Questions Flashcards

Question

MOst neuroimaging findings with OCD

Answer 1

Increased metabolism of orbitocingulate region

Answer 2

Diagnosis - presence of sig. OCD and /or tics - abrupt o sent of symptoms or relapsing remitting course - prepubertal onset - association with strep infection - associated with any neuropsychtric symptoms (anxiety, behavioural regression, sensory/motor abnormalities, somatic sits, depression) est: anti DNAse B

Answer 3

Piper methysticum (kava)

Answer 4

35% on the YBOCS

Answer 5

1) olan and quetiapine, Aripiprazole, done give amisulpride 2) olan, Aripiprazole 3) amisulpride, Aripiprazole 4) lesser with clozapine and atypical 5) quetiapaine, Aripiprazole 6) haloperidol, amisulpride, Aripiprazole

Answer 6

40mg in 2 weeks | Have antidepressant effect

Answer 7

Test dose is not required, need aqueous suspensions immediately For halo Useful for manic relapse, may need 3-6 months to reach steady state

Answer 8

Lack of clinical response to use of at least adequate use of 2 antipsychotics for a period of 6-8 weeks, with on at least from aa atypical group

Answer 9

-augmentation with risperidone (4.5mg, owner dose a and longer trail shows better outcome), fluoxetine sulpiride and amisulpride Also lamotigine which is good for positive symptoms but not egative ones Fish omega oil (ethyl-eicosapentanoate )

Answer 10

Cost Utility of the Latest Antipsychotic Drugs in Schizophrenia Study • It is an unblinded randomised controlled trial comparing first generation v. second generation antipsychotics • The primary outcome was the quality of life at 1 year and symptom measures were the main secondary outcome. • 1, 227 people with schizophrenia included • The second generation drugs were amisulpride, olanzapine, quetiapine or risperidone. • The results showed no advantage of second generation drugs in terms of quality of life or symptom burden over 1 year with those on first generation antipsychotic doing relatively better. • Participants reported no clear preference for either class of drug. • The second phase CUtLASS 2 trial was of similar design and compared clozapine with other second generation drugs in 136 patients who had not responded well to two or more previous drugs. Results showed that there was a significant advantage for clozapine in symptom improvements over 1 year; moreover, patients significantly preferred it.

Answer 11

Mood stabilisation - : carbamazepine (best for depressive type) - lithium and carbamazepine is not superior compared to one another for anis

Answer 12

1 in 6 Secure discharges suggest that nearly 25% will be readmitted within the 12 months after discharge. The reconviction rate for any offence in 2 years is 15%, but for violent offences this is 6%.

Answer 13

Sleepwalking, brain tumor, epilepsy Sane: confusion at state, concussion, reflex actions after bee stings, night terrors, hypoglycaemia

Answer 14

those with non-affective psychosis

Answer 15

Pd 87% 11% are LD

Answer 16

Fit ness to plea

Answer 17

2006). However, elderly sex offenders have increased rates of personality disorders (33% prevalence rates for any personality disorder), especially schizoid, obsessive –compulsive, and avoidant traits

Answer 18

It is asserted that people with LD are more likely to commit sex or fire-raising offences with property offences being the most common (Hodgins).

Answer 19

In 1939, Penrose described an inverse relationship between psychiatric bed numbers and the prison occupancy rate after considering cross-sectional data from 18 European countries. According to the Penrose hypothesis, decreasing psychiatric bed numbers are related to an increase in the prison occupancy rates.

Answer 20

A CAT therapy is weekly for 50-60 minutes sessions. A course of therapy can be from 16-24 sessions

Answer 21

Klermann & Weismann time-limited treatment that lasts for 12-16 hour long weekly sessions, disorder focused which deals with symptoms in the 'here and now

Answer 22

Anima' refers to the unconscious feminine aspects of the male. 'Animus' refers to the unconscious masculine aspects of the female. 'Shadow' refers to the unacknowledged aspects of oneself that includes both creative impulses and destructive urges. 'Self' refers to the main archetype that gives the personality a sense of oneness. Persona refers to the outer concealed aspects of oneself.

Answer 23

Brief dynamic therapy

Answer 24

Eric Bern first developed transactional analysis (TA

Answer 25

Dialectical behavioural therapy

Answer 26

Marsha line han

Answer 27

Carl Rogers

Answer 28

During CAT, by the third session, major maladaptive sequences and main reciprocal roles used by the patient are identified. . Between the third and fourth sessions the therapist writes a reformulation letter to the patient, which outlines the current situation and summarizes the repertoire of reciprocal roles and procedural sequences used by the patient. In the penultimate session, the therapist gives the patient another letter called goodbye letter that summarizes the therapy so far and outlines what remains to be achieved yet.

Answer 29

The four major principles on which a therapeutic community is based are exemplified by the Henderson hospital model. According to this model, the major components are (mnemonic CPD-R) 1. Communalism (Staff are not separated from inmates by uniforms or behaviours, mutual helping and learning occurs) 2. Permissiveness (tolerating each other and realising unpredictable behaviour can happen within the community) 3. Democratisation (shared decision-making and joint running of the unit) and 4. Reality confrontation (self-deception or distortions from reality are dealt with honestly and openly by all members without formalities).

Answer 30

Henderson and Cassell Tom main Maxwell Jones

Answer 31

Ambivalence

Answer 32

Anthony Ryle

Answer 33

Socratic questioning Empirical reasoning Collaborative empiricism Homework tasks

Answer 34

The four modes of treatment in DBT are (1) group skills training, (2) individual therapy, (3) phone consultations, and (4) consultation team. Mindfulness. Others distress tolerance, emotional regulation, interpersonal effectiveness

Answer 35

The cognitive techniques include psychoeducation, including reading assignments, identifying automatic thoughts, Socratic questioning, role play, thoughts diary, thought rehearsal, examining the evidence and working through the options. behavioural techniques include activity scheduling, graded assignments, exposure, response prevention, distraction, relaxation training and assertiveness and social skills training.

Answer 36

Erich from, Harry stack Sullivan, Alfred Adler, Karen hornet

Answer 37

[cat focus on snags and dilemmas, Ipt focus on grief and role transition

Answer 38

Albert Ellis

Answer 39

Palazolli and Milan

Answer 40

Relationships

Answer 41

dependency, pairing, or fight-flight. A 4th basic assumption was introduced by Hopper called massification/aggregation

Answer 42

Systemic family therapy

Answer 43

splitting, projection, projective identification, idealization, denigration, introjection, passive aggression and turning against the self. Neurotic defences include repression, regression, denial, displacement, dissociation, isolation, reaction formation, intellectualisation, rationalization, externalisation and identification with the aggressor. Humour, anticipation, sublimation, altruism and suppression (SASHA) are all mature defence mechanisms.

Answer 44

Task setting (homework tasks) are an essential component of strategic family therapy.

Answer 45

Methadone 2. Buprenorphine and 3. a2 adrenergic agonists (e.g. clonidine and Lofexidine)

Answer 46

Buprenorphine and Naloxone

Answer 47

0.25-2.0 g per day

Answer 48

alpha-2 adrenergic agonist, licensed for the management of symptoms of opioid withdrawal. It can counteract the adrenergic hyperactivity associated with opioid withdrawal, demonstrated by characteristic signs and symptoms such as tachycardia, sweating, runny nose, shivering and goose bumps. Detoxification is much faster than with methadone or Buprenorphine, typically lasting 5-7 days and up to a maximum of 10 days.

Answer 49

The 2007 NICE Guidance on the management of opioid dependence recommends oral methadone or buprenorphine as the preferred pharmacotherapeutic options for opioid dependence. The decision on which to use should be based on the patient's preference. In cases where both methadone and buprenorphine appear equally suitable, the NICE Guidance advises prescribing methadone as first choice

Answer 50

Second trimester

Answer 51

32-72 hours

Answer 52

Benzodiazepine withdrawal

Answer 53

nicotine replacement therapy (NRT); the antidepressant Bupropion prolonged release tablets and Varenicline Tartrate.

Answer 54

24-48 hours after birth, depending on the time of last dose.

Answer 55

40% of chronic alcoholics

Answer 56

Chlormethiazole

Answer 57

synthetic taurine analogue, which appears to act centrally on glutamate and GABA neurotransmitter systems, although the mechanism has not been fully established. It inhibits glutamatergic NMDA receptor function and balances GABA-glutamate imbalance seen in alcohol dependence. It is hypothesized to suppress the 'urge to drink' in response to learned cues. Gastrointestinal disturbance (e.g. nausea, diarrhoea) are the most common side effects reported.

Answer 58

Halitosis is a common side effect of Disulfiram. Disulfiram can act as a helpful adjunct to alcohol detoxification therapy and allow the patient's relatives regain confidence in their ability to remain abstinent. Rare reports of psychotic reactions and hepatotoxicity have been noted. Contraindication: Impulsivity, psychosis, Suicidality, severe hepatic dysfunction, peripheral neuropathies, cardiac diseases Ref: Oxford handbook of psychiatry- 522

Answer 59

Opthalmoplegia

Answer 60

Motivational Enhancement Therapy and Social Behaviour and Network Therapy in treating alcohol problems. SBNT was carried out over eight sessions each lasting 50 min. Components were drawn from network therapy, behavioural marital therapy, unilateral family therapy, social aspects of the community reinforcement approach, relapse prevention and social skills training. The novel social behaviour and network therapy for alcohol problems did not differ significantly in effectiveness from the comparator.

Answer 61

5-7 days after the last drink

Answer 62

Alcohol use disorders identification test

Answer 63

Aldehyde dehydrogenase

Answer 64

Chlordiazepoxide

Answer 65

Disulfiram

Answer 66

The features of type II alcoholism includes inheritance of the condition from the father, onset of alcohol-related problems before the age of 25 years, being found primarily in males, prominent history of criminality and poor prognosis characterized by an inability to achieve meaningful abstinence.

Answer 67

First 24 hours

Answer 68

Naltrexone

Answer 69

this can induce a pattern of repeated use. Dysphoria (crash), anhedonia, anxiety, irritability hypersomnolence, and sometimes agitation usually end within 18 hours though in heavy dependent users this can last up to a week, peaking in 3 days.

Answer 70

Ketamine | Phencyclidine

Answer 71

Muscle spasms and twitching Opioid withdrawal symptoms may include lacrimation, rhinorrhoea, agitation, perspiration, piloerection, vomiting, shivering, yawning and dilated pupils.

Answer 72

Peripheral analgesia

Answer 73

Clinically significant assaultative behaviour, impulsiveness, unpredictability, psychomotor agitation, impaired judgment that developed during, or shortly after, phencyclidine use. Within an hour (less when smoked, "snorted," or used intravenously), two (or more) of the following signs: (1) vertical or horizontal nystagmus (2) hypertension or tachycardia (3) numbness or diminished responsiveness to pain (4) ataxia (5) dysarthria (6) muscle rigidity (7) seizures or coma (8) hyperacusis. Pupil size is variable with PCP use, depending on the degree of hypoxia and intoxication.

Answer 74

Increased metabolism of orbitocingulate region

Answer 75

Brain stem

Answer 76

Anorexia; 55 Bulimia 35% But for dizygotic 30%

Answer 77

Lamotrigone

Answer 78

Calgary depression scale was specifically developed to avoid measurement redundancy with negative symptoms while evaluating depression in schizophrenia patients.

Answer 79

Varenicline tartrate is a partial agonist binding with high affinity to alpha4beta2 nicotinic acetylcholine reecptor. It significantly reduces nicotine withdrawal symptoms and makes smoking less rewarding so it may help prevent 'slips' developing into full relapse.

Answer 80

Downbeat nystagmus

Answer 81

Reduced pulse rate

Answer 82

Rett syndrome

Answer 83

Cognitive analytical therapy

Answer 84

Benefit Realisation Plan is a table used as a tool to ensure that the intended benefits originally planned in a QI project are actually delivered to the stakeholders in a tiemly fashion. The FOCUS approach to QI is shown in the figure below. FOCUS stands for Finding a process to improve, Organising a team, Clarifying current knowledge, Understanding causes of variation and Selecting the process improvement procedures. Model for improvement (MFI) is commonly employed now by many NHS organizations. MFI is an extension of PDSA and describes reflections that need to occur before embarking on a PDSA cycle. To measure outcomes over time, tools are available to generate time series graphs or frequency charts. Commonly used time series graphs include 'run charts' or Statistical Process Control charts (SPC). SPC enables the use of simple statistical concepts to understand processes that are being studied or implemented. In essence, SPC helps to assess the 'system' for predictability of outcome when a change is implemented; if unexpected variations are present, this provides an opportunity to study the external factors that may influence the desired outcome

Answer 85

Nightmares

Answer 86

Topiramate

Answer 87

: 29-35 years 3 months

Answer 88

Nortriptyline

Answer 89

4 times higher

Answer 90

approximate answers, clouded consciousness, pseudo-hallucinations and hysterical conversion symptoms.

Answer 91

Caudate atrophy

Answer 92

MRI shows hypointensity of striatum

Answer 93

Cochran's Q test and the I2 statistic. The basic intent of a meta-analysis is to include enough studies to narrow the confidence interval around the resulting pooled estimate. There are 2 criteria for not combining the results of studies in a meta-analysis: highly disparate point estimates and confidence intervals with little overlap - both these will result in a pooled estimate with wider confidence interval that beats the primary aim. Examining a forest plot, using Galbraith plot (choice B) and L'Abbe plot (

Answer 94

Weighted mean difference

Answer 95

Cohen's d is a measure of effect size. It is obtained by using the data from each study that enters a meta-analysis.

Answer 96

Standardised mean difference

Answer 97

short arm of chromosome four

Answer 98

Quetiapine n clozapine

Answer 99

Lamotrigine

Answer 100

First 3 months of postpartum period

Answer 101

50% of all pregnancies

Answer 102

Social class 5

Answer 103

Bipolar type 2

Answer 104

The male: female ratio for anorexia is 1:10. In major depression, the male: female ratio is 1:2. This is the post-puberty prevalence rate. Before puberty, boys have marginally more depression than girls. Generalized anxiety disorder is twice more often seen in females. Bipolar disorder type 1 is a disorder with equal sex distribution of 1:1. In bipolar disorder type 2, the male: female ratio is 1:1.3. Agoraphobia is more often seen in females with male: female ratio of 1:3

Answer 105

Paroxetine

Answer 106

Flupenthixol depot may have an antidepressant effect. Pipotiazine depot has a fewer incidence of extrapyramidal side effects. Fluphenazine depot can induce depressed mood. Risperidone depot needs aqueous suspension immediately before injection and in practice, a test dose is not required.

Answer 107

Mercury poisoning is featured by CNS symptoms of lethargy and restlessness. The primary symptoms are secondary to severe gastrointestinal irritation, with bloody stools, diarrhoea and vomiting leading to circulatory collapse. It causes depression and mild cognitive impairment with poor attention and concentration with severe anxiety and agitation (Mad hatter's disease). Lead poisoning in children causes an encephalopathy that may be associated with permanent intellectual impairment. Adults exhibit anorexia and colic with cognitive impairment and with chronic exposure can cause psychosis. Manganese poisoning produces symptoms such as headache, irritability, joint pains and somnolence (manganese madness). Lesions involving basal ganglia and pyramidal system result in gait impairment, rigidity, monotonous or whispering speech, tremor of extremities and tongue, masked facies, micrographia, dystonia, dysarthria and loss of equilibrium. Thallium poisoning causes severe pain in the legs as well as diarrhoea and vomiting. Within a week people may develop delirium, convulsions, cranial nerve palsies, blindness, choreiform movements and coma may occur. Alopecia is a common and important diagnostic clue. Behavioral changes include paranoid thinking and depression, with suicidal tendencies. Thallium poisoning almost always follows accidental or intentional ingestion of a rat poison 5) Arsenic poisoning most often occurs during industrial exposure, especially workers in production of pesticides, copper or lead smelting. Psychiatric symptoms include mild impairment of new learning, recent memory and concentration. This may manifest a few years after exposure. Recovery is possible on cessation of the exposure.

Answer 108

Fahr's disease is due to an idiopathic (autosomal dominant) progressive calcium deposition in the basal ganglia. An onset between the ages of 20 and 40 is associated with schizophreniform psychoses and catatonic symptoms. An onset between the ages of 40 and 60 is associated with dementia and choreoathetosis. Depression is also very common, but mania is uncommon. 50% patients report psychiatric problems. Psychiatric symptoms correlate with more extensive calcification. The pattern of cognitive impairment found in FD is of the frontosubcortical type. The commonest neurological features of FD are parkinsonism, chorea, dystonia, tremor, gait disturbance, dysarthria, seizures and myoclonus. MRI shows hypointensity of striatum. EEG is non specific - may show diffuse changes. Fahr's disease is also called familial cerebral ferrocalcinosis.

Answer 109

Following an act of self-harm the rate of suicide increases to between 50 and 100 times the rate of suicide in the general population (Hawton et al., 2003b; Owens et al., 2002). In other words, the subsequent risk of suicide is at least 3% after 10 or more years. The risk of repetition of self harm is extremely high; up to 40% will go on to repeat. About one in six people who attend an emergency department following self-harm will self-harm again in the following year (Owens et al., 2002); a small minority of people will do so repeatedly - 10% will repeat at least 5 times in a given year. This high-repetition group is one reason for the overall high repetition rate observed (40% repetition in 10 years or more). Self-harm can occur at any age but is most common in adolescence and young adulthood (Meltzer et al., 2002a). For example, based on a survey of 12,529 children and young people aged 5 years to 15 years, 1.3% had tried to harm themselves (data collected from parents) (Meltzer, 2002a). In contrast, only about 5% of all episodes of self-harm occur in people over the age of 65 (Dennis et al., 1997; Draper, 1996; Owens et al., 1991). The correct answer is: The proportion of all episodes of self-harm that occur in people over the age of 65 – 5%, The subsequent risk of suicide 10 or more years after an episode of self harm. – 3%, The proportion of individuals who will harm themselves again in their lifetimes – 40%, Proportion of individuals who self harm that will repeat at least 5 times in a given year – 10%

Answer 110

4% Attempts 2% Suicide thoughts 15%

Answer 111

Haloperidol : 30 Chlor 1000 Olan 20 Quetia 750-800 Risperidone 16 Clozapine 900 Citalopram 20-60 Setraline 50-200

Answer 112

Genetic history Poor functioning, Long duration of prodromal symptoms

Answer 113

The suggested drugs for patients with dyslipidemias/impaired glucose tolerance are amisulpride, aripiprazole and ziprasidone. The suggested drugs for patients with sexual dysfunction are Aripiprazole and Quetiapine. Aripiprazole is least likely to cause QT prolongation. The suggested drugs for patients with hyperprolactinaemia are Aripiprazole and Quetiapine.

Answer 114

10 to 15% 15-30%

Answer 115

Anxious Ocpd

Answer 116

Apolipoprotein e2 allele

Answer 117

1% at 65 40% at 85 Risk doubles every 5 years

Answer 118

6th decade

Answer 119

Female gender

Answer 120

Short arm of chromosome 4

Answer 121

``` Ad CJD Prion Subdural hematoma Picks NPH ``` CJD

Answer 122

Nightmares This is followed by 7% with night terrors, 5% with delirium and 3% with delusional disorder. 1/3 hav psych side effect

Answer 123

Older age at onset

Answer 124

Later onset, female gender, an absence of behavioural symptoms, and lack of depressive episodes Depression : Onset less than 70 years of age 2.a shorter duration of illness 3.Absence of physical illness 4.Good previous adjustment 5.Good previous recovery.

Answer 125

The most prevalent anxiety disorder among older adults is phobic disorder and the least common in this age group is the panic disorder.

Answer 126

Vascular dementia

Answer 127

BASDEC (Brief assessment schedule depression cards) Cornell scale for depression is the best validated scale for detecting depression in dementing patients. It is an interviewer-administered scale that uses information both from the patient and an outside informa

Answer 128

Insomnia Bradycardia

Answer 129

CT/MRI shows atrophy of both cerebrum and cerebellum. Generalised periodic 1-2 Hz sharp waves are seen in nearly 90% patients with sporadic CJD. Less often in familial / hormonal

Answer 130

Presenilin 1 gene (Chromosome 14) is associated with early onset Alzheimer's disease. Presenilin 2 genes (Chromosome 1) is also associated with early onset Alzheimer's disease. Beta Amyloid precursor protein gene (Chromosome 21) is the gene for Amyloid precursor protein and is found on the long arm; it is associated with early onset Alzheimer's disease. Apolipoprotein e 4 (Chromosome 19) - Presence of e 4 alleles increases the risk of late-onset dementia of Alzheimer's type.

Answer 131

Risperidone is the only drug licensed in the UK for behavioural and psychological symptoms of dementia. It is indicated for the short-term treatment (up to 6 weeks) of persistent aggression in patients with moderate to severe Alzheimer's disease who are not responding to non-pharmacological measures and when there is a risk of harm to self or others. 2) Several reports have noted that the drug Gingko biloba may increase the risk of bleeding and should be used with caution. 3) The use of galantamine was associated with increased mortality in patients with mild cognitive impairment when compared with placebo. Although no specific cause was predominant, half the deaths reported were due to cardiovascular disorders. As a result, the FDA issued a warning restricting the use of galantamine in patients with mild cognitive impairment (MCI). 4) Memantine can cause confusion and hallucinations in patients although it is rare. The common side effects are headache, dizziness, constipation, somnolence and hypertension. 5) The hormone oestrogen may have actions that have a preventive effect and potentially reduces the risk of Alzheimer's disease.

Answer 132

Donepezil Rivastigmine may be the safest choice in patients with cardiovascular disease given its lack of interaction potential with other drugs.

Answer 133

Donepezil 10mg daily Rivastigmine 6mg bd It’s patch I s 9.5 per 24 hour Galantamine 12mg bd memantine 10mg bd

Answer 134

1: 10 9: 1 3: 1 Depression 1:1 Tourette (mean age is) 7 3:1

Answer 135

Children's depression inventory

Answer 136

Being youngest in the family

Answer 137

Classic conditioning with the bell and pad apparatus is the most effective treatment for nocturnal enuresis, with dryness resulting in more than 60 percent of cases. Desmopressin(intranasal) Imipramine Riboxetine (safe alternative than imipramine)

Answer 138

Atomoxetine and clonidine

Answer 139

Low self-esteem, continual self-deprecation, Sudden speech disorder, Rocking, head-banging, or other neurotic behaviour

Answer 140

Blood pressure and heart rate , Height and weight

Answer 141

Reading: male 4 to 1 Writing 3 :1 Math more female , 6% of school children Stuttering 3 to 1

Answer 142

Adhd 70-80%

Answer 143

ADHD and ocd

Answer 144

2-5% Genes: 5,6, 11 50% 0-1%

Answer 145

5 years old

Answer 146

OCD and adhd More so in ocd

Answer 147

Inadequate parenting

Answer 148

Imipramine

Answer 149

Co-morbid psychiatric illness is common in ADHD children and is seen in 50-80% of cases. 50% children may meet criteria for 2 comorbid conditions. Oppositional Defiant disorder in 35-50%, conduct disorder 25%, anxiety disorder 25% and depressive disorder 15%. Learning disability 15-40%, specific language impairment in 15-75% children.

Answer 150

Ritualistic and repetitive behaviours.

Answer 151

Anxiety disorders

Answer 152

3 and 8 years

Answer 153

Actual incidents of DSH are admitted by only 6.9% of adolescents. The prevalence of ideation is estimated to be far higher.

Answer 154

Dilemma: When a person acts as though available action or possible roles were limited to polarized alternatives, this is referred to as a dilemma. Snag: when appropriate roles are abandoned because the person makes an assumption that others would oppose them or because they are perceived as forbidden or dangerous. Traps; repetitive cycles where consequences of the behaviour feedback into its perpetuation. Here negative assumptions generate acts that produce consequences that reinforce the assumptions. This is introduced in ipt and cat

Answer 155

Cat: anothony Ryle Ipt: klerman and weissman Mentalisatiom : Bateman and fonagy Franz Alexander & Thomas French

Answer 156

Albert Ellis

Answer 157

Miller & Rollnick, 199

Answer 158

Cognitive analytical y

Answer 159

Interpersonal therapy

Answer 160

Focuses mainly on the present functioning of the family rather than its past experiences. Strategies include employing paradoxical injunctions, circular questioning. Focuses on a set of unspoken rules that organize ways in which family members relate to one another. Such a structure will have the hierarchy of power (parents in charge of children) and firm boundaries. involves hierarchies, redesigning, reframing the family systems so that it approximates a normative model of care but open boundaries between generational subsystems.

Answer 161

Psychodynamic therapy

Answer 162

1) Jung expanded the drive theory to include drives other than libido. He also introduced ideas of 'collective unconscious' and personality archetypes. Jung is also associated with concepts such as extroversion and introversion. 2) Melanie Klein introduced methods of play therapy. She is also associated with theories of childhood development including primitive defense mechanisms such as 'splitting'. 3) Donald Winnicott was one of the proponents of the object relations theory. He argued that gratification could be obtained through relationships as well as through satisfaction of desires. 4) Eric Berne is associated with the transactional analysis. He emphasized the importance of therapeutic attributes of genuineness, accurate empathy and unconditional positive regard. 5) Client-centered psychotherapy is associated with Carl Rogers. This therapy is based on the principle that every individual has the motivation and ability to change, and he or she is the best person to decide on the direction of change. Client-centered therapy is nondirective as the therapists avoid directing the therapeutic process. It emphasizes the importance of 'therapeutic attributes of genuineness', 'unconditional positive regard' and 'accurate empathy'.

Answer 163

1) Bion postulated that whenever a group gets derailed from its task, it deteriorates into one of three primary states, that are also called basic assumptions. It includes dependency, pairing, or fight-flight. These basic assumptions must be tackled to allow group work to proceed. 3) The formulation matrix in group therapy was described by Foulkes. It refers to a hypothetical web of communication and relationship in a given group. It is the common shared ground, which ultimately determines the meaning and significance of all events and upon which all communication and interpretations, verbal and nonverbal rest.

Answer 164

In systems approach to couple therapy the focus of treatment is on hidden rules that govern the behaviour of the couple towards one another, on disagreements about who makes these rules and on inconsistencies between these two levels of interaction. Important concepts include enmeshment, which is excessive involvement with the other person and the idea of a cycle of 'cause and effect' such that neither person is whole to blame. These ideas are discussed in conflicts arising in the everyday life of the couple, and it is hoped to arrive at a more balanced and cooperative relationship.

Answer 165

Behavioural systems couple therapy was developed by Crowe. It has two sets of components. The behavioural components are reciprocity negotiating and training in communication. The systems components are structural moves (include requiring disagreement, reversed role play & sculpting, timetables & tasks) and the use of paradox. Treatments usually last for 5-10 sessions over 3-6 months.

Answer 166

Abreaction is the process by which repressed material, particularly a painful experience or conflict, is brought back to consciousness Catharsis is the expression of ideas, thoughts, and suppressed material that is accompanied by an emotional response. It produces a state of relief in the patient.

Answer 167

Tom Main coined the term therapeutic community. Maxwell Jones established the therapeutic community, and Rapoport explained the key features of Therapeutic communities that include communalism, democracy, permissiveness and reality confrontation. Yalom cited 11 'curative' factors responsible for a change in groups. The curative factors include the instillation of hope, universality, imparting information (feedback), altruism, corrective recapitulation, socialisation techniques, imitative behaviour, interpersonal learning, group cohesiveness, catharsis and existential factors. Of these, cohesiveness, and learning from feedback are valued positively though other factors may also be important.

Answer 168

Christopher G. Fairburn, originally intended for bulimia nervosa specifically; it was eventually extended to all eating disorders. CBT for psychosis : Kingdon & Turkington in 1994

Answer 169

Jacob Levy Moren

Answer 170

Masters and Johnson –

Answer 171

Joseph Wolpe

Answer 172

Otto rank Jacobson for relaxation

Answer 173

The token economy was pioneered by Ayllon, Azrin, Paul & Krasner (Camarillo State Hospital, Calif.). The full range of self-care, social, and work behaviors were thought to be modifiable through systematic and preplanned use of antecedents and consequences of these actions. The "psychopathological" behavior of the mentally ill was conceptualized as being subject to the same "laws of learning" that influenced normal behavior. The tokens could be conveniently dispensed to patients contingent on their exhibiting improvements in their behavior. (Am J Psychiatry 157:9, September 2000).

Answer 174

Procedural sequence model and role repertoires

Answer 175

interpersonal role disputes (conflicts with family member, colleague, or friend), role transitions (change from one role to other - includes graduation, beginning or end of career, migration, medical ill health etc.), grief (loss of a loved object/relation) and interpersonal deficits (social impoverishment, inadequate interpersonal relationships).

Answer 176

distress tolerance, Interpersonal effectiveness training, Core mindfulness training and Emotion regulation skills.

Answer 177

Permissiveness and reality confrontation are 2 of the four components of the therapeutic community (Rappaport / Henderson Hospital Model). Permissiveness is tolerating each other, and realizing unpredictable behaviour can happen within the community. Reality confrontation is self-deception or distortions from reality are dealt with honestly and openly by all members without formalities. The other two principles are communalism and democratization.

Answer 178

problem free talk, preferred future, exception finding and scales.

Answer 179

Symptoms include muscle aches, anxiety and agitation, sleep issues, running nose and yawning. Nausea and vomiting, diarrhoea, goose bumps, stomach cramps, depression or dysphoria and intense drug cravings start later (late onset symptoms)

Answer 180

T wave flattening tremulousness, dystonia, hyperreflexia, and ataxia.

Answer 181

Hypophosphatemia

Answer 182

Turner syndrome is relatively common (1/2,500 women) in a phenotypic female. It is associated with a cognitive profile of normal intellectual and verbal function but impairments in visual–spatial, executive, and social cognitive d 1 in 2500

Answer 183

Carbamazepine can cause gingival bleeds due to their propensity to reduce platelet levels. Other antiepileptic drugs that can cause gingival bleed include levatiracetam and phenytoin.

Answer 184

Rapidly fatal intestinal obstruction has been reported with clozapine, sometimes even without prior warning signs. Some case reports also implicate risperidone and olanzapine in intestinal obstructions.

Answer 185

Aid in conflict resolution

Answer 186

External validity

Answer 187

Freeman performed the first transorbital lobotomy on a live patient in 1946; together with Watts, he popularised the procedure in the US.

Answer 188

The correct answer is: An intervention aimed at high risk individuals is the best approach to help those individuals, but population wide benefits are best achieved via universal prevention

Answer 189

Standard and Enhanced

Answer 190

African Caribbean

Answer 191

1 in 4 1 in 6 1 in 7

Answer 192

The Static-99 is a ten item actuarial assessment instrument. It was created by Hanson and Thornton, for use with adult male sexual offenders who are at least 18 years of age at the time of release to the community. Honos is crested by sugarman HoNOS-secure is not a risk assessment tool, but a tool that enable the clinical risk assessment to be translated to need for care and clinical risk management. Rating scales 3) VRAG (violence risk appraisal guide - Quinsley 1995) is entirely reliant on historical factors. It was originally validated at Canadian prisons. It is made of 12 items and includes PCL_R as a subscale. 4) SORAG (Sexual risk offender appraisal guide) is a 14 item actuarial instrument that incorporates PCL_R.

Answer 193

rejected stalker is one who pursues an ex-intimate person, either in the hope of reconciliation or for vengeance. Intimacy seekers who stalk someone they believe they love, and they think they will reciprocate. Incompetent suitors, who inappropriately intrude, someone, usually seeking a date or brief sexual encounter. The resentful stalker pursues victims to exact revenge for actual or perceived injury. The predatory stalker stalks for a sexual offence.

Answer 194

a writ requiring a person under arrest to be brought before a judge or into court, especially to secure the person's release unless lawful grounds are shown for their detention. Doli incapax: deemed incapable of forming the intent to commit a crime or tort, especially by reason of age (under ten years old). Larceny is theft of personal property. Corpus deliciti is the facts and circumstances constituting a crime. concrete evidence of a crime, such as a corpse.

Answer 195

A Guttmann Scalogram is a scale composed of several yes/no items in a manner such that if a respondent agrees to the one statement, he/she is likely to agree to the lower order statements as well. So the total score of the scale represents a single index for the continuum that is measured. In other words, a person's entire set of responses to all items can be reconstructed from their score. This procedure is also called cumulative scaling. The Guttman scale is most suitable for hierarchical constructs e.g. social attitudes, political views, developmental stages, etc. E.g. Bogardus Social Distance Scale is a cumulative scale used to measure the willingness of people in accepting an immigrant into their social groups (E.g., family, work etc).

Answer 196

Rejection of the null hypothesis

Answer 197

1) Factor analysis is essentially a method of data reduction - here groups of variables that are highly inter-correlated in a dataset are identified. Then simple correlation analysis of individual factors is carried out. A good example is factor analysis of positive symptoms by Liddle to describe three groups of variables - reality distortion, psychomotor poverty and disorganization syndromes. 2) Multiple linear regression is a linear regression model in which there is a single dependent variable and 2 or more independent variables. In multiple linear regression, several independent variables together predict a single dependent variable. Consider y = a+b1x1 + b2 x2+ b3x3+ b4x4......................+ bnxn. Multiple regression is a multivariate technique. 3) Logistic regression is used to predict the relationship between a binary dependent variable and several independent variables. For linear regression, the dependent variable must be continuous. If the dependent variable is binary, then the logistic regression is used. It is commonly used to get OR, RR or hazard ratio for independent variables that affect the dependent variable.

Answer 198

authors report a wide array of systematic reviews to assess the benefits and harms of a health care intervention. CONSORT improve quality of rct QUOROM was convened to address standards for improving the quality of reporting of meta-analyses of clinical randomised controlled trials (RCTs). The STROBE statement (Strengthening the Reporting of Observational Studies in Epidemiology) is a good checklist for preparing a publication of observational studies such as cohort, case-control and cross-sectional studies.

Answer 199

The "System for Information on Grey Literature in Europe" (SIGLE) is an European initiative operated by a network of national information or document supply centres active in collecting and promoting grey literature (especially conference abstracts, doctoral thesis etc.). The CINAHL database is a comprehensive and authoritative source of information for nurses, allied health professionals including OTs, and others interested in health care.

Answer 200

Borderline

Answer 201

PCP 3-8 days Cocaine 6-8 hours Amp thiamine 48 hours Heroin 1-3 days

Answer 202

About 80 percent of alcoholic patients recovering from Wernicke's encephalopathy develop Korsakoff's amnesic syndrome.

Answer 203

24-48 hours

Answer 204

Acamprosate

Answer 205

mixed anxiety-depression followed by GA 25% of all GP consultations are for anxiety related symptoms.

Answer 206

Gerstmann,s syndrome is associated with lesions of the dominant parietal lobe. This consists of dyscalculia, agraphia, finger agnosia and right-left disorientation. Anosognosia and dressing apraxia are often seen with non-dominant parietal lesions.

Answer 207

Mirtazapine

Answer 208

GAD = 20-30years, Panic disorder = 22 to 25 years, OCD= 20 years, social phobia = 15 years,

Answer 209

Dysarthria

Answer 210

Self mutilation

Answer 211

Atomoxetine

Answer 212

1-2 per 100000 4-8 per 100000 in the age range of 15-19 years

Answer 213

Lesch-Nyhan Syndrome Correct

Answer 214

Fragile X syndrome

Answer 215

Cognitive analytical therapy

Answer 216

Both Mantel-Haenszel method and Peto method are used to arrive at summary Odds Ratio in a meta-analysis of studies that report dichotomous outcome variables. Peto is often used when the ratio of the number of cases vs. controls or exposed vs. unexposed is not considerably different in individual studies. This is often the case in RCTs. In contrast meta-analysis of cohort studies and case-control studies often use Mantel-Haenszel procedure where there are considerable differences in the ratio of group sizes between individual studies. Also, Mantel-Haenszel is primarily used for stratifying odds ratios to analyse and control confounders in causal studies.

Answer 217

Newborn with anencephaly – Valproate, Newborn with defect of the tricuspid valve – Lithium, 9tricuspid valve abnormality is Epstein) Newborn with spina bifida – Valproate, Newborn with ventral septal defects – Paroxetine

Answer 218

The depressive sign scale has nine items useful to detect depression in people with dementia.

Answer 219

Violence risk appraisal guide

Answer 220

Alcohol use

Answer 221

5% if jr withdrawal, 30% if seizure 8% for seizure 3% if withdrawal is treated

Answer 222

Euphoria, apathy after that } ``` Psychomotor agitation or retardation o Pupillary constriction (if pupillary dilation is seen the overdose may be very severe and anoxia has set in) o Drowsiness or coma o Slurred speech ```

Answer 223

2 days Starts in 6-8 hours ``` Dysphoric mood o Nausea or vomiting o Muscle aches o Lacrimation or rhinorrhea o Pupillary dilation, piloerection (gooseflesh), or sweating o Diarrhea o Yawning o Fever o Insomnia ```

Answer 224

impaired motor coordination, euphoria, a sensation of slowed time, social withdrawal, conjunctival injection, increased appetite (munchies), dry mouth, tachycardia. Mainly cough and red eye Important distinction: heightened perceptual sensitivity, depersonalization and derealization

Answer 225

Intoxication effects include tachycardia or bradycardia (sometimes these arrythmias can be fatal), pupillary dilation, elevated or lowered blood pressure, perspiration or chills , nausea or vomiting , evidence of weight loss, psychomotor agitation or retardation, muscular weakness, respiratory depression, chest pain, or cardiac arrhythmias, confusion, seizures, dyskinesias, dystonias, or coma, psychological effects such as euphoria, changes in sociability, anxiety, tension, stereotyped behaviours and impaired judgment.  Withdrawal effects include dysphoric mood (crash) sometimes with suicidal ideation. fatigue, vivid, unpleasant dreams, hypersomnia, increased appetite, psychomotor retardation and small pupils.

Answer 226

nystagmus, numbness or diminished responsiveness to pain, ataxia and dysarthria with muscle rigidity. Pupil size is variable with PCP use, depending on the degree of hypoxia and intoxication.

Answer 227

Noncompetitive NMDA antagonist binds to sigma receptors

Answer 228

Cannabis intoxication- Tachycardia, red eyes, lack of coordination, postural hypotension. 2) Benzodiazepines intoxication- Sedation, dizziness, respiratory depression. 3) Amphetamine intoxication- Tachycardia, hypertension, anorexia, tremor and restlessness. 4) Cocaine intoxication- Tachycardia, tachypnea, hypertension, headache, chest pain and respiratory depression. 5) Heroin intoxication- Pinpoint pupils, clammy skin, respiratory depression

Answer 229

LSD intoxication

Answer 230

Tourette's syndrome

Answer 231

Microcephaly, short stature, continuous eyebrows, hypertrichosis, prominent philtrum, small hands and feet, profound mental retardation Chromosome 5

Answer 232

Hurler Recurrent infection : hunter Mousy Oder: PKU Self harm leach and Cornelia de Lange Cornelia de Lange

Answer 233

Random post codes

Answer 234

abdominal cramps, low-grade fever, diarrhoea, nausea and vomiting.

Answer 235

Adenosine Correct

Answer 236

Tranquilisers, some painkillers, GHB (Gamma-hydroxybutyrate), ketamine. Cannabis was originally in class B but was downgraded briefly to class C between 2004 and 2009.

Answer 237

Amphetamines, Methylphenidate (Ritalin), Pholcodine Class C drugs-

Answer 238

Borderline personality disorder is seen in nearly 2% of general population, 10% outpatients, 15-20% inpatients and 30-60% of all personality disorders in some clinical samples. UK household survey estimated a 0.7% prevalence in the community.

Answer 239

Late-onset schizophrenia is more common in women. Gender distribution is estimated at 4-9:1 female: male predominance. The correct answer is: 60-69%

Answer 240

8-9 Times Schizophrenia : : 2-3 times

Answer 241

In hospital studies, the mean age of onset is 21 years while it is 17 years in community studies

Answer 242

Paroxetine, fluoxetine, duloxetine and bupropion are strong CYP2D6 inhibitors, which should be avoided in tamoxifen users. Amitriptyline and its metabolite, nortriptyline, are metabolized by and can inhibit CYP2D6. Fluvoxamine and nefazodone both inhibit CYP3A, which could potentially affect the metabolism of tamoxifen.

Answer 243

Sertraline also has an active metabolite, N-desmethyl sertraline, which is ten times less potent than sertraline itself. Fluoxetine also has an active metabolite norfluoxetine with a long half-life.

Answer 244

Signs and symptoms include high fever, seizures, irregular heartbeat or unconsciousness

Answer 245

borderline PD and schizotypal PD had the highest impairment in baseline occupational functioning.

Answer 246

20 per year

Answer 247

‘30-39 40%

Answer 248

1.9 per 1000 live births

Answer 249

Psychoanalytic psychotherapy

Answer 250

The false positive error rate increases. When sensitivity increases, more number of cases will be diagnosed despite not having the disease (an increase in false positive rate). When you select a lower criterion value, then the true positive fraction and sensitivity will increase. On the other hand, the false positive fraction will also increase, and, therefore, the true negative fraction and specificity will decrease.

Answer 251

Increased blood pressure

Answer 252

increased sweating, nausea and vomiting, and diminished potency despite increased libido Withdrawal fatigue, loss of appetite, depression, anxiety, and trouble concentrating.

Answer 253

0.7 Clozapine is very epileptogenic. Among 5% who receive more than 600 mg/day develop seizures.

Answer 254

10% The strongest risk factor of suicide is history of deliberate self harm. Prognosis of non-fatal DSH: 20% repeat and 1% die in next year.

Answer 255

: 0 to 2 weeks

Answer 256

carbamazepine exposed pregnancies, craniofacial defects (11 percent), fingernail hypoplasia (26 percent), and developmental delay (20 percent) were recorded.

Answer 257

50 per 1000

Answer 258

Incestual sex offence against a child

Answer 259

Atomoxetine

Answer 260

Atomoxetine

Answer 261

Strengths-based approach

Answer 262

Heart failure and sick sinus syndrome Lefexidine: severe coronary insufficiency, recent myocardial infarction, cerebrovascular disease or chronic renal failure and patients with bradycardia or hypotension.

Answer 263

Post-traumatic stress disorder – 1:2, Alzheimer's disease – 1:2, Borderline personality – 1:3, Alcohol dependence – 5:1, Antisocial personality disorder – 5:1

Answer 264

1 CONSORT: reporting of RCTs  STARD: reporting of diagnostic studies  STROBE: reporting of observational studies  PRISMA: reporting of meta-analyses of RCTs  MOOSE: reporting of meta-analyses of observational studies

Answer 265

Wilson’s disease

Answer 266

Summarising datasets repeatedly

Answer 267

Internal consistency of an instrument

Answer 268

Presence of statistical heterogeneity

Answer 269

Inter rater reliability

Answer 270

Sample size for a study

Answer 271

Psychinfo Medline

Answer 272

It is associated with disorders such as Parkinson's disease, diffuse Lewy body disease, multiple system atrophy and Gullian-Barre syndrome. RBD may be the prodrome of neurodegenerative disease, such as DLB or Parkinson disease.

Answer 273

Psychomotor changes

Answer 274

Sertraline

Answer 275

Nearly 60% of patients on SSRI experience sexual side effects. The correct answer is: Sexual side effect

Answer 276

All psychotropic drugs enter breast milk but the ratio between infant and maternal plasma levels varies greatly. The rates of adverse effects are uncertain, but there are sporadic reports of problems with, for example, toxicity due to lithium, hepatic dysfunction due to CBZ and thrombocytopaenia or anaemia attributed to valproate. In general, the risks to the infant are the same as those for any patient exposed to the medicine, so clozapine is usually regarded as contraindicated because of the risk of agranulocytosis. Lamotrigine will carry the possibility of rash. Due to its narrow therapeutic index lithium is generally regarded as being a relative contraindication to breastfeeding because it is present in breast milk at 40% of the maternal serum concentration (American Academy of Paediatrics Committee on Drugs, 2000). Though valproate and carbamazepine are equally acceptable, valproate being a better antimanic drug it is recommended as the answer for this MCQ. Evidence-based guidelines for treating bipolar disorder: revised second edition—recommendations from the British Association for

Answer 277

Transsexualism Most centres require a successful real-life test of at least one year prior to consideration for surgery. During this time the patient undertakes to live full time and attempt to find employment in the new sex. Patients will change their name and come out to friends and family.

Answer 278

perivascular macrophage and microglia

Answer 279

bupropion, paroxetine and fluoxetine

Answer 280

About 25 percent of patients experience a recurrence of major depressive disorder in the first 6 months after release from a hospital, about 30 to 50 percent in the following 2 years, and about 50 to 75 percent in 5 years.

Answer 281

Containing Holding

Answer 282

Impulsivity

Answer 283

Frontotemporal dementia

Answer 284

In Lewy Body Dementia, a relative sparing of short-term memory and a relative sparing of medial temporal lobes on CT/MRI scan is noted. Medial temporal lobes are relatively preserved in SPECT-HMPAO scan too.

Answer 285

Learning disability of various degrees can present along with intractable seizures, hamartomas of the central nervous system and depigmented skin patches (ash leaf spots) and fibromas of the nails in tuberous sclerosis. Patients also show salaam seizures and EEG reveals a hypsarrythmic pattern.

Answer 286

Sertraline

Answer 287

10-15% 3-4%

Answer 288

The rate of inpatient suicides occurring in the first week of admission is 25% of all inpatient suicides. The percentage of patients seen by psychiatrist in the last one week is 12.5% and having seen a health worker in last 3 weeks is 33%. The percentage of patients in contact with mental health services within a year of death is 25% and that on psychiatric outpatient registers is 25%.

Answer 289

The inpatient suicides that occurred when under routine observation (not constant or intermittent observations) is 80% of all inpatient suicides.

Answer 290

The percentage of suicide patients with major depression (30-31%) and alcohol dependence is 17-24%. The number that will repeat DSH (deliberate self harm) within one year is 30%.

Answer 291

Ensure equal numbers of participants in all arms

Answer 292

Cronbach's alpha will generally increase as the intercorrelations among test items increase, and is thus known as an internal consistency estimate of the reliability of test scores infinity to 1

Answer 293

3 months Bu: 14 days to a few week

Answer 294

Buprenorphine

Answer 295

Stimulus control therapy

Answer 296

Interpersonal therapy

Answer 297

> 35 of cag

Answer 298

Conduct disorder

Answer 299

Marchiafava-Bignami syndrome Red wine

Answer 300

PPV = true positive/total positive = [16/30)] NPV = true negative/total negative = [46/70)] False positive rate = false positives / total nondiseased or (1-specificity)= 14/60 False negative rate = false negatives / total diseased or (1-sensitivity)= 24/40

Answer 301

Strength and difficulties questionnaire

Answer 302

The Child & Adolescent Functional Assessment Scale is a rating scale to assess the degree of impairment in functioning due to emotional, behavioural, or psychiatric problems. It is completed by a clinical staff and takes about 10 minutes. It measures aggression and conduct problems especially in age between 7 to 17 years.

Answer 303

Framing a research question

Answer 304

The PDSA cycle was initially developed by Tom Nolan and colleagues. The PDSA Model for Improvement consists of: three fundamental questions; the plan-do-study-act (PDSA) cycle; and six areas of knowledge. To make improvements, first ask: What are we trying to accomplish? This will focus the efforts. Then ask: How will we know that a change is an improvement? Identifying criteria and collecting data will help. The final question is: What changes can we make that will result in improvements? This requires testing, especially using the PDSA cycle.

Answer 305

Fragile X is the second most common genetic cause for intellectual impairment, occurring in 1/4000 males and 1/8000 females. Down's syndrome tops the list and occurs in 1/1000 children. Prader Willi occurs in 1/10-30,000 people; Angelman syndrome occurs in 1/12-20,000; William's syndrome occurs in 1/7500-12000 people.

Answer 306

Explanation: Dementia, except potentially in the very early stages, is associated with significant risks around driving and the DVLA generally advises that people stop driving after they receive a diagnosis.

Answer 307

Alcohol dementia, cancer with or without brain metastases; normal-pressure hydrocephalus; subdural haematoma; hypothyroidism; vitamin B12 deficiency; and neurosyphilis.

Answer 308

Good response to SSRI

Answer 309

LN: exclusively male PW: Same RETT; EXCLUSIVELY FEMALE FRAGILE X; MALE TO FEMALE 1:2

Answer 310

Genetic loading

Answer 311

Complex partial seizures and absence of secondary generalized tonic-clonic seizures are risk factors for depression. Treatment with clonazepam, frequent hospitalizations (drug resistance) and lack of occupational activity are additional significant contributing factors.

Answer 312

Donepezil can be associated with bradycardia, heart block and syncope. Heart rate must be monitored when this medication is started and when the dose is increased.

Answer 313

Psychodynamic psychotherapy makes use of hypothetical and circumscribed questions to gain a greater understanding of a patient's underlying thought processes and defenses.

Answer 314

This is likely to be Semantic Primary Progressive Aphasia, which tends to present with incomprehensible but fluent speech. Other variants are Agrammatic and Logopenic Primary progressive aphasia. Ventamedial: apathy, hyperorality and perseveration dominates. There is sparse verbal output and paucity of spontaneous behaviour, eventually me come mute The other variant where perseveration occurs is the prefrontal dorsolateral subtype, which is associated with executive dysfunction and working memory difficulties. This is likely to be Orbitofrontal variant which is characterised by disinhibition, irritability, impulsivity, explosive outbursts and aggression

Answer 315

8 folds in head injury 2 folds in hiv

Answer 316

future-focused questions, past solution questions, miracle questions, except questions, coping questions, scaling questions, time-out, accolades and compliments.

Answer 317

Patients receiving olanzapine as a depot must be monitored for at least 2 hours after administration. Olanzapine post-injection syndrome has been estimated to occur after 0.07% of olanzapine depot injections and in approximately 1.4% of treated patients. Post-injection syndrome includes a range of signs and symptoms such as sedation and delirium that are consistent with olanzapine overdose. It generally starts around 1 hour after administration and resolves after 24-72 hours.

Answer 318

Syphilis There may be a symmetrical, reddish-pink, non-itchy rash on the trunk and extremities, including the palms and soles

Answer 319

Lyme disease (Borrelia burgdorferi)

Answer 320

Hypertension

Answer 321

Split half reliability

Answer 322

Incidence density is expressed in person-time units

Answer 323

Ebstein's anomaly, ASD, VSD, Neonatal goiter, hypotonia, lethargy and cardiac arrhthymias.

Answer 324

excessive daytime sleepiness, sudden sleep attacks (narcolepsy) - the sleep is refreshing as it is REM in nature, cataplexy (seen in 75% of patients), sleep paralysis (seen in 30%), hypnagogic hallucinations. 10%

Answer 325

2 folds 0. 6% for fluoxetine 1. 1% for citalopram 1. 5% for sertraline

Answer 326

East Asians

Answer 327

Vigabatrin

Answer 328

Huntington's disease 6% to 25%

Answer 329

Oral contraceptive, cabarmazepine Lithium increases

Answer 330

Olanzapine

Answer 331

OCD like symptoms may occur due to basal ganglia involvement in patients with Huntington's disease.

Answer 332

Neuroleptic malignant syndrome

Answer 333

Basal ganglia especially on the left hemisphere

Answer 334

4% 1-2% for profound 10% moderate Mild 85%

Answer 335

Digeorge CATCH-22, with the 22 reminding us of chromosome 22, andCATCH referring to Cardiac Abnormality, Abnormal facies (palatal abnormalities, hypertelorism), Thymic aplasia, Cleft palate, Hypocalcemia/Hypoparathyroidism.

Answer 336

For women, prevalence was highest in the group aged from 16 to 19 years (32%), whereas for men the peak was found among those aged 20 to 24 (62%).

Answer 337

10% of the adult population smoke cannabis regularly. The highest numbers of drug users are amongst young adults under 25. 45% have used drugs at some point. Half of all cannabis users are under 24. 12% of all school children used cannabis

Answer 338

Wilcoxon signed rank test is the non-parametric equivalent of the t-test comparing paired observations. 2) Mann-Whitney U test is the non-parametric equivalent of the unpaired, 2-sample t-test, comparing the distributions two independent groups of observation. 3) Kruskal-Wallis test is the non-parametric equivalent of the one-way ANOVA, which is used to compare the distributions of more than two independent groups of observation.

Answer 339

1) 9% 2) 7% 3) 45% 4) 25-30%