PATHWAYS:
GLYCOLYSIS --------------------- CYTOPLASM
*H.M.P SHUNT -------------------CYTOPLASM
*
*FATTY ACID SYNTHESIS ---- CYTOPLASM
*FATTY ACID OXIDATION ---- MITOCHONDRIA
*KETONE BODY SYNTHESIS - MITOCHONDRIA
*KETONE BODY OXIDATION – MITOCHONDRIA
T.C.A CYCLE --------------------- MITOCHONDR
*GLUCONEOGENESIS ----------CYTOPLASM AND MITOCHONDRIA -
*FATTY ACID ELONGATION – S . E . R
*VERY LONG CHAIN FATTY ACID OXIDATION – PEROXISOME *
ETHER PHOSPHOLIPID SYNTHESIS – PEROXISOME *
CHOLESTEROL SYNTHESIS – CYTOPLASM AND ENDOPLASMIC RETICULUM .
SKIN
PSORIASIS
1.typical lesions are erythematous raised scaly well demarcated
plaques on extensor surfaces of trunk limb, knees, elbows, scalp
2. silvery mica scales
3. auspitz sign
4. grattage test
5. wornoff ring
6. burkeley membrane
7. candle grease sign
8. nails onycholysis , thimble pitting of nail
9. munro micro abscess
10. kobners phenomenon
kobners phenomenon seen in
1. lichen planus
2. psoriasis
3. kaposi sarcoma
4. molluscum contagiosum
5. warts
6. vitilligo
7. dle
source of hemorrage or bledding
Extra dural hmrg ---- middle meningeal artery
Sub dural hmrg --- bridging or diploic veins
Sub arachnoid hmrg --- rupture on congenital berry aneursym
Tennis bal injury to eye ---- circulis iridis major
Epistaxis ---- sub mucous venous plexus
Sphenopalantine artery
During tonsillectomy --- para tonsilaar veins, tonsilar and ascending palantine artery
Tracheostomy ----- isthemus and inferior thyroid vein
Heamoptysis ------- bronchial artery
Bronchiectasis
Gastric ulcer ---- left gastric , splenic artery
Duodenalulcer ---- gastro duodenal artery
Hemmoroids ------ submucous venous plexus formed by srv, irv
Retopubic proastatectomy ------ dorsal venous plexus
Hysterectomy ------ internal illac artery
Menstruation ------- spiral arteries
All tumors from pituitary produce hormones except
*Tumors from NULL cell and oncocytoma
Prolactinoma facts:
< 10 mm - microadenoma common
>10mm - macroadenoma
Prolactin levels >200ng/ml - Occurs only in prolactinoma
Diagnosis hyperprolactinemia - Measuring morning Fasting levels of prolactin
MC cause of Hypergonadotrophic hypogonadism (Primary testicular /ovarian failure)
In males - Klinefelter syndrome
In females - Turner syndrome
normal prolactin levels - 0.25 ng/ml
1.what happens to CVP in pregnancy ?
Immunoglobulins update:
1. Smallest Ig- IgG
2. Largest Ig- IgM
3. Maximum serum concentration- IgG
4. Minimum serum concentration- IgE
5.Heat Labile- IgE
6. Earliest to be Synthesised (primary immune response)- IgM
7. Secondary immune response- IgG
8. Crosses Placenta- IgG
9. Minimum half Life- IgE
10. Maximum half life- IgG
11. Protects Surfaces- IgA
12. Warm Antibodies- IgG
13. Cold Antbodies- IgM
14. Present in Milk- IgG and IgA
15. Fix complements via classical pathway- IgM & IgG
16. Fix complements via alternative pathway- IgA & IgD
17. Primary allergic response- IgE
18. Maximum sedimentation cofficient- IgM
19. Reagin activity - IgE
20. Antigen recognition by B cells - IgD
21. Prausnitz kustner reaction - IgE
22. Homocytotropism - IgE
23. Present in milk - IgA & IgG
24. Highest carbohydrate - IgE
25. Lowest carbohydrate - IgG
Trichinellosis: caused by nematodes of the genus Trichinella, most commonly in humans T spiralis. Infection is initiated by ingestion of viable larvae in raw or undercooked meat. Digestive action liberates the larvae. The liberated larvae develop into adults in the duodenum and jejunum, where they mate and bear offspring. The adult worms are expelled in the stool. Newborn larvae penetrate the intestinal wall, enter the lymphatic system, and move via the bloodstream to areas of implantation. The life cycle is completed with the larvae invading a striated muscle cell.Although the larval presence provokes an eosinophilia, generally they are resistant to any immunologic reaction from the host as they migrate out of the capillaries and penetrate muscle cells. Once in the cell, they alter cellular activity to turn the individual cells into "nurse cells." To nourish themselves in the nurse cell, the larvae stimulate angiogenesis leading to formation of a capillary rete around the invaded muscle cell. The normal cell life cycle of the invaded muscle cell enters a permanent arrest, with nuclear DNA remaining for the remainder of the life of the host at the G2/M phase transition.The direct trauma of the larva encysting in muscle cells, coupled with the immunologic response, is responsible for other clinical features (eg, fever, myalgias). Typically, the intramuscular cysts eventually calcify.
Incubation: 8-15 days. Symptoms: gastrointestinal (diarrhea); myalgia (most common in masseter, diaphragm, and intercostal muscles); fever (38.5-40.5°C); weakness; facial edema (usually considered one of the hallmark features, particularly when localized to the eyelids); headache; fatigue/malaise; arthralgia; cardioneurologic syndrome (encephalopathy; focal neurologic deficits; acute myocardial injury (eg, myocarditis, sinus and atrial nodal dysfunction, congestive heart failure, infarction)); hypereosinophilia (=4000 granulocytes/mm3); rash (urticarial; petechiae; splinter hemorrhages; palmar rash ).
Lab test: no definitively positive laboratory test. CBC (eosinophilia in virtually all patients); Creatine phosphokinase and lactic dehydrogenase levels (elevated in 90% of pts); Urinalysis (UA) may reveal myoglobinuria; Parasite-specific indirect immunoglobulin G (IgG) enzyme-linked immunosorbent assay (ELISA) titers (100%) and anti-newborn larvae antibodies (30%) begin to be positive within 2 weeks of infection( possible some cross-reactivity with other parasitic disorders),Western-blot analysis is used as a confirmatory evaluation.
Xray of the extremities (calcified densities in the muscles); CT of the brain; MRI of the brain.
Differential diagnosis: encephalitis; food poisoning; gastroenteritis; hypereosinophilic syndrome; myopathies; neurocysticercosis; polymyositis; Stroke; Strongyloidiasis; Toxocariasis; Visceral Larva Migrans.
a. unchanged
b. slight increse
c. marked increase
d. slight decrease
2.which hormone has the highest production rate in pregnancy ?
a. oestradiol
b. HCG
c. progesterone
d. none
3.CETP cholesterol ester transfer protein cetp refers to
a. apo a
b. apo b
c. apo d
d. apo e
SIADH The following criteria should be fulfilled for a diagnosis of SIADH to be made:
plasma sodium concentration <135 b="" l="" mmol="">
plasma osmolality <280 b="" kg="" mosmol="">
OBSERVATION----> POSSIBLE SIGNIFICANCE
Acanthocytes----> Abetalipoproteinemia, neuroacanthocytosis
Howell-Jolly bodies, target cells, and acanthocytes--->Hyposplenism (congenital, previous splenectomy, celiac disease, amyloidosis)
Cryoglobulin---> Hepatitis C, multiple myeloma
Leukoerythroblastic blood film---> Bone marrow infiltration (e.g., metastatic malignancy)
urine osmolality > 100 mOsmol/kg
urinary sodium concentration >30mmol/L
Info: Lead poisoning Features
"AB CD EF "
A- Anemia
B- Basophilic stippling, burtonian line (on gums)
C- Colic & constipation (most common feature- occurs in 85% of cases)
D- Dry belly ache (ie., diarrhoea is rare), drops (foot drop & wrist drop), dyspepsia
E- Encephalopathy (more common in children)
F- Facial pallor (earliest sign)
Courtesy: U.S centers for Disease control and Prevention
Info: Lead poisoning Features "AB CD EF "
A- Anemia
B- Basophilic stippling, burtonian line (on gums)
C- Colic & constipation (most common feature- occurs in 85% of cases)
D- Dry belly ache (ie., diarrhoea is rare), drops (foot drop & wrist drop), dyspepsia
E- Encephalopathy (more common in children)
F- Facial pallor (earliest sign
In Parkinson's Disease there is a degenerative
process in the brain that leads to a marked
decrease in synthesis of dopamine and a resultant
drop in its levels in the substantia nigra and corpus
striatum (two areas of the brain where dopamine s
ynthesis is important). The lowering of dopamine results
in raising the ratio of acetylcholine to dopamine, in cells
of the nigrostriatal system. Acetylcholine is the neurotransmitter
that stimulates muscle cells. It is considered that the higher ratio
of acetylcholine to dopamine leads to over-stimulating muscle
cells and this imbalance contributes to the various disorders of
movement found in Parkinson's Disease.
Mnemonic for autosomal recessive disorders : ABCDEFGH
A – Albinism.
B – Beta thalassemia.
C – Cystic Fibrosis.
D – Deafness
E – Emphysema (alpha-1 Antitrypsin Deficiency).
F – Friedrichs ataxia
G – Gauchers disease
H – Homocystinuria, Hemochromatosis.
1) A young woman with a history of severe childhood abuse cuts or burns herself when she feels angry or anxious. She claims that hurting herself calms her and causes no pain. Self-injury can have this effect because it triggers the release of?
a. ACTH
b. Endorphins
c. Serotonin
d. Substance P
e. Arachidonic acid
Ans: B) Endorphins.
Patients who have experienced severe trauma readily release opiates in response to any stimulus that reminds them of the original trauma. In turn, causes psychic numbing and a subjective feeling of calm and analgesia.
2) Non-REM (NREM) sleep is associated with?
a. Increased blood pressure
b. Increased heart rate
c. Penile erections
d. Dreaming
e. Night terrors
Ans: E) Night terrors
Rest are seen in REM sleep.
3) A young man with a long history of aggressive and destructive behavior is arrested for assault and battery. His CSF Analysis may show?
a. High levels of endorphins
b. Low levels of endorphins
c. High levels of serotonin
d. Low levels of serotonin
e. Low levels of Substance P
Ans: D) Low levels of serotonin
There the levels of CSF serotonin are inversely proportional to the extent of both violent suicidal behavior in depressed patients and aggressive behavior in patients with personality disorders.
4) In epileptic patients, the life-time prevalence for developing a psychiatric disorder is?
a. 1 to 2%
b. 5 to 10%
c. 10 to 20%
d. 20 to 30%
e. 30 to 40%
Ans: D) 20 to 30% of epileptic patients mostly develop depression and anxiety disorders.
The lifetime prevalence for a Psychotic episode is between 4 and 10%. Highest rate of about 20% in Temporal lobe epilepsy.
5) One of the most common causes of delirium in the elderly is?
a. Substance abuse
b. Accidental poisoning
c. Acute hypoxia
d. Polypharmacy
e. Alcohol withdrawal
Ans: D
6) The occurrence of delusions de novo (ie. out of the blue) in a person over the age of 35 years and without a known history of schizophrenia or delusional disorder should always raise the possibility of?
a. Agoraphobia
b. Frotteurism
c. Sleep disorder
d. Substance abuse
e. Dissociative disorder
Ans: D.
Alcohol, cannabis, cocaine, amphetamines, and hallucinogens are
common causes of organic delusional disorders.
7) The most common psychiatric disorder associated with stroke is?
a. Mania
b. Psychosis
c. Bipolar disorder
d. Depression
e. Generalized anxiety disorder
Ans: D.
Depression occurs in 30-50% of stroke patients within two years of the event. More common with frontal lobe lesions (Lt m/c)
Mania is rare and exclusively occurs in Rt frontal lobe lesions.
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Quick Scroll Wed Jan 02, 2013 2:25 am (1 month ago) #3
8) Mental retardation is a common disorder with a prevalence of 1-2% of the general adult population. Individuals with IQs between 50-70 (mild mental retardation) account for what percentage of the affected population?
a. 20%
b. 40%
c. 60%
d. 70%
e. 90%
Ans: E) 90%
Total prevalence of MR is 1%.
Among them Mild MR ( IQ 50-69%) constitute 90%.
Moderate MR ( IQ 35-49%) constitute 7%
Severe MR (IQ 20-34%) constitute 2-3%
Profound MR (IQ< 20) constitute 1%.
As IQ decreases prevalence also decreases. Just a crude clue.
9) A 17-year-old boy has just been diagnosed with schizophrenia. His parents ask the psychiatrist if their two younger children are likely to develop the same disorder. Prevalence of schizophrenia in siblings is?
a. 2.5%
b. 5%
c. 10%
d. 20%
e. 30%
Ans: C) 10%
10) In the absence of other symptoms, episodic automatisms and olfactory hallucinations are suggestive of ?
a. Schizophrenia
b. Hysterical personality disorder
c. Schizophreniform psychosis
d. Nondominant parietal lobe lesion
e. Temporal lobe lesion
Ans: E) Temporal lobe lesion.
Automatisms, altered states of consciousness (déjà vu, staring spells), visual distortions, and auditory phenomena (hearing a buzz or a hum) are seen in temporal lobe lesions.
11) A 55-year-old male without a previous psychiatric history becomes depressed, withdrawn, and suicidal. One month later, he is diagnosed with cancer. Which type of carcinoma is most likely to manifest with depressive symptoms?
a. Prostatic
b. Renal
c. Gastric
d. Pancreatic
e. Ovarian
Ans: D) Pancreatic Ca is more likely to cause depression. Probably due to humoral factors secreted by tumor (exact reason not known).
12) The percentage of new mothers who are likely to develop postpartum depression is?
a. 0.5 to 1%
b. 10 to 15%
c. 25 to 30%
d. 35 to 40%
e. In excess of 50%
Ans: B.
13) The lifetime risk of suicide in mood disorders is?
a. 1 to 3%
b. 3 to 5%
c. 10 to 15%
d. 20 to 30%
e. 30 to 40%
Ans: C. 10 to 15%
4% of these individuals commit murders before commiting suicide.
14) The most commonly encountered psychological problem with Oral contraceptive pill is?
a. Anxiety
b. Depression
c. Night terrors
d. Short-term memory defecits
e. Long-term memory defecits\
B) Depression
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Quick Scroll Wed Jan 02, 2013 2:37 am (1 month ago) #4
15) A 24-year-old woman is chronically sleepy and fatigued. Her sleep is constantly interrupted because, as soon as she is falling asleep, an uncomfortable, “crawling” feeling in her calves forces her to walk or move her legs. This condition may be seen in?
a. Niacine de?ciency
b. Panic disorder
c. Arteriosclerosis
d. Pregnancy
e. Obstructive apnea
Ans: D. This is a case of Restless Leg Syndrome.
Patients describe the unpleasant feelings in their calves as worms or ants crawling. Only moving the legs or walking alleviates the discomfort.
Seen in: Pregnancy, Anemia, Renal failure, and other metabolic disorders.
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Quick Scroll Wed Jan 02, 2013 3:37 am (1 month ago) #5
16) Which among the following leads to inability to maintain a penile erection?
a. Propanolol
b. Amoxicillin
c. Lorazepam
d. Bupropion
e. Thyroid hormones
Ans: A. Beta blockers lead to decreased sympathetic stim, leading to impotence.
17) Which of the following statements regarding vaginismus is true?
a. It involves the outer one-third of the vagina
b. It occurs only during attempted intercourse
c. It is initiated by erotic arousal
d. It makes female masturbation difficult
e. It is under voluntary control
Ans: A.
18) In a non-tolerant individual, death is likely to occur when the serum alcohol level reaches?
a. 100 mg/dL
b. 200 mg/dL
c. 300 mg/dL
d. >400 mg/dL
e. >600 mg/dL
Ans: D.
19) What non-opioid medications can be used to treat some of the symptoms of opioid withdrawal syndrome?
a. Chlordiazepoxide
b. Haloperidol
c. Methadone
d. Phenobarbital
e. Clonidine
Ans: E. Clonidine. Its an alpha-2 adrenergic agonist. Given in doses of 100 micro gm TID.
20) A medical student is admitted for an appendectomy. The day after
the surgery, he has a severe headache. Which one of his habits can best explain the headache?
a. He smokes one to two cannabis cigarettes every other day
b. He drinks two to three beers once a week
c. He often eats at the local restaurant serving Spicy food
d. He jogs three miles every day
e. He drinks ?ve to six cups of coffee a day
Ans: E.
Caffeine withdrawal occurs very commonly when a patient who is made to stay nil per orally for a couple of hrs before surgery. Severe headache is the mc manifestation.
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Quick Scroll Wed Jan 02, 2013 3:53 am (1 month ago) #6
21) What is the effect of alcohol on sleep?
a. Increase in duration of REM sleep
b. Increase in duration of deep sleep
c. A disruption of sleep pattern with rapid shifts from one cycle to another
d. Vivid and disturbing dreams
e. Hypnopompic hallucinations
Ans: C.
22) Psychotherapy for personali-ty disorders is made more difficult by the fact that character traits are usually:
a. Ego-dystonic
b. Ego-syntonic
c. Unlikely to cause major difficulties
d. Difficult to identify
e. Unrecognized by important persons in the patient’s life
Ans: B.
23) Cognitive psychotherapy focuses on?
a. Unconscious and repressed memories
b. Faulty ideas and beliefs
c. Transference manifestations
d. Dream interpretation
e. Relaxation techniques
Ans: B.
24) A phobic patient who has an overwhelming fear of snakes is
shown the picture of a cobra while she practices deep muscle relaxation. This technique is called?
a. Desensitization
b. Reframing
c. Contingency management
d. Flooding
e. Operant conditioning
Ans: A.
Desensitization is based on the concept that when the feared stimulus is presented paired with a behavior that induces a state incompatible with anxiety (e.g., deep muscle relaxation), the phobic stimulus loses its power to create anxiety.
25) Which of the following therapies is contraindicated in a patient of Paranoid personlity disorder?
a. Hypnosis
b. Cognitive therapy
c. Family therapy
d. Supportive psychotherapy
e. Psychodynamic psychotherapy
Ans: A.
Paranoid patients who are likely to respond negatively to the loss of control that hypnosis evokes.
26) An individual’s ability to be hypnotized is primarily related to?
a. The existence of severe psychopathology
b. The patient’s compliance
c. The patient’s suggestibility
d. The hypnotist’s power of persuasion
e. A lack of strength of character
Ans: C.
27) A system is established wherein the patient earns “points” for accomplishing various aspects of personal hygiene. Points can be redeemed at the snack shop, or they can buy story books. This is an example of a treatment method called:
a. Token economy
b. Social skills training
c. Classical conditioning
d. Reward system
e. Cognitive remediation
Ans: A.
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Quick Scroll Wed Jan 02, 2013 3:58 am (1 month ago) #7
28) A teenage girl with trichotillomania is taught to make a tight ?st whenever she feel the impulse to pull her hair. This is an example of:
a. Habit reversal training
b. Extinction
c. Simple conditioning
d. Flooding
e. Desensitization
Ans: A.
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Quick Scroll Wed Jan 02, 2013 4:14 am (1 month ago) #8
29) Which of the following drugs is a tricyclic antidepressant?
a. Fluoxetine
b. Nortriptyline
c. Phenelzine
d. Tranylcypromine
e. Clonazepam
Ans: B
30) Which antipsychotic can ameliorate negative symptoms of schizophrenia?
a. Chlorpromazine
b. Fluphenazine
c. Risperidone
d. Amisulpiride
e. Thioridazide
Ans: D.
31) Which medication has been proven to be effective for depression and ADHD, in children and adults?
a. Clonidine
b. Pemoline
c. Imipramine
d. Fluvoxamine
e. Bupropion
Ans: E.
32) Choose the correct statement regarding Electroconvulsive Therapy (ECT):
a. ECT is associated with a relatively high mortality in older people
b. ECT is very effective in severe, psychotic depression
c. ECT is not as effective as antidepressants
d. ECT is contraindicated in patients with Parkinson’s disease
e. ECT is not effective in psychiatric disorders other than depression
Ans: B
33) A 9-year-old girl has signi?cant social difficulties due to her unusual behaviors. Her grunts, her motor tics, and her coprolalia are a constant cause of embarrassment and shame. What medication can relieve her symptoms?
a. Methylphenidate
b. Clomipramine
c. Sertraline
d. Trazodone
e. Haloperidol
Ans: E.
This is a case of Gilles-De-La- Tourette syndrome or Touretted diosrder. Haloperidol is effective in controlling tics, grunts and uttering obscene words(coprolalia).
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Quick Scroll Wed Jan 02, 2013 5:10 am (1 month ago) #9
34) Within what time interval can the effects of Lithium be noticed?
a. Less than 24 hours
b. 1 to 4 days
c. 7 to 14 days
d. 2 to 3 weeks
e. 1 to 2 months
Ans: C.
35) Which of the following hormones is used in the treatment of depression?
a. Progesterone
b. Cortisol
c. ACTH
d. Levothyroxine
e. Prolactin
Ans: D.
36) Which medication is recommended for High dose clozapine induced seizures?
a. Carbamazepine
b. Valproate
c. Lorazepam
d. Phenobarbital
e. Phenytoin
Ans: B.
Clozapine in doses of >400mg/day increases chance of Seizures. Valproate is effective in seizures due to clozapine.
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Quick Scroll Wed Jan 02, 2013 5:27 am (1 month ago) #10
38) Privileged communication means:
a. Psychiatrists have the privilege of disclosing information about a patient
to other psychiatrists or physicians.
b. The information revealed by psychiatrists at a probate hearing is handled as privileged.
c. Psychiatrists are granted by the court the “privilege” to disclose information about a specific patient.
d. Patients have the statutory right to prevent psychiatrists from disclosing con?dential information.
e. Psychiatrists can reveal some but not all information.
Ans: D.
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Quick Scroll Thu Jan 03, 2013 3:34 am (1 month ago) #11
Antipsychotic requiring weekly blood counts- Clozapine
Antipsychotic used in intractable itching- Chlorpromazine (due to H1 blocking property)
Atypical Antipsychotic having greatest propensity for Hyperprolactimenia: Risperidone.
Atypical with inherent anticholinergic activity: Clozapine
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Quick Scroll Thu Jan 03, 2013 4:28 am (1 month ago) #12
Thanks a lot sir!!
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Quick Scroll Thu Jan 03, 2013 4:39 am (1 month ago) #13
Neuroleptic induced akathisia treated with Beta blocker (Propranolol)
Neuroloeptic induced tremors or Parkinsonism managed with decrease in dose of the neuroleptic and/or addition of an anticholinergic drug like Benzhexol/Trihexyphenidyl.
Antipsychotic induced Weight gain tackled with dietary measures or with switching to a weight neutral atypical like Aripiprazole or Addition of Topiramate.
1st line Antipsychotic to be used in a psychotic episode is an Atypical agent unless otherwise indicated.
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Quick Scroll Thu Jan 03, 2013 5:22 am (1 month ago) #14
very useful thread...thanks
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Quick Scroll Thu Jan 03, 2013 10:57 pm (1 month ago) #15
thank u so much..
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Quick Scroll Fri Jan 04, 2013 3:03 am (1 month ago) #16
39) Late-onset schizophrenia:
A. is clinically distinguishable from schizophrenia.
B. is more common in men.
C. has an onset after age 60.
D. is associated with a preponderance of paranoid symptoms.
E. results in poorer response to antipsychotic medications.
Ans: E.
40) A schizophrenic patient who states that he feels his brain burning is most likely experiencing a?
A. delusional feeling
B. gustatory hallucination
C. coenesthetic hallucination
D. haptic hallucination
E. hypnopompic hallucination
Ans: C
coenesthetic hallucination or Cenesthetic hallucination are usually hallucinations of deep visceral pain or deep visceral sensation.
Postpartum blues:
-Occur in up to 50 percent of women after childbirth
-Are self-limited
-Begin shortly after childbirth and lessens in severity over the course of a week
-Are considered to be normal
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Quick Scroll Fri Jan 04, 2013 3:16 am (1 month ago) #17
Schizophrenia classified based on age (unofficial classificn.) by Researchers:
Childhood Onset Schizophrenia (COS) < 10yrs
Very Early Onset Schizophrenia (VEOS) < 13yrs
Early onset Schiz (EOS)- Schizophrenia immediately after the age of 13yrs
Late Onset Schizophrenia : Onset > 45 yrs
Very late onset schizophrenia: Onset > 65yrs of age..
Thanks to my professors for teaching me this during bedside clinics.
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Quick Scroll Fri Jan 04, 2013 5:36 am (1 month ago) #18
41) All of the following are associated with a good prognosis in a brief psychotic disorder except
A. Sudden onset of symptoms
B. No affective symptoms
C. Confusion during psychosis
D. Severe precipitating stressor
E. Few premorbid schizoid traits
Ans: B.
Affective symptoms in a brief psychotic disorder is assoc wt good prognosis.
42) Tourette’s disorder has been shown to possibly have a familial and genetic relationship with?
A. panic disorder
B. social phobia
C. generalized anxiety disorder
D. OCD
E. none of the above
Ans: OCD.
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Quick Scroll Sat Jan 05, 2013 1:34 am (1 month ago) #19
Attention-de?cit/hyperactivity disorder (ADHD):
-Symptoms at least by Age 7 years
- Prevalence: 3%- 5%
- Prenatal factors like Poor maternal health and maternal use of cigarettes, alcohol, and drugs.
- Perinatal factors that contribute are Low birth weight and postmaturity.
- Inborn error of metabolism associated with the development of ADHD- Phenylketonuria
- Scales used to assess severity of ADHD are Conner’s teacher or parent rating scales, DuPaul ADHD Rating Scale-IV, Child Behavior Checklist (CBCL)
-
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Quick Scroll Sun Jan 06, 2013 12:51 am (1 month ago) #20
Antipsychotic medication is associated with Pigmentary Retinopathy- Thioridazine
Defense mechanisms are common in delusional disorder:
-Reaction formation
-Projection, and
-Denial
Life event most often associated with development of depression later in life- The loss of a parent before the age of 11.
Double depression- Dysthymia with superimposed Major depressive episode
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Quick Scroll Sun Jan 06, 2013 1:07 am (1 month ago) #21
Electroconvulsive therapy was started by Cerletti and Bini.
Psychosurgery useful in Intractable OCD- Stereotaxic limbic leukotomy and anterior capsulotomy
Common name for somatization disorder- Briquet’s syndrome
Gridiron abdomen- Patients with chronic factitious disorder with predominantly physical symptoms may acquire multiple abdominal scars from repeated surgical procedures.
Four phases in the sexual response cycle in order:
-Desire
-Excitement
-Orgasm
-Resolution
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Quick Scroll Sun Jan 06, 2013 3:10 pm (1 month ago) #22
Phases of Sexual response cycle and corresponding Dysfunctions seen:
Phases Examples of Dysfunction
Desire Hypoactive sexual desire disorder; sexual aversion disorder
Excitement Female sexual arousal disorder; male erectile disorder
Orgasm Male and female orgasmic disorders; premature ejaculation
Resolution Postcoital dysphoria; postcoital headache
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Quick Scroll Sun Jan 06, 2013 3:19 pm (1 month ago) #23
Russell’s sign: Presence of callouses on the knuckles secondary to repeated self-induction of emesis.
Bulimia nervosa was described by Gerald Russell in 1979.
REM latency:
-The amount of time from the onset of sleep to onset of the ?rst REM period.
- Normally 60 to 90 minutes.
- Is decreased in depression, narcolepsy, and with the use of certain hypnotics.
Neurophysiology of sleep:
- Brain stem (Reticular formation) generates REM sleep.
- Forebrain structures (thalamus, hypothalamus, dorsal raphe nucleus, and solitary nucleus) generate non-REM sleep and wakefulness.
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Quick Scroll Mon Jan 07, 2013 11:56 pm (1 month ago) #24
Medications used in maintenance therapy for opioids:
-Methadone
-Naltrexone
-Levo alpha acetyl methadal (LAAM)
-Buprenorphine
Most common drug of abuse in schizophrenia patients- Nicotine
FDA Approved medications indicated for smoking cessation:
-Bupropion
-Varenicline
Most commonly used psychoactive drug in the world- Caffeine
Most commonly used drug of Abuse in the world: Cannabis
Most commonly used drug of Abuse in India: Tobacco
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Quick Scroll Tue Jan 08, 2013 12:19 am (1 month ago) #25
doc for ocd pls?
buks sayin clomipramine / fluoxetine..
best answer??
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Quick Scroll Tue Jan 08, 2013 12:20 am (1 month ago) #26
another query reg cmc psychiatry spl paper..
is neurology and neuroscience imp for cmc psych paper also lik nimhans??
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Quick Scroll Tue Jan 08, 2013 1:14 am (1 month ago) #27
thanks a lot guys
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Quick Scroll Tue Jan 08, 2013 1:17 am (1 month ago) #28
deepanathan1988 wrote:
doc for ocd pls?
buks sayin clomipramine / fluoxetine..
best answer??
For OCD, Clomipramine was approved by the FDA first and later on Fluoxetine. If both are in the options provided, Fluoxetine (a SSRI) is a better choice because it's side effect profile is better than Clomipramine (a Tricyclic antidepressant).
OPSI: Overwhelming post splenectomy infection is most commonly caused by 3 organisms
1.Streptococcus pneumoniae
2.H.influenza
3.N.Meningitides
iron in duodenum , folate in jejumum, b-12 in terminal ileum
GLYCOLYSIS --------------------- CYTOPLASM
*H.M.P SHUNT -------------------CYTOPLASM
*
*FATTY ACID SYNTHESIS ---- CYTOPLASM
*FATTY ACID OXIDATION ---- MITOCHONDRIA
*KETONE BODY SYNTHESIS - MITOCHONDRIA
*KETONE BODY OXIDATION – MITOCHONDRIA
T.C.A CYCLE --------------------- MITOCHONDR
*GLUCONEOGENESIS ----------CYTOPLASM AND MITOCHONDRIA -
*FATTY ACID ELONGATION – S . E . R
*VERY LONG CHAIN FATTY ACID OXIDATION – PEROXISOME *
ETHER PHOSPHOLIPID SYNTHESIS – PEROXISOME *
CHOLESTEROL SYNTHESIS – CYTOPLASM AND ENDOPLASMIC RETICULUM .
SKIN
PSORIASIS
1.typical lesions are erythematous raised scaly well demarcated
plaques on extensor surfaces of trunk limb, knees, elbows, scalp
2. silvery mica scales
3. auspitz sign
4. grattage test
5. wornoff ring
6. burkeley membrane
7. candle grease sign
8. nails onycholysis , thimble pitting of nail
9. munro micro abscess
10. kobners phenomenon
kobners phenomenon seen in
1. lichen planus
2. psoriasis
3. kaposi sarcoma
4. molluscum contagiosum
5. warts
6. vitilligo
7. dle
source of hemorrage or bledding
Extra dural hmrg ---- middle meningeal artery
Sub dural hmrg --- bridging or diploic veins
Sub arachnoid hmrg --- rupture on congenital berry aneursym
Tennis bal injury to eye ---- circulis iridis major
Epistaxis ---- sub mucous venous plexus
Sphenopalantine artery
During tonsillectomy --- para tonsilaar veins, tonsilar and ascending palantine artery
Tracheostomy ----- isthemus and inferior thyroid vein
Heamoptysis ------- bronchial artery
Bronchiectasis
Gastric ulcer ---- left gastric , splenic artery
Duodenalulcer ---- gastro duodenal artery
Hemmoroids ------ submucous venous plexus formed by srv, irv
Retopubic proastatectomy ------ dorsal venous plexus
Hysterectomy ------ internal illac artery
Menstruation ------- spiral arteries
All tumors from pituitary produce hormones except
*Tumors from NULL cell and oncocytoma
Prolactinoma facts:
< 10 mm - microadenoma common
>10mm - macroadenoma
Prolactin levels >200ng/ml - Occurs only in prolactinoma
Diagnosis hyperprolactinemia - Measuring morning Fasting levels of prolactin
MC cause of Hypergonadotrophic hypogonadism (Primary testicular /ovarian failure)
In males - Klinefelter syndrome
In females - Turner syndrome
normal prolactin levels - 0.25 ng/ml
1.what happens to CVP in pregnancy ?
Immunoglobulins update:
1. Smallest Ig- IgG
2. Largest Ig- IgM
3. Maximum serum concentration- IgG
4. Minimum serum concentration- IgE
5.Heat Labile- IgE
6. Earliest to be Synthesised (primary immune response)- IgM
7. Secondary immune response- IgG
8. Crosses Placenta- IgG
9. Minimum half Life- IgE
10. Maximum half life- IgG
11. Protects Surfaces- IgA
12. Warm Antibodies- IgG
13. Cold Antbodies- IgM
14. Present in Milk- IgG and IgA
15. Fix complements via classical pathway- IgM & IgG
16. Fix complements via alternative pathway- IgA & IgD
17. Primary allergic response- IgE
18. Maximum sedimentation cofficient- IgM
19. Reagin activity - IgE
20. Antigen recognition by B cells - IgD
21. Prausnitz kustner reaction - IgE
22. Homocytotropism - IgE
23. Present in milk - IgA & IgG
24. Highest carbohydrate - IgE
25. Lowest carbohydrate - IgG
Trichinellosis: caused by nematodes of the genus Trichinella, most commonly in humans T spiralis. Infection is initiated by ingestion of viable larvae in raw or undercooked meat. Digestive action liberates the larvae. The liberated larvae develop into adults in the duodenum and jejunum, where they mate and bear offspring. The adult worms are expelled in the stool. Newborn larvae penetrate the intestinal wall, enter the lymphatic system, and move via the bloodstream to areas of implantation. The life cycle is completed with the larvae invading a striated muscle cell.Although the larval presence provokes an eosinophilia, generally they are resistant to any immunologic reaction from the host as they migrate out of the capillaries and penetrate muscle cells. Once in the cell, they alter cellular activity to turn the individual cells into "nurse cells." To nourish themselves in the nurse cell, the larvae stimulate angiogenesis leading to formation of a capillary rete around the invaded muscle cell. The normal cell life cycle of the invaded muscle cell enters a permanent arrest, with nuclear DNA remaining for the remainder of the life of the host at the G2/M phase transition.The direct trauma of the larva encysting in muscle cells, coupled with the immunologic response, is responsible for other clinical features (eg, fever, myalgias). Typically, the intramuscular cysts eventually calcify.
Incubation: 8-15 days. Symptoms: gastrointestinal (diarrhea); myalgia (most common in masseter, diaphragm, and intercostal muscles); fever (38.5-40.5°C); weakness; facial edema (usually considered one of the hallmark features, particularly when localized to the eyelids); headache; fatigue/malaise; arthralgia; cardioneurologic syndrome (encephalopathy; focal neurologic deficits; acute myocardial injury (eg, myocarditis, sinus and atrial nodal dysfunction, congestive heart failure, infarction)); hypereosinophilia (=4000 granulocytes/mm3); rash (urticarial; petechiae; splinter hemorrhages; palmar rash ).
Lab test: no definitively positive laboratory test. CBC (eosinophilia in virtually all patients); Creatine phosphokinase and lactic dehydrogenase levels (elevated in 90% of pts); Urinalysis (UA) may reveal myoglobinuria; Parasite-specific indirect immunoglobulin G (IgG) enzyme-linked immunosorbent assay (ELISA) titers (100%) and anti-newborn larvae antibodies (30%) begin to be positive within 2 weeks of infection( possible some cross-reactivity with other parasitic disorders),Western-blot analysis is used as a confirmatory evaluation.
Xray of the extremities (calcified densities in the muscles); CT of the brain; MRI of the brain.
Differential diagnosis: encephalitis; food poisoning; gastroenteritis; hypereosinophilic syndrome; myopathies; neurocysticercosis; polymyositis; Stroke; Strongyloidiasis; Toxocariasis; Visceral Larva Migrans.
a. unchanged
b. slight increse
c. marked increase
d. slight decrease
2.which hormone has the highest production rate in pregnancy ?
a. oestradiol
b. HCG
c. progesterone
d. none
3.CETP cholesterol ester transfer protein cetp refers to
a. apo a
b. apo b
c. apo d
d. apo e
SIADH The following criteria should be fulfilled for a diagnosis of SIADH to be made:
plasma sodium concentration <135 b="" l="" mmol="">
plasma osmolality <280 b="" kg="" mosmol="">
OBSERVATION----> POSSIBLE SIGNIFICANCE
Acanthocytes----> Abetalipoproteinemia, neuroacanthocytosis
Howell-Jolly bodies, target cells, and acanthocytes--->Hyposplenism (congenital, previous splenectomy, celiac disease, amyloidosis)
Cryoglobulin---> Hepatitis C, multiple myeloma
Leukoerythroblastic blood film---> Bone marrow infiltration (e.g., metastatic malignancy)
urine osmolality > 100 mOsmol/kg
urinary sodium concentration >30mmol/L
Info: Lead poisoning Features
"AB CD EF "
A- Anemia
B- Basophilic stippling, burtonian line (on gums)
C- Colic & constipation (most common feature- occurs in 85% of cases)
D- Dry belly ache (ie., diarrhoea is rare), drops (foot drop & wrist drop), dyspepsia
E- Encephalopathy (more common in children)
F- Facial pallor (earliest sign)
Courtesy: U.S centers for Disease control and Prevention
Info: Lead poisoning Features "AB CD EF "
A- Anemia
B- Basophilic stippling, burtonian line (on gums)
C- Colic & constipation (most common feature- occurs in 85% of cases)
D- Dry belly ache (ie., diarrhoea is rare), drops (foot drop & wrist drop), dyspepsia
E- Encephalopathy (more common in children)
F- Facial pallor (earliest sign
In Parkinson's Disease there is a degenerative
process in the brain that leads to a marked
decrease in synthesis of dopamine and a resultant
drop in its levels in the substantia nigra and corpus
striatum (two areas of the brain where dopamine s
ynthesis is important). The lowering of dopamine results
in raising the ratio of acetylcholine to dopamine, in cells
of the nigrostriatal system. Acetylcholine is the neurotransmitter
that stimulates muscle cells. It is considered that the higher ratio
of acetylcholine to dopamine leads to over-stimulating muscle
cells and this imbalance contributes to the various disorders of
movement found in Parkinson's Disease.
Mnemonic for autosomal recessive disorders : ABCDEFGH
A – Albinism.
B – Beta thalassemia.
C – Cystic Fibrosis.
D – Deafness
E – Emphysema (alpha-1 Antitrypsin Deficiency).
F – Friedrichs ataxia
G – Gauchers disease
H – Homocystinuria, Hemochromatosis.
1) A young woman with a history of severe childhood abuse cuts or burns herself when she feels angry or anxious. She claims that hurting herself calms her and causes no pain. Self-injury can have this effect because it triggers the release of?
a. ACTH
b. Endorphins
c. Serotonin
d. Substance P
e. Arachidonic acid
Ans: B) Endorphins.
Patients who have experienced severe trauma readily release opiates in response to any stimulus that reminds them of the original trauma. In turn, causes psychic numbing and a subjective feeling of calm and analgesia.
2) Non-REM (NREM) sleep is associated with?
a. Increased blood pressure
b. Increased heart rate
c. Penile erections
d. Dreaming
e. Night terrors
Ans: E) Night terrors
Rest are seen in REM sleep.
3) A young man with a long history of aggressive and destructive behavior is arrested for assault and battery. His CSF Analysis may show?
a. High levels of endorphins
b. Low levels of endorphins
c. High levels of serotonin
d. Low levels of serotonin
e. Low levels of Substance P
Ans: D) Low levels of serotonin
There the levels of CSF serotonin are inversely proportional to the extent of both violent suicidal behavior in depressed patients and aggressive behavior in patients with personality disorders.
4) In epileptic patients, the life-time prevalence for developing a psychiatric disorder is?
a. 1 to 2%
b. 5 to 10%
c. 10 to 20%
d. 20 to 30%
e. 30 to 40%
Ans: D) 20 to 30% of epileptic patients mostly develop depression and anxiety disorders.
The lifetime prevalence for a Psychotic episode is between 4 and 10%. Highest rate of about 20% in Temporal lobe epilepsy.
5) One of the most common causes of delirium in the elderly is?
a. Substance abuse
b. Accidental poisoning
c. Acute hypoxia
d. Polypharmacy
e. Alcohol withdrawal
Ans: D
6) The occurrence of delusions de novo (ie. out of the blue) in a person over the age of 35 years and without a known history of schizophrenia or delusional disorder should always raise the possibility of?
a. Agoraphobia
b. Frotteurism
c. Sleep disorder
d. Substance abuse
e. Dissociative disorder
Ans: D.
Alcohol, cannabis, cocaine, amphetamines, and hallucinogens are
common causes of organic delusional disorders.
7) The most common psychiatric disorder associated with stroke is?
a. Mania
b. Psychosis
c. Bipolar disorder
d. Depression
e. Generalized anxiety disorder
Ans: D.
Depression occurs in 30-50% of stroke patients within two years of the event. More common with frontal lobe lesions (Lt m/c)
Mania is rare and exclusively occurs in Rt frontal lobe lesions.
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Quick Scroll Wed Jan 02, 2013 2:25 am (1 month ago) #3
8) Mental retardation is a common disorder with a prevalence of 1-2% of the general adult population. Individuals with IQs between 50-70 (mild mental retardation) account for what percentage of the affected population?
a. 20%
b. 40%
c. 60%
d. 70%
e. 90%
Ans: E) 90%
Total prevalence of MR is 1%.
Among them Mild MR ( IQ 50-69%) constitute 90%.
Moderate MR ( IQ 35-49%) constitute 7%
Severe MR (IQ 20-34%) constitute 2-3%
Profound MR (IQ< 20) constitute 1%.
As IQ decreases prevalence also decreases. Just a crude clue.
9) A 17-year-old boy has just been diagnosed with schizophrenia. His parents ask the psychiatrist if their two younger children are likely to develop the same disorder. Prevalence of schizophrenia in siblings is?
a. 2.5%
b. 5%
c. 10%
d. 20%
e. 30%
Ans: C) 10%
10) In the absence of other symptoms, episodic automatisms and olfactory hallucinations are suggestive of ?
a. Schizophrenia
b. Hysterical personality disorder
c. Schizophreniform psychosis
d. Nondominant parietal lobe lesion
e. Temporal lobe lesion
Ans: E) Temporal lobe lesion.
Automatisms, altered states of consciousness (déjà vu, staring spells), visual distortions, and auditory phenomena (hearing a buzz or a hum) are seen in temporal lobe lesions.
11) A 55-year-old male without a previous psychiatric history becomes depressed, withdrawn, and suicidal. One month later, he is diagnosed with cancer. Which type of carcinoma is most likely to manifest with depressive symptoms?
a. Prostatic
b. Renal
c. Gastric
d. Pancreatic
e. Ovarian
Ans: D) Pancreatic Ca is more likely to cause depression. Probably due to humoral factors secreted by tumor (exact reason not known).
12) The percentage of new mothers who are likely to develop postpartum depression is?
a. 0.5 to 1%
b. 10 to 15%
c. 25 to 30%
d. 35 to 40%
e. In excess of 50%
Ans: B.
13) The lifetime risk of suicide in mood disorders is?
a. 1 to 3%
b. 3 to 5%
c. 10 to 15%
d. 20 to 30%
e. 30 to 40%
Ans: C. 10 to 15%
4% of these individuals commit murders before commiting suicide.
14) The most commonly encountered psychological problem with Oral contraceptive pill is?
a. Anxiety
b. Depression
c. Night terrors
d. Short-term memory defecits
e. Long-term memory defecits\
B) Depression
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Quick Scroll Wed Jan 02, 2013 2:37 am (1 month ago) #4
15) A 24-year-old woman is chronically sleepy and fatigued. Her sleep is constantly interrupted because, as soon as she is falling asleep, an uncomfortable, “crawling” feeling in her calves forces her to walk or move her legs. This condition may be seen in?
a. Niacine de?ciency
b. Panic disorder
c. Arteriosclerosis
d. Pregnancy
e. Obstructive apnea
Ans: D. This is a case of Restless Leg Syndrome.
Patients describe the unpleasant feelings in their calves as worms or ants crawling. Only moving the legs or walking alleviates the discomfort.
Seen in: Pregnancy, Anemia, Renal failure, and other metabolic disorders.
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Quick Scroll Wed Jan 02, 2013 3:37 am (1 month ago) #5
16) Which among the following leads to inability to maintain a penile erection?
a. Propanolol
b. Amoxicillin
c. Lorazepam
d. Bupropion
e. Thyroid hormones
Ans: A. Beta blockers lead to decreased sympathetic stim, leading to impotence.
17) Which of the following statements regarding vaginismus is true?
a. It involves the outer one-third of the vagina
b. It occurs only during attempted intercourse
c. It is initiated by erotic arousal
d. It makes female masturbation difficult
e. It is under voluntary control
Ans: A.
18) In a non-tolerant individual, death is likely to occur when the serum alcohol level reaches?
a. 100 mg/dL
b. 200 mg/dL
c. 300 mg/dL
d. >400 mg/dL
e. >600 mg/dL
Ans: D.
19) What non-opioid medications can be used to treat some of the symptoms of opioid withdrawal syndrome?
a. Chlordiazepoxide
b. Haloperidol
c. Methadone
d. Phenobarbital
e. Clonidine
Ans: E. Clonidine. Its an alpha-2 adrenergic agonist. Given in doses of 100 micro gm TID.
20) A medical student is admitted for an appendectomy. The day after
the surgery, he has a severe headache. Which one of his habits can best explain the headache?
a. He smokes one to two cannabis cigarettes every other day
b. He drinks two to three beers once a week
c. He often eats at the local restaurant serving Spicy food
d. He jogs three miles every day
e. He drinks ?ve to six cups of coffee a day
Ans: E.
Caffeine withdrawal occurs very commonly when a patient who is made to stay nil per orally for a couple of hrs before surgery. Severe headache is the mc manifestation.
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Quick Scroll Wed Jan 02, 2013 3:53 am (1 month ago) #6
21) What is the effect of alcohol on sleep?
a. Increase in duration of REM sleep
b. Increase in duration of deep sleep
c. A disruption of sleep pattern with rapid shifts from one cycle to another
d. Vivid and disturbing dreams
e. Hypnopompic hallucinations
Ans: C.
22) Psychotherapy for personali-ty disorders is made more difficult by the fact that character traits are usually:
a. Ego-dystonic
b. Ego-syntonic
c. Unlikely to cause major difficulties
d. Difficult to identify
e. Unrecognized by important persons in the patient’s life
Ans: B.
23) Cognitive psychotherapy focuses on?
a. Unconscious and repressed memories
b. Faulty ideas and beliefs
c. Transference manifestations
d. Dream interpretation
e. Relaxation techniques
Ans: B.
24) A phobic patient who has an overwhelming fear of snakes is
shown the picture of a cobra while she practices deep muscle relaxation. This technique is called?
a. Desensitization
b. Reframing
c. Contingency management
d. Flooding
e. Operant conditioning
Ans: A.
Desensitization is based on the concept that when the feared stimulus is presented paired with a behavior that induces a state incompatible with anxiety (e.g., deep muscle relaxation), the phobic stimulus loses its power to create anxiety.
25) Which of the following therapies is contraindicated in a patient of Paranoid personlity disorder?
a. Hypnosis
b. Cognitive therapy
c. Family therapy
d. Supportive psychotherapy
e. Psychodynamic psychotherapy
Ans: A.
Paranoid patients who are likely to respond negatively to the loss of control that hypnosis evokes.
26) An individual’s ability to be hypnotized is primarily related to?
a. The existence of severe psychopathology
b. The patient’s compliance
c. The patient’s suggestibility
d. The hypnotist’s power of persuasion
e. A lack of strength of character
Ans: C.
27) A system is established wherein the patient earns “points” for accomplishing various aspects of personal hygiene. Points can be redeemed at the snack shop, or they can buy story books. This is an example of a treatment method called:
a. Token economy
b. Social skills training
c. Classical conditioning
d. Reward system
e. Cognitive remediation
Ans: A.
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Quick Scroll Wed Jan 02, 2013 3:58 am (1 month ago) #7
28) A teenage girl with trichotillomania is taught to make a tight ?st whenever she feel the impulse to pull her hair. This is an example of:
a. Habit reversal training
b. Extinction
c. Simple conditioning
d. Flooding
e. Desensitization
Ans: A.
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Quick Scroll Wed Jan 02, 2013 4:14 am (1 month ago) #8
29) Which of the following drugs is a tricyclic antidepressant?
a. Fluoxetine
b. Nortriptyline
c. Phenelzine
d. Tranylcypromine
e. Clonazepam
Ans: B
30) Which antipsychotic can ameliorate negative symptoms of schizophrenia?
a. Chlorpromazine
b. Fluphenazine
c. Risperidone
d. Amisulpiride
e. Thioridazide
Ans: D.
31) Which medication has been proven to be effective for depression and ADHD, in children and adults?
a. Clonidine
b. Pemoline
c. Imipramine
d. Fluvoxamine
e. Bupropion
Ans: E.
32) Choose the correct statement regarding Electroconvulsive Therapy (ECT):
a. ECT is associated with a relatively high mortality in older people
b. ECT is very effective in severe, psychotic depression
c. ECT is not as effective as antidepressants
d. ECT is contraindicated in patients with Parkinson’s disease
e. ECT is not effective in psychiatric disorders other than depression
Ans: B
33) A 9-year-old girl has signi?cant social difficulties due to her unusual behaviors. Her grunts, her motor tics, and her coprolalia are a constant cause of embarrassment and shame. What medication can relieve her symptoms?
a. Methylphenidate
b. Clomipramine
c. Sertraline
d. Trazodone
e. Haloperidol
Ans: E.
This is a case of Gilles-De-La- Tourette syndrome or Touretted diosrder. Haloperidol is effective in controlling tics, grunts and uttering obscene words(coprolalia).
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Quick Scroll Wed Jan 02, 2013 5:10 am (1 month ago) #9
34) Within what time interval can the effects of Lithium be noticed?
a. Less than 24 hours
b. 1 to 4 days
c. 7 to 14 days
d. 2 to 3 weeks
e. 1 to 2 months
Ans: C.
35) Which of the following hormones is used in the treatment of depression?
a. Progesterone
b. Cortisol
c. ACTH
d. Levothyroxine
e. Prolactin
Ans: D.
36) Which medication is recommended for High dose clozapine induced seizures?
a. Carbamazepine
b. Valproate
c. Lorazepam
d. Phenobarbital
e. Phenytoin
Ans: B.
Clozapine in doses of >400mg/day increases chance of Seizures. Valproate is effective in seizures due to clozapine.
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Quick Scroll Wed Jan 02, 2013 5:27 am (1 month ago) #10
38) Privileged communication means:
a. Psychiatrists have the privilege of disclosing information about a patient
to other psychiatrists or physicians.
b. The information revealed by psychiatrists at a probate hearing is handled as privileged.
c. Psychiatrists are granted by the court the “privilege” to disclose information about a specific patient.
d. Patients have the statutory right to prevent psychiatrists from disclosing con?dential information.
e. Psychiatrists can reveal some but not all information.
Ans: D.
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Quick Scroll Thu Jan 03, 2013 3:34 am (1 month ago) #11
Antipsychotic requiring weekly blood counts- Clozapine
Antipsychotic used in intractable itching- Chlorpromazine (due to H1 blocking property)
Atypical Antipsychotic having greatest propensity for Hyperprolactimenia: Risperidone.
Atypical with inherent anticholinergic activity: Clozapine
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Quick Scroll Thu Jan 03, 2013 4:28 am (1 month ago) #12
Thanks a lot sir!!
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Quick Scroll Thu Jan 03, 2013 4:39 am (1 month ago) #13
Neuroleptic induced akathisia treated with Beta blocker (Propranolol)
Neuroloeptic induced tremors or Parkinsonism managed with decrease in dose of the neuroleptic and/or addition of an anticholinergic drug like Benzhexol/Trihexyphenidyl.
Antipsychotic induced Weight gain tackled with dietary measures or with switching to a weight neutral atypical like Aripiprazole or Addition of Topiramate.
1st line Antipsychotic to be used in a psychotic episode is an Atypical agent unless otherwise indicated.
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Quick Scroll Thu Jan 03, 2013 5:22 am (1 month ago) #14
very useful thread...thanks
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Quick Scroll Thu Jan 03, 2013 10:57 pm (1 month ago) #15
thank u so much..
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Quick Scroll Fri Jan 04, 2013 3:03 am (1 month ago) #16
39) Late-onset schizophrenia:
A. is clinically distinguishable from schizophrenia.
B. is more common in men.
C. has an onset after age 60.
D. is associated with a preponderance of paranoid symptoms.
E. results in poorer response to antipsychotic medications.
Ans: E.
40) A schizophrenic patient who states that he feels his brain burning is most likely experiencing a?
A. delusional feeling
B. gustatory hallucination
C. coenesthetic hallucination
D. haptic hallucination
E. hypnopompic hallucination
Ans: C
coenesthetic hallucination or Cenesthetic hallucination are usually hallucinations of deep visceral pain or deep visceral sensation.
Postpartum blues:
-Occur in up to 50 percent of women after childbirth
-Are self-limited
-Begin shortly after childbirth and lessens in severity over the course of a week
-Are considered to be normal
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Quick Scroll Fri Jan 04, 2013 3:16 am (1 month ago) #17
Schizophrenia classified based on age (unofficial classificn.) by Researchers:
Childhood Onset Schizophrenia (COS) < 10yrs
Very Early Onset Schizophrenia (VEOS) < 13yrs
Early onset Schiz (EOS)- Schizophrenia immediately after the age of 13yrs
Late Onset Schizophrenia : Onset > 45 yrs
Very late onset schizophrenia: Onset > 65yrs of age..
Thanks to my professors for teaching me this during bedside clinics.
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Quick Scroll Fri Jan 04, 2013 5:36 am (1 month ago) #18
41) All of the following are associated with a good prognosis in a brief psychotic disorder except
A. Sudden onset of symptoms
B. No affective symptoms
C. Confusion during psychosis
D. Severe precipitating stressor
E. Few premorbid schizoid traits
Ans: B.
Affective symptoms in a brief psychotic disorder is assoc wt good prognosis.
42) Tourette’s disorder has been shown to possibly have a familial and genetic relationship with?
A. panic disorder
B. social phobia
C. generalized anxiety disorder
D. OCD
E. none of the above
Ans: OCD.
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Quick Scroll Sat Jan 05, 2013 1:34 am (1 month ago) #19
Attention-de?cit/hyperactivity disorder (ADHD):
-Symptoms at least by Age 7 years
- Prevalence: 3%- 5%
- Prenatal factors like Poor maternal health and maternal use of cigarettes, alcohol, and drugs.
- Perinatal factors that contribute are Low birth weight and postmaturity.
- Inborn error of metabolism associated with the development of ADHD- Phenylketonuria
- Scales used to assess severity of ADHD are Conner’s teacher or parent rating scales, DuPaul ADHD Rating Scale-IV, Child Behavior Checklist (CBCL)
-
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Quick Scroll Sun Jan 06, 2013 12:51 am (1 month ago) #20
Antipsychotic medication is associated with Pigmentary Retinopathy- Thioridazine
Defense mechanisms are common in delusional disorder:
-Reaction formation
-Projection, and
-Denial
Life event most often associated with development of depression later in life- The loss of a parent before the age of 11.
Double depression- Dysthymia with superimposed Major depressive episode
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Quick Scroll Sun Jan 06, 2013 1:07 am (1 month ago) #21
Electroconvulsive therapy was started by Cerletti and Bini.
Psychosurgery useful in Intractable OCD- Stereotaxic limbic leukotomy and anterior capsulotomy
Common name for somatization disorder- Briquet’s syndrome
Gridiron abdomen- Patients with chronic factitious disorder with predominantly physical symptoms may acquire multiple abdominal scars from repeated surgical procedures.
Four phases in the sexual response cycle in order:
-Desire
-Excitement
-Orgasm
-Resolution
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Quick Scroll Sun Jan 06, 2013 3:10 pm (1 month ago) #22
Phases of Sexual response cycle and corresponding Dysfunctions seen:
Phases Examples of Dysfunction
Desire Hypoactive sexual desire disorder; sexual aversion disorder
Excitement Female sexual arousal disorder; male erectile disorder
Orgasm Male and female orgasmic disorders; premature ejaculation
Resolution Postcoital dysphoria; postcoital headache
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Quick Scroll Sun Jan 06, 2013 3:19 pm (1 month ago) #23
Russell’s sign: Presence of callouses on the knuckles secondary to repeated self-induction of emesis.
Bulimia nervosa was described by Gerald Russell in 1979.
REM latency:
-The amount of time from the onset of sleep to onset of the ?rst REM period.
- Normally 60 to 90 minutes.
- Is decreased in depression, narcolepsy, and with the use of certain hypnotics.
Neurophysiology of sleep:
- Brain stem (Reticular formation) generates REM sleep.
- Forebrain structures (thalamus, hypothalamus, dorsal raphe nucleus, and solitary nucleus) generate non-REM sleep and wakefulness.
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Quick Scroll Mon Jan 07, 2013 11:56 pm (1 month ago) #24
Medications used in maintenance therapy for opioids:
-Methadone
-Naltrexone
-Levo alpha acetyl methadal (LAAM)
-Buprenorphine
Most common drug of abuse in schizophrenia patients- Nicotine
FDA Approved medications indicated for smoking cessation:
-Bupropion
-Varenicline
Most commonly used psychoactive drug in the world- Caffeine
Most commonly used drug of Abuse in the world: Cannabis
Most commonly used drug of Abuse in India: Tobacco
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Quick Scroll Tue Jan 08, 2013 12:19 am (1 month ago) #25
doc for ocd pls?
buks sayin clomipramine / fluoxetine..
best answer??
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Quick Scroll Tue Jan 08, 2013 12:20 am (1 month ago) #26
another query reg cmc psychiatry spl paper..
is neurology and neuroscience imp for cmc psych paper also lik nimhans??
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Quick Scroll Tue Jan 08, 2013 1:14 am (1 month ago) #27
thanks a lot guys
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Quick Scroll Tue Jan 08, 2013 1:17 am (1 month ago) #28
deepanathan1988 wrote:
doc for ocd pls?
buks sayin clomipramine / fluoxetine..
best answer??
For OCD, Clomipramine was approved by the FDA first and later on Fluoxetine. If both are in the options provided, Fluoxetine (a SSRI) is a better choice because it's side effect profile is better than Clomipramine (a Tricyclic antidepressant).
OPSI: Overwhelming post splenectomy infection is most commonly caused by 3 organisms
1.Streptococcus pneumoniae
2.H.influenza
3.N.Meningitides
iron in duodenum , folate in jejumum, b-12 in terminal ileum
