|
PSYCHIATRY QUIZ
|
| E. MOHANDAS |
| Consultant
Psychiatrist |
| Elite Mission Hospital,
Trichur. |
| Choose the most
appropriate answer. |
| 1. First account
of postpartum psychosis was given by |
| a. James
braid |
| b. Robert
Gooch |
| c. Thomas
Sutton |
| d. Wilhelm
Griestinger |
| (Ref: H I
Kaplan & B J Sadock(1991). History of Psychiatry- In synopsis of
Psychiatry, 6th Edition, P 839). |
| 2. What
percentage of patients taking tricyclic antidepressants experience
orthostatic hypo tension? |
| a.
5% b. 15% c. 20% d. 30% |
| (Ref:E
Mohandas(1993) Antidepressant drug use in medically ill depressed
patient-In Osychiatry Update, edited by Mohandas etal, P 149). |
| 3. All the
statements given below are true regarding panic disorder, except. |
| a. MRI
study has reported cortical atrophy in the right temporal lobe of panic
disorder patients. |
| b.
Cerebral blood flow study demonstrated increased blood flow in the
nondominant parahippocampal area of panic disorder patients who had
positive finding on lactate in fusion tests. |
| c. Mitral
valve prolapse is present in as many as 50 percent of all patients with
panic disorder. |
| d. Studies
demonstrated that 25 to 30 percent of first degree relatives of panic
disorder have similar complaints. |
| (Ref: H I Kaplan
& B J Sadock (1991) Synopsis of Psychiatry, P 395). |
| 4. Which
statement about tran sexualism is false? |
| a.
Persistent discomfort and sense of inappropriateness about one's own
assigned sex. |
| b.
Persistent preoccupation for atleast one year with getting rid of one's
primary and secondary sex characteristics and acquiring the sex
characteristics of the other sex. |
| c. Three
types are discribed asexual, homosexual, heterosexual. |
| d. About
70% of male to female and 80% of female-to-male SRS patients report
satisfactory results. |
| (Ref: H I
Kaplan & B J Sadock (1991) Synopsis of psychiatry, P 753). |
| 5. The DSM- III
R Criteria for diagnosing Tourette's disorder include all of the following
except |
| a. The
presence of both multiple motor and one or more vocal tics at sometime
during the illness, not necessarily concurrently. |
| b. The
tics occurence many times daily nearly every day or intermittently for
more that 6 months. |
| c. A
change in the tics anatomical location, number, frequency, complexity and
severity over time. |
| d. Onset
before age 21. |
| (Ref: H I
Kaplan & B J Sadock (1991) Synopsis of psychiatry, P 761). |
| 6 Regarding
prognosis of major depression, which statement is not true. |
| a.
Approximately 50 to 85% of all patients have a second depressive episode. |
| b. Risk of
recurrence is increased by co-existing dysthymia, alcohol and drug abuse,
anxiety symptoms and a history of more than one previous depressive
episode. |
| c. Women
are more likely than men to experience a chronically impaired course. |
| d. At
long-term follow-up, about30% have moderate impairment, 20% have
significant impairment. |
| (Ref: H I
Kaplan & B J Sadock (1991) Synopsis of psychiatry, P 372). |
| 7. Which
statement concerning alcohol withdrawal is false |
| a.
Hypomagnesemia of chronic alcoholism would lead to chronic excitatory
activation and predispose to many of the symptoms of withdrawal especially
seizures and delirium tremens. |
| b. GABA /
Benzodiazepine receptor function is up regulated after chronic alcohol
administration. This up regulation of GABA function could cause or
contribute to the symptoms of alcohol withdrawal. |
| c.
Noradrenaline activity is almost certainly present in alcohol withdrawal. |
| d. It
appears that NMDA function is increased in alcohol withdrawal. |
| (Ref: P
Glue & D Nutt (1990) Overexcitement and disinhibition- dynamic
neurotransmitter interaction in alcohol withdrawal. Brit J Psychiatry 157:
491-496). |
| 8. Probable good
predictors of response of carbamazepine in depressive illness include all
of the following except. |
| a. Bipolar
depression |
| b.
Positive response to sleep deprivation |
| c. Higher
CSF levels of cyclic GMP |
| d. Higher
CSF Opiate binding activity. |
| (Ref
: John P Mathai (1993) Clinical use of anticonvulsants in Psychiatric
disorders - In Psychiatry Update - Edited by E, Mohandas etal, P 53). |
| 9.
Recent research into 'Schizophrenia and the Brain' has demonstrated all
the following except |
| a.
Patients who have never received medication have hypometabolism of the
frontal lobe. |
| b.
Hypermetabolism of the left temporal lobe seems to occur only if the
patient is actively hallucinating |
| c.
The most consistent neuroimagings findings include an increase in the size
of the cerebral ventricles (especially the frontal and the temporal horns)
and a corresponding decrease in cerebral tissue, especially in medial
temborolimbic structures such as the hippocampal complex. |
| d.
Neuropathological findings include neuronal loss, aberrant architecture in
the cingulate gyrus and prefrontal cortex, gliosis in the basal limbic
structures of the forebrain and atrophy in teporolimbic structures such as
the hippocampus and amygdala. |
| (
Ref: M M Mesulam (1990) Schizophrenia and the brain.New Eng J Medicine
322(12) 844-845) |
| 10.
Which of the statements concerning " Koro" is true? |
| a.
The complex Koro Complex has three essential belief : that the penis is
shrinking (breasts and labia in females), that it will disappear into the
abdomen, and that this will result in death. |
| b.
Classic Koro usually occurs in the context of acute severe anxiety. |
| c.
Koro complex may occur after stroke or as an association of
temporoparietal dysfunctions. |
| d.
All of the above. |
| (Ref:
D N Anderson (1990) Koro: the genital retraction symptom after stroke,
brit J Psychiatry 157: 142-144). |
| 11.
All of the following are true regarding Alzheimer's disease except |
| a.
Alzheimer's disease appears to be degeneration of cortico cortical
glutamatergic pyramidal neurons in circumscribed areas of brain cortex. |
| b.
Patients with Alzheimer's disease have reduced regional cerebral blood
flow (rCBF) in the posterior parieto temporal regions compared with
controls. |
| c.
Central cholinergic stimulation with physostigmine does not produce any
change in rCBF in the posterior parietotemporal regions in patients with
Alzheimer's typed in the dementia of Alzheimer's type. |
| d.
They may be a deficit in Choline acetly transferase. |
| (Ref:
K. Wilson etal (1991) effect of Central Cholinergic stimulation in
regional cerebral blood flow in Alzheimer's disease. brit J Psychiatry
158: 558-562) |
| 12.
Which one of the following benzodiazepine hypnotic has clinically
important active metabolites in human blood after either single or
multiple doses? |
|
a. Temazepam |
|
b. Quazepam
|
|
c. Estazolam
|
|
d. Triazolam
|
|
(Ref : D. Greenblatt (1991)
Benzodiazepine hypnotics : sorting out Pharmakinetic :facts. J. Clin
Psychiatry 52 (9, suppl) 4-10)
|
|
13. Antidepressant induced by potension
is due to
|
|
a. Alpha 1 ardrenoceptor blockade
|
|
b. 5HT2 blockade
|
|
c. H1 -histaminic receptor blockade
|
|
d. All of the above
|
|
(Ref : E. Mohandas : (1993)
Antidepressant drug use in medically ill depressed patients. In Psychiatry
Update - edited by Mohandas etal, P 149)
|
|
14. Reported adverse effects of valproic
acid include all of the following except
|
|
a. Tremor
|
|
c. Hypoglycemia
|
|
d. pancreatitis
|
|
(Ref. : John P Mathai (1993) Clinical
use of anticonvulsants in psychiatric disorders - In Psychiatry Update -
edited by E. Mohandas etal, p55).
|
|
15. Tryptaminegic neurons are localised
to some 9 nuclei lying in or adjacent to the midline region of the pons and
upper brain stem. These nuclei are divided into superior and inferior group.
All of the following belong to inferior group except
|
|
a. Caudal linear nucleus
|
|
b. Nucleus raphe pallidus
|
|
c. Nucleus raphe magnum
|
|
(Ref : E. Mohandas & P.M. Said
Muhammed (1993) Serotonin in psychiatric disorders - In Psychiatry Update,
edited by E. Mohandas et al, p 292)
|
|
16. Which statement regarding the
arrhythmogenic effect of antidepressants is false ?
|
|
a. Patients with pre- existing
intraventricular conduction delays (QRS interval more than 0.11 seconds) are
at increased risk.
|
|
b. Tricyclic antidepressants can
aggravate the degree of AV block in patients with first degree AV block.
|
|
c. Patients with uncomplicated left
bundle branch block, isolated left posterior fascicular block and right
bundle branch block are at lower risk for aggravation of heart block by
tricyclic antidepressants.
|
|
d. A prolonged QT interval (QTc more
than 0.440 seconds) is a contraindication for the use of tricyclic
antidepressants.
|
|
(Ref : E. Mohandas (1993) Antidepressant
drug use is medically ill depressed patients. In Psychiatry Update- edited
by E. Mohandas et al, p 152- 153 ).
|
|
17. All of the following are true
regarding vigabatrin, a new anticonvulsant, except
|
|
a. Specific irreversible inhibitor of
gamma amino butyric acid amino transferase
|
|
b. Prescription of this drug is
restricted to patients with intractable epilepsy.
|
|
c. This is another antipsychotic
anticonvulsant.
|
|
d. Commonest side effects include
drowsiness, dizziness and weight again.
|
|
(Ref : M J Brodie and R J Porter (1990
New and potential Anticonvulsants Lancet 336 : 425 - 426)
|
|
18. Various structural, biochemical and
functional abnormalities of the brain have been documented in
schizophrenics. These include all of the following except
|
|
a. Reduction volume of the hippocampus
and parahippocampal gyrus, with significant reduction in the number of
neurons in both structures.
|
|
b. Left sided reduction of GABA uptake
sites in the hippocampus.
|
|
c. Decrease in blood flow in the
prefrontal areas of schizophrenics compared with controls.
|
|
d. Presents of subtale neurological
abnormalities (difficulties in motor sequencing and co-orduination,
sensory extinction, agraphesthesia) in 20% of schizophrenics.
|
|
(Ref : M A Ron & I. Harvey (1990).
The brain in Schizophrenia. J Neurosurg Psychiatry 53:725 -726).
|
|
19. Priapism induced by trazodone
hydrochloride is due to
|
|
a. 5-HT1 receptor blockade
|
|
b. Alpha 2 adrenoceptor blockade
|
|
c. 5HT2 receptor blockade
|
|
d. Alpha 1 adrenoceptor blockade
|
|
(Ref : E. Mohandas (1993)
Antidepresented drug use in medically ill depressed patients- In Psychiatry
Update- edited by E. Mohandas et al, p 164)
|
|
20. Hiccups, headache and mood changes
side effects of
|
|
a. Ethosuximide
|
|
b. Carbamazepine
|
|
c. Phenytoin
|
|
Valproate
|
|
(Ref : M J Brodie (1990) Established
anticonvulsants and treatment of refactory epilepsy. Lancet 335: 350 - 354)
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ANSWERS
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1.b 2.c 3.d 4.d
5.d 6.c 7.b 8.c 9.a 10.d 11.c
12.b 13.d 14.b 15.a 16.b 17.c 18.d
19.b 20.a
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