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Part 2 ISQ Club - Old age / organic

36 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. Anaesthetic accidents can cause a prolonged delirium lasting several weeks.

2. The EEG in delirium shows an increase in theta waves.

3. Waxy flexibility may be seen in encephalitis.

4. Pyridoxine deficiency causes progressive cognitive impairment.

5. Alzheimer’s disease may be caused by HIV infection.

6. The APO E2 allele has been shown to be a risk for Alzheimer’s disease in population studies.

7. HIV dementia has many similarities with Alzhiemer’s disease at post mortum.

8. Apo E allele testing is useful for counselling families with a history of dementia.

9. Cortical lewy bodies have been found in significant numbers in around 30% of patients with dementia at post mortem.

10. Dementia invalidates the capacity to make a gift.

11. The EEG in Huntington’s disease shows increased fast wave activity.

12. Early onset of Huntington’s disease is associated with an affected father rather than an affected mother.

13. Less than 10% of patients with Parkinson’s disease will develop psychotic symptoms during the course of their illness.

14. The prevalence of depression in multiple sclerosis is 20%.

15. Temporal lobe tumours are associated with incontinence.

16. Macrographia is associated with temporal lobe epilespy.

17. Psychosis in HIV is associated with a poor prognosis.

18. 80% of epileptic fugues are preceded by an aura.

19. People with chronic fatigue syndrome display more psychopathology than those suffering with myotonic dystrophy impairment.

20. Even after correcting for IQ, deaf people show a delay in understanding abstract language.

21. The cognitive estimates test assesses the ability to shift sets.

22. Somatization is a common component of mono delusional disorders in the elderly.

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1. Anaesthetic accidents can cause a prolonged delirium lasting several weeks.

TRUE.

Must be...anything prolongs delirium in the elderly. Plus it has the magic word can in the question.

There's a really interesting abstract in 2002 Hospital Medicine 63;626 on postoperative confustion in the elderly. It was by me! I'm feeling particularly arrogant this morning...sorry!  :)

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12) EARLY ONSET OF HUNTINGTON'S DISEASE IS ASSOCIATED MORE WITH HAVING AN AFFECTED FATHER RATHER THAN A MOTHER?

TRUE

FROM POST GRAD PSYCH 2ND EDITION

IN HUNTINGTON'S CHOREA OFFSPRING OF AN AFFECTED FATHER HAS AN EARLIER AGE OF ONSET, A PHENOMENON KNOWN AS GENETIC ANTICIPATION

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2) THE EEG IN DELIRIUM SHOWS AN INCREASE IN THETA WAVES ?

?FALSE

FROM COMP TO PSYCH STUDIES 7TH ED

DELIRIUM- THE EEG MAY BE HELPFUL AND SHOWS &nbsp:lol:IFFUSE BACKGROUND SLOW WAVE ACTIVITY

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3. Waxy flexibility may be seen in encephalitis.

true- Sims pg 370

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Anaesthetic accidents can cause a prolonged delirium lasting several weeks

TRUE.

CEREBRAL COMPLICATIONS FOLLOWING ANAESTHESIA • 1 RC 1

Jakob Trier MØLLER, Lars S. RASMUSSEN .

Prolonged POCD is found days or weeks after anaesthesia and lasts for weeks, months or in the worst cases lasts permanently. In most cases, prolonged POCD resembles the mild neurocognitive disorder for which the American Association of Psychiatrists has developed specific diagnostic criteria [8]. In a few cases prolonged POCD may resemble the more severe impairment, postoperative dementia.

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The EEG in delirium shows an increase in theta waves

TRUE.

EEG in delerium shows increase in slow wave(theta waves)activity.

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. The APO E2 allele has been shown to be a risk for Alzheimer’s disease in population studies

FALSE.

APOE genotype strongly predicts the rate of cognitive decline in Alzheimer disease. The decline shows a dose-response relation with the epsilon4 allele, but the APOE epsilon2 allele is protective. Neurology. 2005 Dec 27;65(12):1888-93

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7. HIV dementia has many similarities with Alzhiemer’s disease at post mortum.

FLASE

LISHMAN organic psychitry-page 326

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Apo E allele testing is useful for counselling families with a history of dementia.

FLASE

Neurology. 1997 May;48(5 Suppl 6):S30-4. Links

Alzheimer's disease: clinical implications of the apolipoprotein E genotype

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THE EEG IN DELIRIUM SHOWS AN INCREASE IN THETA WAVES?

?TRUE

FROM - COMPANION 7TH EDITION

DELIRIUM - THE EEG MAY BE HELPFUL AND SHOWS AN INCREASE IN DIFFUSE BACKGROUND SLOW WAVE ACTIVITY.

BUT -DIFFUSE SLOW ACTIVITY- THETA OR DELTA- IS SEEN IN METABOLIC CONDITIONS OR IN THE ACUTE PHASE OF BRAIN TRAUMA.

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The EEG in Huntington[ch8217]s disease shows increased fast wave activity.

TRUE.

EEG shows poorly developed or complete loss of alpha activity..There may be generalized low voltage fast activity or random slow wave activity but this too may disappear with disease progression.-Leishman.

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Less than 10% of patients with Parkinson[ch8217]s disease will develop psychotic symptoms during the course of their illness.

Around 12%- Celesia and Wanamarker-Leishmen organic psychiatry page 559.

20% according to manchester notes.

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The EEG in Huntington’s disease shows increased fast wave activity.

TRUE.

EEG shows poorly developed or complete loss of alpha activity..There may be generalized low voltage fast activity or random slow wave activity but this too may disappear with disease progression.-Leishman.

The answer is false. Its a common Q & the ans is that the eeg in Huntington's disease is a flat one.

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The EEG in Huntington[ch8217]s disease shows increased fast wave activity.

TRUE.

EEG shows poorly developed or complete loss of alpha activity..There may be generalized low voltage fast activity or random slow wave activity but this too may disappear with disease progression. (Leishman. )

THIS REFERRENCE IS FROM STANDARD ORGANIC PSYCHIATRY TEXT BOOK AND THERE IS INCREASE GENERALIZED FAST WAVE ACTIVITY IN INITIAL STAGES AND WITH &nbsp:lol:ISEASE PROGRESSION EEG BECOMES FLAT

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Temporal lobe tumours are associated with incontinence.

FALSE.

Frontal lobe tumors are associated with incontinence

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Macrographia is associated with temporal lobe epilespy

False.

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The EEG in Huntington’s disease shows increased fast wave activity.

TRUE.

EEG shows poorly developed or complete loss of alpha activity..There may be generalized low voltage fast activity or random slow wave activity but this too may disappear with disease progression. (Leishman. )

THIS REFERRENCE IS FROM STANDARD ORGANIC PSYCHIATRY TEXT BOOK AND THERE IS INCREASE GENERALIZED FAST WAVE ACTIVITY IN INITIAL STAGES AND WITH &nbsp:lol:ISEASE PROGRESSION EEG BECOMES FLAT

My sincere apologies. :)

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2) THE EEG IN DELIRIUM SHOWS AN INCREASE IN THETA WAVES ?

?FALSE

FROM COMP TO PSYCH STUDIES 7TH ED

DELIRIUM- THE EEG MAY BE HELPFUL AND SHOWS  DIFFUSE BACKGROUND SLOW WAVE ACTIVITY

Theta waves are slow waves, so the answer is TRUE. In Delirium there is usually an increase in Delta and Theta waves.

Eg: http://jnnp.bmjjournals.com/cgi/content/abstract/52/8/980

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21. The cognitive estimates test assesses the ability to shift sets.

FALSE. These are two different tests.

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