General MCQs for CT1 trainees composite neuropsychiatry and psychopathology MCQs John O’Donovan.
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Transcript of General MCQs for CT1 trainees composite neuropsychiatry and psychopathology MCQs John O’Donovan.
General MCQs for CT1 traineescomposite neuropsychiatry and
psychopathology MCQs
John O’Donovan
MCQs
History of psychiatry • Pinel treated the marquis de sade • Napoleon’s legal code stipulates that
“no crime exist… if existed in a state of dementia”
• Pinel and Esquirol were empirical in outlook
• Morel is associated with the degeneration theory
• In 19th century Germany there was an intellectual conflict between the mentalists and the somatists
• Griesinger was the original German neuropsychiatrist
History of psychiatry• Cullen=neurosis • Bleuler developed the term
schizophrenia • Griesinger believed that psychoses
were one disorder• 1854 Falret described “folie circulaire”• French psychiatrists particularly
resented the concept of schizophrenia• First ICD was 1855• ICD 8 was the first of relevance to
psychiatry• DSM 3 is “operationalized”
MCQs 2
Schizohprenia• Delusions in schizophrenia are
internally inconsistent• Third person auditory hallucinations
are the most specific sign for schizophrenia
• Over 70% of schizophrenic patients show at least one first rank symptom
• Second person auditory hallucinations are a first rank symptom
• Schizophrenic thought disorder shows metonyms
Schizophrenia• Schneider’s first rank sympoms
are atheoretical • Delusional mood is a first rank
symptom• Hebephrenic schizophrenia is
characterised by absence of disorganisation
• Alogia is common in the early stages of schizophrenia
• Catatonia is most commonly due to schizophrenia
MCQs
Capgras Syndrome• Is one of the DMIS• Also known as “illusion de sosies”• Is most commonly seen in
schizophrenia • Is an example of a primary
delusion• May be associated with lesions of
the fusiform gyrus• The core belief is that an impostor
has replaced someone close to the patient and looks identical or near identical
DMIS• The Fregoli syndrome is associated
with a big red nose • Is a belief one or more individuals
have altered their appearances to resemble famillar people
• Can be associated with intermetamorphosis rather then hypermetamorphosis
• DMIS contain four different types including Capgras, Fregoli, intermetamorphosis and the syndrome of subjective doubles
• Has a prevalence of 1: million
MCQs
Cotard’s syndrome• Is the delusion of negation • Exists in different forms • Is always accompanied by
depression • May be a chronic state • Is the most delusional of the
delusions
Schizophrenic thought disorder
• Does not occur in VLOSLP(very late onset schizophrenic like psychosis)
• Is easily distinguished from a perisylivan stroke
• Is associated with derailment • Tangentiality • Loss of goal • Knight’s move thinking• Prolixity
MCQs
Valproate • Causes tremor • Commonly causes hirsuitism • Is the drug of choice for JME• Was discovered by chance
as a solvent• is particularly likely to cause
a rash when used concurrently with topiramate
Lithium• Can cause hyperthyroidism • Levels of 1.9mEq are
therapeutic • Levels should be taken just
before dosing • May cause cranial diabetes
insipidus • Is metabolised slowly in the
liver
MCQs
Causes of light-near dissociation
• Ventral midbrain syndrome • Holmes-Adie Syndrome • Balint Syndrome • Optic neuritis • Third nerve compressive
palsy secondary to PICA aneurysm
Syringobulbia• May cause anosmia • May cause opthalmoplegia • May cause a pseudobulbar
affect • Classically causes slow wave
jerks and rotatory nystagmus
MCQs
A left frontal stroke• Will classically cause a weak
right leg more so then right arm
• May produce a fluent dysphasia
• May cause deviation of the eyes to the left visual field
• Will have a better prognosis then a right frontal stroke
• May cause agraphia
Non dominant temporal lesions
• Are not good for a violinist • Are not good for writers• May cause strange smells• Are the classical site for
strokes causing a manic presentation
• May be silent neurologically • Are associated with left
hemianopsia