ABSTRACT
Which of the following statements about the neuropathology of premenstrual syndrome is true?
Basal plasma and urinary cortisol levels do not distinguish women with premenstrual syndrome from controls
Its estimated heritability is approximately 20%
The exacerbation of serotonergic activity by tryptophan manifests as premenstrual syndrome
Patients’ levels of allopregnanolone increase after treatment with antidepressants, suggesting a causal pathway involving the GABA system
Lower β-endorphin levels are found in the luteal phase only (APT 2007)
Which of the following statements about the epidemiology of the antidepressant discontinuation syndrome is true?
Of the SSRIs, paroxetine is least associated with discontinuation symptoms
A study with venlafaxine showed that approximately 25% of the sample developed discontinuation symptoms
Its symptoms are less common when higher doses are discontinued
Its symptoms are not associated with the duration of the treatment
Clinical studies show no difference between gradual and abrupt discontinuation (APT 2007)
94The basic principles of motivational interviewing include all of the following except:
Express empathy
Develop discrepancy
Reward reflections
Roll with resistance
Support self-efficacy (APT 2008)
The components of a relapse prevention programme include all of the following except:
The creation of a self-help sheet
Identifying alternative pleasurable activities
The management of anger using problem-solving techniques
Rewarding reflections
Role play (APT 2008)
All of the following statements about the neuropathology of catatonia are true except:
The presence of abnormal metabolism in the thalamus and frontal lobes
The bottom-up modulation of the basal ganglia due to a deficiency of GABA
Clozapine-withdrawal catatonia is due to cholinergic and serotonergic rebound hyperactivity
A dysfunction in glutamate
A sudden block of dopamine receptors (APT 2007)
95Which of the following statements about the diagnosis and classification of catatonia is true?
The Bush–Francis Catatonia Rating Scale aids in distinguishing between catatonia and extrapyramidal symptoms
Ictal catatonia is due to the involvement of the temporal lobe
Catatonia is more commonly a consequence of a mood disorder than of schizophrenia
Catatonia due to physical causes is diagnosed as other catatonic disorder according to ICD-10
Systematic catatonia is linked to chromosome site 15q15 (APT 2007)
All of the following statements about the treatment of catatonia are true except:
Antipsychotics precipitate neuroleptic malignant syndrome in patients with catatonia
Death due to pulmonary embolism is more common in the second week
Organic catatonia responds to benzodiazepines
Patients who do not respond to benzodiazepines require ECT
Recurrence rates are higher for catatonia from schizophrenia than that from affective disorders (APT 2007)
96Which of the following statements about the neurodevelopmental aspects of schizophrenia is true?
A combination of risperidone and CBT has been found to be effective in people at risk of the development of psychosis
Delayed developmental milestones are a specific neurodevelopmental precursor of schizophrenia
Environmental interventions in childhood do not have a positive impact on reducing schizotypy in later life
Impaired cognitive functioning is not related to early onset
Obstetric complication is not associated with poorer outcomes (APT 2007)
Which of the following statements about first-episode psychosis is true?
Attenuated symptoms is a category under trait factors according to the Melbourne criteria
Cannabis use does not promote psychotic experiences in people without a pre-existing vulnerability
A change in mental state lasting at least 1 month is a state character
Only 10% of the general population identified as cases using the Bonn Scale for the Assessment of Basic Symptoms go on to develop a disorder
The rate of transition to psychosis using the Melbourne criteria has been reported to be between 28% and 40% (APT 2006)
97Which of the following statements about the management of people at risk of psychosis is true?
Delays in access to early-intervention services are due to the ego-dystonic nature of the symptoms
High scores on the GAF are a predictor of progress towards psychosis
A 1-year treatment with olanzapine offers a significant advantage
Risperidone at a low dose combined with CBT and needs-based intervention prevents the onset of psychosis
A significant lowering of the transition rate is associated with CBT (APT 2006)
All of the following are tasks that could be used to measure everyday memory functioning in patients receiving ECT except:
The Autobiographical Memory Index
The Everyday Memory Interview
The nine-point mood rating scale
The landmark location task
The virtual map task (APT 2007)
All of the following are recommended elements of a cognitive rehabilitative programme for ECT except:
A comprehensive neuropsychological assessment
Feedback to the patient and family
Psychoeducation for the patient and caregiver
Strategy learning focusing on decompensation
The transfer of acquired skills to all domains of the patient’s life (APT 2007)
98MRI evidence suggests that patients with multiple sclerosis who exhibit mania with psychotic symptoms have plaques in:
The dorso-lateral frontal cortex
The non-dominant parietal lobe
The orbitofrontal cortex
The pre-frontal cortex
The temporal horn (APT 2006)
All of the following drugs have been used for the treatment of pathological laughing and crying in multiple sclerosis except:
Amantadine
Amitryptyline
Carbamazepine
Fluoxetine
Levodopa (APT 2006)
The drug for which there is evidence with regard to treating cognitive impairment in multiple sclerosis is:
Donepezil
Galantamine
Memantine
Rivastigmine
None of the above (APT 2006)
99All of the following statements about the epidemiology of Munchausen’s syndrome are true except:
Nearly a quarter of the people with Munchausen’s syndrome have been working in occupations associated with the medical profession
Simple fictitious disorders involve health workers in their thirties
The typical onset is below the age of 30 years
Being an unmarried male is an indicator of severe Munchausen’s syndrome
Women are more frequently affected than men (APT 2008)
Which of the following statements about the diagnosis of Munchausen’s disease is true?
The absence of visits by family members has been proposed to be of diagnostic significance
Asher described three types of psychological manifestations
Cutaneous type was one of the subtypes proposed by Asher
DSM-IV categorises Munchausen’s disease into physical, psychological and mixed subtypes
The dyad of Munchausen’s disease involves pseudologia fantastica but not peregrination (APT 2008)
All of the following statements about PTSD are correct except:
A genetic factor has been shown to account for 34% of cases of PTSD
High levels of neuropeptide Y have been found in combat veterans with PTSD
Increased levels of corticotrophin-releasing hormone are found in the CSF of patients with PTSD
Numbing is strongly associated with chronicity
The prevalence of PTSD among people directly affected by terrorism is between 12% and 16% (APT 2007)
100Which of the following statements about PTSD is correct?
It involves decreased platelet 5-hydroxy tryptamine levels
It involves decreased plasma dopamine levels
It involves diminished glucocorticoid-receptor sensitivity
The DRD2 gene is associated with comorbid psychosis with PTSD
The hyper-suppression of cortisol with dexamethasone suppression test is indicated (APT 2007)
Which of the following statements about schizophrenia and violence is correct?
Approximately 5% of those found guilty of non-fatal violence have schizophrenia
The annual risk that a patient with schizophrenia will commit homicide is 1 in 10 000
Fewer than 5% of those awaiting trial for murder have a schizophrenic disorder
Minor forms of assault are more common in schizophrenia, at 20% per year
Schizophrenia is five times more common among prisoners than in the general population (APT 2006)
101Which of the following statements about the diagnosis of bipolar affective disorder is true?
Approximately 10% of patients with bipolar affective disorder have been diagnosed with schizophrenia
About 25% of patients with depression have irritable mood
Bipolar type 2 disorder is the only major DSM-IV syndrome not associated with significant social or occupational dysfunction
Bipolar type 2 disorder is more common than bipolar type 1 disorder
Only about 50% of patients with a diagnosis of bipolar affective disorder have ever been treated on monotherapy with a mood stabiliser ( www.psychiatrycpd.co.uk )
Polypharmacy in schizophrenia is associated with all of the following except:
Approximately 15% of patients being discharged on antipsychotic polypharmacy
An increase in at least one adverse event
The increasing fragmentation of services
Long-term antipsychotic polypharmacy during the year after discharge being less than 5%
A prevalence as high as 50% among inpatients ( www.psychiatrycpd.co.uk )
102All of the following statements about the management of falls are true except:
According to the Cochrane Review, multifactor risk assessment is one of the effective factors for the management of falls
Cardiogenic syncope is more likely to be fatal than neurogenic syncope
Fludrocortisone is used as an option in the management of postural hypotension when non-pharmacological measures fail
One of the aims of the NSF is to provide advice on prevention through a specialised falls service
There is robust evidence supporting the use of hip protectors to prevent fractures in community populations ( www.psychiatrycpd.co.uk )
All the following increase urinary frequency without retention except:
Alcohol
Benzodiazepines
Caffeine
Calcium-channel blockers
Diuretics ( www.psychiatrycpd.co.uk )
All of the following matches with regard to ECT and age are correct except:
Adult – posterior beta
Adult – anterior alpha
Infant – low amplitude
Old age – decrease in delta
2–6 years – mature rhythms (SBN)
103As which of the following do focal cerebral lesions show on the EEG?
Dominant theta
Normal record with fast activity
Slow rhythms
Spike and wave pattern
Unreactive delta (SBN)
In which of the following is frontal intermittent rhythmic delta activity seen?
Alzheimer’s disease
Metabolic encephalopathy
Myoclonic epilepsy
Presenile dementias
Renal encephalopathy (SBN)
Which of the following does the neural basis of phonology involve?
The anterior temporal lobe
Broca’s area
The inferior temporal lobe
The left anterior hemisphere
The left superior temporal lobe (CA)
In which of the following are the basal ganglia involved?
Phonology
Prosody
Semantics
Syntax
None of the above (CA)
104Lesions posterior to the sylvian fissure cause difficulties in:
Comprehension
Fluency
Naming
Repetition
All of the above (CA)
In which of the following aphasic syndromes is repetition preserved?
Broca’s
Conduction
Global
Transcortical motor
Wernicke’s (CA)
Which of the following is a word–picture matching test of single-word comprehension?
The Beach Scene Test
The Boston Diagnostic Aphasia Examination
The Boston Naming and Graded Naming Test
The Doors and People Test
The Peabody Picture Vocabulary Test (CA)
Mr Bainbridge presents with miosis, ptosis, anhydrosis and enophthalmos. Which of the following is the possible cause?
Horner’s syndrome
Lambert–Eaton syndrome
Shy–Drager syndrome
Wallenberg syndrome
All of the above (TN)
105In Lambert–Eaton syndrome, against which of the following are antibodies produced?
The acetylcholinesterase enzyme
The acetylcholine transporter
The muscarinic receptors
The nicotinic receptors
The voltage-gated calcium channels (TN)
All of the following types of receptors show slow adaptation ex cept:
The Golgi tendon organs
Merkel’s tactile discs
Nociceptors
Peritrichial nerve endings
Ruffini’s organs (TN)
Which of the following receptors sends nerve fibres through the anterolateral system?
Free nerve endings
Merkel’s tactile discs
Meissner’s corpuscles
Pacinian corpuscles
Peritrichial nerve endings (TN)
With which of the following are Aα myelinated fibres associated?
The Golgi tendon organs
Merkel’s tactile discs
Nociceptors
Peritrichial nerve endings
Ruffini’s organs (TN)
106All of the following are cerebellar nuclei except:
Dentate
Emboliform
Fastigius
Globose
Red (TN)
Taurine is used as a neurotransmitter in the cerebellum by which of the following cell types?
Basket
Granule
Inner stellate
Outer stellate
Purkinje (TN)
Which of the following cell types in the cerebellum is excitatory?
Basket
Golgi
Granule
Outer stellate
Purkinje (TN)
All of the following statements about the lobes of the cerebellum are true except:
The anterior lobe is the spinocerebellum
The flocculonodular lobe consists of the pontocerebellum
The posterior lobe is also known as the neocerebellum
The posterior lobe is involved with non-stereotype skilled movement
The vermis is part of the anterior lobe (TN)
107The efferent fibres that pass through the superior cerebellar peduncle include all of the following except:
The cerebelloreticular fibres
The dentatorubrothalamic pathway
The fastigiothalamic tract
The fastigiovestibular tract
The interpositorubrothalamic pathway (TN)
Which of the following statements about the olfactory pathway is true?
The medial olfactory stria is the main central pathway of the olfactory system
The olfactory bulbs are outgrowths of the metencephalon
The olfactory receptor cells give rise to myelinated axons
The olfactory tract carries both afferent and efferent fibres
The primary olfactory cortex projects to the ventroposteromedial nucleus of the thalamus (TN)
All of the following statements about the limbic system are true except:
The dentate gyrus is part of the archicortex
The hippocampus forms a prominence on the lateral wall of the inferior horn of the lateral ventricle
The output target of the hippocampus includes the mammillary body
The subcallosal gyri form a part of it
The polymorphic layer of the hippocampus consists of interneurons (TN)
108Which of the following statements about the hippocampus is true?
CA2 zone cells are the primary cells contributing to the memory process through long-term potentiation
The cingulate gyrus connects the hippocampus to the hypothalamus
The entorhinal cortex provides major input to the hippocampal formation
The hippocampal archicortex consists of four layers
A lesion of the hippocampal formation causes an inability to retrieve information from long-term memory (TN)
The production of oxytocin and ADH is under the control of:
The preoptic nucleus
The medial preoptic nucleus
The lateral preoptic nucleus
The suprachiasmatic nucleus
The supraoptic nucleus (TN)
Which of the following is the satiety centre?
The arcuate nucleus
The dorsomedial nucleus
The periventricular nucleus
The paraventricular nucleus
The ventromedial nucleus (TN)
109Which of the following statements about the ventricular system is true?
The choroid plexus secretes 500 mL of CSF every day
CSF is transported back into the ventricular system through the foramen of Luschka
The aqueduct of Sylvius is situated above the tectum in the midbrain
The body of the lateral ventricle is situated below the corpus callosum
The fourth ventricle lies above the cerebellum (SBN)
Which of the following statements about the ascending sensory tracts is true?
The affective component of pain appreciation is dependent on the somatosensory cortex
The axons from the lumbar and sacral columns form the cuneate column
The axons that branch to the dorsal horn mediate the polysynaptic reflexes
The second-order neurons of the spinothalamic tract cross two segments above their spinal cord levels
The second-order fibres that carry somaesthetic sensation from the head terminate in the inferior end of the postcentral gyrus (SBN)
110Which of the following statements about the visual pathway is true?
The fibres from the lower field pass to the superior bank of the calcarine fissure
A homonymous defect in an upper quadrant of the visual field suggests a disorder of the ipsilateral temporal lobe
The input to the superior colliculi serves as the efferent to visual avoidance reflexes
The receptors synapse with the ganglion cells
The rods outnumber the cones in all areas of the retina (SBN)
Which of the following statements about the hearing pathway is true?
High-frequency sound is localised by the superior olivary nucleus
The superior cochlear nuclei are situated around the inferior cerebellar peduncle
The auditory pathway is entirely crossed
The third-order neuron crosses in the midline in the trapezoid body
Unilateral lesions of Heschl’s gyrus are accompanied by unilateral deafness (SBN)
All of the following are characteristics of an upper motor neuron lesion except:
The absence of superficial reflexes
A Babinski sign
Hypertonia
Spastic paralysis
Wasting (SBN)
111Which of the following statements about dopamine is true?
DOPA decarboxylase is the rate-controlling enzyme
The extra-neuronal metabolism of dopamine is by COMT
Increasing tyrosine increases the level of catecholamaines
The nigrostriatal system has a higher turnover of dopamine than the mesolimbic system
Plasma HVA shows a very long lag in its response to neuroleptics (SBN)
Which of the following statements about dopamine receptors is true?
Apomorphine is their D2-receptor antagonist
Domperidone is their D2-receptor antagonist
Clozapine has a higher D5-to-D4 receptor binding
Pergolide is their D1-receptor agonist
Sulpiride is their D4-receptor antagonist (N)
Which of the following statements about noradrenaline is true?
In the adrenal medulla, noradrenaline is converted to adrenaline by demethylation
MHPG does not cross the blood–brain barrier
The non-neuronal metabolism of noradrenaline occurs through MAO-A
Noradrenaline is derived from dopamine by noradrenaline-β-hydroxylase
Noradrenergic projection to the forebrain occurs in two bundles (SBN)
112Which of the following statements about adrenergic receptors is true?
Adrenaline is a stronger agonist as a β-receptor than is isoprenaline
The β1-receptors are rich in the cerebellum
Prazosin is their α2-antagonist
Presynaptic α2-receptors control the release of noradrenaline
Yohimbine is their α2-agonist (SBN)
Which of the following statements about serotonin is true?
Platelets store 5% of the serotonin in the blood
5-HIAA has a lumbo-cervical concentration gradient
Alanine competes for the same transmitter as tryptophan
High levels of 5-HIAA are associated with arson
Tryptophan hydroxylase is the rate limiter of synthesis (SBN)
Which of the following is the test of abstract behaviour?
The Doors and People Test
The National Adult Reading Test
The Rivermead Behavioural Memory Test
The Stroop Test
The Wisconsin Card Sorting Test (CA)
Which of the following is a test of the right parietal lobe?
The Boston Naming Test
The Doors and People Test
The Graded Naming Test
The Hayling and Brixton test
The Judgement of Line Orientation Test (CA)
113Which of the following is a verbal subscale of WAIS-R?
Block design
Digit–symbol substitution
Picture arrangement
Picture completion
Similarities (CA)
Which of the following is a performance subscale on WAIS?
Arithmetic
Digit span
Digit–symbol substitution
Information
Vocabulary (CA)
Which of the following is not a WMS subscale?
Digit span
Information and orientation
Logical memory
Mental control
Picture completion (CA)
All of the following are tests of the frontal lobe except:
The Benton Verbal Fluency Test
The Benton Visual Retention Test
The Halstead Category Test
The Trail Making Test
The Wisconsin Card Sorting Test (SBN)
114Which of the following is a specific test for spatial dyslexia and dyscalculia?
The arithmetic scale of the Luria–Nebraska Battery
The Rey Complex Figure
The Left–Right Disorientation Test
The Speech Sound Perception Test
The Trail Making Test (SBN)
All of the following statements about head injuries are true except:
The Galveston Orientation and Memory Test is a specific test of post-traumatic amnesia
Neuropsychological assessment has a sensitivity of 90–95%
The prognostic value of post-traumatic amnesia is most closely seen in closed and blunt head injuries
Retrograde amnesia is a reliable index of the severity of brain damage but not of its prognosis
Retrograde amnesia results from lacerations to the frontal and temporal regions (SBN)
All of the following are tests of language function except:
The Benton Verbal Fluency Test
The Boston Diagnostic Aphasia Examination
Repeating ‘no ifs, ands or buts’ in Addenbrooke’s Cognitive Examination
The Rey Auditory Verbal Learning Test
The Revised Token Test (SBN)
115Which of the following is a test of laterality?
The Dichotic Listening Test
Finger Oscillation
Finger-Tip Number Writing
Right–Left Orientation
The Trail Making Test (SBN)
In which of the following is vascular malformation of the retina seen?
Bilateral acoustic neurofibromatosis
Sturge–Weber syndrome
Tuberous sclerosis
von Hippel–Lindau disease
von Recklinghausen’s neurofibromatosis (SBN)
In which of the following is IgA deficiency seen?
Ataxia telangiectasia
Bilateral acoustic neurofibromatosis
Sturge–Weber syndrome
Tuberous sclerosis
von Hippel–Lindau disease (SBN)
In which of the following is gene deletion on chromosome 22 seen?
Ataxia telangiectasia
Bilateral acoustic neurofibromatosis
Sturge–Weber syndrome
Tuberous sclerosis
von Hippel–Lindau disease (SBN)
116The autosomal dominant form of phakomatoses with an abnormality of chromosome 17 is called:
Bilateral acoustic neurofibromatosis
Sturge–Weber syndrome
Tuberous sclerosis
von Hippel–Lindau disease
von Recklinghausen’s neurofibromatosis (SBN)
Subungual angifibromas are seen in:
Bilateral acoustic neurofibromatosis
Sturge–Weber syndrome
Tuberous sclerosis
von Hippel–Lindau disease
von Recklinghausen’s neurofibromatosis (SBN)
High-amplitude clusters of mixed delta waves and multifocal spikes occurring particularly during sleep are characteristic of:
Grand mal
Hypsarrhythmia
Lennox–Gastaut syndrome
Myoclonus
Petit mal (SBN)
Slow 2 Hz complexes with gradual cessation and the discharge enhancing in non-REM sleep are characteristic of:
Grand mal
Hypsarrhythmia
Lennox–Gastaut syndrome
Myoclonus
Petit mal (SBN)
117All of the following statements about cognitive-event-related potentials are true except:
Attenuated cognitive negative variants have been reported in psychopathy
Children with developmental dysphasia show an abnormal P3b recovery cycle
In contingent negative variation experiments, barbiturates produce positive shifts
In schizophrenia there is generally an increase in the amplitude of P3
P3b may be a marker for conscious thought (SBN)
All of the following statements about evoked potentials are true except:
As measured by auditory evoked potentials, cochlear but not brainstem lesions alter early waves
In multiple sclerosis there is a delay in onset of P100
In myoclonic epilepsy there is a low-amplitude evoked action potential
Leukodystrophies produce delayed evoked potentials
The pathological nature of somatosensory evoked potential seen in multiple sclerosis is due to degeneration of axon from the first-order neuron (SBN)
118All of the following statements about the genetics of personality are true except:
Assortative mating is much greater for personality than for cognitive ability
Functional serotonin transporter polymorphism is associated with neuroticism
Heritabilities in the range 30–50% are typical of personality results
Individuals with longer DRD4 alleles have significantly higher novelty-seeking scores
Openness has less non-additive genetic variance than conscientiousness (PG)
Linkage studies have implicated all of the following loci in schizophrenia except:
1q21-q22
6p24-22
6q
8p22-21
21q11 (PG)
All of the following statements about the genetics of schizophrenia are true except:
T>C polymorphism at nucleotide 102 in the HTR2A gene has been implicated
Homozygosity for Ser9Gly polymorphism in exon 1 of the DRD3 gene has been implicated
Unidentified CAG/CTG repeats are less common in people with schizophrenia than in the general population
Variable findings have been reported with regard to the DRD2 gene that codes for the D2 receptor
The (1;11) (q42;q14.3) balanced reciprocal translocation generates a LOD score of 3.6 in the schizophrenia phenotype, but of 4.5 in the affective disorders phenotype (PG)
119Which of the following statements about the genetics of alcohol misuse is true?
The frequency of ADH2 has been reported to be significantly decreased in members of the Hispanic population with alcoholism
An increased risk of developing alcoholism is associated with the number and proximity of affected relatives
The heritability of alcoholism is 0.25 for males, compared with 0.5 for females
The linkage region on chromosome 11 associated with alcohol misuse is close to the gene that encodes for β1 GABA
A protective locus has been found on the chromosome t that codes for aldehyde dehydrogenase (PG)
All of the following statements about alcohol misuse are true except:
The A1 allele of Taq1 polymorphism close to the DRD2 gene is associated with alcohol dependence
The ALDH2 responsible for acetaldehyde oxidation maps to chromosome 12q24.2
At intoxicating levels, ADH4 may account for up to 40% of ethanol oxidation
Cytochrome P450IIEI is inhibited by ethanol consumption
The GABAAβ2 gene on chromosome 2 has been implicated in alcohol dependence (PG)
120The following genes have been implicated in the opiate response in mouse models. All of them have been correctly matched except for:
DAT – increased reward response
GluR-A – reduced tolerance
Mu opioid – physical dependence
Nociceptin receptor – loss of tolerance
SubP – increase in withdrawal (PG)
Which of the following is a weak agonist at the μ-receptor?
Fentanyl
Meperidine
Methadone
Morphine
Buprenorphine (N)
Which of the following is a drug that shows agonist activity at the μ-receptor and antagonist activity at the κ-receptor?
Buprenorphine
Nalorphine
Naltrexone
Naloxone
Pentazocine (N)
Which of the following is a drug that shows agonist activity at the δ- and κ-receptors and antagonistic activity at the μ-receptor?
Buprenorphine
Nalorphine
Naltrexone
Naloxone
Pentazocine (N)
121Which of the following statements about opioid receptors and endogenous ligands is true?
β-endorphin is equipotent on all three types of opioid receptors
δ-receptors are supraspinal in distribution
Dynorphin is least potent at the κ-receptor
Enkephalins are most potent at the κ-receptor
Spinal receptors are exclusively of the μ type (N)
Which of the following is an antagonist at all three types of opioid receptors?
Buprenorphine
Fentanyl
Nalorphine
Naltrexone
Pentazocine (N)
On which of the following chromosomes is the APP gene located?
3
10
14
17
21 (PG)
122On which of the following chromosomes is the presenilin-1 gene located?
3
10
14
17
21 (PG)
Presenilin is involved in controlling:
α-secretase
β-secretase
γ-secretase
δ-secretase
μ-secretase (PG)
The polymorphic form that may be protective against developing dementia is:
ApoE1
ApoE2
ApoE3
ApoE4
ApoE5 (PG)
The most common genotype associated with type III hyperlipidaemia is:
ApoE1
ApoE2
ApoE3
ApoE4
ApoE5 (PG)
123Which of the following is associated with prolonged QTc intervals?
Chamomile
Hops
Kava
Passionflower
Valerian (BJP 2006)
All of the following statements about the course of affective disorder are true except:
Agoraphobia without panic disorder lacks evidence for influencing course
Anxiety disorders present during relative euthymia predict a worse prognosis
Current comorbid anxiety disorder is associated with a risk of earlier relapse
A longer time period since the resolution of a previous episode predicts subsyndromal symptoms in recurrent unipolar depression
Social anxiety disorder is associated with poor outcomes of bipolar disorder (BJP 2006)
Which of the following statements about crisis resolution/home treatment teams (CRHTs) is true?
Adding assertive outreach teams to existing services did not produce a significant change in hospital admissions
CRHTs significantly reduce the admission of younger adults
Changes in admission patterns are not sustained for 3 months following the setting up of CRHTs
CHRTs cause a significant reduction in the number of admissions of older men
None of the above (BJP 2006)
124Which of the following statements about benzodiazepine discontinuation is true?
Around 1% of the general population uses benzodiazepines
The augmentation of systematic discontinuation with group CBT is no more effective than systematic discontinuation alone
The augmentation of systematic discontinuation with carbamazepine is more effective than systematic discontinuation alone
The odds ratio for minimal intervention is 2.8 compared with treatment as usual
Systematic discontinuation programmes are significantly more effective than simple advice (BJP 2006)
All of the following statements about debriefing are true except:
Debriefing in people with high baseline levels of arousal increases their likelihood of developing PTSD
Emotional ventilation debriefing is safer than educational debriefing
Psychoeducation provided as part of debriefing may increase awareness of stress symptoms
There is no empirical evidence to support single-session debriefing for anxiety
There is evidence for adverse effects of debriefing for PTSD (BJP 2006)
125All of the following statements about schizophrenia are true except:
Group II metabotropic glutamate-receptor antagonists show antipsychotic efficacy
Group II metabotropic receptors are autoreceptors that inhibit glutamate release
Lexical verbal fluency is less impaired with schizophrenia than is semantic verbal fluency
Schizophrenia involves an increased speed of activation in semantic memory
Semantic verbal fluency may be the best candidate for cognitive endophenotype (BJP 2008)
All of the following statements about affective disorders are true except:
Family therapy is neither more nor less effective than crisis management for bipolar disorder
Group psychoeducation as an adjunct to pharmacological therapy may be effective for relapse prevention in bipolar disorder
Internet-delivered brief CBT may be effective in the treatment of depression
Male gender and depression are associated with self-harm in first-episode psychosis
Progressive severity of depressive episodes is dependent on the patient’s age at the onset of the disorder (BJP 2008)
126Which of the following statements about eating disorders is true?
Women with anorexia are more likely to experience preterm birth than women with bulimia
The lifetime risk of bulimia nervosa in adult women is 3%
The rate of partial syndrome in eating disorder is less than that of anorexia nervosa
Women with anorexia nervosa are more likely to deliver babies of normal birth weight than those in the general population
Women with bulimia have significantly higher rates of past miscarriages than those in the general population (BJP 2007 and 2008)
All of the following statements about the genetics of schizophrenia are true except:
Delta-9-tetrahydrocannabinol acts through the CNR1 receptor
CHRNA7 variation alters the risk of schizophrenia
Higher than normal levels of glutamine are found in the anterior cingulate of never-treated patients
Paternal age is consistently associated with the risk of schizophrenia
Tobacco alleviates neurophysiological deficits through activity at the α7-nicotinic cholinergic receptor (BJP 2007)
127Which of the following statements about early psychosis is true?
The 3-year prevalence of adolescent-onset schizophrenia is 3 per 100 000 in the general population
Impaired emotional recognition is not seen among the healthy siblings of patients with schizophrenia
Later childhood growth is associated with schizophrenia spectrum disorder
There is an association between relatively slow early growth and schizophrenia in women
There is no association between a lack of insight and the stability of substance-induced psychosis diagnosis (BJP 2007)
Urea can be measured by using:
19F
1H
2H
14N
31P (KS)
pO2 can be measured by using:
19F
1H
2H
14N
31P (KS)
128pH can be measured by using:
19F
1H
2H
14N
31P (KS)
The rCBF technique involves:
Fluorine-18
Iodine-123
Nitrogen-13
Technetium-99 m
Xenon-133 (KS)
Blood flow is measured by using:
Fluorine-18
l- hexamethyl-propylene amine oxime
Iodine-123
Nitrogen-13
Xenon-133 (KS)
Renal calculi are an adverse effect of:
Gabapentin
Levitracetam
Pregabalin
Tiagabine
Topiramate (KS)
129Which of the following statements about paraldehyde is true?
It blocks the sedating effects of alcohol
Disulfiram increases the metabolism of paraldehyde
An overdose leads to respiratory acidosis
The unmetabolised drug is expired by the lungs
It has a wide therapeutic range (KS)
Gaboxadol acts at which of the following α-subunits of the GABA receptor?
1
2
3
4
5 (KS)
All of the following statements about flumazenil are true except:
It can reverse the effects of zaleplon
It can precipitate seizures
It does not reverse the effects of opioids
It should be used only once at a dosage of 2 mg
Sedation can return in up to 3% of people who are treated with flumazenil (KS)
All of the following are interactions of bupropion except:
Carbamazepine – increases the concentration of bupropion
Levodopa – delirium
Lithium – CNS toxicity
MAOIs – hypertensive crisis
Metoprolol – sinus bradycardia (KS)
130All of the following statements about executive function and stroke are true except:
Antidepressants foster long-term but not short-term improvement in executive function after a stroke
Antidepressants improve outcome after a stroke which is dependent on the improvement of depression
Nortriptyline improves the activities of daily living
Antidepressants reorganise brain circuitry by their effect on brain-derived neurotrophic factor
Sertraline improves morbidity (BJP 2007)
Which of the following statements about frontal-release signs is true?
In patients with schizophrenia, frontal-release sign scores show an inverse correlation with IQ
In patients with schizophrenia, right-grasp reflex scores correlate negatively with the number of perseverative errors on the Wisconsin Card Sorting Test
Single sign scores correlate with clinical pathology
They do not occur in healthy young people
Strong evidence exists for the heritability of neurological soft signs (BJP 2007)
All of the following statements about lithium are true except:
About 50% of patients with bipolar disorder are prescribed lithium
Glomerular dysfunction is more common than tubular dysfunction
It reduces the lethality of suicide attempts
It is retained in monotherapy for much longer than other mood stabilisers
Treatment adherence is a strong predictor of suicidal behaviour (KS)
131Which of the following statements about psychotherapy is true?
Brief CBT influences long-term outcomes in patients with acute PTSD
E-CBT reduces the symptom burden of people with social phobia
Integrated therapy for patients with bipolar disorder and substance misuse is no more effective than group drug counselling
Psychoeducation may be as beneficial as CBT in the prevention of relapses of bipolar disorder
There is level A evidence for debriefing as a treatment of post-traumatic stress disorder (BJP 2008)
Which of the following genes has been linked to depression?
4q
9p
15q
18p
22p (PG)
Which of the following statements about the epidemiology of affective disorders is true?
Bipolar type 1 disorder is more common among married men than others
A higher than average incidence of bipolar type 1 disorder is found among people in lower socio-economic groups
The lifetime incidence of OCD is twice as high among patients with major depression as it is among those with bipolar type 1 disorder
The mean age of onset of bipolar type 1 disorder is 30 years
The mean age of onset of depression is 20 years (KS)
132All of the following statements about the role of amines in affective disorders are true except:
Cholinergic agonists can exacerbate the symptoms of depression
A correlation exists between the down-regulation of β-adrenergic receptors and the clinical antidepressant response
The D1-receptor may be hypoactive in depression
GABA-receptors are upregulated by antidepressants
The platelets of people with suicidal impulses have a high concentration of serotonin uptake sites (KS)
Which of the following statements about the neuroendocrine pathology of affective disorders is true?
The gene coding for neurokinin-mediated BDNF increases after chronic stress
Hypercortisolaemia in depression suggests increased activity from acetylcholine
Increased CSF somatostatin levels have been reported in depression
In affective disorders there is increased feedback inhibition from the hippocampus over the hypothalamo–pituitary–adrenal axis
Around 10% of depressed individuals show a blunted TSH response to a TRH challenge (KS)
Which of the following patient variables is necessary for psychodynamic psychotherapy?
The ability to modulate regression
A modest to moderate need for direction and guidance
Responsiveness to behavioural thinking
Responsiveness to environmental manipulation
Social or communication problems (KS)
133All of the following are limitations of psychodynamic theory except:
Enduring structural change transcends symptomatic relief
Its focus on intrapsychic phenomena may obscure other factors
Long-term open-ended treatment is uneconomical
Personality alteration can be too ambitious
Transference regression can lead to over-idealisation of the therapist (KS)
All of the following are indications for pharmacotherapy in depression except:
Depressive stupor
Early-morning wakening
Loss of control over thinking
Low self-esteem
Marked vegetative signs (KS)
All of the following statements about phototherapy are true except:
It is well tolerated
The light range that it uses is between 500 and 1000 lux
Longer treatment durations are associated with better responses
Sleep disorders in geriatric patients can improve with bright light during the day
It is used between 1 and 2 hours before dawn (KS)
134With which of the following is priapism seen?
Duloxetine
Maprotiline
Nefazadone
Trazadone
Trimipramine (KS)
The hallmark of which of the following therapies is its patients’ ability to be their true selves in the face of familial or other pressures that threaten them with the loss of social position or love?
The Bowen model
The general systems model
The psychodynamic–experiential model
The social network model
The structural model (KS)
In which of the following is the patient encouraged to engage in unwanted behaviour?
The Bowen model
Conjoint therapy
The general systems model
Paradoxical therapy
Reframing (KS)
The most common form of marital therapy is:
Combined therapy
Conjoint therapy
Four-way session
Individual therapy
Individual couple therapy (KS)
135The form of couples therapy in which a different therapist sees each partner, with regular joint sessions in which all of the participants take part, is called:
Combined therapy
Conjoint therapy
Four-way session
Individual therapy
Individual couple therapy (KS)
The modes of treatment in DBT include all of the following except:
Consultation team
Group skills training
Individual therapy
Telephone consultation
Termination letter (KS)
