202 KT Practice Quiz 3
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Questions and Answers

A 10-year-old boy is admitted to the Emergency Department with a small burn on the right forearm, which he is gently rubbing.

According to the gate control theory of pain, stimulation of what type of nerve fibre will REDUCE the sensation of pain?

  • A-beta fibre (correct)
  • A-delta fibre
  • B fibre
  • C fibre
  • In the descending pain modulatory pathway, the serotonergic output runs from the:

  • rostral ventromedial medulla to the dorsal horn (correct)
  • locus coeruleus to the rostral ventromedial medulla
  • PAG to the rostral ventromedial medulla
  • cortex to the PAG
  • Increased sensitisation to pain can be mediated by all of the following EXCEPT:

  • bradykinin binding
  • cyclo-oxygenase (COX) inhibition (correct)
  • prostaglandin binding
  • substance P
  • A 61-year-old woman comes to the clinic complaining of itching and burning pains on the right side of her torso. Inspection reveals a rash in the same area and shingles (herpes zoster) is diagnosed.

    The pain associated with herpes zoster is considered:

    <p>neuropathic</p> Signup and view all the answers

    For several months after the rash has cleared up the patient is still suffering from pain (post-herpetic neuralgia).

    Which of the following drugs can be used to treat this kind of neuropathic pain:

    <p>anticonvulsant</p> Signup and view all the answers

    A 60-year-old man developed a tremor in his right hand. His family noted his walking had changed and he smiled and blinked less frequently.

    Following your clinical assessment, you suspect Parkinson’s disease.

    ‘Pill rolling’ is a classic form of which type of tremor?

    <p>rest tremor</p> Signup and view all the answers

    In the neurological examination, which of the following abnormalities would NOT have been suggestive of untreated Parkinson’s disease?

    <p>ballismus</p> Signup and view all the answers

    The patient was put on medication to boost dopamine function.

    Which of the following is NOT given in treatment for Parkinson’s disease?

    <p>dopamine beta-hydroxylase inhibitor</p> Signup and view all the answers

    Which of the following is TRUE regarding the pathophysiology in PD?

    <p>there is disruption of the dopaminergic inputs to the striatum</p> Signup and view all the answers

    Which of the following statements is true concerning Parkinson’s disease?

    <p>it involves degeneration of dopaminergic neurons of the substantia nigra</p> Signup and view all the answers

    Case study 4: Schizophrenia (Parts 1-5 of 9)

    In the case below match the descriptions in Questions 11 to 15 to the most relevant symptom in the table below.

    <p>delusion of control / passivity = A good friend reported that he had been saying some odd things to her recently: he had said she was influencing his mood using a TV remote control. delusion of persecution = He believed the police had tapped his phone and were investigating him. self-neglect = He had stopped shaving and appeared to have stopped washing his clothes. visual hallucination = He told the GP that he wasn’t sleeping well, because his grandmother kept visiting him in his room. His grandmother had been dead for several years.</p> Signup and view all the answers

    Regarding pharmacological treatments for schizophrenia which of the following is FALSE?

    <p>the therapeutic effects of haloperidol are mediated by its actions at dopamine and serotonin receptors</p> Signup and view all the answers

    Regarding the neurobiology of schizophrenia, which of the following statements is FALSE?

    <p>cocaine can cause the negative symptoms of schizophrenia</p> Signup and view all the answers

    Drug induced psychoses can be treated with:

    <p>D2 antagonists</p> Signup and view all the answers

    Which of the following drugs has these side effects: weight gain, sedation, tachycardia, orthostatic hypotension, and neutropenia?

    <p>clozapine</p> Signup and view all the answers

    A 23-year-old woman goes to her GP clinic complaining of being constantly tired and suffering from insomnia. Further discussion reveals for the past four months she has been increasingly worried about whether her short-term job will end and has been finding it difficult to concentrate in and out of work, experiencing irritability with her flatmates to the point where she thinks they might move out. The patient also complained of excessive sweating and trembling in stressful situations. This was clear to the GP and on further inspection other autonomic symptoms were revealed including tachycardia.

    The most likely diagnosis is:

    <p>generalised anxiety disorder, GAD</p> Signup and view all the answers

    Chronic stress can cause pathological changes in the brain that may underlie anxiety disorders and depression. In relation to the brain areas affected, what can chronic stress lead to?

    <p>hypoactivity of hippocampus, hyperactivity of amygdala</p> Signup and view all the answers

    Regarding the neurochemistry of anxiety and depression, which of the following statements is FALSE?

    <p>MAO inhibitors treat depression by upregulating post synaptic receptors</p> Signup and view all the answers

    Which of the following drugs is LEAST likely to be anxiolytic?

    <p>flumazenil</p> Signup and view all the answers

    A 36-year-old male manager is brought into the GP surgery by his flatmates. He reports an increased mood and energy over the previous three weeks. He now only needs a couple of hours sleep and spends much of the night practising his audition for X Factor. He has recently invested a few hundred pounds on clothes for his audition.

    The psychiatrist enters a tentative diagnosis of:

    <p>hypomania</p> Signup and view all the answers

    Lithium can be used to treat bipolar affective disorder because of its action as a(n):

    <p>mood stabiliser</p> Signup and view all the answers

    A 29-year-old woman who had recently received her Ph.D. in political science began a new job working for the Department for Education. After approximately six months, she began to lose interest in her job and other activities. When she went to work she would do very little, frequently staring out of the window, feeling sad, and crying. She also showed the following additional symptoms: fatigue, loss of energy in performing tasks, refusal to exercise, difficulty in sleeping, loss of weight, and a reduced ability to concentrate. At the request of her employer, she visited her GP who referred her for an evaluation.

    What is the disorder likely to be?

    <p>depression</p> Signup and view all the answers

    Research in to the neurochemical correlates with depression have suggested that, within the brain, there is:

    <p>a deficiency of serotonin</p> Signup and view all the answers

    A 29-year-old woman experiences palpitations about three or four times a month. As they come on unexpectedly, she feels unable to leave her home alone or go to places such as cinemas and crowded shopping centres where help may be difficult to obtain.

    What is the diagnosis likely to be?

    <p>panic disorder</p> Signup and view all the answers

    Experimental evidence relating to the diagnosis above, involves the following neurotransmitter systems:

    <p>serotonin and GABA</p> Signup and view all the answers

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