PAPER B Flashcards
1
Q
wad is the 1 year prevalence of depression in general population
A
5.3%
2
Q
Life time prevalence of depression in general population
A
13%
3
Q
highest risk age group for depression
A
greater than 30`
4
Q
mean onset of depression
A
30 years
5
Q
Mean number of episodes in patients with lifetime MDD is
A
5
6
Q
what is the longest duration of a depressive episode if treated, usually will last how many months
A
24 weeks (6 months) 3 months
7
Q
Mean age of treatment for depression
A
33.5 (lag 3 years for depression)
8
Q
Most common comorbidity with depression
A
alcohol use (>40%) and anxiety (40%) second is personality disorder 30% (mostly cluster C except anakanistic PD)
9
Q
% of depressive patient made suicide attempt
how many more times more a patient will attempt to commit suicide compared to normal population
A
9%
14 times
10
Q
% of person with first episode of depression will have mania episode within 10 years and its risk factors (5)
A
10%,
if illness earlier, switch was earlier (rate is 50%)
family history, antidepressant induced hypomania, hypersomnia, retarded phenomenology, psychotic depression and postpartum episode
11
Q
Mean age of unipolar to bipolar switch
average number of previous episode before the switch
A
32
2-4 episode
12
Q
what is the longest duration of a depressive episode
if untreated
A
if untreated 6-13 months
13
Q
recurrence rate of first episode
% of ppl will not have anymore episode, the rest will have within how long
% did not have a year free of episode
A
50% will not have any further episode, thr erest wil have it within 5 years
15% will not have a year free of episode
14
Q
hows bipolar patient’s episode when compared to depression
A
2 times more
15
Q
Terms for depression
1) remission
2) recover
3) relapse
4) recurrence
A
1) when patient achieved a state where no scales can detect meaningful measures of depression after 3 months of a treated episode
2) if the above more than 6 months
3) any repeat depression within 6 months
4) any depressive episode after 6 months of the initial episode
16
Q
good prognostic indicators for depression (7)
A
1) mild episode
2) <1 episode of hospital admision
3) no psychotic symptoms
4) short hospital stay
5) history of solid friendship during adolescence
6) stable family functioning
7) no comorbid psychiatric disorder
8) good social functioning 5 years before illness
17
Q
bad prognostic indicators for depression (7)
A
1) severity episode (suicidality and psychotic features)
2) persistent dysthymia
3) female sex
4) long previous episode
5) nvr marrying
6) long episode of illnes before seeking treatment
7) comorbid psychiatric and medical disorder
8) greater number of prior episode (3 or more)
9) partial remission at 3 months
18
Q
NICE gudeline, points for management
A
1) first classify severity of the depresion
2) if there’s depression and anxiety, treat depression well
3) mild depression, review withnin 2 weeks, no need meds, can do CBT
4) SSRI first line
5) of moderate, to keep antidepressant for 6 months
6) if >2 episodes, need to keep for >2 years
7) if atypical use SSRI, then refer specialist
19
Q
what study studies the continuation of antidepressants
A
Gedds and colleagues
include 410 patients
31 randomised trails
rate of relapse for 41% for those who stop antidepressant after an acute episode compared to 15%
20
Q
wad is STAR*D
A
- similar world findings - 2/3 has comorbid physical disorder, 2/3 comorbid psych diagnosis, 40% has onset depression <18 years
- 4041 patient enrolled
- step 1 citalopram-> step 2 after 12 weeks to swucth to (buporion, sertaline, venlafaxine, or cognitive therapy or augment citalopram + buporion/buspirone, or citalopram with cognitive therapy
- step 3 switch to mirtazapine/nortriptyline, or augment step 2 treatment with lithium/thyroid medication
- step 4 MAOI, tranylcypromine, venla +mirta
- remission rates drop while relapse rate increases as patient to each level
results
-switch to class withnin SSRi is no diff then switch to outside SSRI
-no stat diff betwen switch options, or augment options , maoi with venla+ mirtaz
cumulative remission rate is 67%
21
Q
gender diff with depression
A
Men report more suicidal ideation, 2-4 times more likely to be successful in their suicidal attempts, ,psychomotor agitation and substance use.
Women reported more suicidal attempts , more symptoms of anxiety and atypical depression, earlier onset, trend towards longer episodes
22
Q
antidepressant -> increase suicide risk?
A
more in younger age group 18-24
Healy study shows in general suicide risk is 1.64 times
2015 study shows that antidepressany is not associated with increased risk of completed suicide
23
Q
three antidepressant drugs that shows greater toxicity
A
TCA : dosulepin and doxepine more toxic than venlafaxine and mirtazapine more toxic than SSRI: citalopram
24
Q
Wad are 5 things that might result in apparent resistance to antidepressant treatment (not true resistance)
A
5A
alcoholism, lack of adequate dosage, lack of adherance, axis 2 disorder, alternate diagnosis
25
Caliofornian rocket fuel is wad
combi of venla and mirtaz
26
what is mirtazepine
tetracyclic piperazinoazepine
27
what is agomelatine
5HT2C antagonist, a melatonergic agonist
28
ketamine
- a anaesthetic abd hallucinogenic drug
- blockade of glutametergic NMDA receptos and relative upregulation of AMPA receptors
- rapid improvemnt in mood
- KIV use ketamine as anesthetic agents
29
point prevalence for bipolar disorder
| life time prevalence of bipolar 1 is % and bipolar 2 is %
1.5%
life time prevalence of bipolar 1 is 1%
life time prevalence of bipoalr of 1.1%
30
mean onset for bipolar 1 and 2?`
1 => 18.2
| 2=> 22
31
suicide rate of bipolar is how mnay times more than general population
15-18 times
32
prognosis of bipolar disorder
| median time to recover
4-5 weeks
| three types of course -> chronicity (with ot without full interepisode recovery), seasonality and repid cycling
33
% of people is predominatelt
1) depressed, risk factors (3)
2) manic, risk factors (3)
1) depressed : 1/3 -> more in bipolar 2, onset depresive, later onset, more suicide attempts, better with lamotrigine
2) manic: 1/4-> more bipolar 1, less seasonal, more substance use, onset often mania, earlier age
34
suicide rate in bipolar
| % in depressive phase?
10-19%
| 80% happens in depressive phase
35
relapse rate of depression
50% in one year, >70% in 4 years
36
biggest predictor of relapse in bipolar
| other 2 contributors
residual symptoms
| -> sleep disruption, comorbidities (substance use disorder)
37
risk of antidepressant induced mania
risk for induced depression
1) previous antidepressant induced mania
2) bipolar family history
3) exposure to multiple antidepressant trails
4) initial illness beginning in adolesence or young adulthood
====
typical antipsychotics
38
differentiating unipolar depression with bipolar depression (4)
for unipolar depression:
1) more anxiety
2) more somatic complaints
3) less withdrawal
4) insomnia
5) less degree of retardation
6) less atypicality
39
rapid cycling is
when is ultra
ultra ultra rapid/ultradian cyclers
% in rapid cycling
4 episode per year (both depression and mania)
ultra is 4 episodes per month
ultra ultra rapid and ultradian cyclers: in in day
20%
40
risk factors of ultra rapid cycling
| studied by whom
women(80%), earlier onset,
studied by STEP BD
hypothyroidism, substance misuse
will have more severe depression
41
drugs tat can cause secondary mania
more common in elderly
L dopa and corticosteriods
hypermania
42
evidence based treatment
| : 1) treatment for acute de novo mania (3 points)
- antipsychotics fist line : haloperidole, olanzapine, quetiapine, rispedone
- dont give lamotrigine
- considered stop antidepressants
- adjunctive benzo such as clonazepam or lorazepam for agitation and insomnia
43
evidence based treatment
| : 2) treatment for acute mania in known bipolar patients (3 points)
- increase dose of mood stabilisers
- check serum lithium consider high if compliance is good
- if already on lithioum, optimise lithium plasma level first then adding haloperidol/olanzapine/quetiapine/resperidone
- ECT for severely ill
44
evidence based treatment
| : 3) treatment for bipolar depressive patients (3 points)
- psychological intervention
- first step: offer fluoxetine with olanzapine, or quetiapine alone
- second step offer lamotrigine
- antidepresants can be discontinue in 3-4 months as depressive episode in bipolar is shorter
45
evidence based treatment
| : 4) treatment for maintainence (3 points)
BAP guidelines recommend: long term treatment after a single severe mania treatment (significant risk and adverse consequences)
-bipolar 1 with 2 or more acute apisode
bipolar two with sign functional impairment or risk
-first line lithium monotherapy - reduced risk of suicide in bipolar suicide
-other options: valporate (for mania), olanzapine (for mania), quetiapine, carbamazepine, lamotrigine (for depressive)
46
evidence based treatment
| : 5) treatment for mixed episode (3 points)
treated as manic episodes
avoid antidepressants
high risk of suicide
-best evidence is valproate (better than lithium or placebo)
-atypical antipsychotic -> combination therapy
47
evidence based treatment
| : 6) treatment for rapid cyclers
- avoid antidepressants
- treat hypothyroidism and substance misuse
- efects of lithium mwithdrawal to check
- erratic compliance
- to consider lithium, valporate, lamotrigine
48
what anticonvulsant should not be prescribe for bipolar
vigabatrin (can even cause visual field defects)
| topimarate, phenytoin
49
incidence (definition) and in schizophrenia (3)
definition: the occurrence, rate, or frequency of a disease
- two times higher in urban settings
- 3-5 times more common in migrants
- winter/spring birth increase to a small extent
- male more than female 1.4:1
50
Prevalence (definition) and in schizophrenia (3)
- the percentage of a population that is affected with a particular disease at a given time.
- 0.4 life time prevalence,
- no diff in male and female
- higher rate in migrants and homeless people
51
wad is AESOP study?
shows that psychoses are more common in black and minority ethnic groups
52
high risk prediction studies shows: whoch kind of risk
genetic risk. functional impairment, higher levels of psychopathology
+/- substance use
53
```
Mean age of onset for
GAD
Panic disorder
OCD
Social phobia
Specific phobia
```
Gender diff in above?
```
GAD 30 years
Panic- 22-25 years
OCD 20 years
Social phobia - 15 years
Specific phobia varies (blood around 5-6 years old)
```
Most are female expect for OCD where majority are boys but equal in adults men and women
54
OCD point prevalence is
| How abt lifetime
1-3% of adults
| -lifetime 2-3 %
55
OCD types of presentation (4)
1) agressive, sexual, religious obsession and checking compulsions
2) symmetry and ordering obsessions and compulsions
3) Contamination obsessions and cleaning compulsions
4) Hoarding obsessions and compulsions
56
For OCD
| Treatment
Clomipramine and SSRI
| KIV antipsychotic augment if no response is seen
57
Treatment for PTSD
If <3 months
CBT, stress management, exposure therapy
Non benzo sleep medication, KIV antidepressant
If >3
EMDR (eye movement densensitisation and reprocessing)
Paroxetine and mirtazepinne,
Then amitriptyline/phenelzine for specialist use
Setraline licensed for female PTSD only
Olan good with SSRI
Fluoxetine, venal, mono for olan not good
58
Prognosis of PTSD
50% of remission at two years
59
Acute stress disorder
| When does it resolved
Appears with in minutes of the impact and disappear within 2-3 days
60
Treatment response for GAD is defined as
How abt clinically recovery?
50% decreased in Hamilton anxiety scale
Less than 7
61
Mic progress to dementia percentage is (in ten years)
In one year?
Wad is the % of it to b vascular
30-40%
10% in one year
30-40%
62
Risk of developing tardive dyskinesia for older ppl is
5-6 times higher
63
Life expectancy of lady body dementia
6 years
64
Late onset of schiz is when
How abt very late onset
40 years
60 years
65
Prevalence of elderly having delirium in intensive care unit Is
How abt surgery
In hospital in general?
70-80%
15% to 56%
In hospital in general 15% to 53%
66
Late onset schizophrenia wad is the ,ost common symptoms
Characteristics name 3
Diff between early onset
80% persecutory delusions Characteristic features of very late onset schizophrenia include a significantly higher number of females being affected than males and a lower chance of observing formal thought disorder, affective blunting and a higher chance of Tardive dyskinesia.
Late-onset schizophrenia is characterised by (Palmer et al. 2001) fewer negative symptoms, better response to antipsychotics and better neuropsychological performance
67
4 contributory changes in psychosis in elderly
The contributory factors for increased risk of psychosis in elderly people would include; Neurochemical changes associated with ageing, age-related deterioration of frontal and temporal cortices, cognitive decline, social isolation, sensory deprivation, age-related Pharmacokinetic and pharmacodynamic properties, use of polypharmacy, etc.
68
Most common cause of late onset psychosis
Alzheimer
69
Name one drug tat decrease lithium and 3 drugs tat increase lithium
Aminophylline increases lithium excretion and reduces serum lithium levels. Anti-inflammatory drugs (NSAIDs) such as Indomethacin, ACE inhibitors, angiotensin two antagonists, fluoxetine can reduce the renal clearance of lithium and, therefore, increases serum lithium levels in the blood.
70
Diff between cordial and subcortical dementia.
Features of cortical dementias include early aphasia, acalculia and significant memory loss in early stages. Examples of cortical dementia include Alzheimer's disease, Picks disease, CJD etc. Subcortical dementias usually have no aphasia and calculation is preserved until late, but speed of cognitive processing is slowed early, along with the appearance of depressed mood, dysarthric speech, slowed motor speed and control, bowed or extended posture, apathetic personality, adventitious movements like tics, chorea, tremors and dystonia. Examples of subcortical dementias include Parkinson's disease, Huntington's disease, Wilson's diseas, hiv, binswanger, etc.
71
Picks diseases mode of transmission and gene involved
Autosomal dominant
17q21
72
Which of the following is used for the differential diagnosis of cognitive dysfunction in older people?
The Cambridge examination for mental disorders, also called CAMDEX-R, gives operational criteria which it suggests are used for clinical diagnosis and guidelines for classifying dementia, according to clinical severity. It enables to make a differential diagnosis of dementia to be made according to the most recent criteria. It comprises of a structured clinical interview; a brief neuropsychological battery; a structured interview with a relative; the diagnostic criteria from DSM-IV and ICD-10 for dementia and other categories including differential with depression
73
Criteria for Alzheimer’s
According to NINCDS-ADRDA criteria proposed in 1984, for a probable Alzheimer's disease, dementia should be established by clinical and neuropsychological examination. Cognitive impairments also have to be progressive and be present in 2 or more areas of cognition. The onset of the deficits has been between the ages of 40 and 90 years and finally there must be an absence of other diseases capable of producing a dementia syndrome. For a definite diagnosis of Alzheimer's disease, the patient should meet the criteria for probable Alzheimer's disease with histopathologic evidence of Alzheimer's disease (autopsy).
74
Which one of the following scales used in delirium has good symptom coverage and distinguishes delirium from other disorders?
Delirium rating scale
confusion assessment method
75
Which of the following scale is useful in the assessment of Alzheimer's disease among the learning disabled population
The Dementia Questionnaire for Mentally Retarded Persons (DMR) is useful for general screening for Alzheimer's disease among the intellectually disabled.
76
Wad is the risk of tacrine
Hepatotoxicity
77
Memantine is a
Nadal antagonist
78
Between the ages of 65 and 85, the prevalence of Alzheimer's disease;
Double every 5 yers
1% in 65
40% in 85
79
Ye4 facts of progressive supranuclear palsy
Onset
Symptoms
PSP is a differential diagnosis of LBD. The onset is in the sixth decade (range 45 to 75 years) and patients present with difficulty in balance, abrupt falls, slurred speech, dysphagia, and vague changes in personality, sometimes with an apprehensiveness and fretfulness suggestive of an agitated depression. The most common early complaint is unsteadiness of gait and unexplained falling (retropulsion).
80
Diff in late onset depression
Although depression in all ages is associated with some degree of impaired concentration and subjective difficulties with memory, these cognitive deficits seem to occur when first onset is in older age
Other diff
Associated more in anhedonia and psychomotor changes
81
Which factor is most likely to increase the risk of paraphrenia?
Female gender
82
Which of the following clinical features would support a diagnosis of depression rather than normal grief reaction
Suicidal ideas, psychotic symptoms other than pseudohallucinations of widowhood and generalized guilt feeling s along with persistent symptoms must suggest a depressive episode requiring intervention.
83
The greatest risk factor for multi-infarct dementia is
Hypertension 30%
84
Hyperhomocysteinaemia is correct?
Dementia
85
What is the most common behavioural change observed in patients with Huntington's disease?
The most common behavioral change observed in patients with Huntington's disease is a lack of initiative followed by poor judgement, blunting of affect, poor self-care, self-centeredness and inflexibility. I
86
Deficits on tests of attention and visuospatial ability may be especially prominent in
neuropsychological studies imply that deficits on tests of attention, concentration and visuospatial dysfunction is seen more in Lewy body type of dementia
87
neurotic disorders in the elderly
Gender
Dominating presentation
Less common presentation
The estimated prevalence of neurotic disorders is between 1-10% with a female predominance. Non-specific anxiety symptoms, phobic (most common) Hypochondriacal and depressive symptoms predominate. Obsessional, Dissociative and conversion disorders are less common.
88
Psychiatric effects of l dopa
Up to 1/3rd of patients complain of psychiatric side effects when taking levodopa therapy. Nearly 30% of those taking levodopa complain of nightmares and vivid dreams. This is followed by 7% with night terrors, 5% with delirium and 3% with delusional disorder.
89
Good prognosis in Alzheimer
Later onset, female gender, an absence of behavioural symptoms, and lack of depressive episodes suggest better prognosis in Alzheimer's disease.
90
Risk of Alzheimer
actual predicted risk of developing Alzheimer's disease in the first-degree relatives of probands with Alzheimer's disease is 15-19%, compared with 5% in controls. Thus, the risk to the first-degree relatives of patients with Alzheimer's disease who developed the disorder at any time up to the age of 85 years is increased some 3 - 4 times relative to the risk in controls.
91
Which two drugs always cause postural hypotension
Risperidone and clozapine
92
Which of the following antidementia drugs produces significant improvements i
Rivastigmine
93
4 forms of prion disease
There are four forms of the disease in humans, all of which are rare. These are; 1. Kuru 2. Creutzfeldt-Jakob Disease 3.Fatal familial insomnia 4. Gerstmann Straussler syndrome
94
dementia with Lewy bodies, visual hallucinations have been reported in;
80%
95
Hachinski score is a way of looking into risk factors for
Vascular dementia
96
ADHD had % heritability factor?
70-80%
97
Percentage of children that are dry
At 2
3
5
Voluntary control does not begin until 15-18 months.Most children are reasonably dry by day at 18 months. By 2, years 50% are dry at night, by 3 years 75% are dry at night and by 5 years 90% are dry at night.
98
Difference between truancy and school refusals
Truancy is phenomenologically different from School Refusal. School Refusers are characterised by the presence of emotional rather than antisocial symptoms, with a familial tendency towards neurosis rather than antisocial behaviour, with parents being over-protective rather than inconsistent. The academic achievement in school refusers is usually satisfactory whereas truants have poor track record. Small family size is associated with school refusal while larger families have more truants.
99
Average age of Tourette syndrome
Diagnostic citeria
3-9 years old
Tourette’s may be diagnosed when a person exhibits both multiple motor and one or more vocal tics over the period of a year; the motor and vocal tics need not be concurrent. The onset must have occurred before the age of 18, and cannot be attributed to the effects of another condition or substance (such as cocaine)
100
Blockade of which of the following receptors can reduce vocal and motor tics seen in Tourette's syndrome?
D2 antagonism at basal ganglia
101
Bipolar in children
may be more likely to have mixed bipolar disorder. Prevalence of bipolar disorder (BD) in youth may be as high as 1%. The most common comorbidities are ADHD (greater than 50%) and anxiety disorders. The rate of comorbid substance use increases in adolescence.Approximately 20% of youth with MDD will be diagnosed with bipolar disorder later in life. Equal gender distribution is characteristic (unlike MDD); however F:M ratio for rapid cycling BD is closer to 3:1
102
Which one of the following treatments is most helpful for treating PTSD in children?
Trauma focussed CBT
103
The prevalence of ADHD in the UK is
2-5%
104
Prevalence of sex in school refusal is
Equal
105
First tier for pharmacological treatment for tics
. The first tier is comprised of alpha 2 adrenergic agonists such as clonidine, the second tier comprised of drugs such as anticonvulsant topiramate used for many decades as off-label prescriptions, and the third-line comprised of D2 blocking agents such as haloperidol. (
106
What percentage of patients with autism has mental retardation?
70%
107
The ratio of prevalence of ADHD in males to females is
4:1
4% -12% in school age children
0-1 in girls
108
Risk of adhd
Maternal smoking during pregnancy and attention deficit hyperactivity disorder symptoms in offspring-)
109
The blood abnormalities seen in Anorexia Nervosa include;
The blood abnormalities seen in anorexia include moderate normocytic normochrmic anaemia, mild lecopenia with relative lymphocytosis and thrombocytopenia.
110
Average age of onset in schizophrenia
25
111
The prevalence of suicidal ideations in the past year for adolescent cohort in Britain is
15%
Female 22%, male 15%
112
Stuttering
| Gender dominance
3:1
113
The overall prevalence of psychiatric problems in adolescence is
16-20%
114
Sibling rivalry disorders usually emerge in which of the following time periods?
Within 6 months after the birth of the sibling
115
3 facts abt Rhett’s
Rett syndrome is a neurodevelopmenal disorder that affects girls almost exclusively. It is characterized by normal early growth and development followed by a slowing of development, loss of purposeful use of the hands, distinctive hand movements, slowed brain and head growth, problems with walking, seizures, and intellectual disability.
116
The most common psychiatric co-morbidity associated with Asperger's syndrome is
Depression
117
good prognostic factor in children with conduct disorder?
1. Female gender 2. High IQ 3. Resilient temperament 4. Good parenting among several others.
118
Reactive attachment disorder is generally diagnosed before the age of
Two characteristics are
5 years old
Fearfulness and hyper vigilance
119
Which SSRI drug is now specifically contraindicated in children and adolescents due to increased risk of suicide?
Paroxetine
120
The most common co-morbid disorders seen in Tourette's syndrome is
OCD and ADHD are commonly comorbid with tics.; more in ocd 1/2 to 1/3 for children
121
aetiology of ADHD
There % increase in monozygotic twins?
How abt siblings?
Which gene
Wad can u see in Neuro imaging
Predominantly what neurotransmitter dysregulation and where?
50%
Twice the chance for sibling
5,6,11
Neuroimaging shows lower cerebral blood flow and metabolic rates in the frontal lobe areas of children with ADHD than in controls
Predominant DA and NA dysregulation is seen in the prefrontal cortex
122
Pica typically occurs during
It typically occurs between 2 to 3 years of age and may persist in some children.
123
Which neurotransmitter system is commonly postulated to be involved in the aetiology of Tourettes syndrome?
Dopamine
124
total sleeping time of a newborn baby is approximately
16 to 17 hours in total each day and will sleep up to 6 hours at a time.
125
Which is the first line drug in an 8-year-old with uncomplicated ADHD
Atomoxetine
126
long-term effect of prescribing high doses of methylphenidate over long periods without drug holidays?
Growth suppression
127
The commonest age of presentation for school refusal is
11
128
Which of the following symptoms is most likely to remit first? For
ADHD
How abt the last?
Usual age for remission?
Hyperactivity
Last Is distractability
12-20
129
biological risk factor associated with conduct disorder
Low CSF serotonin
130
percentage of reading difficulties in children in Britain is estimated to be around
5%
131
The rate of depression in males is as much as in females in which of the following age groups?
pre-pubescent age group, the prevalence is up to 3% with 1:1 gender ratio
132
The rate of self-harm in teenagers who identify with Goth culture is around
50% self harm
| 47% suicide
133
Autism can see wad in the mri
Hypoplasia of cerebellar vermal lobules
134
Enuresis boy or girls more
Boys
135
What is the most likely risk factor that predisposes to criminality at age 17 in a boy who has behavioural problems at the age of 8?
Inadequate parenting
136
Separation anxiety disorder (SAD) is defined as developmentally inappropriate and excessive anxiety concerning separation from home or from those to whom the individual is attached. This condition occurs in about %
Wad usually it’s comorbidity
3.5%
School refusal
137
What is the chance of a 12-year-old boy with conduct disorder developing antisocial personality disorder?
50%
138
The condition commonly associated with autistic spectrum disorders is;
ADHD
139
most common co-morbid psychiatric disorder seen in children with ADHD is
Oppositional defiant disorder
140
Children with enuresis have shown improvement with which one of the following antidepressant?
Imipramine is efficacious and has been approved for use in treating childhood enuresis, primarily on a short-term basis. Desmopressin, an antidiuretic compound that is available as an intranasal spray, has shown some initial success in reducing enuresis.
141
Heller's syndrome is characterised by normal development until
Wad is it’s other name
2 years of age
Cdd : childhood disintegration disorder
and disintegrative psychosis is characterized by a marked regression in several areas of functioning after at least 2 years of apparently normal development. There is normal development for 2-3 years, followed by a loss of acquired motor, language, and social skills between ages 3 and 4 years.
142
The onset of autistic spectrum disorder occurs generally before the age of
Male or female
3
| Male
143
Which of the following sleep-related movement disorders is associated with the use of stimulants?
Bruxism
144
autistic spectrum disorder, the symptom that does not improve over time is
Prognosis (2)
Ritualistic and repetitive behaviours.
acquisition by ages 5 to 7 years and high intelligence (IQs above 70).
145
Which of the following disorders is among the most common psychiatric presentations seen in the adolescents?
Anxiety
146
irregular respiration are commonly associated features seen in
Rett syndrome
147
Which of the following drugs has the most supportive evidence base for the treatment of obsessive-compulsive disorder in childhood?
Setraline
148
The onset of oppositional defiant disorder is generally between the ages
3 and 8 years
149
What is the prevalence of depression among subjects with a learning disability
2-4%
150
What is the prevalence of schizophrenia in people with learning disability?
3%
151
Which of the following categories of learning disability is more commonly associated with disruptive behaviours and misconduct than the others listed ?
Mild learning disability
152
Wad may be effective in the treatment of repetitive self-injury
Opiate antagonists (e.g. Naltrexone)
153
```
Percentage of severity
Mild
Mod
Severe
Profound
```
Mild -85
Mod- 10
Severe - 4
Profound 1-2
154
The prevalence of epilepsy among patients with a learning disability is about
20-25%
155
Which of the following is the most common predisposing factor for developing learning disabilities?
Defects in embryonic development seem to be the most common aetiology of learning disabilities with Down's syndrome leading the list.
156
One of the following techniques is used to treat stuttering
Prolonged
157
Which of the following conditions is associated with skin picking?
Prader Willi syndrome
158
The most common inherited cause of Learning disability is
Fragile x syndrome
159
Lesch-Nyhan syndrome
Mode of transmission
Wad defect
Characteristic
Lesch-Nyhan syndrome is an X-linked recessive condition
defect in hypoxanthine guanine phosphoribosyl-transferase with accumulation of uric acid is noted
Compulsive self-mutilation
