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We apologise for the typing (OCR) mistakes in this page. We are working on them as time permits. We could have published this page after all the corrections, but then we thought that we would still publish while working on it. Hope it would still be useful as it is.
NEUROANATOMY
Dr. Yagoub
A Sample Preliminary Test
1.Limbic structures include
:F(a)Insula
T(b)Fornix
F(c)Anterior commissure
T(d)Cingulum
T(e)Hippocampus
T(f)Amygdala
2.The following may be due to disorders of the extrapyramidal system:
F(a)Clasp-knife rigidity
T(b)Tremor of the lips ?
T(c)Spasmodic torticollis
T(d)Akathisia
T(e)Festinant gait
F(f)Rotatory nystagmus [ Labyrinthine ]
3.The following structures are part of the neo-cortex:
T(a)Broca's area
F(b)Hippocampus
T(c)Operculum
T(d)Superior temporal gyrus
T(e)Cingulum [F for cingular gyrus]
4.The following are involved in the control of eye movement:
F(a)Inferior colliculus
T(b)Medial longitudinal bundle
F(c)Broca's area
F(d)Medial forebrain bundle
T(e)External geniculate ganglion
F(f)Corpus striatum
5.The following are associated with disorder of the parietal lobe:
T(a)Gerstmann's syndrome
T(b)Astereognosis
F(c)Expressive dysphasia
T(d)Tactile inattention
T(e)Dressing apraxia
F(f)Word blindness
6.The cerebellum contains the following
T[a]Dentate nucleus
F[b]Substantia nigra
T[c]Vermis
F[d]Hypocampus
F[e]Globus pallidus
7.In the cerebellum
TA)The pathways leave via both superior and inferior peduncles
FB)The pathways from the middle peduncle are mostly from the red nucleus
FC)The anterior spinocerebellar tract arrives by the inferior peduncle
TD)Most fibers leaving the dentate nucleus exit through the superior peduncle
E)The archicerebellum is concerned mainly with balance
8.Characteristic clinical signs of cerebellar dysfunction include.
T[a]ataxia
F[b]hypertonia
T[c]disdiadochokinesia
T[d]nystagmus
F[e]nominal aphasia
9.Cerebellar lesions may result in:
T[a]uncoordinated voluntary movements
T[b]ipsilateral hypotonia
F[c]contralateral hypotonia
T[d]dysdiadocokinesia
F[e]resting tremor
10.Characteristic features of Gerstmann's syndrome include:
F[a]Ophthalmoplegia
T[b]Finger agnosia
T[c]Acalculia
T[d]Agraphia
F[e]Ataxia
11.Characteristic features of non dominant parietal lobe damage include:
F[a]Diplopia
F[b]Confabulation
T[c]Spatial agnosia
T[d]Anosognosia for hemiplegia if present
T[e]Dressing apraxia
12.The following structures form apart of limbic system:
T[a]Fornix
T[b]Amygdala
F[c]Vermis of the cerebellum
T[d]Hippocampus
T[e]Septal nuclei
F(f) Red nucleus
F(g) Pyramid
NEUROLOGY AND NEUROPATHOLOGY
1.Bells Palsy is associated with:
F[a]loss of smell
T[b]alteration in sense of taste
F[c]an increase in the number of lymphocytes in the CSF
T[d]change in auditory acuity
F[e]diplopia
2.A frontal meningioma can cause:
T[a]visible changes on the skull Xray
T[b]unilateral papilloedema
T[c]epilepsy
T[d]loss of smell
T[e]expressive dysphasia
3.A cerebellar lesion can give:
F[a]sphincter disturbance
F[b]loss of deep reflexes [diminished or pendular]
F[c]hypertonia
F[d]resting tremor
T[e]dysarthria
4.Neck stiffness may be caused by:
T[a]Acute poliomyelitis
T[b]cerebral AIDS
T[c]cervical spondylosis
T[d]Huntingdons Chorea
T[e]subarachnoid heamorrhage
5.Parietal lobe lesions are associated with:
T[a]pure agraphia without aphasia
T[b]in the non-dominant hemisphere a dressing apraxia
T[c]Gerstmann's syndrome
F[d]personality changes
T[e]contralaterai homonomous upper quadrantic field defect
6.Frontal lobe lesions are associated with:
T[a]disinhibition
T[b]apathy
F[c]memory impairment
F[d]hypersexuality
F[e]dyscalculia
7.Characteristic symptoms of frontal lobe syndrome include:
F[a]organic hallucinosis
T[b]indifference to the feelings of others
T[c]a general lack of drive
T[d]lack of foresight
F[e]loss of memory
8.Papilloedema is associated with:,
F[a]Retrobutbar neuritis [doctor sees nothing & the patient sees nothing too]
T[b]benign intracranial hypertension
T[c]respiratory failure
F[d]Wilson's disease
F[e]Syringobulbia
9.The following symptoms suggest a cortical rather than brain-stem lesion:
F[a]diplopia
F[b]vertigo [inner ear, VIII, brain stem lesion ]
T[c]dyslexia
T[d]dysphasia
F[e] dysphagia [VII, IX, X, XII]
10.Unconsciousness can be induced by a small area of damage in the:
T[a]reticular formation.
F[b]cerebral cortex
F[c]thalamus
F[d]limbic system
F[e]internal capsule
11.In the brains of old people there is a loss of:
F[a]astrocytes
F[b]ependymal cells
T[c]cortical neurones
[d]leptomeningeal cells
T[e]purkinje cells
12.Recognised clinical tests of the second cranial nerve include:
T[a]pupillary light reflex
T[b]visual field determiation
T[c]visual acuity
F[d]Queckenstedt test [to test block of flow of CSF by manometer in the spine and palpate jugular vein]
F[e]tests for Rombergs sign
13.Refelexes typically associated with directing the eyes to an object close at hand include:
F[a]delayed ankle jerks
T[b]convergences
T[c]accomodation
[d]ciliospinal reflex
T[e]pupillary consitiction
14.Recognised causes of nystagmus include-.
F[a]anosmia
F[b]degeneration of the substantia nigra
T[c]irritation of the VIII cranial nerve
T[d]damage to the vestibular nuclei
T[e]acute alcohol intocication
15.The grasp reflex is a recognised symptom of:
F[a]depressive psychosis
F[b]cerebellar disorders
F[c]hypomania
T[d]widespread disorderes of the cerebral cortex
T[e]frontal lobe lesions
16.Recognised causes of anosmia include:
T[a]meningitis
T[b]fracture of the ethmoid bone
F[c]cerebellar astrocytoma
F[d]congenital abscence of the corpus callosum
T[e] common cold
17.Resting tremor is a cteristic symptom of-
F[a]cerebellar disorders
F[b]temporal lobe epilepsy
T[c]parkinsonism
T[d]alcoholism
T[e]thyrotoxicosis
18.Lesions in the following areas typically result in aphasia:
F[a]The cerebellum
T[b]Brocas area of the dominant hemisphere
T[c]the posterior part of the superior temporal gyrus of the dominant hemisphere
F[d]the posterior part of the temporal lobe of the non-dominant hemisphere.
F[e]the occipital lobe of the non-dominant hemisphere
19.Recognised consequences of syringomyelia include:
F[a]loss of proprioception
T[b]interruption of the lateral spinothalamic fibres which cross from one side to the other
F[c]loss of simple touch sensibility
T[d]loss of pain sensibility
T[e]loss of temperature sensibility
20.Recognised features of VIII cranial nerve disorder include:
T[a]hearing loss
T[b]tinnitus
T[c]the Weber test lateralises to the normal ear
F[d]bone conduction is better than air conduction [the opposite in normal people and in sensory neural deafness]
[e]a threshold deficit in the reception of tones in the higher frequencies
21.Characteristic features of Horners syndrome include:
F[a]ataxia
T[b]pupillary consliction
F[c]sweating on the affected side
T[d]ptosis of the eyelid
F[e]paralysis of the lower part of the face
22.Recognised consequences of hemisection of the spinal cord include the following on the side of the lesion:
T[a]motor paralysis
T[b]hyperactive tendon reflexes
F[c]loss of pain sensation
F[d]loss of temperature sensation
T[e]loss of position sense
23.The following statements concerning lower motor neurone lesions are correct:
T[a]they result from damage to the anterior horn cell
F[b]result from damage to the pyramid
F[c]they result from the damages to ventral root of the mixed spinal nerve
F[d]they result in increased tone of the affected muscles
T(e)they result from thiamine deficiency
F[f]they result from cerebro-vascular accidents
24. Lesions in the spinal cord causing loss of sensation include:
T[a]tabes dorsaiis
T[b]Brown-Sequard syndrome
T[c]syringomyelia
F[d]acute polio-myelitis
F[e]peripheral neuriritis
25.Recognised functions of the glossopharyngeal nerve include:
F[a]taste sensation from the anterior third of the tongue
T[b]innervations of the parotid gland
T[c]sensations from the pharynx
F[d]innervation of the muscles of mastication
F[e]innervation of the superficial muscles of the face
26.The following are found in neurons:
[a]Mitorhondria
[b]Golgi Apparatus
[c]Centrioles
[d]Polar body
[e]Endoplasmic eticulum
27.Recognised features of upper motor neurne lesions of the facial nerve include:
F[a]trigeminal neuralgia
T[b]sparing of the upper part of the face from paralysis [upper spares upper]
T[c]paralysis of the muscles of the lower part of the face
T[d]an apparent abscence of paralysis during involuntary contraction of the muscles of facial expression
F[e]Bells palsy [LMNL]
28.The parts visible on the outer surface of an undamaged postmortem brain include:
F[a]amygdaloid nuclei
F[b]inteventricular foramen
T[c]optic chiasma
T[d]dura mater
T[e]trigeminal nerve roots
29.Recognised features of the stimulation of the parasympathetic nervous system include:
T[a]penile erection
F[b]ejaculation
T[c]pupillary constiction
T[d]salivation
F[e]bronchiolar dilatation
30. Optic chiasma :
[a]Is anterior to the pituitary stalk
[b]Is lateral to the internal carotid
[c]Carries fibres from nasal fields of vision
[d]Contains axons from bipolar cells
[e]Contains fibres terminating in the lateral genicalete body.
31.The oculomotor nerve innervates the following muscles:
T[a]inferior oblique
F[b]lateral rectus
F[c]superior oblique
T[d]superior rectus
T[e]ciliary muscle
32.The direct pupillary light reflex requires an intact..
[a]Optic nerve
[b]Optic radiation
[c]Occipital cortex
[d]Superior corpora quadrigemina (superior colliculus)
[e]Stellate ganglion
33.The following are extrapyramidal features:
F[a]Clasp-knife rigidity.
F[b]Diplopia.
T[c]Festinant eait.
T[d]Intention tremor.
T[e]Scanning speech.
34.Blockage of the left posterior cerebral artery may cause
F[a]Aphasia.
T[b]Dyslexia.
T[c]Hemianopia.
T[d]Visual agnosid.
T[e]Diplopia.
35.Non-dominant temporal lobe abnormalities may produce:
T[a]Impaired ability to plan ahead.
T[b]Reduced appreciation of music.
F[c]Impaired learning of new words.
F[d]Difficulty planning tasks.
F[e]Confabulation.
36.In frontal lobe damage the following are commonly found:
F[a]Long term memory impairment.
T[b]Disinhibition.
T[c]Impaired attention.
F[d]Hypersexuality.
T[e]Apathy.
37.The Grasp reflex can be found in
T[a]Frontal lobe tumours.
T[b]Babies under the age of six weeks.
T[c]Motor neurone disease.
F[d]Wemicke's psychosis.
F[e]Dystrophia Myotonica.
38.The following are common manifestations of TIA of the vertebrobasilar system .
T[a]Transient vertigo .
T[b]Transient ocular palsy .
F[c]Transient ipsilateral monocular blindness
T[d]drop attacks .
F[e]Transient dysphasia
39.The following favour CVA in the carotid rather than the vertebro-basilar artery territory
T[a]Unilateral visual loss .
F[b]Dysarthria.
F[c]Headache.
F[d]Vertigo
T[e]Central aphasia.
40.In the assessment of parietal lobe lesions
T[a]Ideational (ideomotor) apraxia is the inability to copy a movement when the instruction is understood there is no motor weakness.
T[b]Apparent dressing apraxia may be caused by left sided neglect.
T[c]Constructional apraxia is revealed by an inability to copy two dimensional designs using matchsticks.
F[d]Difficulty in writing is likely to be caused by astereognosis.
F[e]Prosopagnosia is a synonym for Cotards syndrome.
41.Parietal lobe symptoms include
T[a]Astereognosis.
T[b]Dressing apraxia.
T[c]Acalculia.
T[d]Ideomotor apraxia.
T[e]Tactile inattention.
1.Cerebellar signs include:-
F[a]Clasp-knife rigidity.
F[b]Loss of reflexes.
[c]Causes true vertigo
T[d]Intention tremor.
[e]Loss of shoulder swing. [symptom of parkinsonism]
2.Parasympathetic signs:-
T[a]Slow heart rate.
F[b]Dilated pupils.
T[c]Increased acid secretion of stomach.
T[d]Salivary secretion.
F[e]Increased diameter of the bronchioles.
3.Fronto-subcortical links:
{a}Cingulate involved with anxiety.
{b}Interruption of the cortical part of the links can have similar effects to interruption of subcortical parts.
{c}Fatuousness caused by degeneration
F{d}Parkinson's patients show patterns of frontal lobe dysfunction.
4.Limbic system includes:-
T[a]Cortical and subcortical structures.
[b]pituitary release.
T[c]Ablation in cortex affects emotional responses.
5.Areas involved in anxiety:
{a}Amygdala.
T{b}Hippocampus.
{c}Periaqueductal grey matter.
{d}Parietal lobes.
PHYSIOLOGY
Dr. Yagoub
Basic Sciences:
-scalp:**
T(a)CNV.[ie. Contingent negative verbatum]
T(b)P 300.
T(c)Theta waves.
T(d)Brainstem auditory potential.
T(e)VEPS.
13.Alpha waves on the EEG:-**
T(a)Between 7 to 13 Hz.
F(b)Absent with eyes open.
F(c)Latetality difference in amplitude is pathological.
F(d)Increased with attention.
T(e)Greatest in occipito-parietal area.
2. 5HT is involved in:-**
T(a)Sleep.
T(b)Sex.
T(c)Aggressive outbursts.
T(d)Attention.
T(e)Mood.
60.Prolactin is stimulated by:-**
F(a)DA -agonists.
T(b)TRH.
T(c)5HT.
T(d)Stress.
F(e)Adrenaline..
40.The following nuclei are neurosecretory:-**
F(a)Edinger-Westphal.
T(b)Supre-optic.
T(c)Para-ventricular.
F(d)Amygdala.
F(e)Caudate nucleus.
43.The levels in the normal CSF are as follows:-**
T(a)Cells-- less than 5.
(b)Glucose-- 40-80mgs/100 ml.
T(c)Proteins-- 20~40 mgs/100 ml.
T(d)Clear.
(e)Chloride-- 20 meq/litre.
41.Protein found in the CSF above the level of 2 gms/ml is indicative of:-**
F(a)Guillian-Barre Syndrome.
F(b)Alzheimers Disease.
F(c)Multiple Sclerosis.
F(d)Spinal epidural abcess.
T(e)Acoustic neuroma
-------------------------------------------------------
Psychiatry
15.EEG:-**
T(a)Alpha waves are maximal over the occiput.
F(b)Is unchanged in delirium.
T(c)Beta is increased by BZD.
(d)Has high amplitude over hippocampus.
T(e)REM & EEG are same when a person is awake. ?
Subspecialities
164.EEG:-**
T[a]Is a reliable diagnostic measure of acute organic syndrome over time.?
T[b]Alpha frequency is greater over the occipital area.
F[c]Maturational changes do not occur after 10 years of age.
T[d]Benzodiazepines increase beta activity.
-------------------------------------------------------
+14.REM sleep time is decreased by:
T(a)Barbiturates
F(b)Lysergic acid diethylamide ?
F(c)Heroin ?
T(d)Chlorpromazine
T(e)Nitrazepam
+15.An abnorml brain respiratory rate is found in:
T(a)Senile dementia ?
F(b)Surgical anaesthesia ?
F(c)Schizophrenia ?
T(d)Insulin hypoglycaemia
F(e)Depressive stupor
T(f)A grand mal seizure
+2.Anterior pituitary function is regulated by
F[a]The nigro-striatal pathway
T[b]Hypothalamic control
T[c]CNS control
T[d]Negative feedback control
T[e]Enviromental influence
+4.Defence reaction arousal in animals may be produced by stimulating the following:
F(a)Dorsomedial thalamic nucleus ?
F(b)Mammillary bodies
F(c)Posterior pituitary
T(d)Amygdala
F(e)Dentate nucleus ?
T(f)Hypothalamus.
+27.The reticular activating system:
T(a)Is excited by somatic afferents
T(b)Activates all areas of the cerebral cortex
F(c)Is inhibited by auditory afferents
T(d)Produces behavioural arousal
F(e)Causes an increase in EEG slow wave activity [ fast ]
+35.The EEG pattern:
T(a)Changes according to the level of conscious awareness
T(b)Shows naked-eye changes in response to alterations of mood ?
F(c)When normal excludes cerebral disease
F(d)In temporal lobe epilepsy is characterized by 3 per second spike and wave activity
T(e)Is a sensitive indicator of encephalopathy in liver disease
+5o.The EEG pattern:
F(a)Shows an increase in theta activity in hypnotized subjects ?
F(b)Does not change as a function of maturation after the age of 10 years
T(c)May show increased dysrhythmia in those taking benzodiazepines
F(d)Characteristically shows high voltage activity in those with Huntington s clorea
T(e)Shows maximal alpha activity over the occipital region
+6.Parasympathatic action characteristically include:
F[a]Dilatation of the pupil
T[b]Decrease in heart rate
F[c]Decrease in salivation
T[d]Bronchial constriction
F[e]Decrease in peristalsis
+17.The following statements accord with the Yerkes-Dodson law.
F[a]at a low level of inxiety further stimulation is associated with decresed performance
F[b]the relationship between anxiety and performance is a straightforward one of negative correlation
T[c]if an anxiety level is low, taking an anxioiytic drug may reduce performance
F[d]anxiety and performance are unrelated
T[e]a sudden drop in performance may result from stimulating further an already highly anxious suject
+23Factors influencing the rate of conduction of an axon include.-
F[a]Placebo reactivity
F[b]Length
F[c]Degree of neurasthenia
T[d]Diameter
T[e]Whether it is mylinated
+24.Recognised function of the hypothalamus include control of.
F[a]Balance
T[b]Hunger
F[c]proprioception
T[d]Sexual behavior
F[e]Fear ?
+24.The action potential of a nerve fibre is due to:
T(a)Movement of sodium ions inwards
F(b)Movement of phosphate ions outwards
F(c)Movement of chloride ions outward
F(d)Movement of potassium ions inwards
T(e)Voltage reversal across the nerve membrane
+16.Recognized functions of the reticular activating systein include control of:
T[a]Sleep
F[b]Fine motor skills
T[c]Arousal
F[d]The histamine reaction
T[e]Vigilance
+23.On examination of the visual fields:
T[a]Bitemporal hemianopia is indicative of chiasmatic compression
T[b]The finding of a right homonymous hemianopia would be consistent with a space-occupying lesion in the left occipital lobe
F[c]Bilateral concentric constriction of the fields call only be due to conversion hysteria
F[d]A central scotoma is consistent with a lesion of the lateral geniculate body
T[e]An upper quadrantic homonymous defect would suggest a temporal lobe lesion
+28.The pupillary light reflex pathway includes:
T[a]Superior colliculus
T[b]Edinger-Westphal nucleus
T[c]Cranial nerve 111
F[d]Dentate gyrus
F[e]Fimbria
+29.The following statements concerning the sympathetic nervous system are correct: [?]
F[a]Adrenaline relaxes bronchi by its action on alpha receptors
T[b]Alplia receptors are blocked by phentolamine
F[c]Beta receptors are stimulated by propranolol
T[d]Adrenaline increases the heart rate by its action on beta receptors
T[e]Adrenaline dilates pupils by its action on beta receptors
MCQ oct 1993
6.EEG evoked potentials:**+
T[a]useful in M.S.
T[b]in diagnosis of hysteria.
F[c]reduced latency in dementia. [increase d latency]
30.decrease prolactin level:**+
F[a]antipsychotic effect.
F[b]after epilepsy.
F[c]SSRI antidepressants. ?
F[d]after ECT.
S[e]depression
7.Calvanic skin response:**+
T[a]increased in agrophobia.
T[b]reduced after treatment.
14.Endorphine:**+
T[a]associated with gate theory of pai.n [ATK149]
F[b]never found extra cerebrally. {or are only in the brain }
T[c]increase after exercise. [P49]
T[d]act on dopamine receptors
T[e]p'tentiate dopamine
5.Prolactin secretion :**+
F[a]Increased in schizophrenia.
F[b]Decreased in depresion.
T[c]Decreased by some neuroleptics.
T[d]Prolactin levels correlate with extrapyramidal side eftects. [typical neuroleptics?]
F[e]Is under serotoninergic control. ?[S?]
21.Skin conductance galvanic skin response **+ [ie. increase resistence]
F[a]Increased in depression.
T[b]Increase with exposure -desensitization and reduce after it.
T[c]Increased in Agoraphobia.
T[d]Variable in chronic schizophrenia.
T[e]Reduced when administering a short acting benzodiazepine.
41.Serotonin mediates**+
T[a]Aggressive behaviour.
T[b]Sexual
T[c]Sleep.
NEUROLOGY AND NEUROPATHOLOGY
11.Regarding the EEG:
F[a]There are no maturational changes after 10 years
F[b]Beta waves occur in hypnosis.
T[c]Alpha waves predominate in the occipital areas
F[d]Huntingdons Chorea is characterised by high voitages
T[e]It may reamin abnormal weeks after
14.with regard to the EEG:
T[a]an adult under severe stress is likely to show a frequency of 13Hz
T[b]a relaxed adult with eyes closed would show a frequency of 8-13Hz
T[c]a child with behaviour disorder would show a low frequency, high amplitude pattern
T[d]benzodiazepine overdose causes sio ave activity
F[e]a person in deep sleep shows a frequency of >7 Hz
18.The EEG in man:
F[a]is unaffected by barbiturates
T[b]may show epileptiform spikes after chlorpromazine
T[c]Chows fast wave activity after benzodiazepines
T[d]shows slow waves after imipramine administration
F[e]shows slow waves during REM sleep
22.The following statements are true of the EEG:
F[a]alpha waves are predominant from birth
F[b]barbiturates slow the rate
T[c]dementia is associated with slow activity
F[d]theta waves are from 14 to 30 Hz
T[e]diazepam causes fast activity
------------------------------------
78.In The autonomic nervous system the **+?
FA)Sphenopalatine ganglion is a relay station for fibers destined for the lacrimal gland
TB)Grey rami communicantes are carrying preganglionic sympathetic fibers
FC)Pelvic plexus has contribution from both thoracic and sacral outflow
TD)Innervation of the heart comes from all the three cervical sympathetic ganglia
FE)Vagus nerve supplies sympathetic preganglionic fibers as far as the transverse colon
*88.Selective REM sleep deprivation leads to
T[a]Irritability
F[b]A reduction in non REM sleep
F[c]Schizophrenia
T[d]Poor concentration
T[e]Selective disorders of memory recognition
---------------------------------------------------------
PSYCHIATRIC TREATMENT
55.Spontaneous lactation may occur-
T[a]with chlorpromazine therapy
T[b]with contraceptive steroid therapy
F[c]with chlorothiazide therapy
F[d]in association with psychosis
T[e]with some pituitary tumours
-------------------------------------------------------
M.C.Q'S INVOLVING E.E.G
1.Features of narcolepsy include:
F[a]Excess theta activity on the EEG
2.In which of the following is genaralised theta activity most likely in the EEG:
[a]Patient who has taken 10mg nitrazepam 12 hrs previously [W207]
T[b]In hepatic encephalopathy [W201]
F[c]Immediately after the administration of ECT[C825 brief periods of episodic delta ][P65 increase with successive treatment]
F[d]after hemispherectomy [flat]
T[e]6 years after frontal leucotomy ? [P65]
3.A 'flat' EEG is found:
F[a]immediately alter a convulsion in ECT [W206 generalized high voltage activity]
T[b]Huntinadon's chorea
T[c]brain death in the presence of adeauate oxygenation
F[d]in Alzheimers disease
F[e]Gilles de la Tourette syndrome
4.The EEG can:
T[a]distinguish hysterical from organic stupor [W200]
T[b]show a distinctive pattern in photosensitive epilepsy to a stroboscope flicker [P64]
T[c]show a distinctive pattern in chronic measles encepnalitis [P]
F[d]differenciate potassium deficiency from any other electrolvte disturbance
F[e]shows a specific pattern in digitalis toxicity
5.The EEG in man:
F[a]is unaffected by barbiturates
T[b]may show edileptiform spikes after chlorpromazine [W207]
T[c]shows fast wave activity after benzodiazecpines
T[d]shows slow waves after imipramine
F[e]shows slow waves during REM sleep [P68]
F[d]T.L.E is characteried by 3 per second spike and wave
T[e]sodium valproate and ethoximide are the drugs of choice in petit mal
12.The following are true statements:
F[a]in patients with P.K.U an abnorma1 EEG is seen in 75% cases
F[b]specific reading retardation is characterised by specific EEG changes
[c]in hyperkinetic syndrome specificEEG changes are seen in 35%
[d]night terror is characterised by waking and EEG
13.With regard to the EEG:
T[a]an adult under severe stress is likely to show a frequency of >15Hz
T[b]a relaxed adult with eyes closed would show a frequencv of 8-13Hz
T[c]a child with a behavioural disorder would show a low frequency high amplitude pattern? [dysmaturation?]
T[d]benzodiazepine overdose causes slow wave activity
T[e]a person in deep sleep shows a frequency of <7 Hz [delta &theta]
14.The EEG is
T[a]slower in infants
F[b]when normal, excludes a diagnosis of epilepsy
T[c]shows a 3 per sec. spike and wave pattern in petit mal
F[d]amplitude is decreased over diseased areas ? [B]
T[e]in ECT, may con-inue to show a convulsive pattern after all obvious physical fitting has ceased
15.The following are true statements:
F[a]Characteristic features of Creutzfeldt- Jacob disease- normal EEG
T[b]The schizophrenia like psychoses of epilepsy are due to the type of epilepsv as found on EEG
F[c]Characteristic features of communicating hydrocephalus include pathognonomic changes in the EEG
T[d]Characteristic features of delirium tremens include increased fast activity in the EEG
T[e]The level of "arousal" (used as a physiological concept) is reflected in the EEG [ie.cortical arousal versus sensory excitability due to hormonal activity]
------------------------------------------------------
1.Arousal is :**@
[a]psychopliysiological concept
[b]Low in chronic schizophrenics
[c]Is related to depth of sleep
[d]May be estimated by plasma cortisol
[e]Is associated with changes in EEG
3.Sympathetic stimulation causes:**@
[a]Pupil constriction
[b]Relaxation of bronchial smooth muscle
[c]Irkibition of salivary secretion
[d]Stimulation of lacrimal secretion
[e]Tachycardia
23.The following are under control of pituitary hormones:**@
[a]Testes
[b]Ovary
[c]Adrenal Medulla
[d]Pancreas
24.Hormones under control of the hypothalamus are:**@
[a]Prolactin
[b]Growth hormone
[c]Corticotrophins
[d]Calcitonin
PHARMACOLOGY
Dr. Yagoub
Basic Sciences
11.The following drugs prevent ejaculation:-**
F(a)Beta-adrenergic blockers.[GAN]
T(b)Alpha-adrenergic blockers.[]
T(c)Diazepam/benzodiazepines. [LIST &decease libido]
T(d)MAOI [LIST &impotence]
F(e)Lithium. [LIST decrease libido &impotence]
T(b)Benperidol.
T(c)Trifluoperazine.
T(d)Benzodiazepines.
64.The following drugs can cause impotence:-**
T(a)Antipsychotics(Phenithiazines)
T(b)TCADS.
T(c)MAOIS.
(d)Benzodiazepines.
T(e)B-blockers
F(e)SSRI
65.The following drugs cause tremors:-**
T(a)Haloperidol.
T(b)Amitriptyline.
T(c)MAOITS.
T(d)Lithium.
F(e)BZD.
66.The following drugs have a 1/2 life less than 24 hours:-**
T(a)Lorazepam.[S71][7-35h]
T(b)Oxazepam.[][5-15h]
F(c)Nitrazepam.[][20-50h]
F(d)Diazepam.[][20-100h]
F(e)Flurazepam.[][2h----metabolites 30-100h]
100.Drugs effective in the symptomatic treatment of delirium tremens include:**
T(a)Ascorbic acid.
T(b)Clonidine.
T(c)Haloperidol.
T(d)Diazepam.
T(e)Chlormethiazole.
102.The lack of response to TCADS:-**
T(a)Phenothiazines are given concurrently.
T(B)Barbiturates.
T(c)The plasma level is too high.
T(d)Reduced gastric motility
67.The following drugs act b inhibiting of GABA Transaminase (or GABA inhibitors):-**
F(a)Ethosuximide.
F(b)Carbamazepine.
T(c)Vigabatrin.
F(d)Clonazepam.(or diazepam).
T(e)Sodium Valproate.
68.The following drugs are likely to produce ataxia at therapeutic doses:-**
T(a)Diazepam'
F(b)Imipramine.
F(c)Chlorpromazine.
T(d)Carbamazepine.
F(e)Pimozide.
69.Beta Adrenoceptor agonists cause:-**?
[eg. isoprenaline]
T(a)Tremor.[BNF102]
F(b)Pupil dilatation. [alpha ]
T(c)Increased blood flow to the muscle
T(d)Stronger heart contraction. .[BNF]
T(e)Increases melatonin secretion [GANON189 %synthesis]
71.Clinical significant adverse reactions may occur if the following drugs given with TCADS:-**
(a)Isoprenaline.
(b)Adrenaline.
(c)Propranolol.
(d)Guanethidine.
(e)Tranyncypromine.
72.Patients on phenelzine:-**
F(a)Should abstain from alcohol.
F(b)Need be given no advice about diet.
T(c)May suffer a hypertensive crisis.
T(d)May develop postural hypotension.
F(e)Should be given pethidine rather than morphine for relief of severe pain.
73.Recognised side-effects of chlorpromazine:-**
T(a)Galactorrhoea.
T(b)Impotence.
T(c)Postural hypotension.
F(d)Hypertensive encephalopathy.
F(e)Hypothyroidism.
74.The following drugs exacerbate schizophrenia in some cases:-**
T(a)Methylphenidate.
T(b)L-Methionine.
F(c)Physostigmine.
F(d)Beta-Endorphine.
T(e)Dopamine.
75.Tricyclic Antidepressants:-**
F(a)Are safer than ECT in a patient with myocardial infarction.
F(b)Should not be given to patients with early cataract.
F(c)Are effective in prophylaxis for preventing a relapse of unipolar depression.
T(d)May cause considerable increase in weight.
T(e)Potentiate the pressor effect of nor-adrenaline.
76.Recognised side-effects of haloperidol are:-**
F(a)Double vision.
T(b)Reversible tardive diskinesia.
T(c)Acute dystonia.
T(d)Cholestatic jaundice.
F(e)Dangerous interaction with MAOIS.
79.The following treatments are shown to be effective:-**
F(a)Phenelzine and school phobia.
T(b)Pimozide and schizophrenia.
T(c)Haloperidol and Gilles de la Tourette Syndrome.
81.The following antidepressants should be avoided in a patient who has recently had a heart attack:-**
T(a)Amitriptyline.
F(b)Mianserin.
(c)Doxepin.
T(d)IMipramine.
F(e)Trazadone.
84.Depression may be caused by the following drugs:-**
T(a)Atenolol. .
T(b)Methyldopa. .
T(c)Reserpine.
T(d)Frusemide
T(e)Digoxin
84.The following have clinically significant interaction with TCADS:-**
(a)Isoprenaline.
(b)Proprietary cough mixtures.
(c)Propranalol.
(d)Adrenaline.
(e)Tranylcypromine.
86.A depressed patient who fails to improve symptomatically with tricyclic antidepressants may be the result of:-**
T(a)Alcohol dependence.
T(b)Phenothiazine treatment.
T(c)Anti-parkinsonian drugs.
T(d)Doctor-patient interaction.
T(e)Failure to resolve difficulties in social environment.
87.The following cause sedation in the majority of patients:-**
T(a)Dothiepin.
F(b)Imipramine.
T(c)Mianserin.
T(d)Clomipramine.
F(e)Phenelzine.
88.The following are true:-**
T(a)Chlorpromazine causes hypersensivity.
F(b)Thioridazine causes hepatocellular jaundice.
90.Depression in the elderly may be caused by:-**
T(a)Reserpine.
T(b)Clonidine.
T(c)Frusemide.
T(d)Digoxin.
80.Benzodiazepines:-**
T(a)Withdrawl may cause grand mal convulsions.
F(b)Potentiate antidepressants.
93.Psychomimetic effects of stimulants and antipsychotic effects of neuroIeptics favour:-**
T(a)Dopamine hypothesis.
F(b)Serotonin deficiency theory.
F(c)MAO theory.
F(d)Nor~adrenaline theory.
F(e)GABA THEORY.
95.Maintainance lithium therapy in affective disorders:-**
F(a)The serum level should not be less than lmmols/L.
T(b)Tremor may be controlled by propranolol.
F(c)Polyuria can be controlled with vasopressin.
T(d)Should be generally stopped during pregnancy.
T(e)Reduces capacity of the kidneys to concentrate urine.
96.The following drugs cause sedation in majority of cases:-**
F(a)Desipramine.
T(b)Trimipramine.
T(c)Mianserin.
T(d)Dothiepin.
F(e)Protriptyline.
97.Recognised side effects of tricyclics:-**
T(a)Blurred vision.
T(b)Tremulousness.
F(c)Diarrhoea.
98.Recognised side effects of trifluoperazine:-**
T(a)Oculogyric crisis.
T(b)Cholestatic jaundice.
T(c)Dystonic reaction.
T(d)Myoclonus.
F(e)Spastic diplegia.
53.Unwanted side-effects of TCADs include:~**
T(a)Hypotension.
F(b)Diarrhoea.
T(c)Weight gain.
T(d)Difficulty in micturition.
T(e)Blurred vision.
50.Side-effects of trifluoperazine are:-**
T(a)Cholestatic jaundice.
T(b)Dystonic reaction.
T(c)Myoclonic jerks.
T(d)Oculogyric crisis.
31.Benzodiazepines-partial agonists:-**
(a)Causes hyperpolarisation of cells.
(b)Is antagonised by BNZ antagonists.
(c)Antagonises GABA.
28.Benzodiazepines:-**
F(a)Commonly lead to dependence within 2 months.
(b)Are especially indicated when panic attacks are associated with GAD.
F(c)Are better than TCAS.
33.Clozapine acts on the following receptors:-**
T(a)5HT2 agonists.
F(b)Mostly on Dl receptors.
F(c)Has selective striatal D2 blockade.
T(d)Mostly on D3 and D4 receptors.
T(e)Is an Alpha2 adrenergic antagonist.
29.Clozapine has less of the following side-effects:-**
F(a) Sedation.
T(b)Dry mouth.
F(c)Postural hypotension.
F(d)Weight gain.
F(e)Blurred vision.
30.Lithium causes:~**
T(a)Drowsiness.
T(8)Fine tremors.
T(c)Nephrogenic Diabetes Mellitus.
T(d)Hyperparathyroidism.
T(e)Hypothyroidism.
26.Confusional state may be caused by:-**
T(a)Paracetamol.
T(b)Cimetidine.
T(c)Procyclidine.
T(d)Dothiepin.
F(E)Methylcellulose.
19.Lithium reacts dangerously with:-**
F(a)Phenelzine.
F(b)Clomipramine.
F(c)Haloperidol.
14.The following are true:-**
T(a)1st pass metabolism in benzodiazepines produces active metabolises.
T(b)Lithium potentiates action of TCADS.
T(c)Tryptophan potentiates the action of TCADS.
F(d)Lithium is less effective in elderly compared to the middle aged patients in prophylaxis for depression.
T(e)Thioridazine causes retinal pigmentation.
15.Side-effects of chlorpromazine:-**
T(a)Rabbit Syndrome.
T(b)PISA Syndrome.
T(c)Tardive akathesia.
T(d)Torticollis.
T(e)Hyperprolactinemia.
10.Fluoxetine:-**
F(a)Is related to suicide.
T(b)Is contra-indicated with MAOIS.
T(c)Is a 5HT reuptake inhibitor.
9.The half-life of the following benzodiazepines is more than 24 hours**
F(a)Nitrazepam.
T(b)Lorazepam.
T(c)Oxazepam.
F(d)Flurazepam.
F(e)Diazepam.
7. Neuroleptic malignant syndrome:-**
T(a)Increased neutrophils. (or increased WBC)
T(b)Males affected more than the females.
T(c)Untreated mortality is 20%.
F(d)Worse with drug holidays.
T(e)Caused by D2 receptor blockade. [OX554]
F(f)Invariably recurs.
6. Chronic barbiturate intoxication causes:-**
T(a)Dysarthria.
T(b)Nystagmus.
T(c)Increased frontal fast activity on EEG.
T(d)Withdrawl delirium.
(e)Brisk tendon reflexes.
4. As regards Neuroleptic treatment:-**
T(a)D3 is most frequently affected in the limbic system.
T(b)Dl activates adenyl cyclase.
T(c)Thioxanthines show stero-isomerism.
T(d)CPZ+Promazine --effect is enhanced.
T(e)5-10 mgs of haloperidol blocks most of the D2 receptors
59.Drugs which induce liver enzymes include:-**
T(a)Haloperidol.
T(b)Chlorpromazine.
F(c)MAOIS.
T(d)Barbiturates.
F(e)Anticholinergics.
63.Caffeine:-**
T(a)Can counteract anxiolytic effect of diazepam.
T(b)Can counteract hypnotic effect of benzodiazepines.
T(c)Breaks down by smoking.
T(d)Likely to develop withdrawl symptoms if more than 8 cups are consumed per day.
F(e)Can be reliably measured from the daily intake of tea or coffee.
*31.Lithium toxicity is associated with:**
F(a)fine tremor
T(b)large urine output
T(c)drowsiness, ataxia and giddiness
T(d)loose stools
T(e) nystagmus.
Psychiatry
169.Side effects of beta agonists:-** ?
F(a)Tremor.
(b)Increased muscle flow.
(c)Pupil dilatation.
(d)Increased contractility of the heart.
(e)Melatonin secretion.
178.Visual hallucinations can be caused by:-**
T(a)Butane :
T(b)Cannabis.
F(c)Opium.
15.Tacrine:**+ [Tetrahydro amino acridine]
F{a}Is associated with irreversible liver damage.[S394]
T{b}Is associated with less peripheral side effects than phystostigmine.[S393]
F{c}Has been shown to improve memory.[S393 improves simple task and attention and decrease vulnurability to acute confusional state]
F{d}Stops the growth of phaques.[]
22.Benzodiazepine withdrawal rather than anxiety is suggested by:**+
F{a}Tinnitus.[Magdi]
T{b}Hyperawareness of senses.
T{c}A feeling of movement.[drug misuse41]
F{d}Poor sleep.
T{e}Metallic taste.
46.Neuroleptics:**+
T{a}Can cause a Parkinsonial crisis in patients with Lewy Body disease.
F{b}Have only a small risk of causing dystonia.
F{c}Have only a small risk of causing tardire dyskinesia.
{d}Are better for treating anxiety in depression than benzodiazepines.
F{e}Clozapine is contra-indicated in those > 65 years.
F[f]Acute dystonia more fequent than akathesia
48.Add-on treatment for depression includes:**+
T{a}Benzodiazepines. [Biological ttt in psych]
T{b}Pindolol.[]
T{c}Thyroxine.[]
T{d}Lithium.[]
T{e}Tyrasine.[][also T for Tryptophan,L dopa &5 HTryptophan]
22.GABA inverse agonists:**+
T{a}Block effects of benzo's.
{b}Block..
T{c}Cause anxiety.
F{d}Cause sedation.
23.T 1/2:**+
T{a}Half time taken to reach mean concentration.
13.NMDA receptors:**+
F{a}Are stimulated by PCP.[antagonist]
F{b}Are damaged by antagonists.[blocked]
F{c}Alcohol has an effect on these.
14.The following are central neurotransmitters:**+
T{a}ACTH.?
T{b} CCK.?
-------------------------------------------------------
+10.The following are recognized side-effects of chiorpromazine:
T(a)Hypothermia
F(b)Retinitis pigmentosa [S]
T(c)Akinctic mutism
F(d)Haemolytic jaundice ?
T(e)Galactorrhoea
F(f)Teratogenicity [S499]
+25.The following drugs are excreted more rapidly in urine of low pH:
T(a)Amphetamine [P117]
T(b)Pethidine ?
F(c)Phenobarbitone
T(d)Imipramine
F(e)Salicylic acid
+26.Noradrenaline and 5-hydroxytryptamine:
F(a)Are limited in their site of action to the diencephalon
T(b)Probably play a part in the control of REM and other stages of sleep
F(c)Are produced by the action' of monoamine oxidase
T(d)Are chemically related to known hahucinogenic compounds ?
T(e)Are probably neurotransmitters
+3o.Dopamine is:
T(a)A precursor of noradrenaline
T(b)Decreased in amount in the substantia nigra of those with Parkinsonism
F(c)Useful in the treatment of extra-pyramidal disorders ?
F(d)Formed by the hydroxylation of tyramine
T(e)A putative transmitter substance in the brain
+31.Recognized side-effects of tricyclic antidepressive drugs include:
F(a)Cataract
F(b)Hypertension
T(c)Ilius
F(d)Prostatitis
T(e)Cardiomyopathy
F(f)Hypothyroidism
+32.Combined administration of tranylcypromine with the following substances may have untoward clinical results:
F(a)Nicotinic acid ?
T(b)Ephedrine
T(c)Methyldopa
T(d)L-tryptophan
F(e)Atropine
T(f)Morphine
+55.Prolonged administration of lithium carbonate may produce:
T(a)Weight gain
F(b)Craving for carbohydrates ?
F(c)Diarrhoea ?
T(d)Hyperthyroidism
T(e)Thirst
T(f)Osteoporosis
+58.Drug combinations which may prove detrimental rather than beneficial include:
T(a)Phenelzine and pethidine
T(b)Coumarol anti-coagulants and barbiturates
F(c)Benztropine and L-dopa ? [no interaction in BNF]
T(d)Guanethidine and nortriptyline
F(e)Trifluperidol and diazepam ?
+28.The following statements are true of the biosynthesis noradrenaline from tyrosine:
T[a]Dopamine beta hydroxylase is required
T[b]phenylalanine is an intermediary
F[c]Dopamine is formed by the addition of a hydroxyl group to DOPA
F[d]Tryptophan is in intermediary
T[e]Noradrenaline is formed by the addition of a hydroxyl group to dopamine
+1.The following metabolises of psychotropic medication are active compounds:
T[a]7-Hydroxychlorpromazine
[b]Mesoridazine
[c]p-Fluorophenaceturic acid
T[d]N-Desmethyidiazepam
T[e]Desipramine
+8.Recognized unwanted effects of tricyclic antidepressants include
T[a]retention of urine
T[b]paralytic ileus
T[c]sudden death
T[d]visual hallucinations
T[e]parkinsonion symptoms
+9.Mianserin [S180]
T[a]is a tetracyclic antidepressant
T[b]is an inhibitor of NA uptake
T[c]is an inhibitor of 5HT uptake ?
T[d]acts on presynaptic alpha 2 receptors
T[e]decreses brain concentration of NA and increases NA turnover
+18.The following are catecholamines:
F[a]Dihydroxyphenylalanine
T[b]Dopamine
T[c]Adrenaline
F[d]Serotoin
F[e]Imipramine
+20.Enzymes involved in the formation of catecholamines include:
T[a]Dopamine beta hydroxylase
T[b]Dopa decarboxylase
F[c]Monoamine oxidase
T[d]Tyrosine hydroxylase
T[e]Phenylalanine hydroxylase
+21.Suxamethonium (Scoline)
F[a]extremely irritant to the tissues in the event of extravenous injection ?
F[b]Is a competitive blocker of neuro-muscular transmission ?
T[c]Has a prolonged action in liver failure [BNF 572]
T[d]Is known to cause muscle pain post-operatively [BNF132]
T[e]Is known to cause bradycardia when administered intermittently ?
+24.The following statements concerning tardive dyskinesia are correct:
T[a]it is significantly associated with the treatment of chronic schizophrenia
F[b]it is effectively treated by intramuscular benztropine
F[c]it occurs predominantly in young females
F[d]Benhexol is an effective prophylactic
T[e]reducing the dose of a phenothiazine is a recognized precipitant
+51.The followinging statements about the pharrnacokinetics of Lithium are correct
T[a]Serum levels peak between 1 - 4 hours of a single dose of Lithium
F[b]It takes about 22-26 hours for Lithium to reach maximal level in the brain [S194 12 hours]
F[c]It takes about 7- 14 days for lithium to equilibrate in the body [5-7 days]
T[d]Major route for the elimination of lithium is the kidney
T[e]Serum lithium determinatioris should be carried out 12 hours after the last dose of lithium
MCQ oct 1993
8.recognised neurotransmitters:**+
T[a]CCK.
T[b]ACTH.
T[c]Taurine.
T[d]GABA.
T[e]Glutamic acid
31.Barbiturates intoxication
T[a]Nystacrnus.
T[b]Ataxia.
T[c]Increased fast activity in frontaI areas in EEG.
31.5HT effects on CNS:
T[a]increase irritability ?
F[b]penile erection [delays ejaculation but no effect on erection ]
T[c]control sleep.
F[d]decrease prolactin level.
F[e]antipsychotic effect.
36.Moclobamide:
T[a]less side effects than old MAOI.
F[b]no interaction with tyramine.
F[c]can be combined with SSRIS.
F[d]is irreversible.
T[e]short 1/2 life.
37.The following have direct action on NA neurons:
F[a]amphetamine.
T[b]Noradrenaline.
T[c]N.A.
F[d]tyramine.
T[e]ephidrine.
M.R.CApr1993
17.Dopamine receptors
T[a]Research shows that 5-10 mg of Haloperidol is enough to block 80% dopamine receptors.
T[b]DI receptors linked to adenylate cyclase.
T[c]D3 receptors exist in hich concentration in the limbic system.
F[d]Sulpiride specifically blocks D 1.
18.Dopamine neurones
F[a]Also secrete Noradrenaline.
F[b]Exist in rubrospinal tract.
T[c]Exist in mesolimbic
T[d]Exist in tuberoinfundibular tract.
T[e]Retina
MCQ1900
3.FLOWING DRUGS CAN CAUSE IMPOTENCE
a)ANTYPSYCHOTICS (PHENOTHAZINES)
b)TRYCYCLICS.
c)MAOI
d)BENZODIAZEPINES.
7.FOLLOWING DUNG CAUSE TREMOR:
Ta)HALOPERIDOL.
Tb)AMITRYPTILINE.
Tc)MAOI.
Td)LlTHIUM
Te)BZD.
------------------------------------------------
9.In a depressive illness failure to respond to the usual regime of TCAs may be attributed to:
T[a]Too high a dose
T[b]The taking of barbiturate
F[c]The taking of phenothiazines
F[d]Reduced gastrointestinal motility
T[e]Unusual metabolism
16.The following in true of lithium in affective disorders:
F[a]Serum level of 1.2#nmoill is necessary
F[b]Tremor denotes toxicity
F[c]Should not be used with MAOis
F[d]Is contraindicated with 5HT reuptake inhibitors
F[e]Polyuria may be controlled with vasopressin [by Amioride]
T[f]Tremor mav be controlled with propranolol
F[g]Routine checks should be performed on thyroid function every 2-3 months
T[h]Is used in unipolar depression for prevention of relapse
F[i]Works in resistant depression by increasing serum levels of tricyclics
35.A 'Therapeutic windowm effect has been convincingly shown to exist (relating plasma levels to therapeutic.efficacy) [C828]
F[a]Amitriptyline
T[b]Nortriptyline [plasma level 50-140 can be achieved by a dose of 150mg/day]
F[c]Protriptyline
F[d]Trimipramine.
F[e]lmipramine
F[f]Doxepin
36.Prospective and double blind controlled studies have suggested that predictors of good response to tricylic antidepressants include:
T[a]Anorexia and weight loss [ie. endogenous depression]
F[b]Lower socioeconomic class,
F[c]Middle and late insomnia [T for early morning wakening]
T[d]Psychomotor retardation
F[e]Multiple prior episodes
37.In severe tricyclic antidepressant poisoning:
F[a]Gastric aspiration and lavage is of no value, beyond 6 hours after ingestion of the drug [C829-24h]
T[b]Cardiorespiratoty support and c rdiac monitoring is important []
F[c]Antiarrhythmic drugs should be used routinely [BNF22]
T[d]Convulsions may occur and need prompt treatment []
T[e]Physostigmine may reverse some of the symptoms?
39.When alcohol and TCAs are taken together the following occur:
F[a]Reduction of the sedative effects of ethanol
T[b]Enhancement of the sedative effects of ethanol [BNF537]
F[c]Blockage of the depressant effects of ethanol
[d]Increase in cerebral capillary permeability of alcohol
F[e]No interactive effects
40.Concerning TCAs the following are true:
F[a]There is low binding to plasma protein [C829-90% protein bound]
F[b]Peritoneal and haemodialysis are effective in treating TCA overdose. []
T[c]Tissue levels are 1 0 times higher than plasma levels ?
F[d]Highest tissue concentration is in fatty tissues ?
[e]Tissue binding is 40 to 200 times the plasma levels
46.Early symptoms of lithium toxicity include
T[a]Muscle twitching
F[b]Haematuria
T[c]Slurred speech
T[d]Drowsiness
F[e]Hypothyroidism
*3.Regarding benzodiazepines
F[a]The longer acting preparations are less likely to cause dependence
T[b]Increased sensitivity to noise occurs in withdrawal
T[c]Most patients who have been on BDZ's for 1 year do not experience withdrawal,
[15-45% of long term users experiance withdrawal ]
F[d]Shorter acting preparations are used to withdraw patients
F[e]Depression is a common sequeiae after withdrawal
NEUROLOGY AND NEUROPATHOLOGY
34.The followign statements are true of acetylcholine in the nervous system:
T[a] it is the chemical transmitter of the parasympathetic nervous system
F[b]it is absent from the brain
T[c]some receptors are blocked by atropine [blocks muscarinic receptors]
T[d]some receptors are blocked by curare [blocks nicotinic receptors ]
F[e]it stimulates beta receptors in the sympathetic nervous system
-------------------------------------------------------
7.Side effects of Haloperidol are**s
FA)Double vision
TB)Depression
TC)Cholestatic jaundice
TD)Hypersomnia
TE)Tardive dyskinesia
10.Cyproterone Acetate
FA)Is a female hormone
TB)Is a testosterone inhibitor
FC)Transform perverted persons to normal sex drive [BNF]
FD)Produce transvestism
TE)Has a specific depressant action
47.Side effects of Trifluoperazine
TA)Cholestatic Jaundice
TB)Dystonic Reaction
FC)Myoclonic jerks
TD)Oculogyric crisis
TE)Orthostatic hypotension
86.Which of the following are catecholamines?
FA)Serotonin
FB)DOPA
TC)Dopamine
TD)Noradrenaline
FE)Homovanillic acid
-------------------------------------------------------
NEUROPHARMACOLOGY [good ansewers]
74.Recognised side~effects of chlorproniazine include
T[a]hypothermia
T[b]retinitii pigrmntosa [BNF]
F[c]akinetic mutism
T[d]haernolytic jaundice [haemolitic anaemia?]
T[e]galatorrhoea
75. REM steep time is decreased by
T[a]barbiturates
F[b]lysergic acid diethytemide
F[c]heroin
T[d]chlorpromazine ?
T[e]nitrazepam
76.The following drugs are excreted more rapidly in urine of low PH:
T[a]amphetamine
T[b]pethidine
F[c]phenobarbitone
T[d]imipramine
F[e]salicylic acid
77.Recognised side effects of tricyclic antidepressants include:
F[a]cataract
F[b]hypertension
T[c]paralytic ileus
F[d]prostatitis
T[e]cardiomyopathy [B324]
78.Combined administration of tranylcypromine with the following substances may have untoward clinical results:
F[a]nicotinic acid
T[b]ephedrine
T[c]methyldopo
T[d]L-tryptophan [BNF]
T[e]atropine [antimuscarinic]
79.The following are recognised as having hallucinogenic effects:
T[a]atropine
T[b]tetrohyrdocannobinol (THC)
F[c]heroin
T[d]psilocybin
F[e]methaqualone [G?]
80.Prolonged administration of lithium carbonate may cause:
T[c]weight gain
F[b]craving for carbohydrates
F[c]diarrhoea
T[d]thirst
T[e]osteoporosis
81.Drug combinations which may prove detrimental rather than beneficial include:
T[a]pheneizine and pethidine [hypertensive crisis]
T[b]coumoral anti-coagulants and barbiturates [Nicomaloe--decrease anticoagulant effect]
F[c]benztropine and L-dopa
T[d]guanethidine and nortristyline
82.The abstinence syndrome may be caused by:
T[a]benzodiazepines
T[b]butobarbitone
[c]methaqualone
T[d]caffeine
F[e]cannabis
88.Haloperidol:
F[a]inhibits prolectin secretion
T[b]inhibits central effects of amphetamine
T[c]is anti-emetic
T[d]produces extrapyramidal side- effects
83.Halaperidol differs from chlorprormazine in that:
F[a]it has no anti-ernetic effect
F[b]it has no enticholinergic effect
F[c]it has a greater tendency to reproduce postural hypotension [BNF]
T[d]it is less likely to produce urinary retention
F[e]it does not produce ejaculatory failure
84.Fast activity in the E. E.G. is caused by
F[a]chlorprornazine
F[b]nortriptyline
T[c]butobarbitone
F[d] lithium
T[e]diazepam
85.The following drugs affect uptake of noradrenatine at noradrenergic neurofactor junctions:
F[a]bretyllum
F[b]bethanidine [decrease release]
F[c]methyldopa [decrease synthesis]
F[d]reserpine
T[e]nortriptyline
86.Chlorprormazine blocks the effect of :
T[a]dopamine
F[b]isoprenaline
T[c]histamine
T[d]serotonin
T[e]noradrencline
87.The benzodiazepines in normal dosage:
F[a]block the reuptake of arnines
F[b]prevent stresis- induced increase in brain metabolism
F[c]depress the cardiovascular system
F[d] have no effect on the reticular formation
F[e]inhibit monoamine oxidase
89.Visual accommodation is affected by:
F[a]chlormethiazole
F[b]diacetyl morphine
T[c]amitriptyline
F[d]tetrahyderocannibinal(THC)
T[e]benztropine
90.Toxic confusional psychosis is a recognised adverse reaction to :
T[a]benzoodiazepines
T[b]alpha methyldopa
T[c]benzhexol
T[d]levodopa
T[e]amitriptyline
91.Chlorpormazine:
F[a] is a piperazine phenothiazine
T[b]has a molecular weight less than haemoglobin ?
T[c]contains a chlorine atom
T[d]is an aliphatic phenothiazine
F[e]causes dose-related jaundice [JOHN169]
92.Drug-induced Parkinsonism [OX224]
T[a]can be caused by reserpine [S306]
F[b]results from blockadeof central 5-HT receptors
F[c] is associated with degeneration of the nigrostriatal pathway
[d]is associated with a low CSF homovanillic acid concentration
F[e]is more common with thioridazine than chlorprormzine [BNF]
93.In a patient suffering from glaucoma the following should be used with caution:
F[a]baclofen [GABAb agonist]
T[b]amitriptyline
F[c]tetrabenazine
T[d]thioridazine
F[e]pyridostigmine [muscarinic action ie. anticholinesterase]
94.In a hypertensive patient treated with alpha methyldopa
F[a] tricyclic antidepressants should not be used [enhance hypotensive effect]
T[b]Parkinsonism may be caused by the hypotensive drug [BNF]
T[c]depression may be caused by the hypotensive drug
T[d]skin pigmentation my occur [M dopa --> SLE like syndrome]
T[e]monoamine oxidase inhibitors should not be used
95.Lithium :
F[a]causes a fall in TSH in the majority of patients [BNP]
T[b]increases the levels of 5-hydroxytryptomi'ne on patients who improve
F[c]is an effective prophylactic in recurrent unipolor depression in over 50% of cases
[OX ttt 35% ---less for prophylaxis ]
T[d]is excreted less efficiently when thiazide diuretics are given concurrently
F[e]leads to a leucocytosis in many patients [S209 can cause]
96.Monoamine oxidase inhibitors:
T[a]increase sensitivity to injected adrenaline [inhancement of effect of Adrenaline & Noradre.]
T[b]cause Porkinsonism
T[c]interact with pethidine
T[d] increase synoptic levels of 5HT
F[e]cause hypertension [hypertention crisis]
97.Bromocriptine
T[a] is an ergot alkaloid [BNF323]
F[b]increases growth hormone levels [inhibits release of GH]
T[c]is a dopamine receptor against
F[d]is contra-indicated in Parkinson's disease [used for treatment of Parkinson's disease ]
F[e]increases secretion of prolactin [inhibits]
99.The following drugs induce the hepatic drug-metabolising enzymes in normal drugs:
F[a]haloperidol [P122]
T[b]pentobarbitone
T[c]dichloralphenazone [GAI54]
T[d]fluphenazine [P phenothiazines produce their own metabolism]
F[e]chlordiazepoxide
100.Side-effects of lithium include
T[a]drowsiness
T[b]fine tremor of the hands
T[c]nephrogenic diabetes insipidus
T[d]hyperparathyroidism [OX]
T[e]hypothyroidism
101.Side-effects of the tricyclic antidepressants include
F[a]galactorrhoca
T[b]cardiomyopathy
T[c]blurred vision.
F[d]oliguria.
F[e]diarrhoea.
102.Chronic intoxicotion by barbiturates,In doses equivalent to 400mg. of pentobarbitone daily,
T[a]Failure of oral contraceptives
F[b]increased sensitivity to oral anticoagulants [increase enzyme->decrease level->decrease sensitivity]
T[c]nystagmus
T[d]ataxia
F[e]a greater probability of hepatic failure following an overdose of paracetamol
103.A thiazide diuretic may :
F[a]raise the blood pressure
T[b]reduce the blood pressure [BNF61][for ttt of hypertention]
F[c]alleviate gouty arthritis [gout is side effect]
F[d]precipitate diabetes insipidus [for ttt of DI]
T[c]reduce urinary output in diabetes insipidus [increase enzyme->increase metabolism]
104.Enkephalins are:
T[a]brian peptides
T[b] linked to methionine and leucine [P47]
T[c]opiate-like in their analgesic properties
F[d]four-chain compounds [P47 at least 5 aminoacid sequance]
T[e]found in the general circulation [p48]
5.The plasma half- life of a drug-
F[a]refers to its rate of excretion by the kidney
F[b]is always unaffected by the drug
T[c]is related to its effectiveness
T[d]is usually longer in the elderly.
F[e]is usually longer in adoloscents
105.The following apply to the benzodiazepines
T[a]clorazepote dipotassium is changed to desmethyldiazepam in an achlorhydric[acidic]stomach [S119]
T[b]desmethyidlazepom has a half life longer then 50 hours [P118 --96 hours]
F[c]nitrozepam has'a half-life of less than 24 hours [20-50h]
T[d]N-desalkylflurazepam is a rnetabolite of flurazepam [S53]
T[e]N-desalkytflurazepom has a half-life of over 100 hours [S118 --- 30-120h]
106.Tetrabenazine
T[a]is a benzoquinolizine derivative [S306]
F[b]is related to lithium salts
F[c]is related to rauwolfia alkaloids
T[d]been used in the treatment of Huntington's Chorea
-------------------------------------------------------
PSYCHIATRIC TREATMENT
1.Combined adminstration of tranylcypromine with the following substances may have. untoward clinical results -
T[a]Methyldopa
T[b]Morphine.
F[c]Food containing milk protein
F[d]Food containing synthe preservatives
T[e]Food contaminated with bacterial toxins
2.Largactil may more readily induce hypothermia in
T[a]The elderly
T[b]Myxoedema
T[c]Epilepsy
F[d]Anxiety states
F[e]Psychopaths
4.The Catecholamines
T[a]include doparine adranaline
F[b]are synthesized from trypophan
T[c]are stored in granules at the nerve endings
T[d]are found in adrenal medulla
F[e]pass easily into the brain
6.Phenytoin may cause the following side effects-
T[a]hirsutis
F[b]adrenal failure
F[c]pulmonary fibrosis
T[d]lymphadonopathy
24.Unwanted effects of enitriptyline(Tryptizol) include-
T[a]arrythmias
F[b]hypertensive crises
T[c]fits
T[d]prostation
T[e]glaucoma
17.In lithium therapy-
T[a]concomitant treatment with chlortbiazide increases the risk of toxic effects
F[b]a persistent tremor means that the drug must be withdrawn
T[c]hyperrthyroidism may occur
F[d]a steady state blood level in obtained by the second day of treatment
18.long -acting phenothiazines-
T[a]avoid first pess metabolism in the liver
F[b]are long-acting because they are deeply injected
F[c]are contra-indicated in the elderly
T[d]may cause improvement when oral drugs haye failed
F[e]must be prescribed with an anti-Parkinson drug
20.These drugs are effective in treating hyperrtensive crises oceurring during treatment with MA0Is-
F[a]propanolol
T[b]phentolamine
T[c]parenteral chlorpromazine
F[d]reserpine
F[e]morphine
21.Lithium salts are reported to be use!ul in tretment of-
F[a]obsessive compulsive nuerosis
T[b]manic depressive illness
T[c]pre-menstrual tension
T[d]schizo-affective illness
F[e]catatonic excitement
23.Tetrabenazene
T[a]Causes depletion of dopamine
T[b]causes depletion of noradrenaline
T[c]causes depletion of serotonin
T[d]is used in the treatment of tardive dyakinesia
T[e]can cause severe depression
16.Recognised side effects of benzodiazepines include-
T[a]confusional stae
T[b]ataxia
F[c]torsion spasm
T[d]release of aggressive impulses
T[e]sudden onset of sleep with only a modest alcohol intake
25.recognised side effects of chlorpromazine include-
T[a]impairment of vision
F[b]primary biliary cirrhosis
T[c]galactorrhea
T[d]ejaculatory failure
T[e]postural hypotension
26.methylpbenidate(Ritalin)
T[a]improves the attention in hyperkinetic children
T[b]may cause insomnia
F[c]should not be given together with carbamazepine [BNF it also jncrease level of phnytoin , phenobarbitone ,&primidone ]
F[d]produces addiction in children under five [G]
T[e]may produce stunted growth
29.Parenteral injections of long-acting neuroleptics-
F[a]are released slowly because they are injected deep
T[b]are effective when oral nueroleptics hava failed
T[c]miss out the first pass effect in the liver
30.Tricylic antidepressants-
F[a]are safer thanE.C.T in elderly depressed patients
T[b]maycause excessive weight ga
F[c]once tolerance to the intial side effects has developed, can be given on a long term without risk of further adverse effects
31.Patients established on lithium maintenance treatment -
F[a]should have serum lithium estimations once a week
F[b]should have a seruum lithium of at least 1 mol/l
F[c]should.have thyroid function tests every three months
F[d]should have lithium discontinued if hypothymidism develops
33.Pnelezine has been shown to be more effective than placebo, in a controlled trial, for the treatment of -
T[a]depressive psychosis
T[b]agrophobia
T[c]obsessional rituals
T[d]social phobia
F[e]specific phobia &(animal phobia)
33.Pnelezine has been shown to be more effective than placebo, in a controlled trial, for the treatment of -
T[a]depressive psychosis
T[b]agrophobia
T[c]obsessional rituals
T[d]social phobia
F[e]specific phobia &(animal phobia)
40.Trifluoperazine is-
F[a]an alkylamino benzodiaze
F[b]an alkylamino phenothizine
F[c]a piperidine compound
42.Chloropromazine produces the following adverse effects-
F[a]dose-related hepatocellular jaundice
T[b]hyper sensitivity cholestatic jaundice
F[c]retrobulbar nouritis
T[d]corneal pigmentation
T[e]cardiac dyarbythmias
37.In the following pair of drugs the first of- the pair is significantly more expensive than the second -
T[a]flurazepam nitrazepam
F[b]chlorpromazine thioridazine
T[c]mianserin amitriptyline
T[d]maprotiline dothiepin
F[e]fluphenazine decasnoate flupenthixol decanoate
39.The following is safe when taken with tranylcyproxine
F[a]methyldopa
F[b]tryamine in foods
F[c]pethidine
T[d]quinidine
T[e]salicylates
35.Diazapam
T[a]has a hypnotic effect
T[b]has an anticonvulsant effect
F[c]has an antidepressant effect.
T[d]releases aggressive impulses
T[e]is a resp iratory depressant
41.The "Cheese Reaction" is-
F[a]occurs most commonly in patients on phenothiazines.
F[b]occurs most commonly in patients on tetracyclisc antidepressants
F[c]occurs most commonly in patients on tricyclic antidepressants
T[d]has been reported in patients on phenelzine
F[e]depends upon the presence of presseramines of the phenylethylamine
36.Long-acting depot neumleptics-
T[a]are slowly absorbed because they are deeply injected.
F[b]by-pass first pass metabolism in the liver ectaboli
F[c]must be given with an anti- Parkinsonian drug
F[d] are ineffective in the elderly
T[e]may be effective where oral nueroleptics are not
43.Thiazide diuretic may-
F[a]raise blood pressure-
T[b]reduce blood pressure
F[c]aleviate gouty arthritis
F[d]precipitate diabetes insipidus
T[e]reduce urine output in diabetes insipidus
63.Fatal- overdoses have occurred with
F[a]nitrazepan ?
T[b]mandrax ?
T[c]amitriptyline
T[d]barbiturates
T[c]lithium carbonate
44.The following compounds contain fluorine ?
F[a]promazine
T[b]fluphenazine
F[c]thloriadazine
F[d]perphennizine
T[e]fenfluranine
47.Recognised side effects of amitriptyline include:
T[a]postural hypor tension
T[b]tremor
F[c]diarhoea
T[d]blurred vision
T[e]impotence
49.Following antidepressants have sedative effects in majority of patients-
T[a]trimiipramine
F[b]protriptyline
F[c]nortriptyline
T[d]clomipramine
F[e]desipramine
T[f]maprotiline
52.A patient talking MAOIs should be advised not to eat
F[a]fresh calf liver
T[b]pickled herrings
F[c]broad beans freshly, removed from their pods
F[d]cottage cheese
T[e]a well hung pheasant
53.The following drugs are used in the 1ong term management of schizophrenia
F[a]Naloxene
T[b]Chlorpromazine
T[c]Fluphenazine decanoate
F[d]Mianseri
T[e]Primoside
56.Digitalis intoxication ?
T[a]is more comon in the elderly
F[b]may cause facial pain
T[c]is more likely to occur in the presence of myxoedema
F[d]is always associated with slowing of the heart
T[e]may mimic gastric neoplasm
54.Dopamine
T[a]is a catecholamine
T[b]is a percursor of noradrenaline via the enzyme dopamine-beta-hyc
T[c]synthesis is inhibited by methyl(para) tyrosine
T[d]levels are increased by the therapeutic doses of L-dope in Parki
T[e]its most important inactivation in the synaptic cleft is by active re-uptake into presynaptic storage vehicles
57.Largactil may more readily induce hyperthermia in-
T[a]the elderly
T[b]myxoedema
F[c]epilepsy
F[d]tabes dorsa-
F[e]phenothiazines
58.Postural hypotension in the elderly may be caused by ?
F[a]Parkinsonism
T[b]diabete mellitus
F[c]peripheral nueropathy
F[d]tabes dorsa-
T[e]phenothiazines
60.Petit-mal absence can be treated with
F[a]phenytoin
T[b]sodium valproate [BNF]
F[c]carbanazepine
F[d]prinidone
T[e]ethosyximide
61.Phenoytoine may lead to
T[a]lymphadenopathy
T[b]dupuytren's contracture
T[c]amarcocytic anaemia
T[d]relief of pain in trigenial nueralgia
T[e]osteomalacia
62.Drugs:the cost is higher of the first than second in pair ?
T[a]mianserin and diazepam
T[b]fluraxepam and nitrazepez
F[c]chlorpromazine and thioridazine
F[d] modecate and depixol
F[e]amitriptyline and imipramine
65.Which drugs cannot be given in the case of a recent cardiac infarction
T[a]amitriptyline
[b]bolvidon [miansren ?]
F[c]maprotiline
F[d]doxepine
T[e]iprindole
68.Tyramine- ?
F[a]is a lipo-protein
T[b]is a svmpathomimetic substance
T[c]in found in 1arge amounts in cheese
T[d]releases presssor amines from storage particularly in conjunction with monamine oxidase inhibitors
F(e)is a monoamine
70.Citrated calcium carrbimide -
F[a]is specific in the treatment of lymphatic meningitis
T[b]blocks oxidation of alcohol at the acetaldehyde state
T[c]interacts vith coughmixtures ?
F[d]interacts vith salad dressings
[e]has a three benzene ring structure with a piperazinyl side chain ?
71.Fluspirilene,when injected in therapuetic doses ?
F[a]has a 6 week duration of effect
T[b]has a 7 day duration of effect
T[c]contains fluorine atoms
T[d]is a diphenylbatyl piperidine
F[e]never caused dyakinesias or akasthisia
72.Lithium
T[a]was first used in psychiatry for the treatment of mania in 1950 by Cade in Australia
F[b]was first used by Cade in 1950, not for mania but for gout
T[c]toxicity is likelyat serum concentra!ions of2mol/l and above
F[d]thiatide diuretrics selectively remove lithium in preference to sodium
73.Benzodiaazepines could-
T[a]in combination with alcohol cause severe hypersomnia
T[b]release agression in some people
T[c]lead to drowsiness
F[d]cause torsion spasms
T[e] give ataxia as a side effect
74.Cyproterone acetate-
T[a]is a tertesterone antagonist
F[b]is an oestrogen compound
T[c]makes perverted sexual drives into normal ones
F[d]has a specific antidepressant action
T[e]is used in trearment of sexual deviations
75.the following are side effects of Haloperidol-
T[a]tardive dyskinesia
F[b]double vision
T[c]hypersomnia
T[d]hepatotoxicity ?[BNF161]
T[e]depression
76.Lithium therapy
T[a] causeshyperthyroidsm as a late effect
F[b]side effects of tremor could be stopped only by withdrawal of the drug
T[c]is harmful in combination with chlorothiazide
F[d]after the second day of therapy good blood levels are obtained
78.Tricyclic antidepressants-
F[a]are safer than ECT in recent myocardial infarction
F[b]produce early cataract with prolonged treatment
T[c]cautious combination with MAO inhibitors is a recognised form of treatment for depression
F[d]if initial side-effects are controlled the patient need not be followed up
Psychopharmocology [my]
M 1.In the trial of a new Psychiatric drug:
F(a)permission from an ethical committee is not advised
F(b)double-blind procedures are mandatory by law
F(c)th e patient's second degree relatives must be included in cm consenting
T(d)Patients 16 and over can give ccnsent
F(e)the solicitor must be informed
M 2.Drug interactions
T(a)may occur by mixing in syringes
F(b)never occur in the gastrointestinal tract
T(c)may occur at protein binding sites
F(d)never in the liver
F(e)never occur in the kidmy
M3.Noradrenaline is a precursor of:
T(a)adrenaline
F(b)tyrosine
F(c)phenylalaninine
F(d)dopamine
F(e)typotophan
M4.MAO is the enzyme in inactivating the following:
F(a)GABA
T(b)5Ht(serotonin)
F(c)acetylcholine
F(d)ampbetamine
F(e)tyrosine
M6.The following drugs differ significantly in price-the first costing more than the second:
F(a)flupenthixol decanaote: fluphenazine deaacanoate
T(b)nomifensine: thioridazine
F(c)chloropromazine: thioradazine
T(d)mianserin: doythiepin
(e)flurazepam:nitrazepam
M7.In the fo11owing pairs of drugs the first of the pair is significantly more expensive than the second:
(a)fluorazepam: nitrazzepam
T(b)mianserin: amitriptyline
T(c)maprotiline: dothiepin
(d)fluphenazine decanoate: flupenthixol decanoate
T(e)disprin:aspirin
M8.A thiazide diuretic may:
F(a)raise blood pressure
T(b)reduce blood pressure
F(c)alleviate gouty arthritis
F(d)precipitae diabetes inspidus
T(e)reduce urine output in diiabete insipidus
M9.Beta-adrenergic blockade may cause:
F(a)nocturnal enuresis
T(b)asthma
T(c)heart failure
F(d)tachycardia
T(e)impotence
M10.Recognsed side effects off benzodiazepines include:
T(a)a confusional state
T(b)ataxia
F(c)torsion spasm
T(d)release of agressive impulses
T(e)sudden onset of sleep with nly a modest alcohol intake
M11.Diazepam:
T(a)has an hyonotic effect
T(b)has an anticompulsant effect
F(c) has an antidepressant effect
T(d)releases aggressive impulses
T(e)is a respiratory depressant
M12.Thiopentone is widely used short acting general anesthetic because it is:
F(a) quickly metabolised [S34]
F(b)quickly excreted
F(c)heacvily bound to plasma protein
T(d)diverted to fat deposits
T(e)does not cause laryngeal spasm
M13.Phenytoin intoxicatien can present as:
T(a)pseudodementia [S352]
F(b)visual disturbance involving photophobia
T(c)an increase in fit frequency [S352]
T(d)involuntary movements [T for nystagmus]
F(e)parasthesiae and hyper ventillation [S318]
M14.Phenytoin commonly has the following side effects: [S358]
F(a)megalablastic anaemia [rare]
F(b)thrombocytoponeia [rare]
T(c)hypertrophy of the gums [reversible]
F(d)hyperventillation
F(e)sedation
M15.Lithium:
T(a)was first used in psychiatry for the treatment of mania in 1950 by Cade in Australia
F(b)was first used by Ode in 1950 not for mania but for gcut
T(c)toxiicity is likely at serum ccncentratiam of 2mol/l and above
F(d)thiozide diuretics selectively remove lithim in preference to sodium
[causes Na deplesion --decrease leathium clearance by 40%]
T(e) produces generalised theta in the EBG in ciasm of CNS toxicity even when the serum level is below 2mol/l
M16.In lithium therapy
T(a)concomitant treatment with chlorthiazide incrases the risk of toxic effects
F(b)a persistent tremor means the drug must be withdrawn
T(c)hyperthyroidism may occur
F(d)a steady state blood level is obtained by the second day of treatment [5-7 days]
T(e)a decreasein agression may occur
M17.Prolonged administration of lithium causes:
F(a)diarhoea
T(b)hypo thyroidism
T(c)weight gain
T(d)polyuria
T(e)ataxia
M18.Phenothiazines are competitive antagonists at:
T(a)muscarinic cholinergic receptors
F(b)nicotinic cholinegic receptors
T(c)histamine receptors
T(d)adrenoreceptors
F(e)5-hydrxyptamine 5HT receptors
M19. The folloing compounds contain fluorine; ?
F(a)promazine
T(b)fluophenezine
F(c)thioridazine
(d)perphanazine
T(e)fenfluramine
M20.Trifluoperazine is:
F(a)an alkylamino benzodiazepine
F(b)an alkylamino phenothiazine
F(c)a piperidine mcompund marketed as "Stelazine"
T(d)is a piperazine compound
F(e)usual for patients with obsessional symptoms
M21.Chlorpromazine produces the following adverse effects:
F(a)dose-related hepatocellular jaundice
T(b)cholostatic jaundice as a hyper sensitivity reaction
(c)retrabulbar neuritis ? [S297 -optic neuritis]
T(d)cornealpigmentation [S292]
T(e)cardiac dysthythmias
M22.Side effects of haloperidol are:
F(a)double vision
T(b)depression
T(c)cholestatic hepatitis ?
T(d)hypersomnia
T(e)tardive dyskeniasis
M24.Long acting depot neuroleptics:
F(a)are slowly absorbed (or are long-acting) because they are deeply injected
T(b)by-pass first pass metabolism in the liver
F(c)must be given with an anti-Parkinsonian drug
F(d)are ineffective in the elderly
T(e)may be effective where oral neuroleptics are not
F(f)are contraindicated in the elderly
M25. Tricyclic antidepressants:
F(a)are safer than ECT in a middle aged man with a recent myocardial infarction
F(b)should not be usedd in the presence of an early cataract
F(c)may be used without fear of side-effects in the long-term once the initial sideffects are over
T(d)according to growing opinion, may be used in combination with MAOIs though not without risk
T(e)may be contra-indicated in those who are being treated with antihypertensive drugs
M23.Fluspirilene, when injected in therapeutic doses:
F(a)has a 6weeks duration of effect
T(b)has a 7 day duration of effect
(c)contains flourine atoms
T(d)is a diphenylbutyl piperidine
F(e)never causes dyskenesias or akathisia
M26.The following antidepressant drugs have a sedative effect in the majority of patients:
F(a)desipramine
T(b)trimipramine
T(c)clomiprmine
T(d)dothiepin
F(e)protriptyline
M27.Phenalzine has been shown to be more effective then placebo in a conrolled trial, for the treatomt of: ?
T(a)depressive psychosis
T(b)agorophobia [S149]
T(c)obsessional rituals ?
T(d)social phobia
F(e)specific phobias (animal phobia)
M33 The following are features of competitive antogonists:
F(a)the dose-response curve of the agonist is shifted to the left
T(b)the dose response curve of the agonist in the presence of the competitive antagonist is parallel to the normal dose-response curve
T(c)the maximal response to the agonist is unchanged
F(d)the antogonist irreversibly binds to the receptor site
T(e)they may have agonist activity
M29.The"cheese reaction"
F(a)occurs most commonly in patients on phenothiazines
F(b)occurs most commonly in patients on tricyclic antidepressants
F(c)occurs most commonly in tetracyclic antidepressants
T(d)has been reported in patients on phenelzine
T(e)depends upon the presence of pressor amines on the phenylethylamine group
M28.The following are safe when taken with tranylcypromine;
F(a)methyldopa
F(b)tryamine
F(c)pethidine
F(d)quindine
T(e)salicylates
M30.The following drugs are effective in the treatment of mania:
T(a)promazine
T(b)haloperidol
T(c)lithium carbonate
F(d)imipramine
F(e)chlordiazepoxide
M31.Anti-depressantswith marked sedative proprties include
F(a)desimipramine
T(b)dothiepine
T(c)Mianserin
T(d)trimiprimine
F(e)protriptyline
M32.The following are side effects of amitriptyline
F(a)mictunition
F(b)postural hypertensinn
T(c)blurring of vision
T(d)weight gain
F(e)diarrhoea
-------------------------------------------------------
MCQB
12.MAO is the enzyme in activating the following:
[a]GABA
[b]5HT (seretonin)
[c]Acetylcholine
[d]Amphetamine
[e]Tyrosine
13.Nor-arenaline is a precursor of:
[a]Adrenaline
[b]Tyrosine
[c]Phenylalaninine
[d]Dopomine
[e]Tryptophan
14.Prolonged administration of lithium causes:
[a]Diarrhoea
[b]Hyperthyroidism
[c]Weight gain
[d]Polyuria
[e]Ataxia
64.The following drug interacts with tricyclic antidepressants:
[a]Isoprenaline
[b]Adrenaline
[c]Propanolol
[d]Tranylcypremine
[e]Guanethidine
[f]Methysergide
73.When taking phenelzine:
[a]The patient should avoid alcohol altogether
[b]The patient may have pcstural hypotension
[c]The patient may have a hypertensive crisis
[d]Pethedilie should be substituted for morphine for analgesia
[e]Patient does not need advice regarding diet
74.In lithium maintenance:
[a]The serum level should be checked at least weekly
[b]The serum level should be at least 1.5 mmol/1
[c]Thyroid function tests should be checked regularly
[d]Tricyclic antidepressants may not be used
79.The following are side effects of trifluoperazine:
[a]Cholestatic jaundice
[b]Myoclonia
[c]Occulogyric crisis
[d]Dystonic reactions
[e]Spastic paraparesis
-------------------------------------------------------
*1.These drugs may cause erectile failure
F[a]Bromocriptine
F[b]Insulin
T[c]Propanolol
F[d]Phenytoin
T[e]Thioridazine
*2.The following apply to Carbamazepine
[a]Side effects are concentration dependent
T[b]May lead to SIADH .
T[c]Is relatively safe in pregnancy
T[d]Is Metabolised in the liver .
T[e]Reduces the circulating levels of Phenytoin
*3.Carbamazepine
F[a]Is a weak diuretic
T[b]Is chemically related to MAOI
T[c]May be toxic to bone marrow .
T[d]Maybe used in prophylaxis in affective disorders
T[e]Causes neural tube defects
*4.Features of the Neuroleptic Malignant Syndrome include
T[a]Hyperthermia .
F[b]Preserved level of conciousness
T[c]Chorea
T[d]Labile blood pressure
F[e]Mortality around 2%
*5.Features of the neuroleptic malignant syndrome include
F[a]Gradual onset .
T[b]Generalised muscular hypertonicity
T[c]Myoglobinuria
F[d]Leucopenia
T[e]Raised creatinine phosphokinase
*6.With regard to the Neuroleptic Malignant Syndrome
F[a]Has 5% mortality
T[b]may occur with TCA's
F[c]Creatinine Kinase is always raised
F[d]Hypothermia is a common feature
F[e]Antiparkinsonian drugs may speed recovery
*7.The following statements about SSRI's are true
T[a]May cause nausea .
T[b]May cause Convulsions
F[c]are combined with MAOI's
T[d]May cause agitation .
T[e]Have been linked with increased suicide risk
*8.The following are best avoided when breast feeding and an alternative should be sought
T[a]Sulpiride
F[b]Carbamazepine
T[c]Lithium
F[d]Temazepam
F[e]Amitriptyline
*9.Beta-Adrenergic blockade may cause
F[a]Nocturnal enuresis
T[b]Asthma
T[c]Heart Failure
T[d]Erectile Failure
F[e]Tachycardia
*10.Ataxia may be caused by the following drugs in therapeutic doses : F[a]Imipramine
F[b]Chlarpromazine
F[c]Lithium.
T[d]Carbamazepine
T[e]Diazepam
*11.The common side effects of amitriptyline include
F[a]Insomnia
F[b]Diarrhoea
T[c]Nausea
T[d]Fine Tremors
F[e]Diplopia
*12.Tricyclic Antidepressants
T[a]Include Lofepramine
T[b]Prolong P-R interval on ECG
T[c]May cause SIADH
T[d]May cause weight gain
T[e]Lower the fit threshold
*15.The mechanism of action of TCA includes
T[a]Blockade of pre-synaptic noradrenaline reuptake
T[b]Inhibition of pre-synaptic serotanin re-uptake
F[c]Dopamine receptor blockage
F[d]Inhibition of mono-amine oxidase
F[e]Increase in serotonin synthesis
*13.Recognised side effects of TCA's include
F[a]Cataract.
F[b]Hypetention
T[c]Ilieus
F[d]Prostatitis
T[e]Cardiomyopathy
*14.Imipramine
F[a]Is a bicyclic antidepressant
F[b]Is incompatible with Tyramine rich foods
F[c]Is a second generation antidepressant
T[d]Inhibits noradrenaline reuptake
F[e]Is more sedative than trimipramine
*16.The Following are side effects of TCA's
T[a]Galactorrhoea
T[b]Cardiomyopathy
T[c]Blurred Vision
T[d]Urine retention
T[e]SIADH
*17.Unwanted effects of TCA include
F[a]Bradycardia
F[b]Reduced intraocular pressure
T[c]Neuroleptic Malignant syndrome
T[d]Constipation
T[e]Antidiuresis
*18.These drugs or foodstuffs are contraindicated in patients receiving MAOI'S.
T[A]Isoprenaline.
F[b]Bananas
T[c]Ephedrine
F[d]Salbutamol.
T[e]Strong matured cheese
*19.A patient being treated with a MAOI should not eat
F[a]Broad beans removed from their pads
F[b]Cottage cheese
T[c]Pickled herrings .
F[d]Fresh calf liver .
T[e]Well hung pheasant
*20.MAOI's
T[a]May cause hypotension
F[b]Type B have major antidepressant ef f ects.
T[c]May be used in combination with TCA's
F[d]May interact with cottage cheese with dangerous effect.
T[e]May interact with red wine with dangerous effect.
*21.Lithium in the body
F[a]Is lipid soluble
F[b]Is unionised .
T[c]Is exceted through the kidneys
F[d]Is not absorbed from the gut
F[e]Cannot be detected in plasma
*22.Recognised side effects of Lithium in Therapeutic doses
T[a]Thirst
T[b]Tremor
F[c]Diarrhoea
F[d]Diplopia
F[e]Abnormal liver function tests
*23.Lithium may cause unwanted clinical effects by interfering with the physiological activity of
F[a]Corticotrophin
T[b]Renal Tubular Function
F[c]FSH
T[d]TSH.
F[e]Prolactin
*24.Lithium
F[a]May cause cranial diabetes insipidus
T[b]May be monitored by saliva concentration
T[c]May cause hyperthyroidism
T[d]Is teratogenic .
T[e]Has a narrow therapeutic index
*25.Phenytoin
T[a]In toxic doses may increase seizure frequency
T[b]Is metabolised by zero order kinetics
F[c]Is first line in petit mal epilepsy
T[d]May induce pathological fractures
T[e]In pregnancy is assoc with neural tube defects
*26.Tardive Dyskinesia
F[a]Is commonest in young children
T[b]May be made worse by benztropine treatment
T[c]May remit spontaneousley on stopping the neuroleptics
F[d]Is most sensitively demonstrated by foot examination
T[e]Disaonears during sleep.
*27.Tardive Dyskinesia
T[a]Is related to increased sensitivity of post synaptic dopamine receptors
T[b]Is more common in women
T[c]Disappers during sleep
T[d]May be worsened by haloperidol
F[e]Is more common in patients under 65
*28.A toxic confusional psychosis is a recognised adverse reaction to :
T[a]Benzodiazepines
T[b]Levadopa
T[c]Ranitidine
T[d]Benzhexol
T[e]Amitriptyline
*29.Chlorpromazine produces the following adverse effects
F[a]Dose related hepatocellular jaundice
T[b]Cholestatic jaundice .
F[c]Retrobulbar neuritis .
T[d]Corneal pigmentation .
T[e]Cardiac Dysrhythmias -
*30.The following may result from neutaleptic toxicity
T[a]Retinal pigmentation
T[b]Thrombocytopenia
T[c]Raised cholesterol
T[d]Cardiac arrest
T[e]Galactorrhoea
*31.Antipsychatic drugs
F[a]Raise the seizure threshold .
T[b]Block D2 dopamine receptors .
T[c]Stimulate Prolactin release .
F[d]May cause intention tremor
T[e]May inhibit ejaculation .
*32.The use of cannabis can be assoc. with
F[a]Hyperbilirubinaemia .
T[b]Relaxation
T[c]Physical Dependence
T[d]Visual hallucinations
T[e]Transient flashbacks
*33.Physical dependence is assoc. with the taking of
F[a]Cannabis
T[b]Morphine
F[c]LSD
F[d]Cocaine
T[e]Alcohol
*34.Cessation of diazepam after chronic use may be complicated by :
T[a]Convulsions
T[b]Depression
T[c]Transient psychosis
T[d]Perceptual alteration
T[e]Depersonalisation
*35.The following drugs may cause ataxia in the normal therapeutic range :
F[a]Lithium
F[b]Amitriptyline
F[c]Chlorpromazine
T[d]Benzodiazepines
T[e]Carbamazepine.
*36.The following drugs are used as Neuroleptics
T[a]Butyrophenones
F[b]B-Blockers
F[c]Benzodiazepines
F[d]Phenytoiti.
F[e]Amphetamines
*39.With respect to anti-Parkinsonian drugs
F[a]Benzhexol usually improves Tardive Dyskinesia
T[b]Orphenadrine may cause insomnia .
T[c]Benztropine is more sedating than benzhexol
T[d]Procyclidine may be given (iv) in the treatment of acute dystonia.
T[e]Benzhexol can produce visual hallucinations
*37.The following drugs commonly cause weight gain
T[a]Lithium
F[b]Carbamazepine
F[c]Benzodiazepines
T[d]Chlorpromazine
T[e]Amitriptyline
*38.Consider the following statements
T[a]Nitrazepam has a longer duration of action than temazepam
T[b]Diazepam can be used as a hypnotic .
F[c]Buspirone is a short acting benzadiazepine
F[d]Dependancy on chlormethiazole will not occur if used only as an hypnotic
T[e]Lorazepam has a shorter duration,of action than diazepam
*40.Depression of mood may be caused by
T[a]Propanolol .
T[b]Methyldopa .
T[c]Clonidine
T[d]Frusemide
T[e]Digoxin
*41.The following antidepressant drugs only have a significant sedative effect in a minority of patients
T[a]Desipramine
F[b]Trimipramine
F[c]Clomipramine
F[d]Dothiepin
F[e]Protriptyline .
*42.The following drugs may be used in the treatment of bipolar disorder :
T[a]Carbamazepine .
T[b]Haloperidol.
T[c]Lithium.
T[d]Imipramine
F[e]Chlordiazepoxide
*43.The following drugs have an effect an dopaminergic transmission in the brain
F[a]Diazepam .
F[b]Fluoxetine
F[c]Amitriptyline
T[d]Haloperidal
T[e]Pimozide
*44.The following drugs are potent inhibitors of the uptake of noradrenaline into pre-synaptic neurones
F[a]Chlarpromazine
T[b]Cocaine
T[c]Imipramine
T[d]Iprindole
T[e]Amitriptyline
*45.Drowsiness is a characteristic unwanted effect in patients treated with
F[a]Haloperidol
T[b]Thioridazine
T[c]Amitriptyline
F[d]Fluoxetine
T[e]Mianserin
*46.L-tryptophan is
F[a]A neurotransmitter
T[b]An amino acid .
T[c]Used as an antidepressant
F[d]A precursor to noradrenaline
T[e]Effective in the symptomatic treatment of insomnia
*47.Benzodi'azepines
T[a]Potentiate GABA
T[b]Modulate Chloride channel flow
F[c]Are eleptogenic
T[d]May have 'hangover' effects .
F[e]Are antagonised by naloxone .
*48.Vigabatrin anticonvulsant
T[a]Inhibits GABA catabolism .
F[b]Is licenced for absence seizures
T[c]May cause weight gain .
F[d]Is recommended for the treatment of behavioural problems
T[e]May cause Psychosis
BASIC PHARM MCQS/UPDATE
*5.The following drugs are Noradrenergic agonists
F[a]Yohimbine.
T[b]Terbutaline.
F[c]Naltrexone.
F[d]Prazosin.
F[e]Lofexidine.
*1.The following phaimacokinetic principles are true
F[a]Neuroleptics are well absorbed from the stomach.
T[b]Many sustained release preparations rely on colonic absorption.
T[c]Low bioavailability usually implies high first pass metabolism.
F[d]At steady state, concentrations of a drug increase by upto 20% from one dose to the the next.
T[e]For lipid soluble drugs, reabsorption occurs in the renal tubule.
*2.Regarding the blood brain barrier:
T[a]It consists of the capillary endothelium of the subarachnoid space.
F[b]The pH of CSF is dependent upon plasma pH.
F[c]Amino acid transport mechanisms prefer the dexto-isomer form.
F[d]Capillary endothelium is uniformly permeable across all brain areas.
F[e]The protein bound fraction of a drug crosses the blood brain barrier.
*3.The following are recognised neurotransmitters
T[a]Glutamate.
T[b]Adenosine .
T[c]Dynorphin. -
T[d]Thyrotrophin-releasing hormone.
F[e]Kainate.
*4.The following drugs are serotinergic antagonists
T[a]Blockers .
F[b]Buspirone.
T[c]Methyser-ide.
T[d]Ondansetron.
F[e]L.S.D.
*7.The following drugs are notifiable
T[a]Pethidine.
T[b]Dipipanone.
F[c]Temazepam.
T[d]Methadone.
F[e]Amphetamine
*6.When prescribing controlled drums
F[a]A prescription is valid for 8 weeks from date stated.
T[b]Cannabis can be prescribed under licence from the Home secretary.
T[c]Temazepam is a controlled dru-
T[d]Phenobarbitone is exempt from handwriting requirements.
T[e]Human Chorionic -onadotrophin is a class C drug.
*8.Idiosyncratic drug reactions of doparnine antagonists include
T[a]Retinitis.
F[b]Arrhythmias.
T[c]Cholestatic 'aundice.
T[d]Dermatitis.
F[e]Lowered seizure threshold.
*9.Risperidone
T[a]Is a Benzisoxazole derivative.
F[b]Is not licensed for use in acute psychosis.
T[c]May cause poor concentration.
T[d]May lead to extrapyramidal side effects.
F[e]Does not cause hyperprolactinaemia.
10.Clozapine
T[a]Causes reversible neutropenia in about 3% of patients.
F[b]On average is implicate in about 6 blood dyscrasia deaths per year in UK.
F[c]Hypoglycaemia is a recognised side effect.
T[d]Hypertension is a reported side effect.
T[e]Has a dibenzyl structure.
*11.Idiosyncratic drug reactions are
F[a]Common.
F[b]Dose dependent.
F[c]Occur early on in treatment.
T[d]May be irreversible.
F[e]Have been classified as Type "A" by Rawlins and Thompson
*15.The following are neuroleptics
T[a]Thioxanthines.
T[b]Dibenzoxazepine.
T[c]Diphenylbutylpiperidines.
F[d]Azapirone.
F[e]Substituted benzamide.
*12.Tricyclic antidepressants have the following effects on the heart
T[a]Flattened T waves.
T[b]Widened QRS complexes.
F[c]Bradycardia.
T[d]Cardiomyopathy.
T[e]Postural hypotension.
*13.The following inhibit the uptake of serotonin.
T[a]Clomipramine.
F[b]Fluphenazine.
T[c]Sertraline.
T[d]Fluvoxamine.
F[e]Buspirone.
*I4.Benzodiazepines
T[a]Act at specific benzodiazepine receptors.
T[b]Reduce REM sleep.
F[c]Are enzyme inducers.
T[d]Effects are enhanced by cimetidine.
T[e]Cause ataxia in the elderly.
*16.The following should be avoided with MAOI's.
T[a]Pethidine.
T[b]Phenylpropanolamine.
T[c]Ginseng.
T[d]Pseudoephedrine.
T[e]Pemoline.
*17.Moclobemide
T[a]Has a short half life.
F[b]Is selective for MAO(B).
F[c]Can be safely given together with an SSRI.
F[d]Readily produces a " Tyramine reaction " if strict dietry measures are not followed.
F[e]Is more dangerous in overdose than TCA's..
*18.Clinically important side effects of Clozapine include
T[a]Hypersalivation-
F[b]Acute Dystonia.
F[c]Tardive Dyskinesia.
T[d]Drowsiness..
F[e]Pancytopenia.
CHEMISTORY
Dr. Yagoub
Basic Sciences:-
8.Dopamine receptors:-**
F(a)Dl causes E.P.side effects. [S289]
T(b)D2 is found in mesolimbic area.
F(c)Sulpride affects Dl+D2. [P129 S289]
T(d)All neuroleptics influence D2.
T(e)Post-synaptic adenylate is affected by Dl antagonists.
61.Dopamine receptors:-**
T(a)Dl is related to adenyl cyclase.
T(b)D2 is found in limbic system.
T(c)Dl is associated with extrapyramidal symptoms.
T(d)Clozapine acts on Dl and D2.
T(e)D4 has been cloned.
12.Dopamine receptors+drugs:-
T(a)D4 receptors are cloned.
T(b)Clozapine acts on Dl and D2.
3. Dopamine is involved in:-
T(a)Release of GH.
T(b)Mesolimbic tract.
T(c)Tuberoinfundibular tract.
F(d)Rubrospinal tract.
16.Specific D2 receptor blockade causes less:- [ie. Sulpride]
T(a)Sedation.
T(b)Anti-cholinergic side-effects.
T(c)Parkinsonism.
T[d]Postural hypotention
48.Drug receptors:-
T(a)Dl is linked to adenylate cyclase.
F(b)BDZ are antagonists to GABA receptor complex.
T(c)D2 blockers are more effective antipsychotics than Dl blockers.
F(d)Buspirone is a 5HT2 receptor agonist.
T(e)D3 receptors are in high density in limbic system.
T(f)5-10 mgs of Haloperidol effectivily block D2 receptors.
44.Muscarinic effects of acetyle choline are potentiated by:-
(a)Atropine.
(b)Physostigmine.
(c)D.F.P.
45.The following are precursors of Nor-Adrenaline:-
T(a)Tyrosine.
F(b)Serotonin.
F(c)Adrenaline.
F(d)Acetyl choline.
56.Monoaminooxidase:-
F(a)Is inhibited by TCADS.
T(b)Is involved in the metabolism of tyramine.
T(c)Found in nerve endings.
T(d)Situated in mitochondria.
36.The following are precursors of Monoamines:-
T(a)5OH Tryptophan.
F(b)5OH Tryptamine.
T(c)Dihydroxy phenylalanine.
F(d)5OH DOPA.
62.The following are peptides:-
T(a)ACTH.
T(b)Oxytocin.
F(c)Prostaglandins.
F(d)Oestrogens.
T(e)TRH.
37.The following are recognised Neurotransmitters:-
T(a)Glycine. .
T(b)Glutamic Acid.
T(c)Taurine.
T(d)ACTH. .
T(e)Cholecystokinine
The following are recognised Neurotransmitters:-
T(a)Nor-Adrenaline
T(b)Acetyle~Choline.
F(c)L-Dopa.
T(d)5HT
STATISTICS
Dr. Yagoub
Sociology & Psychology
13.In an experiment to see whether extrapunitive is more prevalent in depressed patients two groups are considered.One group is depressed and the other one is the control group.What statistics would you use ?
T(a)Spearsman rank correlation coefficient
T(b)Chi-Square(Group score) [W102]
F(c)T-Test.
F(d)Pearson's product moment correlation coefficient .
16.Case registers ,can be a reliable estimate of the prevalence of the following
T(a)Schizophrenia.
F(b)Alcoholism.
T(c)Dementia.
F(d)Monosymptomatic phobias.
19.Epidemiologically:-
T(a)Adopted children whose parents suffer from schizophrenia have a higher rate of schizophrenia than general population.
T(b)Depressive symptoms are commoner in adolescents girls than boys. [C694]
T(c)50% of adolescents report mild psychological symptom [OX713 &G]
34.The following inventories are useful in a general hospital setting:-
T(a)CAGE.
F(b)Spelberg's anxiety scale.
36.The following tests assume a normal distribution:
T(a)T tests.
F(b)X2
T(c)ANOVA.
F(d)Standard deviation. [ not a test ?]
42.Answering questionaires:-
F(a)Rating anologue scales requires a team consensus.
T(b)Central bias occurs with bipolar scales. [eg. semantic dif ]
T(c)The Halo effect involves questions close to each other on the paper. [B5]
44.Random sampling:-
T(a)The telephone directory is regarded as a valid source.
T(b)The electoral register can be used for independent variables including sex and social class.? (or stratified sampling from electoral register)
T(c)Snowballing is an accepted technique.
T(d)Using every 10th name on a hospital admission register would be appropriate.
T(e)Clinical surveys often multistages ?(or multistage sampling allows ease of identification)
F[f]Is not random if age and sex are known
86.As regards psychiatric screening instruments in a General Hospital population:-
T(a)They require normal distribution of scores.
T(b)Include CAGE Questionnaire.
F(c)Usually given to detect uncommon syndromes.
T(d)Should have cut-off scores determined by sensivity & not by specificity. [W126]
87.The following are true of standard deviation:-
T(a)Measure of scatter of observations from mean.(or--ls a scatter of values around mean )
T(b)Unit is the same as that of the observation. (or--as those of the variables measured )
F(c)Is the square root of the variance.
[a]Its value is larger than the standerd error of its mean
88.Variance:-
T(a)T-tests are used.?
T(b)Normal distribution.
105.Errors:-
T(a)A type I error is when a false positive judgement is made.
T(b)A,type II error is when a false negative judgement is made.
F(c)Power is a measure of the likelyhood of a tyoe II error. [1-type 1 error]
108.In sampling,the following may be used:
T(a)Telephone directory.
T(b)Electoral register.
T(c)Is not random if age and sex are known.
T(d)Multistage sampling allows ease of identification.
115.Comparison of 2 groups:- [W]
T(a)Use ANOVA.
T(b)Use
T(c)Use X2.
(d)Use regression.
T(e)Use correlation.
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ROYAL
A Sample Preliminary Test
6.Semantic differentials: [C]
T(a)Are frequently used to measure the evaluative aspects of attitudes
F(b)Are properly described as 'forced-choice' techniques
F(c)Are free from the tendency to evoke social desirability responses in the respondents
T(d)Are useful in identifying schizophrenic thought disorder ?
F(e)Characteristically involve the use of unipolar adjectival pairs
T(f)Are often used to measure the meanings which people attach to concepts
7.The following statements are true of prospective but untrue of retrospective studies:
T(a)Patients can be randomly assigned to treatment categories or groups
T(b)Evaluative measures can be modified on the basis of feed-back results ?
F(c)Information from clinical files can be used in the analysis of results
F(d)An interview with the patient's relatives is a necessary procedure
F(e)All the relevant information can be obtained from existing records.
F(a)An untreated control
F(b)Double-blind procedure
T(c)A valid measure of change
F(d)Patient self-reports
F(e)Physiological measures
9.The Standard Deviation is a statistical measure of: [HM]
F(a)Frequency
T(b)Variability
F(c)Range
(d)Individual differences
T(e)The significance of departure from the mean
41.Factor analysis:
T(a)Has been used in attempts to arrive at a classification of psychiatric illness
T(b)When carried out on the correlations between symptoms is the same as numerical taxonomy ?
F(c)Is an appropriate method of comparing the effectiveness of two treatments ?
F(d)Was first devised by H. J. Eysenck ?
F(e)Necessarily involves factors or dimensions that are independent (at 90) of each other ?
42.In normal distribution: [HM]
T(a)The mean and mode fall at the same point
F(b)The standard deviation is equal to the value of the mean
F(c)Several sources of variation may be represented simultaneously ?
T(d)The two 'tails' are equal and symmetrical-,
T(e)About two-thirds of the cases fall within one standard deviation on either side of the mean
44.For a set of metrical observations:
T(a)The Mean is a representative parameter in the sense that every reading contributes to it in an equivalent way .
T(b) When the readings are arranged in rank order from least to greatest, the number of
readings below the median is the same as the number above it
F(c)Extreme readings (far from the centre of the distribution) exert more influence on the value of the median than on the value of the mean
T(d)The median and the 50th percentile are alternative descriptions of the same parameter
T(e)If the'distribution is a symmetrical one, the median and the mean invariably coincide in value
54.To test the hypothesis that two samples are drawn from the same population an investigator can use:
T(a)A one way analysis of variance
F(b)An unstated factor analysis
T(c)A Chi-squared (X') test for independence
f(d)The product-moment correlation ?
f(e)An analysis of co-variance ?
7.Incidence refers to:
T[a]The number of new cases emerging in a designated period and population
F[b]The point prevalence of an illness
F[c]The period prevalence of an illness
F[d]The readmission rate
F[e]The number of beds occupied in a designated population
19.Reliability of an instrument
T[a]is high if.the ratiing of thesame instrument by different raters using that instrument are similar
T[b]concern the reliability of it's measurements
F[c]means it measures what it is intended to
T[d]is high if its measurents accord with those of another instrument supposed to have the same function
F[e]is concerned with the accuracy of its measurements
20.Aplacebo in a clinical trial
T[a]should be given with as much confidence as the'active' drug
T[b]is pharmacologically inert
T[c]should be identical in appearance to the drug being studied
F[d]has no effects
T[e]is best adminstered by someone who is unaware of the tablet's contents
21.Placebo effect [B311]
F[a]bear no relation to tablet size
F[b]are more likely in older people
T[c]are influenced by the status of the therapist
T[d]include headache
F[e]are stronger in introverts
T[a]Matching in pairs is satisfactory way of assignment of patients to teatment groups ?
F[b]Random assignment is the only safe way of assignment to treatment groups
F[c]Double boind procedures are absolutely essential
T[d]Treatment outcome should be evaluated by independant measures ?
F[e]Matching of total groups before treatment allows for different amounts of kind of dropout ?
26.Characteristics of a perfect positive correlation include:
T[a]An increase in one variable is associated with an increase in the other ?
T[b]A change in one variable is matched by a change of equal degree in the other variable ?
T[c]All the points of the scattergraph lie on the line of best fit ?
F[d]A Pearson product-moment coefficient of correlation of value zero (0) ?
F[e]Absence of spurious correlation ?
27.Tests which characteristically measure the statistical significance include:
T[a]Chi-squaired ?
T[b]Those which test the null hypothesis ?
T[c]t-test ?
T[d]Probibility (P) tests ?
F[e]Validity tests ?
T[a]An effective means of comparing two active drugs
T[b]An effective means of comparing an active drugand a placebo
T[c]Including a design in which the judge is not aware of which patient received the drug being tested
F[d]An effective means of comparing the efficacy of individual and group psychotherapy
T[e]including a design in which the patient is not aware of which patient received the treatment being tested
34.In the normal distribution:
T[a]Greater than 95% ot the distribution lies within three standard deviations below the mean and three standard deviations above the mean
F[b]Less than 50% of the population are within one standard deviation below the mean and one standard deviation above the mean
F[c]The curve is asymmetric
T[d]The mean and median fall at the same point
T[e]The mode and mean fall at the same point
M.R.CApr1993
38.Screening tests in General Hospitals setting
F[a]Should have cut off points with high sensitivity and specificity.
T[b]Includes CAGE.
T[c]Scores must have normal distribution.
T[d]Includes MMSE
[e]Depressive Anxiety Inventory
STATISTICS
*1.In a positively skewed distribution
T[a]There is a long tail to the right
T[b]The median is greater than the mode
[from the diagram the 'halfway' observation will be to the right of the most frequent observation ]
T[c]The mean is greater than the median
F[d]There is more than one peak
F[e]There are relatively few low values [more observations lie to the left than the right of the mean ]
*2.The following are true of-the normal distribution
F[a]The SD is the square of the variance [The SD is the square root of the variance ]
T[b]The two parameters are the mean and the SD
T[c]Many sorts of biological data can be adequately described by the normal distribution [eg. Height,weight, blood pressure ]
T[d]Approximately 95% of the sample lies between 2 SD of the mean [1.96]
T[e]skewed data may be transformed mathematically into a normal distribution [Logadthmic transformations for positive skews. Square or cube transformations for negative skews ]
*3. Regarding sampling distributions
T[a]When the sample size is large, they are normally distributed
[Even if the observation on which it is based is not normally distributed]
T[b]They show less variability when the sampling size is large,
F[c]Their mean is always larger than the population mean
[It should be approximately equal to the population mean ]
F[d]Their,SD is known as the standard error
[The S.E is the population SD divided by the square root of the sample size]
T[e]They can be used,to construct confidence intervals for the estimate of the sample mean
[+/-1.96 x SD ]
*4.Regarding estimation in statistics
T[a]The intention is to generalise from a sample to the population from which it is drawn
F[b]With qualitative data the sample mean is often used to estimate the true mean [quantitative]
T[c]An estimate based on a large sample is preferable to one based on a small sample
F[d]The point estimate is the most likely value of the sample mean by crude inspection of the data
[ It is the observed mean, and is bracketed by confidence intervals.]
T[e]Confidence intervals become narrower as the sample size increases
[ Precision and power both increase]
*5.The following are true of hypothesis testing
F[a]The null hypothesis is generally rejected if the p-value is less than 0.1
[0.05. NB p= the probability that an effect or one more extreme may have been arrived at by chance]
T[b]Falsely rejecting a true null hypothesis is called a type I error
[A spurious significant finding. Probability = significance, traditionally set at 0.05]
T[c]Failure to reject a false null hypothesis is called a type 11 error
[Missinga true association. Probability = 1 -power]
T[d]The larger the study size, the higher is its power for detecting a true difference between two
treatments
F[e]The power of a study refers to the probability that a type 1 error will not be made [Type II]
*6.The following statements are true
F[a]In calculating sample size for a study comparing two treatments, a power of 60% is generally
sufficient [80% is the absolute minimum for most studies]
T[b]Statistical power is a relevant concern for a research ethics committee
[Studies which lack power to spot a true association waste volunteers time, and can bias the literature.]
T[c]In calculating sample size if the variances of the two treatment groups are likely to be very
different, a separate estimate of each should be used.
F[d]The Yates correction, applied to 2x2 tables is controversial as it often results in a spuriously
large figure for chi-square
[It used on occasions when sample size is low corrects for over inflation of Chi sq.]
F[e]If the confidence interval includes zero, the value of p will always be greater than 0.05
*7.The t-test
F[a]Was devised by Stanislav Student [W. Gossett ]
F[b]Is a non-parametric test
T[c]Assumes that the population from 'which the samples are drawn have similar standard deviations
[And that they are both normally distributed]
F[d]Is very sensitive to violations of its assumptions, even with large sample sizes.
[t-tests and non-par. tests give similar results even in quite skewed samples.]
F[e]Must have samples of equal sizes
[True of paired tests eg. paired t-tests and Wilcoxon rank pairs test ]
*8.The following are non-parametric tests
T[a]Kolmogorov Syndrome
T[b]Mann Wittney U
T[c]Wilcoxon
F[d]ANOVA (Analysis of variance) [special sort of T-test ]
T[e]McNemar
*9.Confounding variables in epidemiological studies
T[a]Can be identified in a stratified analysis
[Sometimes called classical analysis. Stratify by the confounder and calculate a weighted average of the effect size across strata (e.g the Mantel Haenszel Odds Ratio) ]
T[b]Can lead to a spurious association between the disease and the exposure
[Confounders are associated both with the exposure and the outcome in such a way as to spuriously strengthen or weaken the apparent association between Exposure and outcome ]
T[c]Should be considered at the design stage of each study
[You cannot adjust in the analysis for confounders which you have not measured]
T[d]May be adjusted for by matching each case