are at increased risk of alcohol dependence.   FALSE (will develop 'red man' syndrome - thus natural aversion to alcohol)

9. One of the questions in the CAGE screen is “do you crave alcohol?” FALSE (?Cut Down/Annoyed/Guilt/Eye opener)

11. Plasma viscosity measurements can be used to identify problem drinking in medical inpatients.   FALSE (MCV - together with raised GGT; BUT in 'medical' patients there might be other reasons for a raised MCV; so I would certainly be more suspicious of a possible drink problem)

13. Disulfiram works by negative reinforcement. FALSE (Punishment)

Share this post


Link to post
Share on other sites

4. People with low levels of alcohol dehydrogenase are at increased risk of alcohol dependence.   FALSE (will develop 'red man' syndrome - thus natural aversion to alcohol)

I'm not sure if its false......... :-/

I'd agree with you if it was aldehyde dehydrogenase

13. Disulfiram works by negative reinforcement. FALSE (Punishment)

Share this post


Link to post
Share on other sites

3. Alcohol intoxication increases plasma endorphins-TRUE

[beta-endorphin and endogenous alcohol level of the blood in alcoholic patients] [biull Eksp Biol Med. 1984]

Share this post


Link to post
Share on other sites

People with low levels of alcohol dehydrogenase are at increased risk of alchohol dependence--TRUE

The alcohol tolerance is connected with activity of Alcohol dehydrogenases (a group of enzymes responsible for the breakdown of alcohol) in the liver, and in the bloodstream. High level of Alcohol dehydrogenase activity results in fast transformation of ethanol to more toxic acet acetaldehyde. Such atypical alcohol dehydrogenase is less frequent in alcoholics than in nonalcoholics. Furthermore, among alcoholics, the carriers of this atypical enzyme consume lower ethanol doses, compared to the individuals without the allele.

Share this post


Link to post
Share on other sites

NMDA is blocked by ionic magnesium--true

: Clin Calcium. 2004 Aug;14(8):76-80. Related Articles, Links

[Role of magnesium ions on the regulation of NMDA receptor--a pharmacopathology of memantine]

Share this post


Link to post
Share on other sites

NDMA is associated with physical addiction-FALSE

Study of the behavioural responses related to the potential addictive properties of MDMA in mice.

1: Naunyn Schmiedebergs Arch Pharmacol. 2004 Mar;369(3):338-49. Epub 2004 Feb 3

Share this post


Link to post
Share on other sites

13. Disulfiram works by negative reinforcement.

True

One is right in thinking inasmuch the flush reaction acts as a 'punitive' reaction but 'removal of punitive measure' by not drinking alcohol is negative reinforcement.

hope this helps.

Share this post


Link to post
Share on other sites

Disulfiram.....- false.

all re inforcers encourage behaviour. disulfiram acts by aversive conditioning i.e reduces undesirable behaviour by introducing dangerous consequences.

-bhooshan

Share this post


Link to post
Share on other sites

Disulfiram works by negative reinforcement. F

-ve reinforcer increases the probability of a responce happening again by removing aversive condition eg. threat. In this case we are trying to stop a person from drinking, which means reducing the probability of alcohol consumption by aversive conditioning.

Share this post


Link to post
Share on other sites
13. Disulfiram works by negative reinforcement.

True

One is right in thinking inasmuch the flush reaction acts as a 'punitive' reaction but 'removal of punitive measure' by not drinking alcohol is  negative reinforcement.  

hope this helps.

False! 'not drinking' is not a behaviour but the absence of a behaviour. although there is logic in your argument (well known that the divisions between punishment and reinforcement are artificial and depend on the perspective one takes) - convention trumps verbal gymnastics here :lol:

Share this post


Link to post
Share on other sites

Q15 :false

See companion pg 370 7th ed

although Oxford handbook of clinical medicine advocates use of high doses of oral  thiamine as generally safe(page 736 5th edition) & parentral to be given if oral route is impossible or there is a danger of rapid progress to Korsakoff's-which is usually the case.

Share this post


Link to post
Share on other sites
Sign in to follow this  
Followers 0