Neuropsychiatry

neuropsychiatry-1

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Question 1 of 1

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424719

120

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67 yr old female who has been started on Venlafaxine 2 weeks ago presents with I confusion, headache, and muscle cramps and has a seizure in the emergency department. Her sodium levels are 115 Meq/1 ( 125- 135 Meq/1)

Select the correct answer(s).

(0/0)

495133

480

none

What are the important genetic associations in psychiatric disorders in terms of relative risk in relatives?

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Explanation

RR = a/(a+b)/c/(c+d) or relative risk of developing a disorder with exposure to the factor verses developing the disorder when not exposed to the factor.

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ADHD
Autism
Schizophrenia
Bipolar disorder
Alcoholism
GAD
Anorexia
Unipolar depression

Click and drag
1.5-3
10
45
55 RR
2-5
2-4
7
6

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180

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Genetic risk of developing schizophrenia

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Both parents with schizophrenia
MZ Twins
DZ Twins

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50-60%
12%
45%

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360

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Genetics of mood disorders

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Match the text
MZ co-twin lifetime risk of bipolar disorder
MZ co-twin lifetime risk of unipolar disorder
First degree relative lifetime risk of bipolar disorder
First degree relative lifetime risk of unipolar disorder
Lifetime risk of bipolar disorder in general population
Lifetime risk of unipolar disorder in general population

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5-10%
45-75%
8-20%
0.5-1.5%
4-9%
15-25%

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420

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Match the common genes with their disorders

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Match the text
Schizophrenia
Huntington's
Prader Willi
Angelman's
Fragile X
Rett's
William's syndrome

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CGG trinucleotide repeats
CAG trinucleotide repeats
DISC-1
Gene for elastin on chromosome 7
Chromosome 15 inherited from the mother
Chromosome 15 inherited from the father
X chromosome

426311

120

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70 yr old man from Fiji presents with a bilateral foot drop, blurred vision and CSF showing elevated protein and an increased cell count.

Select the correct answer(s).

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426312

120

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22 yr old female living in army barracks presents with headache, fever, photophobia and lethargy.

Select the correct answer(s).

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426317

120

none

52 yr old man with a long standing history of Alcohol intake presents with a sore tongue, paraesthesias in the extremities of hands and feet.

Select the correct answer(s).

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426319

120

none

50 yr old Italian male who has recently had an eye operation presents with a change in personality namely irritability. A brain scan revealed abnormality in the thalamic region.

Select the correct answer(s).

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426322

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23 yr old woman who is intoxicated comes to the emergency department, appears confused and "cross eyed"

Select the correct answer(s).

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52 yr old female with depression complains of feeling cold and easily fatigues on exertion.

Select the correct answer(s).

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426324

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35 yr old female with a diagnosis of Bipolar disorder on mood stabilisers presents with loin pain, worsening of mood and lethargy

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426325

120

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For each of the following effect select the most likely mechanism

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23 yr old male diagnosed with treatment resistant schizophrenia is started on Clozapine due to its unique mechanism
22 yr old male with untreated acute psychosis who is neuroleptic naive presents with slow writhing movements of his neck.
42 yr old female with long standing schizophrenia on typical depot preparation presents with chewing and writhing neck movements
A new development targeting drug antagonists at this receptor
35 yr old female who was changed from Olanzapine to Ziprasidone for weight gain, showed a reduction of 6 kgs in weight

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GABA receptor with postulated role in schizophrenia
Serotonin receptor agonism described as a potential mechanism for this effect
Supersensitivity of dopamine receptors
Strong blockade of D2 receptor
Serotonin dopamine antagonist with rapid dissociation from D2 receptors

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For each of the following scenarios select the most likely diagnosis

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32 yr old man who complains of an excessive focus on not getting much sleep. He has difficulty getting falling asleep at his bedtime but has no difficulty falling asleep during other periods of inactivity.
17 yr old boy presents with recurrent episodes of abrupt awakening with intense fear, rapid breathing and sweating. On awakening he is confused and disoriented and is not able to recall what woke him up.
A 50 yr old man with parkinsonism is brought in by his wife reporting that he is often found kicking and punching in his sleep and has hurt her as a result. He recalls his dreams vivid ly.
A 55 yr old female complains of lack of sleep due to a constant urge to move her legs mainly at night due to unpleasant sensations in her legs.

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Rapid eye movement sleep disorder
Psychophysiological insomnia
Restless legs syndrome
Parasomnias

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120

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For the following select the most appropriate investigation

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Match the text
Subarachnoid haemorrhage
Multiple sclerosis
Variant CJD
Differentiating Alzheimer's from Lewy Body
Explore D2/D3 receptor binding

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Dopamine transporter scan
MRI
CT
FLAIR
Raclopride SPECT scan

Neuropsychiatry

Question 1 of 1

Time Left

67 yr old female who has been started on Venlafaxine 2 weeks ago presents with I confusion, headache, and muscle cramps and has a seizure in the emergency department. Her sodium levels are 115 Meq/1 ( 125- 135 Meq/1)

Select the correct answer(s).

(0/0)

What are the important genetic associations in psychiatric disorders in terms of relative risk in relatives?

Match the text (click and drag)

(0/0)

Explanation

ADHD

Autism

Schizophrenia

Bipolar disorder

Alcoholism

GAD

Anorexia

Unipolar depression

1.5-3

10

45

55 RR

2-5

2-4

7

6

Genetic risk of developing schizophrenia

Match the text (click and drag)

(0/0)

Both parents with schizophrenia

MZ Twins

DZ Twins

50-60%

12%

45%

Genetics of mood disorders

Match the text (click and drag)

(0/0)

MZ co-twin lifetime risk of bipolar disorder

MZ co-twin lifetime risk of unipolar disorder

First degree relative lifetime risk of bipolar disorder

First degree relative lifetime risk of unipolar disorder

Lifetime risk of bipolar disorder in general population

Lifetime risk of unipolar disorder in general population

5-10%

45-75%

8-20%

0.5-1.5%

4-9%

15-25%

Match the common genes with their disorders

Match the text (click and drag)

(0/0)

Schizophrenia

Huntington's

Prader Willi

Angelman's

Fragile X

Rett's

William's syndrome

CGG trinucleotide repeats

CAG trinucleotide repeats

DISC-1

Gene for elastin on chromosome 7

Chromosome 15 inherited from the mother

Chromosome 15 inherited from the father

X chromosome

70 yr old man from Fiji presents with a bilateral foot drop, blurred vision and CSF showing elevated protein and an increased cell count.

Select the correct answer(s).

(0/0)

22 yr old female living in army barracks presents with headache, fever, photophobia and lethargy.

Select the correct answer(s).

(0/0)

52 yr old man with a long standing history of Alcohol intake presents with a sore tongue, paraesthesias in the extremities of hands and feet.

Select the correct answer(s).

(0/0)

50 yr old Italian male who has recently had an eye operation presents with a change in personality namely irritability. A brain scan revealed abnormality in the thalamic region.

Select the correct answer(s).

(0/0)

23 yr old woman who is intoxicated comes to the emergency department, appears confused and "cross eyed"