A 7 year old boy has multiple motor tics and makes clicking sounds at unpredictable intervals. What is the diagnosis?Your answer was Tourettes syndrome which is correctTourettes syndromecorrect answer

Normal varient

ADHD

Autism

Hyperekplexia

Explanation:Tourettes is diagnosed by the presence of multiple motor and at least one vocal tic over a year with no more than three tic free months. The onset must be before the age of 18 and autism, drug use and non tourette causes of tics must be ruled out.

A 19 year old is brought to A+E. He was on a night out 2 nights ago and is described by his friend as a "party animal". He is now acting very oddly. He is clearly hallucinating and is speaking rapidly. He is euphoric and laughing inappropriately. He appears agitated and his affect is blunted. His pupils are dilated and he is tachycardic. What is the most likely diagnosis?Your answer was Amphetamine induced psychosis which is correctAmphetamine induced psychosiscorrect answer

Schizophrenia

Cannibas induced psychosis

Bipolar disorder

Heroin use

Explanation:Amphetamine is a stimulant and this, cocaine and other hallucinogens can lead to psychosis as seen here. The other symptoms and clinical findings are inkeeping with this. The fact this patient was on a night out and is described as a party animal may suggest recreational drug use. Amphetamine induced psychosis can occur with drug misuse acutely or can be associated with chronic misuse. Cannibas tends to lead to depression and anxiety although it less commonly has been associated with manic like psychosis. Schizophrenia is less likely in this case as the findings are more in keeping with drug induced psychosis. There is no history to suggest bipolar disorder. Opiates lead to pupillary constriction and are less commonly associated with psychosis.A 45 year old patient who is known to drink excessively presents in acute alcohol withdrawal. On examination he appears malnourished. He is commenced on diazepam. His BM is 4.2mmol/l. What is the next course of action?Your answer was Commence IV Thiamine which is correctCommence IV Thiaminecorrect answer

IV dextrose

IM glucagon

Liason psychiatry

IV magnesium

Explanation:In patient who suffers from alcohol dependency there is a high risk of thiamine deficiency which can lead to Wernicke's Encephalopathy. In any patient with alcohol withdrawal IV thiamine should be commenced. There is a theoretical risk of precipitating Wernicke's encephalopathy in patients with alcohol dependency if they are given IV dextrose before thiamine as oxidation of glucose utilises thiamine and it is therefore advised to give glucose concurrently or after thiamine. Patients with alcohol dependency are at risk of hypoglycaemia and thus BM and formal glucose should be measured. Similarly they are at risk of hypomagnesaemia and this should be measured. Both hypoglycaemia and hypomagnesaemia should be treated if required however in this case IV thiamine can be commenced and bloods awaited. A BM should be performed before commencing treatment.A 45 year old male was brought to A+E. He was found wandering the streets of a city and was unsure of where he was or who he was. He could not recall anything from his past. Which of the following is the most likely diagnosis?Your answer was Transient Global amnesia which is incorrectFugue statecorrect answer

Transient Global amnesia

Transient Ischaemic Attack

Malingering

Multiple personality

Explanation:The above history is indicative of Dissociate fugue or fugue state. In fugue state there is complete loss of memory including their identity and patients are unable to recall a long period of their life and the patient is usually found wandering. This can last for months. Sometimes patients take on a new identity. In transient global amnesia there is global loss of recent memory with the patient unable to retain new things and unable to recall recent memories. The patient often repeats themselves and can become agitated.A man is brought to the GP by his wife. Over the previous 4 months he has been aggressive, rude to strangers and has noticeable memory loss. He is not on any medication, does not smoke or drink and takes no recreational drugs. On examination his BP is 145/9 mmHg, bloods are normal including thyroid function, and there is nothing else to note. An MRI shows increased T2 signal in the frontal lobe white matter and frontal lobe atrophy. A PET scan demonstrates hypometabolism in the front and temporal areas. What is the most likely diagnosis?Your answer was Picks disease which is correctPicks diseasecorrect answer

Alzheimers disease

Stroke

Lewy Body demetnia

Huntington disease

Explanation:Picks disease is a progressive frontotemporal dementia characterised by the presence of tau and ubiquitin proteins in the degenerating cells and has no known cause. It causes behavioural and personality changes such as lethargy, disinhibition, and apathy. It also causes a loss of executive function and memory but these occur AFTER the personality change. An MRI shows increased T2 signal in the frontal lobe white matter and frontal lobe atrophy and PET scans typically demonstrate hypometabolism in the front and temporal areas.You are reviewing a patient who tells you she feels like a failure. She has no friends and claims no body would want to be her friend, lives alone, has never had a partner, finds it hard to interact with her family, has feelings of rage in between longer bouts of emptiness and self harms. Her notes detail 8 previous suicide attempts, including two whilst admitted. What is the diagnosis?Your answer was Bipolar depression which is incorrectBorderline personality disordercorrect answer

Bipolar depression

Dissociative disorder

Substance abuse

Schizophrenia

Explanation:Borderline personality disorder is defined by the DSM IC TR as a pervasive pattern of instability of interpersonal relationships, self image and affects, as well as marked impulsivity, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following,-efforts to avoid abandonment, -unstable interpersonal relationships, -identity disturbance, -impulsivity, -suicidal behavious, -affective instability, -feelings of emptiness, -inappropriate anger or paranoid ideation.It is common for BPD to occur alongside suYou are reviewing a patient who tells you she feels like a failure. She has no friends and claims no body would want to be her friend, lives alone, has never had a partner, finds it hard to interact with her family, has feelings of rage in between longer bouts of emptiness and self harms. Her notes detail 8 previous suicide attempts, including two whilst admitted. What is the diagnosis?Your answer was Bipolar depression which is incorrectBorderline personality disordercorrect answer

Bipolar depression

Dissociative disorder

Substance abuse

Schizophrenia

Explanation:Borderline personality disorder is defined by the DSM IC TR as a pervasive pattern of instability of interpersonal relationships, self image and affects, as well as marked impulsivity, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following, efforts to avoid abandonment, unstable interpersonal relationships, identity disturbance, impulsivity, suicidal behavious, affective instability, feelings of emptiness, inappropriate anger or paranoid ideation. It is common for BPD to occur alongside substance abuse, depression and other disorders,bstance abuse, depression and other disorders,

Which of the following is false regarding obsessive compulsive disorder?Your answer was The dose of SSRI needed to treat OCD is lower than depression which is correctThe dose of SSRI needed to treat OCD is lower than depressioncorrect answer

Clomipramine may be trialed if SSRIs dont prove effective

The chance of developing OCD is increased if you have a first degree relative

Surgery on the cingulate cortex is a last resort but effective treatment in 30% of patients

CBT is an effective treatment

Explanation:The dose of SSRI needed to treat OCD is higher than depression

Which of the following is not commonly found in a manic episode of bipolar disorder?Your answer was Pressured speech which is incorrectVisual Hallucinationscorrect answer

Hypersexuality

Low attention span

Pressured speech

Elevated mood

Explanation:Visual hallucinations are rare in bipolar mania and would warrant investigation for an organic cause.

Somatisation disorder is a diagnosis of exclusion in which multiple symptoms are found to have no physical cause. The symptoms are often vague and occur in different systems. The patient normally has a previous diagnosis of mental illness, the symptoms started before the age of 30 and usually will have rejected other professionals advice. The main difference between this and malingering is that malingerers choose to produce the symptoms to receive a conscious benefit from the illness. It is thought to be a way of dealing with stress as it is more common in people that have underwent traumatic experiences. Treatment is with CBT and antidepressants.

A 24 year old female presents to her GP with feeling anxious. On further questioning she states she is constantly ruminating about things. On numerous occasions she constantly obsesses about whether or not she has locked the doors or switched off the gas and she has to go back three or four times to check if this is the case. She has also had repeated images of violent acts which she tries to resist but cannot. What is the most likely diagnosis?Your answer was Obsessive compulsive disorder which is correctObsessive compulsive disordercorrect answer

Anxiety

Depressive disorder

Schizophrenia

Obsessional personality

Explanation:This patient is demonstrating both obsessions and compulsions. The thoughts are her own and are resisted which is contrary to schizophrenia where they often believe thoughts are inserted. Anxiety and depressive symptoms are often observed.Which of the following could be used to distinguish dementia from severe depressionYour answer was Grasp reflex which is correctGrasp reflexcorrect answer

Visual disturbance

Weight loss

Testosterone level testing

Weight gain

Explanation:The grasp reflex is a primitive reflex that babies have and lose at about 6 months. If something is put in their hand they will grab onto it. With neurone loss, particularly in the frontal lobe, this reflex reappears.Which of the following is characteristic of Lewy Body dementia?Your answer was Hypersensitive to SSRIs which is incorrectFluctuating mental statecorrect answer

Aphasia

Symptoms worse on exertion

Hypersensitive to SSRIs

Auditory hallucinations

Explanation:Lewy Body dementia is easily mistaken for Alzheimers and Parkinsons disease. The core symptoms are rapidly fluctuating cognition, visual hallucinations and parkinsonism, particularly shuffling gait, reduced arm swinging, reduced facial expression, cog wheel rigidity. Tremors are less common buy may exist. Hypersensitivity to neuroleptic is an important feature and these drugs must be avoided.An elderly man is on the ward due to a left sided pneumonia. He becomes acutely distressed and punches a nurse. His notes state that he drinks 4 pints of beer a day. On examination his temperature is 38.1 C, BP is 110/60 mmHg, pulse is 95/min and regular, there is consolidation at his left lung base, his white cell count is raised significantly and renal function is impaired. What has caused his symptoms?Your answer was Delirium secondary to infection which is correctDelirium secondary to infectioncorrect answer

Delirium tremens

Undiagnosed dementia

Wernickes encephalopathy

Korsakoffs psychosis

Explanation:The white cell count, temperature, hypotension, heart rate, renal impairment and consolidation strongly suggest delerium. Alcohol is a common problem to consider but less likely in this case.A 68 year old woman that drink 4 glasses of wine per evening is admitted to hospital. Her history includes controlled hypertension and a previous admission for a urinary tract infection. The nurses ask you to see her as she appears to be acting strangely. She has a slightly lowered haemoglobin but the rest of her bloods are normal. Which of the following symptoms would strongly suggest alcohol withdrawal?Your answer was Amnesia which is incorrectInsects crawling up the wallscorrect answer

Hearing the voice of her mother

Aphasia

Delusions about being an angel

Amnesia

Explanation:Alcohol withdrawal can cause tremors, agitation, nausea and vomiting, visual hallucinations and convulsions. Alcoholic hallucinosis is hallucinations when withdrawing from alcohol that is less severe, has no autonomic effects and cannot lead to the potentially lethal convulsions of delerium tremens. The visual hallucinations tend to be at the visual periphery and insects are often the offending sight. Formication is tactile hallucinations that feel like insects crawling on the skin and is common.A 29 year old man is brought in by his friends. He claims that his phone is allowing the government to read his thoughts and his girlfriend cheated on him with someone from the government. His history notes a previous diagnosis of anxiety 5 years previous that was not treated. He has returned from a trip to Africa with his friends and on the trip they used mefloquine for malaria prevention, used cannabis and drank excessively. There is nothing else of note. What is the diagnosis?Your answer was Personality disorder which is incorrectMefloquine induced psychosiscorrect answer

Schizophrenia

Personality disorder

Acute alcohol withdrawal

Illicit drug use

Explanation:A rare side effect of mefloquine is unexplained anxiety, mood change, depression (including suicidal ideation), hallucinations and confusion. It is contraindicated in patients with recent psychiatric problems, seizures or recreational drug use.A lady is referred by her GP with visual hallucinations, periods of both mania and depression and a belief that her child is the messiah. She had given birth 5 days previously. What is the diagnosis?Your answer was Postpartum psychosis which is correctPostpartum psychosiscorrect answer

Postnatal depression

Bipolar disorder

Adjustment disorder

Baby blues

Explanation:Postpartum psychosis describes the onset of psychotic symptoms following birth. It is most common in first time mothers and those with a history of psychiatric illness. Symptoms includes mania, overactivity, flight of ideas, disinhibition, delusions which are often grandiose, visual hallucinations, and swinging between hypomania and mania. Baby blues is a mild moodiness that effects over 75% of mothers, tends to last a few days and symptoms include tearfulness, irritability, insomnia, feelings of isolation and hypochondriasis. Postnatal depression can occur up to a year post partum and symptoms include low mood, low self esteem, guilt, exhaustion, anhedonia, social withdrawal, sleep disturbance, low sex drive, weight gain and many others. The Edinburgh Postnatal Depression Scale can be used to evaluate for signs of postnatal depression.A man presents to his GP on the insistence of his girlfriend. He was in a motorcycle accident in which another friend died 4 months previous and since then he has been low in mood and now hears the voice of his dead mother. He has lost 8 kilos in weight. Examination and blood tests reveal nothing. What is the likely diagnosis?Your answer was Post traumatic stress disorder which is incorrectPsychotic depressioncorrect answer

Adjustment disorder

Post traumatic stress disorder

Post concussion syndrome

Bipolar disorder

Explanation:Psychotic depression is characterised by low mood, anhedonia, delusions and hallucinations. Adjustment disorder cannot be diagnosed if there has been a recent bereavement. Post traumatic stress disorder is unlikely due to the hallucinations and post concussion syndrome is characterised by a headache, dizziness and psychological symptoms such as anxiety or depression.Which is not a side effect of lithium?Your answer was Weight gain which is incorrectRed eyecorrect answer

Hypothyroidism

Polyuria

Weight gain

Dry mouth

Eyelid ptosiscorrect answer

Polydypsia

Tremor

Explanation:Lithium has an incredibly long list of side effects. Up to a quarter of patients develop hypothyroidism. Polyuria occurs as the lithium damages renal tubule cells causing nephrogenic diabetes insipidus. Weight gain and dry mouth are also very common.A 68 year old man is agitated and is suffering from insomnia during a hospital admission for an elective operation. He is very sensitive to noise and bright lights, and complains of sore muscles. He has a long history of anxiety and controlled hypertension. Examination and blood results are normal. What is the most likely problem?Your answer was Benzodiazepine withdrawal which is correctBenzodiazepine withdrawalcorrect answer

Sepsis

Anxiety

PTSD

Anaesthetic reaction

Explanation:Benzodiazepine withdrawal syndrome describes the clinical picture of someone withdrawing from benzodiazepines that have dependence. It is characterised by agitation, sensitivity to light and sound, insomnia and sore muscles. The onset of symptoms depends on the half life of the drug used. Serious cases of withdrawal can cause seizures with a high mortality rate.Which of the following gives the strongest indication that a suicide attempt was serious and not a cry for help?Your answer was Timed so that intervention is highly unlikely and takes measures to prevent discovery or intervention which is correctTimed so that intervention is highly unlikely and takes measures to prevent discovery or interventioncorrect answer

Drug addiction

Did not make any final plans such as making a will or leaving a note

Taking excessive amounts of paracetamol as the method

Phoned the samaritans during the act

Explanation:The Beck suicide intent scale identifies the strongest indicators of suicidal intent as isolation from other, timing so intervention is highly unliekly, active precaution against discovery or intervention, no contact with potential helper, the creation of a will or similar, writing a suicide note, and planning that has taken more than 3 hours.Which of the following would suggest delirium rather than dementia?Your answer was Fluctuating level of consciousness which is correctFluctuating level of consciousnesscorrect answer

Shouting

Confused more about the present than the past

No tearfulness

Low MMSE score

Explanation:Delerium is characterised by an acute onset, fluctuating levels of impaired consciousness, nocturnal worsening, poor concentration, sleep wake cycle disturbance, hallucinations and agitation. A cause of the delerium should always be sought.You are asked to see an 81 year old woman by her daughter. The daughter explains that her mother was started on haliperidol 3 days earlier and has become feverish and extremely confused. The daughter describes a progressive change in the mothers personality over the past 3 years. What is the most likely diagnosis?Your answer was Neuroleptic malignant syndrome which is correctNeuroleptic malignant syndromecorrect answer

Stroke

Alzheimers

Delerium

TIA

Explanation:The patient is suffering from neuroleptic malignant syndrome which has been caused by giving haliperidol to a patient with Lewy Body dementia. Its symptoms include pyrexia, altered consciousness, sweating, rigidity and autonomic imbalance.Which of the following is not commonly found in a manic episode of bipolar disorder?Your answer was Low attention span which is incorrectVisual hallucinationscorrect answer

Pressured speech

Elevated mood

Low attention span

Hypersexuality

Explanation:Visual hallucinations are rare in bipolar mania and would warrant investigation for an organic cause.Which of the following is common secondarily to alcohol abuse?Your answer was Lower levels of bipolar syndrome which is incorrectMorbid jealousycorrect answer

Agorophobia

Depression

Lower levels of bipolar syndrome

Increased creativity

Explanation:Secondary diseases caused by alcohol abuse include morbid jealousy, Wernickes and Korsakoff syndrome. Conversely, alcohol abuse may be secondary to problems such as depression.Which of the following is common secondarily to alcohol abuse?Your answer was Lower levels of bipolar syndrome which is incorrectMorbid jealousycorrect answer

Agorophobia

Depression

Lower levels of bipolar syndrome

Increased creativity

Explanation:Secondary diseases caused by alcohol abuse include morbid jealousy, Wernickes and Korsakoff syndrome. Conversely, alcohol abuse may be secondary to problems such as depression.Which of the following supports a diagnosis of alcohol dependence syndrome?Your answer was History of falls which is incorrectContinued drinking despite physical harmcorrect answer

Drinking a variety of alcohol types

History of falls

Morbid jealousy

Drinking despite criminal convinctions related to drink

Explanation:The signs of alcohol dependence syndrome are narrowing of the drinking repertoire, strong drink seeking behaviour, high tolerance, withdrawal symptoms, awareness of a compulsion to drink, drinking to avoid withdrawal or reinstatement of dependence after abstinence.Which of the following suggests a good prognosis for anorexia?Your answer was Adult onset which is incorrectShort durationcorrect answer

They do not exercise excessively

Adult onset

Weight loss has not been severe

No history of psychological problems

Explanation:A long duration of illness is a poor prognostic factor for anorexia nervosa. Psychological problems, including abnormal social adjustment as a child, is a poor prognostic factor as is adult onset. Excessive exercise is not known to be linked to prognosis.What is the most common presenting symptom of anorexia nervosa?Your answer was Amenorrhoea which is incorrectExcessive physical activitycorrect answer

Damaged teeth

Amenorrhoea

Peripheral oedema

Social isolation

Explanation:The ICD 10 diagnostic criteria for anorexia nervose includes a bodyweight 15% below the expected weight for the patients height, avoidance of food, excessive exercise, vomiting, use of appetite suppressants, distorted body image, amenorrhoea or low libido in men and delayed onset of pubery (if younger). The earliest symptom tends to be excessive exercise as the others take longer to develop.A 31 year old woman attends her GP as she cant stop worrying about most things in her life. She is worried about her job as she cannot concentrate and thinks she will be fired soon. She feels low in mood, cannot sleep well and hasnt been socialising for at least 9 months. What is the likely diagnosis?Your answer was Generalised anxiety disorder which is correctGeneralised anxiety disordercorrect answer

Agoraphobia

Panic disorder

Social anxiety disorder

Depression

Explanation:The ICD 10 criteria for Generalised anxiety disorder says that the patient must have had 6 months of anxiety almost every day. There must be one or more autonomic symptom such as palpitations, sweating, trembling or dry mouth. At least 4 of the following symptoms must be present including difficulty breathing, feeling of choking, chest pain, nausea, dizzy spells, derealisation, fear of losing control or dying, hot flushes or cold spells, numbness or tingling sensations, muscle tension or aches, restlessness, irritability or sleep disturbance.A 41 year old complains of low mood and problems sleeping which get a lot worse during the winter months. The rest of the history and examination reveal nothing of note. What is the likely diagnosis?Your answer was Seasonal affective disorder which is correctSeasonal affective disordercorrect answer

Depression

Bipolar disorder

Dysthymia

Normal

Explanation:The diagnosis of Seasonal Affective Disorder is controversial. The American Psychiatric Association DSM IV criteria does not recognised it as an individual condition, but as a cluster of symptoms of depression disorders or bipolar syndrome. When classed as a condition, it is described as the onset of low mood, sleeping problems and often weight gain during the winter months. It is thought to be related to falling levels of light as the treatment is often with bright light to mimic natural daylight.A 31 year old man is brought to see you by the police. He is unable to recall his name, address or any personal details. He is not agitated but is confused as to why he cannot recall the information. Recall tests show that he can form new memories. The next morning, he remembers who he is and that his company had just went bankrupt. He is low in mood but has no other problems. What is the diagnosis?Your answer was Dissociative amnesia which is correctDissociative amnesiacorrect answer

Major depression

Catatonic state

Vascular dementia

Bipolar affective disorder

Explanation:Dissociative amnesia is defined as retrograde amnesia in the absence of antegrade amnesia with a psychological cause. It may be global, as in this case, in that the patient cannot remember a lot of their past such as their name or specific in which they forget a particular event or time. It typically starts suddenly, usually in response to a major event such as the loss of a partner, and ends suddenly within a few days.A 26 year old female presents to her GP, writing on paper, that she can no longer talk. She had no problems with her voice before and no medical history of note. She has recently lost her job and has recently been told her flat is being repossessed. A full examination is unremarkable. What is the most likely diagnosis?Your answer was Conversion disorder which is correctConversion disordercorrect answer

Somatisation disorder

Hypochondriac

Epilepsy

Stroke

Explanation:Conversion disorder is the presence of neurological symptoms without an organic cause. Symptoms can include paralysis, blindness, aphonia, deafness, gait problems, neck cramps and many others. Diagnosis starts by excluding all neurological disease, attempting to exclude feigning the symptoms and then finding the psychological cause of the illness. It name derives from the theory that repressed psychological pain is converted into psychical symptoms.A 39 year old male complains that in the past few weeks he has been losing control of his body. He describes an irregular movement that spreads throughout his body which he cannot stop. His history has nothing of note. What is the diagnosis?Your answer was McLeod syndrome which is incorrectHuntingtons diseasecorrect answer

Lewy body dementia

Wilsons disease

McLeod syndrome

Early onset parkinsons disease

Explanation:Huntingtons disease is an autosomal dominant disease that causes cerebral degeneration. Jerky movements which the patient cannot control is the most common and characteristic feature. The mildest and earliest symptoms are restlessness or small uncontrolled movements. The disease rapidly worsens with rigidity, writhing, abnormal posturing and dementia. There is no cure, treatment is for symptoms of problems and most live less than 20 years after its initial presentation.A newborn baby has thin lips, a smooth philtrum, small eyes and a small head. Whilst examining him he suffers a seizure. What is the diagnosis?Your answer was Williams syndrome which is incorrectFetal alcohol syndromecorrect answer

Noonan syndrome

Aarskog syndrome

Down syndrome

Williams syndrome

Explanation:The three facial characteristics of foetal alcohol syndrome are small palpebral fissures, a thin vermilion and a smooth philtrum. This symptoms may be very slight in mild exposure to alcohol during pregnancy. Growth abnormalities, such as a small head or being very small, are common as are neurological problems such as epilepsy. Behavioural problems, learning disabilities and cognitive impairment often present as the child develops. Diagnosis is controversial and is often based on a combination of symptoms combined with known maternal alcohol exposure.A woman has not left her house for 2 months. The last time she was out she suffered a panic attack on the train and the thought of going out again makes her very anxious. What is the likely diagnosis?Your answer was Agoraphobia which is correctAgoraphobiacorrect answer

Social phobia

Psychosis

Hypomania

Dissociative disorder

Explanation:Agoraphobia is a fear of places where you feel that you might not escape easily to a safe place which is usually your home. This includes open spaces, transport such as trains or buses, shops, bridges or anywhere that is not your home. Thinking about going to these places may cause anxiety and panic attacks often occur in these situations. Social phobia may be specific, such as a fear of public speaking, or generalised in which patients have a fear of social encounter and act to avoid social interaction.A mother is concerned about her 6 year old son. He causes a lot of problems with his siblings, does not concentrate, is liable to emotional outbursts and teachers describe him as unruly. He has no medical problems and apart from being very active, his examination is otherwise normal. What is the most likely problem?Your answer was Attention deficit hyperactivity disorder which is correctAttention deficit hyperactivity disordercorrect answer

Tourettes syndrome

Aspergers

Learning difficulties

Early onset bipolar

Explanation:ADHD is a triad of inattention, hyperactivity and impulsivity which is more common in males. The symptoms must have been displayed in two separate settings and have lasted six months or longer. It is important to compare the symptoms to other kids their age.

The previous question:An 8 year old boy is falling behind at school. He was one of the brightest in the class but has become quiet and unconfident, especially during English lessons. There is no history of note and physical examination is unremarkable. What is the likely diagnosis?Your answer was Dyslexia which is incorrectADHDcorrect answer

Dyslexia

Asperger syndrome

Conduct disorder

Normal

Explanation:Dyslexia is a learning disability that impairs a persons ability to read. It manifests itself in many ways such as problems learning the alphabet, delayed developmental milestones or poor spelling. It can easily be unnoticed until later in life, such as university, by the sufferer compensating for their difficulty.Which of the following would be used to describe the inability to form new memories?Your answer was Anterograde amnesia which is correctAnterograde amnesiacorrect answer

Retrograde amnesia

Prosopamnesia

Source amnesia

Lacunar amnesia

Explanation:Anterograde amnesia is the inability to form new memories. It may be caused by trauma, drugs such as benzodiazepines or alcohol, seizures and many other things. Retrograde amnesia is the loss of previous memories, prosopamnesia is the inability to remember faces, source amnesia means that you can remember information but not the source of the information, and lacunar amnesia is the loss of memory about a single specific event.

uring her parents divorce, a 12 year girl spent 2 days crying a lot, not speaking or communicating in any way. Since then she avoids confrontation and if the divorce is brought up she becomes extremely emotional. What is the diagnosis?Your answer was Reactive anxiety disorder which is incorrectRepressioncorrect answer

Reactive anxiety disorder

General anxiety disorder

Depression

Lacunar amnesia

Explanation:Repression is when you choose to block out a bad memory. It differs from amnesia in which memories are either not stored or lost.Which of the following demonstrates the Premack principle?Your answer was Taking away a childs toy when it is bad which is incorrectGiving a child a new toy if it has done its homeworkcorrect answer

Taking away a childs toy until it has done its homework

Taking away a childs toy when it is bad

No longer rewarding a child for doing their homework

A child achieving a reward which they didnt realise they could earn

Explanation:The Premack principle is when a person agrees to perform a less desirable activity to subsequently get access to a more desired activity. It is used in a variety of psychological therapies.Which is an example of social learning?Your answer was When a child starts to pretend to use a sword after seeing one in a film which is correctWhen a child starts to pretend to use a sword after seeing one in a filmcorrect answer

When a group solve a problem together

When a community spread a message, such as a warning, between each other

Using Facebook to study

Reading your friends study notes

Explanation:Social learning is when you observe a behaviour, retain it and then reproduce it. It is learning by example.What is the Garcia effect?Your answer was An avoidance reaction based on a previous negative reaction to the taste of something which is correctAn avoidance reaction based on a previous negative reaction to the taste of somethingcorrect answer

When an anorexic patient feigns weight gain to pretend they are complying with treatment

Avoidance of something due to an irrational thought or idea

The term used to describe the enamel damage from repeated vomiting

A term used when a bulimic patient gains weight despite frequent purging

Explanation:The Garcia effect is an aversive reaction in response to a taste that previous gave a negative effect. Avoiding a berry if it has previously made you sick would be an example. This can be a problem if the sickness was unrelated, if you got the flu after eating grapes for example.Who would be most likely to suffer anaclitic depression?Your answer was Orphan which is correctOrphancorrect answer

A new mother

A new father

A newly widowed man

An elderly man in a care home

Explanation:Anaclitic depression is a rare type of depression that occurs when a childs caregiver is removed for a prolonged period early on in life, usually when the child is between 6 months and 3 years old.A child has not started to babble. At which age should a child start babbling 2 or 3 words repeatedly?Your answer was 4 months which is incorrect1 yearcorrect answer

4 months

10 to 12 weeks

18 months

2 years

Explanation:By 8 weeks a child should be vocalising. By 3 months they should be making vowel noises. By 1 year they should be babbling a few words. By 2 years they should be making simple sentences.Which of the following is NOT associated with tuberose sclerosis?Your answer was Hypomelanic macules which is incorrectGlossitiscorrect answer

Learning difficulty

Kidney tumours

Epilepsy

Hypomelanic macules

Explanation:Tuberous sclerosis is a autosomal dominant disorder that effects most organ systems. Most sufferers will have hypomelanic macules which are pale patches of skin. Epilepsy and learning problems are very common and kidney tumours, angiomyolipomas, are found in 60 to 80 percent of patients also. Other signs include facial angiofibromas, retinal lesions, liver tumours and periungal fibromas.Which of the following is NOT a feature of Prader Willi syndrome?Your answer was Hypertonia which is correctHypertoniacorrect answer

Mental retardation

Short stature

Obesity

Undescended testicles

Explanation:HYPOtonia, mental retardation, short stature, obesity, undescended testicles, strabismus, overeating due to an insatiable appetite and extreme flexibility are common signs of Prader Willi syndrome.Which of the following is NOT a feature of Lesch Nyhan syndrome?Your answer was Long limbs which is correctLong limbscorrect answer

X linked genetic inheritance

High levels of serum uric acid

Self mutilating behaviour

Hypotonia

Explanation:Lesch Nyham syndrome is a rare X linked disease which results in high levels of uric acid throughout the body. Epilepsy, facial grimacing, involuntary writhing, hypotonia and developmental delay are common neurological signs. Gout like arthritis, kidney stones, recurrent UTIs and haematuria are signs of the high uric acid levels. The most characteristic sign is self mutilating behaviour, which often starts as biting of the lips and progresses to finger biting and head banging.What is the most common inherited cause of severe intellectual impairment?Your answer was Fragile X syndrome which is correctFragile X syndromecorrect answer

Prader Willi syndrome

Lesch Nyhan syndrome

#Although Down syndrome is a more common genetic abnormality, fragile X syndrome more commonly causes mental retardation. The other conditions are rare.

Which of the following is strongly linked with Alzheimers?Your answer was Downs syndrome which is correctDowns syndromecorrect answer

Rett syndrome

Marfan syndrome

Lesch Nyhan syndrome

Fragile X syndrome

Explanation:Most individuals with Downs syndrome develop the cerebral plaques and tangles that are normally associated with Alzheimers disease. This does not mean that they all have Alzheimers disease, but 10% do by 45 and over 50% do by the age of 60.Which of the following is a long acting opioid antagonist ?Your answer was Naloxone which is incorrectNaltrexonecorrect answer

Naloxone

Nalorphine

Buprenorphine

Oxymorphone

Explanation:Naltrexone is a long acting opioid receptor antagonist that is used for the treatment of opiate addiction. Naloxone is a fast acting competitive antagonist used to reverse opioid overdose. Nalorphine is an unusual opioid that has antagonistic and agonistic effects, and can be used to reverse overdose or provide anaesthesia. Buprenorphine and oxymorphone are synthetic opioids.What is acamprosate used for?Your answer was Smoking cessation which is incorrectMaintaining abstinence from alcoholcorrect answer

Alcohol intoxication

Inducing rapid alcohol withdrawal

Smoking cessation

Maintaining abstinence from benzodiazepines

Explanation:Acamprosate is a centrally acting compound that supports abstinence from alcohol in detoxified patients. It should be combined with support of some sort and may be used alongside naltrexone.Which of the following is NOT as use for bupropion?Your answer was Anorexia nervosa which is correctAnorexia nervosacorrect answer

Depression

Smoking cessation

Anxiety

Seasonal affective disorder

Explanation:Bupropion has been recommended for all of the conditions except anorexia nervosa. It is contraindicated in individuals with a lower seizure threshold, such as epileptics, those undergoing alcohol withdrawal and anorexics.What is Disulfiram used for?Your answer was Treatment of alcohol dependence which is correctTreatment of alcohol dependencecorrect answer

Treatment of opioid dependence

Treatment of delerium tremens

Reversal of alcohol intoxication

Prevention of Wernickes encephalopathy

Explanation:Disulfiram, also known as its trade name Antabuse, is used to treat alcohol dependance. It blocks the enzyme acetaldehyde dehydrogenase. The build up of acetaldehyde in the patients system quickly results in a very harsh range of symptoms including nausea, vomiting, headache, flushing and palpitations. It is often given under supervision and in conjunction with other supportive therapies.Which of the following would be prescribed for ADHD?Your answer was Modafinil which is incorrectMethylphenidatecorrect answer

Modafinil

Lorazepma

Calpol

Fluoxetine

Explanation:Methylphenidate is commonly known as Ritalin. It acts as a central nervous system stimulant, increasing levels of dopamine and noradrenaline in areas of the brain that regulate attention. When used it should be combined with behavioural therapy.A 31 year old lady avoids leaving her house unless she has to. She has gained a lot of weight and thinks that people talk about her when they see her. When she does leave the house, she does it at times when she thinks the neighbours will not see her. She knows her reaction is excessive but she cant control how she feels. What is the diagnosis?Your answer was Delusional disorder which is incorrectSocial phobiacorrect answer

Agoraphobia

Bipolar disorder

Delusional disorder

Depression

Explanation:Social phobia is the fear of embarrassing yourself around people which results in the patient avoiding social situations. It is not agoraphobia as she can leave the house, it is not delusional disorder as she understands that it is unreasonable, and she does not exhibit enough features to suggest bipolar or depression.Which has the highest mortality?Your answer was Anorexia nervosa which is correctAnorexia nervosacorrect answer

Schizophrenia

Alcoholism

Depression

Prescription medication addiction

Explanation:Anorexia nervosa has a high death rate with some suggesting 10 20% per decade. Most recover fully but it is estimated that 20 40% become chronic. Complications from the disease is the most common cause of death, such as arrhythmias, with suicide accounting for the next highest percentage.

What percentage of people with anorexia nervosa are male?Your answer was 10% which is correct10%correct answer

1%

1 to 5%

50%

35%

Explanation:It it suspected that 1 in 10 anorexic nervosa sufferers are male, but this number appears to be growing. Males are less likely to present and are diagnosed less frequently.What receptor does buspirone exert it action?Your answer was Serotonin which is correctSerotonincorrect answer

Noradrenaline

GABA

Histamine

Adenosin

Explanation:Buspirone acts on serotonin receptors. It is used in the treatment of generalised anxiety disorder and has a favourable side effect profile with low addictiveness.A 34 year old female presents with a week long history of nausea, headache and muscle spasms. A full history reveals depression treated with fluoxetine and examination is unremarkable. What physiological imbalance could be the cause?Your answer was Hypokalaemia which is incorrectHyponatraemiacorrect answer

Hypernatraemia

Hypokalaemia

Hyperkalaemia

Hypomagnesaemia

Explanation:Hyponatraemia is a well documented side effect of fluoxetine, and other antidepressants, and can cause a variety of symptoms that worsen in line with the degree of depletion including nausea, vomiting, headache, confusion, fatigue, appetite loss, restlessness, weakness, spasms, seizures, and coma.