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mrcpsych. 1/2 march08 solved questions with refs.

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1. An elderly man in a surgical ward has been experiencing fluctuating level of consciousness and visual hallucinations. He is finding it difficult to turn over in bed.

A. Alzheimers

B. Lewy Body dementia

C. Picks Disease

D. Delirium

E. Pseudodementia

References: OHP (2005) Semple et al. CH 17, Pg 734

Dr. Who: Delirium is extemely common in surgical and medical inpatients (10- 20%). The elderly are especially vulnerable. Fluctuating consciousness is characteristic. Disturbance of sleep wake cycle, emotional lability and poorly developed paranoid delusions may also be seen. (D)

2. A child can that a tall glass and a wide mouthed glass of equal volume hold the same amount of water in which stage of Piagets model?

A. Sensori motor

B. Pre operational

C. Concrete operational

D. Formal operational

E. Conventional stage

References: Gross R., The Psychology of Mind and Behaviour 4th edition (2001) pg 494

Dr. Who: This is conservation. Conservation is the understanding that any quantity including number, liquid, quantity, length and substance remains the same despite physical changes to their arrangement. The stages are 1) Sensorimotor (0-2y): Object permanence develops 2) Pre-operational stage (2-7y) Development and use of schemas, symbols and language.3) Concrete operational stage (7-11y) The child is able to perform logical operations but only in the presence of actual objects, Conservation and reversibility are acquired. 4) Formal operational stage: The child can manipulate ideas and propositions mentally without the presence of objects. ©

3. The term schizophrenia was coined by:

A. Bleuler

B. Kraepelin

C. Schneider

D. Kahlburn

E. Cade

References: OHP (2005) Semple et al. CH 6, Pg 178

Dr. Who: Kraeplins separation of insanity into manic -depressive and dementia praecox varieties, gained widespread acceptance in the 19th centrury. It was in 1911 that Eugen Bleuler coined the term schizophrenia, probably influenced by Freud's psychoanalytical ideas which emphasised the splitting of the mind as opposed to Kraeplins focus on it as a disease of the brain. (A)

4. The term dementia praecox was coined by:

A. Bleuler

B. Kraepelin

C. Schneider

D. Kahlburn

E. Cade

References: OHP (2005) Semple et al. CH 6, Pg 178

Dr. Who: Kraepelin in 1896 divided insanity on the basis of different symptoms and prospective outcome data into 2 forms. Manic depression and dementia praecox. (B)

5. The term catatonia was coined by:

A. Bleuler

B. Kraepelin

C. Schneider

D. Kahlburn

E. Cade

References: OHP (2005) Semple et al. CH 6, Pg 178

Dr. Who: Kahlbaum coined the term Katatonie in 1868 (D)

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My mistake. These aren't March '08 questions. Working on 'em!

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Actually a few of them are! I'm gonna go lie down now :P

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i think that the answer to the firt question is lewy body disease rather than delirium. Lewy body disease is charecterised by fluctuating conciousness, visual halluinations and parkinsonism (i.e. man coudn't turn over) . The surgical ward bit is probably to throw us off

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i think that the answer to the firt question is lewy body disease rather than delirium. Lewy body disease is charecterised by fluctuating conciousness, visual halluinations and parkinsonism (i.e. man coudn't turn over) . The surgical ward bit is probably to throw us off

Common things first... I would say. You are more likely to get a delirium in a surgical ward than DLBD... And rather than fluctuating conciousness, it is fluctuation in cognitive function that is a key feature (although conciousness could be called a cogntive function), ie variable performance of both cogntive tasks and variablity in behavioural components... This is seen more in DLB... but is not specific to it... In fact, it is also a key feature of delirium.

Although I am not sure about the answer, I would go for delirium...

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i think that the answer to the firt question is lewy body disease rather than delirium. Lewy body disease is charecterised by fluctuating conciousness, visual halluinations and parkinsonism (i.e. man coudn't turn over) . The surgical ward bit is probably to throw us off

Common things first... I would say. You are more likely to get a delirium in a surgical ward than DLBD... And rather than fluctuating conciousness, it is fluctuation in cognitive function that is a key feature (although conciousness could be called a cogntive function), ie variable performance of both cogntive tasks and variablity in behavioural components... This is seen more in DLB... but is not specific to it... In fact, it is also a key feature of delirium.

Although I am not sure about the answer, I would go for delirium...

they had same question in birmingham course and it was DLB

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I would still go for delirium...

Did the question say parkinsonism??? or did you/they assume that from the fact that he couldnt turn, he has parkinsonism???

And what about the onset, was it insidious or acute?

I think there are a lot of confounding factors...

If I get called to see this case, in real life, my first dd would be delirium...

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