Transcript General MCQs for CT1 trainees

General MCQs for CT1 trainees
composite neuropsychiatry and
psychopathology MCQs
John O’Donovan
MCQs
History of psychiatry
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
• 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
Schizophrenia
• 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
• 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
DMIS
• 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
• 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
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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
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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