General Adult
All of the following indicate a better treatment response to ECT except
Shorter illness duration
Past response to antidepressant treatment
Significant post-ictal suppression on EEG
High ictal amplitude on EEG
Past history of mania
Past history of mania
The social approach of providing a pattern of life as ordinary as possible for the learning disabled population is called
A. Community rehabilitation
B. Eugenics
C. Normalization
D. Realityorientation
E. Standardization
Normalization
All of the following are features of visual hallucinations reported in dementia of Lewy bodies except
The images are vivid
The images are mostly grey or black and white
Animate objects are often seen
The images are usually three dimensional
They predict better response to cholinesterase inhibitors
The images are mostly grey or black and white
Which of the following is the treatment of choice for status epilepticus in a case of alcohol withdrawal?
A. Diazepam
B. Chlordiazepoxide
C. Lorazepam
D. Carbamazepine
E. Phenytoin
C. Lorazepam
The lifetime prevalence of psychosis in patients suffering from epilepsy is around
A. 1–2%
B. 7–12%
C. 16–22%
D. 27–32%
E. 37–42%
B. 7–12%
While treating social anxiety disorder with SSRIs, an adequate treatment trial should probably extend to
4weeks
6 weeks
12 weeks
24weeks
18 months
12 weeks
An 18-year-old man with learning disability has ectopia lentis, fair hair, long thin limbs, and osteoporosis.The most likely diagnosis is
Phenylketonuria
Homocystinuria
Marfan syndrome
Tay Sach’s disease
Fragile X syndrome
Homocystinuria
Hyponatraemia is a troublesome side-effect of treating depression in elderly people.All of the following are true with regard to the above except
More common in males
More frequent when diuretics are co-prescribed
Often related to inappropriate ADH secretion
Risk increases with increase in age
Symptoms overlap with primary depressive features
More common in males
What is the typical time period in which withdrawal delirium appears in an alcohol-dependent person who has stopped drinking?
Within 6 hours
6–12 hours
2–3 days
After 7 days
2 weeks
2–3 days
Which of the following is least associated with a frontal lobe tumour?
Decline in IQ
Dysexecutive syndrome
Disinhibition
Akineticmutism
Manic syndrome
Decline in IQ
A 32-year-old woman presents with concerns regarding her ‘ugly appearance’. She had been convinced for a long time that her appearance was defective and was particularly worried about her ‘streak’ eyes. She admitted spending at least 14–16 hours a day thinking about her appearance and comparing herself with other people or seeking reassurance from others.Which of the following is true with regard to the treatment of this condition?
She may respond to higher than usual antidepressant doses of serotonin re-uptake inhibitors (SSRIs)
There is a good evidence for response to ECT in this condition
She has a comparable likelihood of response to SSRIs and non-SSRID antidepressants
She will require a shorter than usual duration of treatment trial with SSRIs
Cognitive behavioural therapy (CBT) has no role in the treatment
She may respond to higher than usual antidepressant doses of serotonin re-uptake inhibitors (SSRIs)
The point prevalence of schizophrenia in people with learning disability is
A. 1%
B. 20%
C. 3%
D. 15%
E. 10%
C. 3%
Which of the following is associated with poor antidepressant response in geriatric depression?
Earlier age of onset
Structural white matter abnormalities
Enlarged cerebral ventricles
Cingulate hyper-metabolism during depression
Presence of somatic symptoms
Structural white matter abnormalities
A patient who was found to be unconscious on the roadside was brought to the A&E.While transporting him, he had a seizure in the ambulance.Which of the following best points towards a diagnosis of generalized epilepsy rather than a seizure associated with alcohol-related complications?
Electrolyte disturbances
Hypoglycaemia
Occult subdural haematoma
Presence of illicit substances in the drug screen
Generalized spikes and waves on the inter-ictal EEG
Generalized spikes and waves on the inter-ictal EEG
Which of the following is the most important factor in increasing the risk of suicide in epilepsy?
Presence of comorbid psychiatric disorder
Young male
Temporal lobe seizure
Greater duration of seizure disorder
Inadequate therapy
Presence of comorbid psychiatric disorder
A 17-year-old girl is admitted to a medical unit following a prolonged period of repeated bingeing and vomiting. She induces vomiting at least six times a day but does not use laxatives or diuretics.Which of the following laboratory finding is most likely in this patient?
Low urea levels
High potassium levels
Low bicarbonate levels
Increased thyroxine levels
High amylase levels
High amylase levels
The proportion of the learning disabled population with an IQ in the range 50–70 is
A. 10%
B. 2%
C. 4%
D. 85%
E. 40%
D. 85%
Which of the following present at the time of onset of depression predict greater risk of depressive relapse after treatment discontinuation in elderly patients with depression?
Depressivecognitions
Presence of guilt
Executive dysfunction
Episodic memory loss
Psychomotor retardation
Executive dysfunction
The mortality rate in a person being treated for alcohol withdrawal delirium is
A. 0–1%
B. 10–20%
C. 20–30%
D. 30–40%
E. >50%
A. 0–1%
Which of the following is NOT considered a feature of irritable bowel syndrome (IBS)?
Abdominal discomfort not relieved by defaecation
Altered stool frequency
Altered stool form
Altered stool passage
Passage of mucus
Abdominal discomfort not relieved by defaecation
Which of the following mechanisms is proposed to underlie hypersalivation seen in patients taking clozapine?
MuscarinicM1blockade
Muscarinic M4 stimulation
Histaminic H1 blockade
Serotonergic 5HT2C blockade
Noradrenergic á1 blockade
Muscarinic M4 stimulation
Comparable male and female prevalence rates are found for which of the following psychiatric disorders in children?
Eatingdisorders
Hyperactivity disorders
Nocturnal enuresis
Selective mutism
Tourette’s syndrome
Selective mutism
Secondary depression may be caused by physical illnesses in elderly people. Which of the following is correct with regard to depression and physical illness?
Primary depression is not diagnosed in the presence of chronic medical illnesses in elderly people
Secondary depression is more common than primary depression in elderly people
Subclinical hypothyroidism is more common among depressed than non-depressed elderly people
Depression is two to three times more common in those with chronic medical illnesses
Many apparent physical illnesses are found on investigation to be due to somatoform disorders
Depression is two to three times more common in those with chronic medical illnesses
Failure to diagnose and failure to institute adequate thiamine replacement therapy for Wernicke’s encephalopathy is associated with a mortality of nearly
A. 5%
B. 10%
C. 20%
D. 30%
E. >50%
C. 20%
Which of the following is considered the cardinal feature of delirium?
Disturbance of sleep wake cycle
Psychomotor disturbance
Hallucinations
Disturbance of consciousness
Affective lability
Disturbance of consciousness