Emis

Sodium Valproate
Diazepam
Carbamazepine
Opiods
Smoking

1-10 year old with cleft palate and delayed milestones (Valproate)
2-Microcephaly-challenging behavior and poor memory, 2kg at birth (alcohol)
3- Jittery child, overarousal 2 hrs after delivery- cocaine- heroin xxx-smoking

3-Which of the following would you do (new drug) initially for side effects of a drug?
Case series
Case control
N of 1
Cohort

4- Which study to see the association between depression and lithium level
Case control/ cohort/ ecological/cross sectional

5- Study for Effectiveness of Trainee Gp in managing medical issues for pt with schizo –
Cluster/ case control/service evaluation/ Qualitative
Check research methodology emi

6- Transmission of Down syndrome transmitted equally by both parents?

Robertsonian translocation
Trisomy
Mosaicism

7-2 Radiologists for MRI results- Concurrrent validity /Content validity/ inter rater validity

8- New test for suicide, was seen that those who scored higher were more like to commit
suicide- Predictive validity / Concurrrent validity /Content validity/ inter rater validity

9-Galbraith plot is used for – measuring publication bias/heterogeneity

10- In regards to the following which one is true- gailbrath plot and forest plot can both be
used- to check heterogeneity

11- bournewood case- Liberty / Gillick /Tarasoff/Bolan’s/ Prichard/Negligence doc

12- Which of the following drugs shud you avoid with Tamoxifen? Amitryptyline,
Fluoxetine( PBDF paroxetine, duloxetine, flouxetine, bupripion)

13- Block Randomisation is used for: ensuring equal no. of pts in each arm/ confounders
14- 40+ yr old woman who has completed detox for alcohol, now wants a drug to maintain
abstinence. She is on Tramadol for chronic back pain and had history of ischemic heart
disease. Which drug would you choose
Naltrexone/ acamprosate/diazepam/disulfiram

15- Drug with effect on GABA and NMDA antagonist- multiple uses –
Ketamine/cocaine/cannabis/LSD

16- Homeless man found with confusion, unstable gait and double vision: what would you
give him- Glucose/ Thiamine/

17- Female, partner left, chronic back pain, now feeling helpless with pain- somatoform pain
/cfs/depression/fibromyalgia

18- Pt with muscle, episodic low mood, palpitation motor tension, muscle aches- GAD/
cfs/depression/fibromyalgia/panic disorder

Viral infection, c/o pain in body- cfs/depression/fibromyalgia

19- Young man feeling low, experimented with drugs and presented with 2 episodes of
seizures, sweating, rigidity, tachycardia- Amphetamines/Cocaine/Psycobilin /Ketamine.

20- New born baby- jittery, shaking – cocaine/Heroin/alcohol

21- Person with epilepsy brought to A&E with carbamazepine induced hyponatremia, also
has depression. Which antidepressant would you choose
Amitryptiline
Sertraline
Citalopram
Mirtazapine
Venlafaxine

22- Patient presented with memory issues since 8 months- Gp suspected Alzheimer which
of the following would make you consider an alternative diagnosis? Urinary Incontinence/
Preserved long term memory/ apathy/ forgot location

23- Which of the following cannot be a Comorbid diagnosis with recurrent depressive
disorder? Dysthymia/Cyclothymia/EUPD/schizoaffective/adjustment

24-ECGs findings
1. U wave , 2.Saddle shaped ST segment
3.Sinus rhythm with increased rate
4.Sinus rhythm with decreased rate(donepazil)
5.Low voltage QRS(TCA6.other morphologies
7.Tall tented (hyperkalemia) P waves 8. U wave
 ● Lady with Bulimia ( flat inverted Twave in mild hypokalemia,then QT prolongation,
Uwave in severe, VT)
● person recently started on clozapine reports chest pain 2 Saddle shaped ST segment
Prolonged QT citalopram

25- 80 year old woman recently started on donezepil presented with ankle swelling
Donezepil 10mg – gastrointestinal side effect- reduce dose /change to galantamine/add
pantoprazole

26- 80 year old woman needs an antipsychotic, eGfr >25 ml,

Chlorpromazine/Olanzapine/amisulpride/sulrpide

27- 14 year old female took overdose of paracetamol after fight with BF, presented with
flushed face, tongue, confusion, mmse- 21/30, psychotic feature which of the following can
explain the presentation:
Acute stress disorder/ Delirium/ adjustment disorder /drug induced psychosis/Personality

28- Which of the following gait will you see in an upper motor Neuron lesion: High
steppage/ Magnetic gait/stiff leg Scissoring gait /antalgic gait

29- CEAR- curve -Estekatime improved Qualy 0.07 and costed 16,6xx in community and
16,9xx in hospital- which is true:
Esketamine was more expensive than the antidepressant and not effective
We will need to do an CEAR curve to determine WTP before making a decision.
We need a CEAC plane to determine.

30- Which describes the outcome in units of Qualy--Cost Utility / cost consequence/ cost
benefit/

31- Mother come to visit him and he becomes agitated. What is the best way to make him
understand about the visits? CBT/social stories.

Patient finds it funny when others imitate his behavior- social stories/intensive
interaction technique /Makaton/now and then cards/ behavioural support

The schedule is fixed LD what would you use to tell about what is happening now and
next-( planning activities)
social stories/intensive interaction/Makaton/now and next cards/activity card

Xxxxxxxxxx

32- Best predictor of violence- Previous violence attempts/ alcohol and drugs /possession of
firearms.

33- The majority of the violent acts.(homicide, theft) are due to:
Alcohol and drugs/ personality disorders /
34- Amnesia after violent offence – seen in crimes of passion /often resolves after the trial is
over/ often seen in malingering.

35- Post stroke incidence due to antipsychotics- 0.1/ 0.01%/ 3% /1%/10%

36- A woman kills her baby due to psychosis ‘end the misery’ of the sick child- this is
diminished responsibility/ insanity

37- Cost benefit analysis refers to- Reducing the cost for the same outcome (monetary
terms)

38- What is ICER- The cost of intervention compared to control for same outcome/ Ratio
between cost and benefit in terms of quality of life.

39- Patient with severe self harm behaviour- Lesch Nyhan syndrome

40- Agomelatine study— in high heild, mock 1

The strength of the study – unpublished studies
Conclusion- It may be a useful antidepressant/ it works well as an adjunct antidepressant
Where will you find the literature- medline, google scholar, psychinfo, New opt.. (don’t rem)

41- ECT Forest plot –

Best Treatment in relation to benefit and tolerance _Priming
Treatment with the most precise – BT (left)

42- Cannabis usage- (mock 1)

Odds ratio of those using it daily (user- 410, psycho 123= Control- 310, 41) 2.5/ 3.4/ 0.3
Psychosis was most related to – frequency of usage/ duration

43- ICER curve

Which of the following regarding SD is true:
There was >50% increment in the effectiveness as compared to the community.
Cannot be commented.
44- Funnel plot – what would be the effect if the studies were not imputated?
The smaller negative studies would be missed/ large negative effect

-Reason for imputation- more representative (increase P, prevent type 1error) /prevent type
2 err

45- Consort diagram for CBT in prenatal : (The loss to follow 46 in R arm & 44 in L arm) The
same no. were imputated in the primary analysis.
What was the reason for imputation in the study? Representation of the Missing data.

46- family therapies

Eclectic( focus on how family member communicate with each other)
Systemic
Strategic
Structural
Psychodynamic

1- Family functioning on previous behaviors (psychodynamic

2- Paradoxical injunctions systemic
3- Unsaid rules structural

47- Female presented to A&E sudden aphonia after mother coming to live with them-
Motor dissociative disorder/ dissociative seizures/ acute stress/ adjustment/somati

48- Pt on antipsychotics, non compliant, using amphetamines presented with mutism,

catalepsy, fever-not on antipsychotics- what is the diagnosis- Malignant catatonia/
Malignant hyperthermia/NMS

49- Pt with parietal lobe infarct, agitated and confused which of following would you give-
Low dose Risperidone as needed trial, low dose haloperidol trial, lorazepam.

50-33 yr, Female with moderate ID and mania, which of the following would you not
prescribe:
Lithium/ Carbamazepine/ Valproate/ Lamotrigine/ Levetiracetam

51- female in 30s, 3 dy hx of mutism and immobility- what would you do first?
ECT
Lorazepam
Haloperidol
Watchful waiting

52- Elderly male female, presented with QTC of 490ms on sertraline 50 and risp 2mg, next
step:
Reduce Risperidone
Switch to Quietapine
Repeat Ecg next week
Refer to cardiologist urgently

53- Woman on Citalopram 40mg for 2 months, no response what next?

Switch to another SSRi
Augment with lithium
Increase the dose.

54- Stat tests ( 3

1- Non parametric -mann whitney U.
2- ANCOVA /anova 2 v- baseline at 3month/6 month/ 12 month/ (HAMD)
3- T test

Chi sq/Linear regression/t test/

55-difference btw the mean of Mirtazapine and placebo group at 12 weeks. Check hand
written recall Nov 2020

55- Dementia wants to know how to reduce his risk- reduce smoking, aspirin, cannot do
anything/omega 3/ vit B rich /zinc

56- which of the following is unethical for cannabis and psychosis – case control/
RCT/cohort/N of 1

57- prevalence throughout European countries – socioeconomic levels and depression–

study design- ecological/ cross sectional/

58-

59- Life increase, total cases were increasing new cases of dementia were slowly reducing-
true- prevalence going down, incidence reducing slowly

60- Audit – implementing the change wasn’t done. (repeat)

61-you wish to get views of mdt members about role of psychiatrist= purposive sampling/
triangulation/ reflexivity/focus group

62- Choose 2 different views for --Triangulation/

Reflexivity/ grounded theory

Researcher’s views/opinions - reflexivity

63-Analysis

64- Histogram-
Skew can be seen
Width

65-kaplein meire…. time to hospitalization for ALz + LBD – early hospitalization than Alz/
more at home Alz than LBD. / at the end were significantly different/

66- significant reason for lower life expendency in schizo- suicide/copd/CVD/DM

67- toxicity of Lithium – polyuria/ abd pain/ fine tremor /myoclonic twitches

68- pt with EPSE- which would you see- clasp knife rigidity /intentional tremor/bradykinesia/
lead pipe rigidity

69- Post-partum, intrusive recurring thoughts, distress causing- traumatic birth precieved by
mom- 1 year baby- OCD

70- Tool to measure loneliness 0.38 and depression what does this indicate:
0.38 linear regression-

71-( F=1.34, Cl- 1.02-1.5) what does that F mean- adjusted effect size/unadjusted effect
size/variance.

72- refractory OCD- Clomipramine and Citalopram/ Fluxeotine/ Clomipramine and Prozin/

73- NNT- 9

74- BDI- mean difference. 1.7

75- since 12 weeks on Risperidone 1mg BD and citalopram 20mg 2 days ago - options
increasing to 1.5 once, increase citalopram/ reduce risperidone/add lorazepam 1mg or reg

76- Key role for CBt in psychosis

Acceptance
Validation
Reattribution
Distress tolerance
77- phone call for which of the following therapy:
DBT

78- which of the following do you hierarchy of anxiety

ERP/Desensitisation/CBT

79- Motivational interview – amplifying cognitive dissonance in which therapy/incentives.

80 alcohol reduction – increasing the price per unit /social awareness.

81- prevalence of antisocial in prison- 50%

82- You see remission of EUPD after diagnosis- 10 years <10%, 20-30%

83- Which of the disorders increases in severity and prevalence btw 10-12?
ASD/Tourettes/OCD/adhd

84- ASD- prevalence – heritability 90%/ 40% normal in intelligent/

85- Suicide in prison- more common in females/ sentenced vs pt in remanded /physical

health issues
(pt in single cell, substance use)

86-International suicides- males more than females/suicides in prison are more than gen
pop/overcrowded prisons/lower education of staff.

87- Increased risk of psychosis, 20-30% more common in- Fragile X, Velocardiofacial, William

88- Equal male to female prevalence- prader villi- fragile x

89- Schizophrenia in child and adolescent- Hospital admission is preferred for Mdt
assessment, 1% prevalence, incidence higher after the age 15

90- Sleep terror vs nightmare- not recalling the episode,

91- Narcolepsy- sleep paralysis- catalepsy- extracampine hallucination

92- melatonin in children,what will be seen- sleep latency/duration/ sleep

architecture/no.of wakening. (decrease sleep latency or increase sleep duration)

93- Theft – substance use/personality disorder.

94- ITT_ done to- give accurate results despite patient’s nonadhrenece to protocol./ prevent
type 2 error

95- Seq diagram formulation used in – CAT

96- conditioning in OCD= negative reinforcement. /reciprocal inhibition/classic conditional/

97- study, avoiding attrition for finding a risk btw xxx- case control/ cohort/

98- Clozapine not given- paralytic ileus/ HTN

99- Cutlass results- second generation have lesser side effects/ except clozapine, other
antipsychotic equally effective/ Olanzapine had the highest tendency to gain weight/
clozapine was more effective.

100- therapist gives interpretation and results – neg therapeutic reaction. (Cat)

101- pt with schizophrenia- active psychotic sym- which cognitive test would be affected-
selective attention/ Ray orchit/ Clock drawing (speed processing)

102- clonidine in adhd is given – what does it not improve- aggression/ attention/impulsivity

103- Simple motor tic example would be – throat clearing/ grunting/ grimacing
If simple vocal tic see screen shot

104- Roc accuracy --- AUC 0.86 .. sensitivity 100%

105- Mild euphoria, gigly, relaxed and this is usually smoked- cannabis/nicotine

106- Balance of participants choosing people based on initial selection- minimization

Participants based on age group= matching/stratified randomisation

107- Short acting stimulant and full agonist- heroin/ codeine/ buprenorphine /synthetic
cannabinoid/cannabis.

108- 10 year old mild depression- digital Cbt/ group CBT/ watchful waiting/ medication.

109- Child with PTSD- talk to him apart from parents directly about PTSD sx/ Avoid talking
till the child talks/ early debriefing

110- ASPD in prison- 50% or 70%

111- Study on LD participants which is true- they can withdraw the consent anytime/ they
cannot withdraw consent after signing

112- methadone 70ml, 10 week pregnant wants to stop, next step- reduce in 2 weeks,
continue the same

What % of Borderline get better in 10 year? 10% 50%

88%
40% in 2 yrs

Predictor of ECT response?

114 peurperal psychosis most common symptom? Affective symptom

115which is affected in cocaine user? Sustained attention

116 most common behaviour in Alzheimer? wandering

117 what % of severe dementia get stroke in 12 weeks?

Full Opiod agonist? Methadone

Tachycardia? Codeine

Drug addiction Q(hash) = mock 7

STD start Q = mock 10

Behavioural activation therapy = what we are assessing

Recently aggressive, what to do? Behavioural analysis

Most common suicide in prison?

Bournwood case? Liberty

Depression is common of infanticide

What kind of illness get worst in 10-12 yrs? ADHD / touratte

Mock 1 == agomelatine

Bipolar on lithium, now depressed?

Ssri/ Quetiapine

Initial mng of Catatonia? Lorazepam

High risk mental state before going to psychosis? CBT?

Base analysis, mean score of 2 groups at baseline, Midpoint, endpoint….. ANOVA

Lithuim salt in water? Ecological study

Low dose ECT can be given if medicine given before? Lofepramine

Predictor of ECT response?

Degree of avoidance?

LBD get hospitalised early than alzheimer in kaplein meire graph

cost effective curve cannot determine effect on willingness to pay

Loneliness causes low depression score

ROC curve? Accuracy is good

Icer definition?

Specificity at its maximum 100

Behavioural element in depression? Degree of avoidance

Susser _time order (temporal association)

**********These similar to above but maybe more detailed options

But for what’s it’s worth I remember these-

1. Concurrent validity (new OCD scale/established)
2. Predictive validity
3. Gailbrath plot
4. gailbrath plot and forest plot - to check heterogeneity
5. bournewood case

variance

Paradoxical injunction in which? FT

Most common BPSD in AD:?

Agitation/aggression
Apathy
Depression '' '' most common

Which is most strongly suggestive of lithium toxicity

Abdominal discomfort
Fine tremors
Muscle twitching
(Forgot the other two)

Emis were bad. One series was to identify the ecg picture in the following scenarios:
- 19 yr old girl with eating disorder who admits to ?induce vomiting
- person recently started on clozapine reports chest pain
- person on citalopram 40, recently bought OTC drug containing diphenhydramine
-

Elderly male with alzheimers dementia now severe agitation in ward . Newly diagnosed
infarct.

Low dose risperidone

Low dose haloperidol
Avoid psychotropic

In which of the following is there equal chance of inheritance from either father or mother
Mosaicism
Trisomy 21 47xx+21
Trisomy 47xy +21
Robertsonian translocation