Questions & answers _SPMMS - 1

Question 1

What pharmacological option is most suitable for a long-standing user of skunk cannabis experiencing irritability, agitation, and impulsive aggression after cessation?

Answer 1

Benzodiazepine

Benzodiazepines can help manage withdrawal symptoms.

Question 2

Increased need for handling in babies is seen in withdrawal of which drug?

Answer 2

Nicotine

Question 3

Which drug should be avoided in a 79-year-old gentleman with insomnia?

Answer 3

Diazepam

Question 4

Naltrexone can prevent relapses in the treatment of which substance use disorder?

Answer 4

Alcohol

Question 5

Which benzodiazepine could be used for a patient with alcohol dependence showing raised AST and ALT levels?

Answer 5

Lorazepam

Question 6

Which cognitive test will NOT be impaired in a patient with Korsakoff’s psychosis?

Answer 6

Digital span

Question 7

What does the Gillick test refer to?

Answer 7

Issues of consent in people under the age of 16.

Question 8

The Bolam test concerns which area?

Answer 8

Cases of medical negligence.

Question 9

The Pritchard criteria refer to what?

Answer 9

Fitness to plead.

Question 10

The Edwards and Gross criteria concern which condition?

Answer 10

Alcohol dependence.

Question 11

What is the probable diagnosis for a 17-year-old female with a BMI of 17 who believes she is obese?

Answer 11

Atypical anorexia nervosa

Question 12

Melatonin is considered an effective treatment for which group?

Answer 12

Children with neurodevelopmental disorders.

Question 13

What physiological parameter significantly increases on using melatonin?

Answer 13

Sleep duration

It also increases REM duration and reduces REM latency.

Question 14

Which statement is incorrect regarding sleepwalking in children?

Answer 14

Children usually wake up during sleep.

Question 15

What is the most likely diagnosis for a 7-year-old boy with motor tics and facial grimacing for 1 year?

Answer 15

Chronic motor tic

Question 16

Children with William’s syndrome usually have which type of intellectual disability?

Answer 16

Mild to moderate intellectual disability.

Question 17

Fragile X syndrome is characterized by which social behaviors?

Answer 17

Social anxiety, including poor eye contact and challenges forming friendships.

Question 18

Children with Angelman’s syndrome exhibit which behavioral characteristics?

Answer 18

Highly social with a happy demeanor.

Question 19

What repetitive behavior is commonly displayed by children with Rett’s syndrome?

Answer 19

Hand-wringing and other hand movements.

Question 20

To locate a conference abstract on language development in schizophrenia, which database would you use?

Answer 20

SIGLE

Question 21

To identify a recent trial comparing a new drug’s effectiveness, which database would you use?

Answer 21

PubMed

Question 22

Which database would you use to identify the dominant psychoanalyst viewpoint of borderline personality disorder in the 1870s in the USA?

Answer 22

PsycINFO

Question 23

To identify treatment guidelines for cardiac failure in the geriatric population, which database would you use?

Answer 23

Cochrane reviews

Question 24

To identify guidelines on treatment of new onset adolescent depression, which database would you use?

Answer 24

NICE

Question 25

What is an example of a non-degenerative dementia?

Answer 25

Alcoholic dementia ## Footnote Other examples include normal-pressure hydrocephalus and vitamin B12 deficiency.

Question 26

What physiological parameter is most important to monitor when starting Donepezil?

Answer 26

Heart rate

Question 27

What diagnoses are associated with benzodiazepine use in older people?

Answer 27

Panic disorder ## Footnote Other associated factors include female sex and mild cognitive impairment.

Question 28

Which diagnosis is most commonly associated with dangerous driving?

Answer 28

Dementia

Question 29

What is the most common neurodegenerative disorder in those aged less than 65 years?

Answer 29

Alzheimer's dementia

Question 30

What is the most appropriate management plan for a patient with mild Alzheimer's dementia showing low mood and withdrawal?

Answer 30

Urine dip and blood tests to exclude organic causes.

Question 31

What is the most appropriate treatment for a patient with severe treatment-resistant depression?

Answer 31

ECT

Question 32

Which personality disorder is most associated with suicide in older age?

Answer 32

Avoidant personality disorder

Question 33

What is the most appropriate treatment for Lewy Body Dementia?

Answer 33

Rivastigmine

Question 34

Which depot medication requires at least 2 hours monitoring after administration?

Answer 34

Olanzapine

Question 35

What intervention is likely to help a patient with treatment-resistant schizophrenia return to independent living?

Answer 35

Supported employment

Question 36

What physical health condition increases the risk of suicide the most?

Answer 36

Head injury

Question 37

Which feature would not be consistent with a diagnosis of PTSD?

Answer 37

Hypersomnia

Question 38

What symptom is a patient with moderate severity depression likely to exhibit?

Answer 38

Somatoform disorder

Question 39

What is the most likely diagnosis for a patient presenting with fever, confusion, and auditory hallucinations with lymphocytosis in lumbar puncture?

Answer 39

Herpes encephalitis

Question 40

What treatment is most appropriate for managing a mixed affective episode in a patient with bipolar affective disorder?

Answer 40

Sodium Valproate

Question 41

Which electrolyte disturbance requires monitoring during the refeeding of profoundly underweight patients?

Answer 41

Phosphate

Question 42

What is not an early sign of opiate withdrawal?

Answer 42

Hypersomnia

Question 43

Which of the following is not an early sign of opiate withdrawal?

Answer 43

Diarrhoea ## Footnote Early signs of opiate withdrawal include agitation, anxiety, muscle aches, increased tearing, insomnia, runny nose, sweating, yawning.

Question 44

What are the early signs of opiate withdrawal? List at least three.

Answer 44

* Agitation * Anxiety * Muscle aches * Increased tearing * Insomnia * Runny nose * Sweating * Yawning ## Footnote Later symptoms include abdominal cramping, diarrhoea, dilated pupils, goose bumps, nausea, vomiting.

Question 45

What cognitive function is most likely to be impaired in people with schizophrenia during cognitive testing?

Answer 45

Working memory ## Footnote Impairment in working memory can affect other cognitive functions, such as selective attention and abstract reasoning.

Question 46

Which medication is most associated with neurotoxicity when prescribed with lithium?

Answer 46

Haloperidol ## Footnote Haloperidol, along with uphenazine and upenthixol, has been associated with irreversible toxic encephalopathy when combined with lithium.

Question 47

What must be maintained within a specific therapeutic range when treating bipolar disorder with lithium?

Answer 47

Lithium levels ## Footnote Maintaining lithium within the therapeutic range is crucial to prevent subtherapeutic levels or toxicity.

Question 48

True or False: Diarrhoea is an early sign of opiate withdrawal.

Answer 48

False ## Footnote Diarrhoea is considered a later symptom of opiate withdrawal.

Question 49

List three medications associated with neurotoxicity when prescribed with lithium.

Answer 49

* Haloperidol * Uphenazine * Upenthixol ## Footnote These medications can lead to irreversible toxic encephalopathy even when lithium is within the therapeutic range.