Wednesday 26 December 2007

1. physiological activity associated with PTSD include all except:

A. Decreased parasympathetic tone.
B. Excessive sweating.
C. Increased blood pressure.
D. Increased circulating thyroxine.
E. Elevated baseline heart rate.

2. A 72 year-old lady with 4 months history of memory loss, urinary incontinence and falls. On examination she has mild memory loss and a broad based, slow gait. Muscle tone is normal and both plantar reflexes are down going. What is the likely diagnosis?

A) Alzheimer's disease
B ) Frontal lobe dementia
C ) Multi-infarct dementia
D ) Normal pressure hydrocephalus
E) Parkinson's disease

3. A 73-year-old man with advanced Parkinson's disease is being treated on the ward for a urinary tract infection. His regular medicationincludes co-careldopa, entacapone, cabergoline, and prn subcutaneousapomorphine injections. His wife tells you that for the last month hisbehaviour has changed and he has become agitated, disinhibited and hekeeps asking her for money. His dyskinesia has also become more
denies having hallucinations and, after probing questioning, you canfind no evidence of delusional thought. Mood assessment shows him tobe cheerful and there are no cognitive or biological features ofdepression. What is the likely physiological cause of the behaviouralchange?

A. Reduced breakdown of dopamine
B. Change in sensitivity to dopamine
C. Confusional state due to urosepsis
D. Direct dopamine agonism
E. Coexisting dementia

4. 15. A 24-year-old man is admitted to the psychiatric ward from home, where he lives alone. His neighbours have been increasingly concerned about rubbish piling up inside his flat and sometimes he isn't seen fordays. His family tell you that over the last year he has become veryodd and isolated. On examination, he is withdrawn and quiet and youfind it difficult to understand his answers as he frequently wandersoff the point, as if he is answering a different question. Althoughspontaneous movements are reduced, there are no neurological signs and
older brothers have both had episodes of major depression. Are thereany features that suggest a favourable outcome from this episode?

A. Young age
B. Insidious onset
C. No favourable features
D. Quiet speech
E. Family history of depression

5. An 83-year-old man is undergoing cognitive assessment in apsychogeriatric clinic. He was referred because of a change in hisbehaviour, and his wife has noticed a few aggressive outbursts overthe past months. His Mini-Mental test score is 18. Which patterns ofcognitive deficit would favour a dementia of subcortical origin?

A. Poor Visuospatial performance
B. Preserved verbal fluency
C. Severe memory disturbance
D. Constructional apraxia
E. Reduced verbal output

6. A 77 year old woman complains of memory loss. Which of the following makes a diagnosis of pseudodementia less likely:-

A. Rapid onset
B. Depressed mood
C. Patchy memory loss
D. Great effort in performing tests
E. Rapid progression

Tuesday 25 December 2007

Psychiatry BoFs

1. Which of the following statements regarding rapid cycling bipolar disorder is true?

A. Often responds to tricyclic antidepressants.
B. Hospitalisation of these patients is rare.
C. More common in men than women.
D. Alcohol, stimulants or caffeine use is risk factors.
E. Defined as at least 4 episodes per month.

2. true statements about structural brain abnormalities in patients with schizophrenia include:

A. Abnormalities have not been correlated with cognitive deficits.
B. Abnormalities are present from birth.
C. Abnormalities are present in a minority of patients.
D. None
E. Cortical involvement is multifocal rather than diffuse.

3. Memory for knowledge and facts , like the first president of the united states:

A. Episodic memory.
B. Recent past memory.
C. Immediate memory.
D. Semantic memory.
E. Implicit memory.

4. A 45-year-old woman attends her GP surgery complaining of poor sleep. On closer questioning she says she avoids leaving the house because she is scared of people looking at her, and 2 weeks ago at a restaurant she had an episode of tachycardia and breathlessness with intense fear. What is the likely diagnosis?

A. Agoraphobia
B. Social phobia
C. Panic disorder
D. Generalised anxiety disorder
E. Depression

5. 4. A 25-year-old man is started on chlorpromazine having been diagnosed as suffering from paranoid schizophrenia. Two months later he is seen in clinic as an emergency due to concerns from his friends over an apparent deterioration in his mental state. The patient complains of an extremely distressing sense of restlessness and a complete inability to remain still. On examination he shifts constantly in his chair and fidgets with his coat. There is a slight increase in tone on the right side and a detectable resting tremor in the hands. He describes some vague feelings of 'being watched' but there are no other psychotic symptoms elicited. Which one of the following is the MOST likely diagnosis?

a. Acute dystonic reaction due to chlorpromazine
b. Breakthrough of his psychotic symptoms
c. Akathisia
d. Tardive dyskinesia
e. Tardive dystonia