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Gurpal

June 2009 - Paper 2 feedback

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Please post your feedback on the Paper 2 exam. If you can remember any questions and stems, please include them. Please do not discuss answers in this thread.

Thank you and good luck!

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No replies on this post as yet. strange !!!!!

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Ok! That was interesting to say the least! I had to walk it off and shower and now finally I am on the forum!

Lets see... some interesting stuff...

Some medication that starts with Varc... dunno what it is.. how is its mode of axn

some intense detail about receptors in the EMI: Heteroreceptor, auto receptor...

a question about D2 receptors are they pre or post-synaptic

What is the neural crest made of?

Endoderm

Ectoderm

Mesoderm

What is the risk of a child with an alcholic father to become alcoholic

2-3

4-3

4-5

What is the most likely risk factor to predispose to criminality

ADHD

maternal depression

paternal depression

there wasn't even any mention about ASPD or callousness!

What is the factor that will improve in BPD in 2 years:

anger control

self harm

... dunno

Question about not recognising faces...

Prosopagnosia (not sure if that was part one)

A question about the neurotransmitter involved with AD

EMI about genetics:

Description of syndromes:

can't remember:

Angelmans

Cri du chat

prader willi

I think there was Williams

hmmm...

will come back later on to put whatever else I remember up... must feed the stress monster :D

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Wow still no more posts...

ok lets try to remember some more of these..

EMI

The genes associated with:

Schizophrenia : DISC1, NRG1, Dysbindin

Parkinsons

There was an mcq: which of these is least likely:

Schizophrenia shows anticipation

BAD shows anticipation

Huntigtons of paternal shows earlier onset

Huntingtons with maternal shows later onset

Which of these is supplied by the anterior cerebral arter:

corpus callosum

occipital lobe

parahippocampus

will continue later :D

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it was almost guess work..... i am wondering what to read for this exam....i dont how others feel about exam..... i felt completely alient questions mostly :'(

...to add some more questions.....

finger-nose ataxia due to...

superior colliculus

inferior colliculus

olive nucleus

cant remember other two choices....

antipsychotic in hepatic impairement wityh GFR120

amisulpiride

clozapine

olanzapine

the combi meds which counteracts former side effects

citalopram buspiron

raboxetine doxazocin

meds used for alchohol withdrawl in liverfailure

chlordioazepoxide

lorazepam

other three cant remember

apoe4 -risk of alziemers

3%

5%

7%

which part seperates frontal and temporal lobe

corpus callosum

precentral gyrus

central gyrus

lateral gyrus

recent evidence for BPD

no psychological treatments useful

DBD

other three cant remember

which 0f the following not potentiate dependency

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function of endosomes, mechanism of action of khat, memantine, verenicycline, stuff on tau, genes in Parkinsons D, Sz, FTD.

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one on suicide rates:

which one of the following countries has a male:female suicide rate of 1:1

i think the options were

russian federation

japan

china

mexico

united kingdom

(following a quick wiki looks like china is roughly 1:1 so got that one wrong amongst maaany others)

also one or two questions on moral development - kohlbergs stages which was also in paper 1 but had not looked at)

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few more to add....

contributors....

klien

jung

winnicote

bion

etc.......

paranoid-schiziod position

good enough mother

preconscious

2 more options in the same vignett

language difficulities

specific language

expressive aphasia

schizophrenia

autistic spectrum

ADHd

1. 8yr old girl difficult to express her self, difficult to express wiyh others in the same line

2. 6yr old boy good communication skills...utters to strangers...'deep down to nine u should cross step six and kill few soldiers'(diificult to remember exact sentence)

4-8 hz waves on eeg

alpha

beta

theta

gamma

receptors

buspiron,mirtazapine- serotonin

donepezil- choline

tobacco-opoids

lerning disability in general population

1%

2%

6%

sexual dysfuction

participation anxiety

previous sexual abuse

1premature ejaculation

2vaginismus

following is correct----

SAD- melatonin clear evidence

melatonin rises during day and falls during night

questions regarding prevelance and incidence---

infant mortality rate

still birth rate

some thing in same line

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Wow! Good Job BMind! I have been struggling to remember more questions!

U r right! Only good thing about the alien questions is I have no guilt about not putting in enough effort its stuff that is mostly pie in the sky!

I wasn't surprised though, from talking to ppl that is the norm with this exam... a friend said it was dramatically better since they removed STATS!

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connection between schizophrenia and cannabis, what advice would you give a mum

# no connection

10%

100%

which neurotransmitter increases in the glial cells in time of psychological stress

structural family therapy

bedside tests for a patient with nystagmus, ataxia

memory storage process

#iconic to echoic

#short term to long term

woman living alone develops hallucinations

#NSAID's

#visual problems

#auditory problems

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  • Rosette shaped neurotransmitter is ?????

    Theme - Relationship of Clozapine with D2 receptors - quite confusing

    CNS is developed from - Ectoderm/Endoderm/Mesoderm/...

    What structure seperates Frontal lobe from Parietal lobe ?

    Drug that has half life of around 3 days - Arpiprazole/ Fluoxetine/...

    What improves without treatment in BPD after 2 years? Anger / impulsiveness/ Emptiness/ Relationship problems.....

    Amygdla - required for storing emotional memory & .... few other options

    The 2 most affected in Korsokoff's - Mammillary bodies & ???????

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visual path and structures involved- geniculate bodies, superior colliculus

Prosody, nominal aphasia , which hemisphere

Foods that you should avoid on tranylcypromine - chesse, wine, processed meats, grapefruit juice

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1) A man has to get up at 6.30 am and needs help with sleeping. Which medication in terms of half life most appropriate

a) flurazepam

B) zopiclone

c) zolpidem

d) temazepam

e)?trazadone

2) Another question on schizophrenia prevalence. Woman with schizophrenia wants to know what the prevalence of schizophrenia would be in a) child, b)parent, c) brother d)brothers child with downs syndrome

0-5%

5-20%

10-15%

15-20%

25-30%

3) Man with alcohol withdrawal and liver disease. Which drug most appropriate

a)chlordiazepoxide

b)diazepam

c)lorazepam

4) EMI which drug/reason most likely to cause the following

a) priaprism, B) vaginismus c) premature ejaculation

trazadone

childhood sexual abuse

5) A mum asks you to do some tests on her child with downs syndrome who seems to have a milder version of the disease. Which variant are they likely to have

a) Robertsonian translocation

B) Trisomy 21

c) Mosaicism

couple other translocation options

6) Which theory associated with which person

a) good enough mother

B) collective unconsious

c) Paranoid schizoid position

Winicott

Bion

Jung

Klein

7) something like people with longstanding REM sleep disorders are mor prone to

a) bipolar disorder

B) alzheimers

c) Multiple sclerosis

etc

8) what part of the WAIS? test is most likely to be resistant to brain damage

a)block design

b)object assembly

c)digit span

9) risk of alzheimers disease in someone heterozygous for APOE4

a)3%

b)5%

c)7%

d)9%

10) a)would would incidence/prevalence do in a rare disease that people tend to die from early.

B) number of deaths of infants under the age of 1.

infant mortality rate

perinatal mortality rate

low incidence low prevalence

high incidence low prevalence

high incidence high prevalence

low incidence high prevalence

something like that

11) something about in SAD

a) clear evidence for circadian rhythm disruption

B) increased melatonin production in the day

12) the drug khat is most similar to which drug?

a)cannabis

B) LSD

13) which drug when taken for a long time are you least likely to get withdrawal symptoms on stopping?

a)cannabis

b)Cocaine

c)LSD

d)?ecstacy

14) Percentage of adolelscents with suicidal ideation

a)0-5%

b)5-10%

c)10-15%

d)15-20%

15) ?percentage of people diagnosed with depression aged over 65

16) which factor most likely to predict delinquient behaviour age 18

a) large family size

B) ADHD

c) ?Autism

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Felt like an aptitude test...!!

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just cant wait to see my result!!

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Hi,

Ill see what i can do!...

mechanism of action for cyproterone acetate

testosterone agonist

testosterone partial agonist

testosterone antagonist

working memory involves

hippocampus

thalamus

...

DSH in adolescents in last year

5%

10%

15%

20%

Rate of depression in elderly

1-5%

5-10%

10-15%

15-20%

which therapy uses 'mentalisation'

DBT

CBT

Family Therapy

..

What can you have with MAOI

cheese

red wine

grapefruit juice

picked herring

Which drug do you need caution in high doses in a patient with acute angle glaucome

paroxetine

other SSRIs

finger-nose ataxia?

inf olive

sup colliculus

EMI

temporal lobe

thalamus

other structures

Q

structures involved in karsakoffs

...

carbamazepine

fluoxetine

st johns wort

other meds

Q

2 meds with decrease effectiveness of OCP

med which wound need urgent INR for patient on warfarin

Ataxia and nystagmus

Which part of Cerebellum?

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Glutamate neurotransmitter ... Have dilated endings (rosettes)!!

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Hey!

This post is especially dedicated to the two that said it was straightforward without any problems... Where did u guys study from? What did u study?

:D

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What a contrast between paper 1 and 2 based on the polls! :o

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development stages

child- smiles at mom-4mth

6 words- 1/2 yrs

babling- 7months

chromosomes

5

15paternal /maternal

22

child with aggressiveness,low set ears,abnormal cry cardiac abnormality

child with hypogonadism,

defect in downs syndrome

vsd

coarctation of aorta

alpha synneuclein-- one mcq

both ballon cells and hirano bodioes present in

alzeimers

lewy

picks

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hi Gee,

i was also surprised after seeing poll who mentioned it was straiforward. i would like to know whether Royal college leaked paper to those two guys ;):lol: other wise its impossible to say those q are straitforward

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The BOF question on the MRCPsych website where the answer is extinction was in p.2

People on one of the MAOIs can have as much of which as they like...

- red wine

- grapefruit juice

- cheese

- pickled herring

- brewer's yeast

(I answered grapefruit juice)

EMI on the risks of various relatives of a woman with schizophrenia developing the condition

- sister's kid with Down's syndrome

- various others, can't remember - it was very similar to a q. in the SPMM course

EMI on which medicine's would you ask a woman to change if she wants to take the pill

- I answered St John's Wort and Carbemazepine, can't remember all the choices

Will put more on later

-

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emi on PTSD mgmt

thread-man has been recently diagnosed with ptsd not responding to zopiclone continues to experience sleep difficulties.takes 6 units of alcohol everynight as a result

emi options

relaxation

comfort from wife

CBT

Zolpidem

change sleep position

few other options cant remember

questions

1.what next step in mangement

2.sleeping in day time -mgmt?

3.having ?sleep apnoea mgmt ?

a couple more questions cant remember

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Good job Reekay!

This was a funny one:

1.what next step in mangement

2.sleeping in day time -mgmt?

3.having ?sleep apnoea mgmt ?

a couple more questions cant remember

it went into: daytime nap of 30 mins

or daytime nap of 60 mins lol! :D

That exam was hilarious retrospectively! :lol:

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Hope these might help those who are going to take paper 2 about what to read ...

I could just remember the keys words

1. Gene of CADASIL

A: Notch 3

2. FTD

A: Pregranulin gene (PGRN)

3. % of VD among all dementia

A: ? 20-25%

4. Prevalence of LD

A: ? (statistically IQ<70 = 2.5%, actual prevalence in UK 1-2%)

5. Tau protein

A: hyperphosphorylation

6. Glial cell metabolises posses which enzyme

A: cholinesterase (other choices: COMT, MAOI, beta-hydroxylase etc)

7. EEG of CJD

A: 1-2 Hz

8. Night terro, choose the incorrect choice

A: onset at 6

9. Crptoperone mechanism

A: Testosterone antagonist

10. Khat

A: mechanism similar to amphetamine

11. REM in depression, choose incorrect statement

A: (present in first degree relatives, present before depression, increased duration of REM should be the correct statement)

12. SAD

A: Melatonin

13. Definition of heriditability

A:? the variances in the distribution of a phenotype which is due to genetic cause

14. Finger Nose ataxia

A: inferior olivary nucleus

15. Pathology of DLB

A: Ach loss

16. HI + personality change, aggression, disinhibition, ask for site of injury

A: ? coutrecoup to orbitofrontal

17. Risk factor for criminal record by 17

A: ? ADHD

18. Risk factor for child abuse, ask for incorrect statement

A: old age of parents

19. Predictor of good outcome in schizophrenia

A: good premorbid functioning

20. Screen depression with more cognitive items

A: ? HAMD

21. Ataxia/ Nystagmus, site of insult

A: ? both flocculonodular and vermis

22. Rt brain function

A: Pictorial

23. Structure which is larger on left hemisphere

A: planum temporale

24. D2 receptor

A: ? excitatory on both pre and post synaptic receptor

25. HI, poor performance on

A: digit symbol/ digit span or object assembly

26. Not for screening of psychosis

A: GHQ

27. Ax for treatment response

A: MARDS

28. Drug with half life of 3 days

A: fluoxetine

29. Time to reach steady state in zero kinetic

A: 5 half lives

30. Risk of AD if heterozygous of Apo E gene

A: 3 ( most paper quote 5 instead of 5)

31. Example of confounding effect

A: People with stress and low 5HT who were depressed (sorry could not remember the exact line)

32. Balloon cell and Hirano body finds in

33. Mode of inheritance if 25% of offsprings were affected

A: autosomal reccessive

34. Effect of X link reccessive

A: all daughters were carrier if father is affected

35. MD + Self injurious behavior

A: Lesch Nyhan syndrome

36. Meds that exacerbate acute angle glaucoma

A: paroxetine among all choices of SSRI

37. meds that added for attenuating the side effect of the other

A: Roboxetine + doxazosin (decrease urinary hesitancy)

38. Illicit drug without dependence

A: LSD

39. Pure form of memory loss without affecting time and place

A: ? semantic (other choices: assimilation, schema, episodic)

40. A man with hx of bipolar, already on Lithium, many relapses, ask for next step

A: ? add epilim

41. Definition og metabotropic receptor

A: couple to protein

42. Conventional morality

A: obey to authority

43. Development, choose correct choice

A: social smile at 4 months/ babble at 6mths/ speak _ words at 18 months

44. Defective transcription

A: lesion in promoter region

45. Akathisia resulted from

A: high D2 occupancy

46. Parkinson's dz result fom

A: ? low occupancy of D2

47. BZ withdrawal due to

A: ? low GABA function

48. A man complained of insomnia but need to drive in the early morning, which drug to use

A: stilnox (quick onset in 15mins, short half-life 2-3 hours)

49. Alcohol withdrawal+ liver impairment, BZ of choice

A: Lorazepam

50. Psychosis + liver impairment, GFR 120, drug of choice

A: Amisulpiride

51. Factor leads to long DUP

A: low socioeconomic status/ lives alone/ low education or insidious onset

52. latest site for brain maturation

A: ant frontal lobe (full maturity at 25)

53. Adopted son from alcoholic biological parents, risk of alcoholism

A: 3-4 fold

54. Boy with s/s of Fragile X, ask for the tendem repeat

A: CGG

55. Memantine mechanism

A: non competitive NMDA antagonist

56. Ribot's law

A: recent memory more easily affected than old in retrograde amnesia

57. Lesion at dominant temporal/parietal lobe

A: gerstman syndrome

58. Anatomical landmark between frontal and temporal lobe

A: Lateral sulcus

59. Connection btn of uncinate

A: fronto-temporal connection

60. Non dominant cerebral function

A: prosody

61. Downs with high cognitive function, likely genetic basis

A: mosaicism

62. Presenile dementia associated with

A: Amyloid precusor gene

63. Not included in BIG 5

A: carefulness

64. IV drug addict, fatuous mood, slow cognition, like dx

A: drug induced psychosis/ HIV dementia or opioid intoxication

65. Galvanic skin conductance

A: the answers were all related to REM

66. suicide ratio 1:1 in

A: China (female more than male)

67. About Ainsworth's attachment

68. Meiosis

A: where recombination occurs

69. EEG increased with eye closeure

A: alpha

70. EEG of 4-8 hx

A: Theta

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