June 2023 Flashcards
(332 cards)
1
Q
What is a core feature of Probable Dementia with Lewy Bodies (DLB)?
A
REM sleep behavior disorder.
2
Q
Explain DLB core clinical features.
A
Fluctuating cognition, visual hallucinations, REM sleep disorder, parkinsonism.
3
Q
List supportive clinical features of DLB.
A
- Neuroleptic sensitivity
- Postural instability
- Falls
- Syncope
- Autonomic issues
- Hypersomnia
- Hyposmia
- Delusions
- Other hallucinations
- Apathy
- Anxiety
- Depression
4
Q
What is sane automatism in forensic terms?
A
Loss of consciousness for a short duration caused by an external factor.
5
Q
Give examples of sane automatism.
A
- Sleep terrors
- Confusional states
- Concussion
- Reflexes after bee stings
- Dissociative states
- Hypoglycemia
6
Q
What is the legal consequence of sane automatism?
A
Complete acquittal.
7
Q
Describe insane automatism legally.
A
Due to an intrinsic cause; results in acquittal on grounds of insanity.
8
Q
Give examples of insane automatism.
A
- Sleepwalking
- Brain tumors
- Epilepsy
9
Q
Order forensic terms: remand, conviction, sentence, trial.
A
Remand, trial, conviction, sentence.
10
Q
Define ‘remand.’
A
Detaining an accused person in custody pre-trial, or a case sent back for further consideration.
11
Q
Define ‘trial.’
A
Formal legal proceeding to examine facts, hear witnesses, decide guilt.
12
Q
Define ‘conviction.’
A
Court’s formal declaration of guilt after trial or guilty plea.
13
Q
Define ‘sentence.’
A
Court-imposed punishment after conviction (fine, prison, probation, etc.).
14
Q
Are released prisoners or patients from hospitals more likely to reoffend?
A
Neither is inherently more likely, but both can have risk factors.
15
Q
Is suicide risk higher in prisoners compared to the general population?
A
Yes, rates of suicide are higher in prisons than the general population.
16
Q
What are risk factors for suicide in prison?
A
- Psychiatric illness
- Substance misuse
- Repetitive self-harm
17
Q
What is the most common method of suicide in prisons?
A
Hanging.
18
Q
What is the association between overcrowding and prison suicide?
A
Inconsistent evidence; may sometimes reduce risk.
19
Q
Which disorder is common in arsonists?
A
Substance use disorder, especially alcohol, and personality disorders.
20
Q
Describe arson characteristics.
A
Usually male, late teens/early 20s, unmarried, poorly educated.
21
Q
What age group is most likely to be victims of female homicide perpetrators with psychosis?
A
Children under 16 years of age.
22
Q
What age group of women has the highest risk of committing homicide?
A
Women aged 30-39.
23
Q
What is a key factor in being deemed unfit to plead?
A
Inability to understand trial proceedings or instruct counsel.
24
Q
Is amnesia for the event likely to cause unfitness to plead?
A
No. Amnesia of the event alone does not make someone unfit to plead.
25
Which condition most often causes 'unfit to plead'?
Schizophrenia.
26
Define Type 1 Error.
Rejecting a true null hypothesis, a false positive.
27
What is the consequence of mean imputation in intention to treat?
It increases the risk of Type 1 error.
28
How can effect modifiers and confounders be evaluated?
By stratification.
29
What can control known and unknown confounders?
Randomization.
30
When to use Mann-Whitney U test?
When comparing two independent groups with non-parametric data.
31
When are risk ratio and hazard ratio similar?
When the prevalence of the outcome is low.
32
What assumption must be met before using a Cox regression?
Hazard ratio remains constant over time.
33
What does hazard ratio assess?
Average risk, weighted for at-risk patients over a follow-up.
34
Define 'indirect costs' in economic evaluation.
Costs due to reduced productivity of the patient or caregiver.
35
What effect do outliers have on study validity?
They can reduce study validity.
36
What is per-protocol analysis?
Analysis that only includes participants that sufficiently complied with the trial’s protocol.
37
What is 'intention-to-treat' (ITT) analysis?
Analysis includes all randomized patients regardless of compliance.
38
What is the main goal of ITT analysis in RCTs?
Assess treatment effects as randomized despite patient non-adherence.
39
In research, what does 'SEM' mean?
Standard Error of the Mean, a measure of the dispersion of sample means.
40
How do you calculate SEM?
SEM = SD divided by the square root of the sample size.
41
If variance is 36, what is the Standard deviation?
The Standard deviation is 6 (square root of the variance).
42
Define standard error of the mean.
Dispersion of sample means around the true population mean.
43
How do you calculate LR-?
LR- = (1-sensitivity) / specificity.
44
How do you calculate NNT?
NNT = 1 / Absolute Benefit Increase (ABI).
45
How do you calculate NNH?
NNH = 1 / Absolute risk increase.
46
What is the effect of an increase in sample size on statistical non-significance?
It may help detect smaller effects, increasing statistical power.
47
When to consider starting treatment despite no statistical significance?
If results are clinically significant or may have a clinical impact.
48
What is the primary use of qualitative research?
Exploration of experiences, perspectives, in-depth understanding.
49
What can be used to transform skewed data?
* Log
* Square root
* Reciprocal transformations
50
Name an agreed reporting standard for meta-analyses and reviews.
QUORUM/PRISMA.
51
How is causation shown in path analysis?
P-value.
52
Define dichotomous data.
Data with two possible values (e.g., yes/no, present/absent).
53
What differentiates dichotomous data?
* Easier to represent
* Easier to interpret
* Different testing methods
54
Which is categorical data?
Gender.
55
What is the appropriate test to use for 2x2 data?
Chi Square.
56
What measure cannot be calculated if there are zero events in a group?
Risk Ratio.
57
Which study uses odds ratio?
Case control.
58
Which study uses relative risk?
Cohort study.
59
If the SD is 16, what is the SEM if the sample size is 12?
4.624 (16/sqrt(12)).
60
What does a higher SEM suggest?
Lower accuracy of the sample mean to represent the true population mean.
61
What is the point of confidence interval becoming non-significant?
Zero.
62
What's the first-line medication for ADHD?
Methylphenidate.
63
When is clonidine indicated in ADHD?
If tics worsen with stimulants.
64
What medication is useful for both depression and ADHD?
Tricyclics.
65
For ADHD with aggression, which medication is less beneficial?
Atomoxetine.
66
What is first-line treatment for acute mania in adolescents?
Aripiprazole or alternative antipsychotics like olanzapine or quetiapine.
67
What is a commonly used antipsychotic in the first trimester of pregnancy?
Quetiapine.
68
If a patient is on lithium with good serum levels and has severe depression, what can be added?
Lamotrigine.
69
A bipolar patient presents with mania, which antipsychotic is recommended in the first instance?
Haloperidol, olanzapine, quetiapine, or risperidone.
70
What is a diagnostic feature of Binswanger's disease?
Subcortical dementia with vascular risk factors, small infarcts on MRI.
71
When should Parkinson's Disease Dementia be diagnosed?
When parkinsonian symptoms precede dementia by > 12 months.
72
What is characteristic of Alzheimer's dementia?
Progressive cognitive decline, temporoparietal dysfunction.
73
What are the features of Friedreich's ataxia?
* Clumsy gait
* Repeated falls
* Heart issues
* Intact cognition
74
What brain issue is most linked to HIV?
Progressive multifocal leukoencephalopathy (PML).
75
Describe paradoxical injunction.
A strategic technique used to overcome resistance.
76
What type of therapy uses 'unspoken rules'?
Structural family therapy.
77
Which family therapy emphasizes past experiences?
Psychodynamic therapy.
78
What can anorexia with binge eating cause?
* Hypokalemia
* U waves
* PR prolongation on ECG
79
What ECG change can clozapine cause?
Saddle T inversion.
80
What ECG change can citalopram and diphenhydramine cause?
QTc prolongation.
81
What ECG change can Donepezil cause?
Sinus bradycardia.
82
What does low mood with obesity in the face, neck, abdomen, back suggest?
Cushing's syndrome.
83
What does depression with red tongue, mouth ulcers, and decreased taste in someone on phenytoin suggest?
Folate deficiency.
84
What does memory loss, tingling, numbness, and a smooth tongue suggest?
Vitamin B12 deficiency.
85
Low mood, emotional dysregulation, dry skin, nail changes suggest what?
Hypoparathyroidism.
86
What is 'diagnostic overshadowing'?
Attributing symptoms to a known condition, overlooking other problems.
87
What is a key aim of normalization of care for people with ID?
Social roles and life circumstances that are not too different from others.
88
What kind of data is '1-5 scale with mild to severe'?
Ordinal.
89
What is the study type where cases and controls are recruited at the same time?
Case control.
90
What is the study type where individuals are followed up from a baseline for future outcomes?
Cohort.
91
What is the best study type to find the efficacy of ECT?
RCT.
92
What is represented by a funnel plot?
Publication bias in meta-analyses.
93
What is the chart that represents decreasing survival with time?
Kaplan-Meier survival plot.
94
What plot categorizes continuous data into a number of categories?
Histogram.
95
What chart can show comparison between categories?
Bar chart.
96
What does a scatter plot show?
The association or relationship between two continuous variables.
97
What chart can represent 3 categories across 4 wards?
Frequency Curve.
98
What is the validity of a tool when its result correlates with a future outcome?
Predictive validity.
99
What does concurrent validity measure?
The agreement of a new instrument with a currently valid scale.
100
What does content validity measure?
Whether the contents of an instrument align with its intended purpose.
101
What's a common medication for child depression?
Fluoxetine.
102
12-year-old with 12-month tics + ADHD?
Clonidine.
103
Child on methylphenidate develops tics; consider what?
Atomoxetine.
104
Tourette's, no ADHD/OCD, first-line treatment?
CBIT (Comprehensive Behavioural Intervention for Tics).
105
Tourette's + ADHD, second-line medication?
Alpha-2 agonists (e.g., clonidine or guanfacine).
106
Tourette's + OCD, first-line treatment?
CBT (Cognitive Behavioural Therapy).
107
Best first step for aggressive behaviour in intellectual disability (ID)?
Functional behaviour assessment/analysis.
108
What does functional assessment assess?
Behavior, situations, consequences, and reinforcers.
109
Male to female ratio for Tourette's?
3:1.
110
ICD-11/DSM-5, ADHD symptoms must be before what age?
12 years old.
111
First-line OCD med for child if sertraline not an option?
Fluvoxamine.
112
16-year-old OCD + depression, first-line medication?
Fluoxetine.
113
UK-licensed SSRIs for child OCD?
* Sertraline (from 6yo)
* Fluvoxamine (from 8yo)
114
Why not paroxetine for children with OCD?
Not recommended for this age group.
115
First-line treatment for paraphilia with compulsive sexual preoccupation, OCD?
SSRI.
116
What to do after SSRI + CBT for OCD ineffective?
Switch SSRI or try Clomipramine.
117
NICE guideline for severe, refractory OCD?
Anterior Cingulotomy.
118
What if anterior cingulotomy not an option?
Consider DBS.
119
Besides OCD, what else can DBS treat?
* Tourette's
* Dystonia
* Parkinson's
120
Vivid dreams, increased appetite, dysphoria suggest withdrawal from what?
Cocaine.
121
What are the symptoms of amphetamine withdrawal?
* Fatigue
* Hypersomnia
* Psychomotor changes
* Increased appetite
* Vivid dreams
122
What is the first-line medication for ADHD?
Methylphenidate.
123
What is considered when ingulotomy is not an option?
Consider DBS.
## Footnote
DBS stands for Deep Brain Stimulation.
124
Besides OCD, what else can DBS treat?
Tourette's, dystonia, Parkinson's.
125
What withdrawal symptoms suggest withdrawal from cocaine?
Vivid dreams, increased appetite, dysphoria.
126
What are the symptoms of amphetamine withdrawal?
Fatigue, hypersomnia, psychomotor changes, increased appetite, vivid dreams.
127
Psychosis is possible in withdrawal from which drugs?
Alcohol, benzodiazepines.
128
Which substance has the least risk of dependence?
LSD.
129
What do tactile hallucinations and jaw rigidity suggest?
Abuse of ketamine.
130
What are common features of amphetamine-induced psychosis?
Paranoia, visual, auditory, and tactile hallucinations.
131
What substance causes long-term cognitive deficits, specifically sustained attention?
Cocaine.
132
What is Mephedrone chemically?
Synthetic cathinone drug.
133
What is the best predictor of gaming addiction in youth?
Novelty-seeking behaviour.
134
What is important before starting detoxification?
Take detailed history.
135
Which brain imaging finding is typical in chronic alcohol abuse?
Enlargement of the lateral ventricles.
136
What is the common radiological finding in alcohol-related dementia?
Generalised cortical atrophy.
137
What condition is linked to homemade red wine and damages the corpus callosum?
Marchiafava-Bignami syndrome.
138
What is an antecedent in behavioral terms?
A stimulus that cues a learned behavior.
139
What are the key characteristics of Cri du Chat Syndrome?
Noisy infant with hypertelorism, microcephaly, hypotonia, moderate ID.
140
What is hypertelorism?
Increased distance between eyes.
141
What common behavioral issue is seen in Fragile X syndrome?
Hyperactivity and cluttering speech.
142
What mutation is seen in Rett Syndrome?
Mutation in MECP2 gene.
143
What is the usual progression for Rett syndrome?
Regression of speech and motor skills, seizures, growth issues.
144
What is the age of the child with epilepsy and language of 6 years in Landau Kleffner Syndrome?
11 years.
145
What is the gender distribution for Prader Willi syndrome?
1:1.
146
What other disorder shares the same gender distribution as Prader Willi syndrome?
Child OCD and Bipolar disorder.
147
What is the first step for aggressive behavior in ID?
Functional behavior assessment/analysis.
148
What is the initial medication for ID girl hitting stomach during menstruation?
Ibuprofen.
149
What is the most appropriate option if an ID patient refuses a blood test?
Benzodiazepines or distraction.
150
What is the principle of moving patients from institution to community?
Normalization.
151
What does DBT comprise?
A hierarchy of goals.
152
How should you ask a child about trauma?
Ask the child directly.
153
What does behavioral activation assess in depression?
Degree of avoidance.
154
Which therapy focuses on interpersonal relationships/social milieu?
Interpersonal Therapy (IPT).
155
What is an element of motivational interviewing?
Cognitive dissonance amplification.
156
What is a correct statement about transference?
Explained by the mechanism of sublimation.
157
Which antipsychotic is best for eGFR < 5?
Olanzapine.
158
Which antipsychotics should be avoided in renal impairment?
Sulpiride and Amisulpride.
159
When should you use Memantine with caution?
eGFR 53, history of epilepsy.
160
What is the first-line antipsychotic for psychosis in epilepsy?
Haloperidol.
161
Which antidepressants should be avoided with Tamoxifen?
Paroxetine and Fluoxetine.
162
What are CYP2D6 inhibitors?
Bupropion, Amitriptyline, Nortriptyline, Paroxetine, Duloxetine, Fluoxetine.
163
What should be done if QTc is over 500 ms?
Reduce the dose and consider referral to cardiology.
164
What favors psychogenic non-epileptic seizures (PNES)?
Side-to-side head movements.
165
What is a predictor of long-term cognitive impairment after TBI?
Duration of post-traumatic amnesia (PTA).
166
What common psychiatric issue follows TBI?
ADHD.
167
What differs Bulimia from Anorexia?
Poor impulse control.
168
What is the first-line treatment for bulimia?
Guided self-help.
169
What should be the next step for BDD if Sertraline 200mg has no effect?
Augment sertraline with buspirone.
170
What disorder involves sudden aphonia after stress?
Motor dissociative disorder.
171
How does Bipolar I differ between sexes?
Men have higher suicide rates.
172
What is the worst prognostic factor in psychosis?
Insidious onset.
173
What is an early symptom in young-onset schizophrenia?
Disorganized behavior, increased negative symptoms.
174
What is the best predictor for response to ECT?
Psychotic depression.
175
What is the first-line treatment for affective stupor?
Lorazepam.
176
What is an absolute contraindication for rTMS?
Cochlear implant.
177
What is the most common comorbidity in gender dysphoria?
Mood disorders.
178
What is the duration of cyclothymia?
2 years.
179
What is true about treating first episode psychosis?
Lower antipsychotic doses are effective.
180
What is the usual first-line medication for first episode psychosis?
Antipsychotic monotherapy.
181
What is the best universal prevention against alcohol dependence?
Increase price.
182
What is one of Nolan's key QI questions?
What are we trying to accomplish?
183
What is the minimum time to withdraw mood stabilizer?
4 weeks/1 month.
184
What is the prevalence of postnatal depression in developed countries?
11-15%.
185
What is Tay-Sachs?
Rare autosomal recessive disorder; deficiency of Beta-N-acetylhexosaminidase A.
186
What kind of disorder is PKU?
Autosomal recessive disorder.
187
What causes PKU?
Deficiency of phenylalanine hydroxylase (PAH).
188
What are key features of untreated PKU?
Microcephaly, language delay, hypopigmentation, hyperactivity, severe LD, self-injury, musty odour.
189
What symptoms are seen in a four-year-old Indian boy with PKU?
Epilepsy, severe mental retardation, behavioral problems, lack of pigment in skin and hair.
190
What is a key clinical triad of Korsakoff's syndrome?
Ophthalmoplegia, ataxia, and confusion.
191
Which test is useful for identifying Korsakoff's?
Address and recall test.
192
What type of memory is most affected by ECT?
Retrograde (explicit) memory.
193
What causes fluctuating memory loss typical for which type of dementia?
Lewy Body Dementia (LBD).
194
What cardiac malformations are linked to paroxetine use in pregnancy?
ASD and VSD.
195
What is the recommendation for lithium dosage before delivery?
Suspend 24-48 hours before, check level 12 hours after last dose.
196
How often should lithium be monitored during pregnancy if continued?
Every 4 weeks until 34 weeks, then weekly until 2 weeks post-partum.
197
What is 'healthy entrant bias'?
Study participants are healthier than the general population, affecting findings.
198
What is characterized by acts of threats, humiliation, and intimidation to harm?
Coercive control.
199
What is the gender ratio for OCD?
1:1.
200
What is an example of an immature defense mechanism?
Identification.
201
What is the first-line treatment for ODD?
Parenting skills training.
202
What is a key difference between PTSD and malingered PTSD with nightmares?
Malingered PTSD: exact same dream nightly; PTSD: varying dreams.
203
What is the term for pathological lying with a mix of truth and lies?
Pseudologia fantastica.
204
What type of treatment should be offered to a young person with mild depression after a period of watchful waiting?
Group CBT.
205
What should be the first-line antidepressant for a 13-year-old?
Fluoxetine.
206
What is the incremental cost formula for QALY?
Difference in cost x 52 weeks for 1 year of placement.
207
Which economic analysis uses QALYs?
Cost-utility analysis.
208
What is the first phase of CAT?
Exploration of traps, dilemmas, and snags.
209
What should be the first line antidepressant for a 13-year-old?
Fluoxetine
210
What is the incremental cost formula for QALY?
Difference in cost x 52 weeks for 1 year of placement
211
Which economic analysis uses QALYs?
Cost-utility analysis
212
What is the first phase of CAT (Cognitive Analytic Therapy)?
Exploration of traps, dilemmas, and snags
213
What is the ethical document guiding human research?
Helsinki Declaration or Belmont Report
214
In qualitative research, what is bracketing?
Setting aside researcher preconceptions
215
What is 'member checking' or respondent validation?
Comparing researcher's account with research participants
216
What statistical measure is used to assess heterogeneity in a meta-analysis?
I-squared (I²) statistic
217
Which method of randomization ensures more or less equal sample sizes in a study?
Block randomization
218
What is the purpose of stratification in a study?
To control for confounding factors
219
What analysis technique reduces the impact of dropouts?
Intention-to-treat (ITT) analysis
220
What is the method of qualitative data collection that explores subjective experiences?
Phenomenological research
221
In family therapy, which approach uses the concept of circular questioning?
Systemic family therapy
222
What medication worsens hallucinations in Parkinson's?
Levodopa
223
What medication is indicated to treat psychosis in LBD?
Rivastigmine
224
What does paroxetine cause in late pregnancy?
Irritability in the neonate
225
What medication is associated with pancreatitis?
Sodium valproate
226
What medication can cause hypercalcemia?
Lithium
227
What drug reduces seizure duration in ECT?
Chlordiazepoxide
228
Which antidepressant is usually used first line in adolescent depression?
Fluoxetine
229
What is the choice of medication for alcohol withdrawal in a patient taking tramadol?
Acamprosate
230
What syndrome is associated with self-hugging, self-injury, and sleep disturbance with moderate LD?
Smith-Magenis syndrome
231
What syndrome presents with self-harm, spasticity, choreiform movements, and microcephaly?
Lesch-Nyhan syndrome
232
What is the term for increased sensibility to stimuli?
Hyperesthesia
233
What is the term for pain due to a normally non-painful stimulus?
Allodynia
234
What is the term for decreased sensibility to stimuli?
Hypoesthesia
235
What is the first step in DBT treatment after pre-preparation?
Reducing life-threatening behaviors
236
What do you do for a patient on flupentixol and procyclidine for 20 years?
Consider reducing flupentixol, then consider tetrabenazine. Stop procyclidine if not needed
237
What is a feature of drug-induced Parkinsonism vs. Parkinson's disease?
Drug-induced parkinsonism is usually symmetrical
238
What is the most significant risk factor for vascular dementia?
Hypertension
239
What is a difference in development between autism and schizophrenia?
In autism, development is never normal. In schizophrenia, it is normal or near-normal
240
What stimulant use by the mother can cause a newborn to be jittery?
Cocaine
241
What is catamenial epilepsy?
Worsening of seizures related to the menstrual cycle
242
The most common cause of mild learning disability is?
Unknown cause
243
What is the risk of social anxiety in childhood?
Increased risk of substance misuse in adulthood
244
How to differentiate MCI and Dementia?
Informant assessment of ADLs (activities of daily living)
245
What is the most likely electrolyte abnormality in a refeeding anorexic patient?
Hypophosphatemia
246
A patient with a non-dominant parietal stroke, what are the symptoms?
Contralateral hemi-spatial neglect, dressing apraxia, construction apraxia, and anosognosia
247
Which is the least psychologically addictive substance?
LSD
248
What are the most common causes of drug-induced pancreatitis?
Antipsychotics and mood stabilizers
249
What symptoms do you see in a patient using PCP?
Violent behavior, dysarthria, nystagmus, tachycardia, hypertension, anesthesia, and analgesia
250
What are the key symptoms of opioid toxicity and withdrawal?
Respiratory depression, use of accessory muscles, tachycardia, hypotension. Use naloxone
251
What technique is used when a therapist confronts a client about missing details in a conversation?
Confrontation
252
What technique is used when a therapist seeks clarification on a client's statements?
Clarification
253
What is the diagnosis for an 8-year-old with 6-month eye blinking, grimacing, obscene words/gestures, resolved after 3 months?
Transient tic disorder
254
How long should tics persist to be considered a transient tic disorder?
Symptoms must be present for less than 12 months
255
What is most likely to prevent an adult shoplifter from reoffending?
Appearance in court is the most effective deterrent
256
Which disorder is least likely associated with shoplifting?
Obsessive-compulsive disorder is the least common comorbid condition
257
What are some common comorbidities with shoplifting?
* Depression
* Substance misuse
* Personality disorders
258
What is kleptomania?
Kleptomania is an impulse control disorder marked by compulsive stealing
259
What is the suicide risk within 1 year after a self-harm attempt?
0.7% (0.5% in females, 1.1% in males)
260
What is the increased risk of suicide following a self-harm attempt?
Suicide risk increases 66x compared to the general population
261
In an eating disorder, what is the most immediately life-threatening sign?
Severe dehydration is the most critical
262
What is the risk associated with a heart rate of 50 bpm in eating disorders?
Heart rate 50 bpm in eating disorders is considered amber risk
263
How much does Alzheimer's risk increase from age 65 to 85?
The risk increases approximately 16 times
264
How much is the risk of dementia higher at age 85 than at 65?
Dementia risk is 4x higher at age 85 compared to age 65
265
How long is amphetamine detectable in urine?
Amphetamine is detectable up to 48 hours
266
What is a common symptom of ketamine abuse?
Urinary frequency, urgency, and hematuria can occur
267
What are common symptoms of cocaine intoxication?
* Ischemic changes
* Tachycardia
* Tachypnea
268
What effect does long-term cocaine use have on attention?
Long-term cocaine use can impair sustained attention
269
What is the purpose of a urine drug screen (UDS) in treatment?
UDS monitors treatment compliance and detects relapses
270
What is a common cause of neonatal jitteriness related to substance use?
Heroin use is a common cause of substance-related jitteriness in babies
271
What psychiatric disorder is most associated with DiGeorge syndrome?
Schizophrenia is the most commonly associated condition
272
What can lead to cleft palate and developmental delay in babies?
Antenatal sodium valproate exposure is a strong risk factor
273
What are the signs of fetal alcohol syndrome?
* Microcephaly
* Growth deficits
* Developmental delay
274
What are the genetic inheritance mechanisms for Down's syndrome?
* Trisomy 21
* Mosaicism
* Robertsonian translocation
275
What inheritance type does Lesch-Nyhan follow?
Lesch-Nyhan follows an X-linked recessive inheritance pattern
276
What correlation is used for two binary variables?
Phi coefficient is used for two binary variables
277
What statistical test compares weight before and after in the same people?
A paired t-test is used for within-subject comparisons
278
What tests are used for comparing cholesterol levels in three groups?
* ANOVA if no adjustment
* ANCOVA with adjustment
279
What does the likelihood ratio for a negative test (LR-) indicate?
Probability of a negative test in those with vs. without the disease
280
What is the formula for calculating the likelihood ratio for a negative test?
(1 - Sensitivity) / Specificity
281
What is the likelihood ratio of a negative test if sensitivity is 60% and specificity is 80%?
0.5
282
What does a high beta value in path analysis indicate?
A high beta suggests a strong association between the variables
283
What type of bias does Intention-To-Treat control?
ITT analysis controls for attrition bias
284
What is the most conservative approach in ITT when handling missing data?
Worst-case scenario is the most conservative approach
285
What is statistical power used to determine?
Power is used to determine sample size
286
Which analysis measures results in monetary terms?
Cost-benefit analysis measures results in monetary terms
287
What does a forest plot arrowhead indicate?
An arrowhead on a forest plot indicates point estimate imprecision
288
What does a ROC curve show?
A ROC curve shows the balance between sensitivity and specificity
289
Which test has the best specificity in SCQ, SRS, CCQ?
SCQ has more specificity than SRS and CCQ
290
What does a high correlation coefficient indicate?
A high correlation indicates a strong linear association
291
What statistical method is used to fill in missing values using observed data?
Multiple Imputation fills missing data by using observed data
292
What is the likely cause of 6th nerve palsy and fluctuating consciousness in an elderly patient?
Wernicke's encephalopathy is a possibility
293
What part of the brain is implicated in snout reflex/frontal release signs?
The frontal lobe is implicated in frontal release signs
294
What is the term for pain with light touch?
Allodynia is pain with non-painful stimuli
295
What is the strongest link of clozapine?
Sedation & motivation are associated with clozapine use
296
A patient on clozapine still has hallucinations, what is the next step?
Assess medication adherence first
297
What type of drug lowers seizure duration during ECT?
Benzodiazepines and anticonvulsants lower seizure duration
298
Which medication is contraindicated for community initiation due to risk?
Clozapine has caution in initiation due to risks
299
What is the risk of citalopram in a person with a history of seizures?
Citalopram can lower the seizure threshold in patients
300
What is a common side effect of mirtazapine that could cause patients to leave a study?
Mirtazapine can cause adverse effects leading to study withdrawal
301
Which medication can cause Torsades de Pointes?
Some medications can cause Torsades de Pointes; check BNF/local policy
302
Which dementia has REM sleep behavior disorder as a core feature?
Lewy body dementia includes REM sleep behavior disorder
303
What increases the risk of developing depression in epilepsy?
Complex partial seizures increase the risk of depression
304
Which mental health condition was statistically significant in COVID and mental health outcome studies?
Schizophrenia was the only significant mental health outcome
305
What predicts first episode psychosis (FEP)?
Frequency of cannabis use is the most significant predictor of FEP
306
Which religious group has the lowest rates of suicide?
Roman Catholics aged 55-74 had lower suicide rates in a specific study
307
What is the most common condition seen in mental health rehabilitation services?
Psychotic disorder is the most common diagnosis
308
Which is the best antidepressant for narcolepsy to help with cataplexy?
Antidepressants are used to treat cataplexy in narcolepsy
309
What is the first-line medication for a child with aggression not responding to non-pharmacological measures?
Risperidone can be considered for aggression if first-line measures fail
310
Which factor distinguishes prolonged grief from depression?
Excessive guilt is more common in depression than grief
311
What is blinding used to prevent?
Blinding is used to minimize measurement bias
312
Which randomization strategy aims for balanced groups?
Block randomization is used to balance groups in studies
313
What is minimization used for in randomization?
Minimization aims to balance confounders between groups
314
When does selection bias occur?
Selection bias occurs when the sample is not representative
315
When does information bias occur?
Information bias happens with flawed data collection
316
What are types of sampling methods in qualitative studies?
* Purposive
* Snowball
* Case studies
317
What is the primary purpose of a clinical audit?
Clinical audit is used to check a service's performance
318
What step is omitted in an audit if change is not implemented after the initial audit?
Implementing a change
319
What occurs when the sample is not representative?
Selection bias occurs when the sample is not representative.
## Footnote
Selection bias can lead to inaccurate conclusions in research.
320
When does _______ occur?
Information bias happens with flawed data collection.
## Footnote
Information bias can result from poor survey design or data entry errors.
321
What are types of _______ methods in qualitative studies?
Purposive, snowball, and case studies are used in qualitative studies.
## Footnote
These methods help researchers gather in-depth insights from specific populations.
322
What is the primary purpose of a _______ audit?
Clinical audit is used to check a service's performance.
## Footnote
Clinical audits help in maintaining and improving quality in healthcare services.
323
What step is omitted in an audit if change is not _______ after the initial audit?
Implementing a change after the initial cycle is important.
## Footnote
Without implementation, the audit process becomes ineffective.
324
Which type of validity uses a _______ validated measure?
Concurrent validity correlates to a previously validated measure.
## Footnote
This type of validity helps establish the reliability of new instruments.
325
Which type of validity measures a prediction of _______ difference?
Predictive validity looks at future group differences in a study.
## Footnote
It assesses the effectiveness of tests in predicting outcomes.
326
Which type of validity is measured when testing a score against itself over _______?
Test-retest validity assesses the stability of the test over time.
## Footnote
This type of validity is crucial for ensuring consistency in measurements.
327
Which sampling allocates participants based on _______?
Stratification sampling allocates based on group characteristics.
## Footnote
This method ensures representation from various subgroups within the population.
328
What is most important in _______ risk assessment?
Dynamic risk factors are most important in short-term assessment.
## Footnote
These factors can change rapidly and influence immediate risk levels.
329
What increases the risk of _______ in prison?
Being on remand increases suicide risk in prison.
## Footnote
Remand prisoners often experience higher levels of distress and uncertainty.
330
What is the first-line treatment for an opioid overdose with _______ depression?
Naloxone is the first-line treatment.
## Footnote
Naloxone quickly reverses the effects of opioid overdoses.
331
What is a goal of _______ psychotherapy?
Hypothesizing is a goal of systemic therapy.
## Footnote
This approach encourages understanding the dynamics within relationships.
332
What is considered to be a primary _______ mechanism?
Repression is considered to be a primary defense mechanism.
## Footnote
Repression involves unconsciously blocking out painful or distressing thoughts.
