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MRCPSYCH A – Questions With Verified Answers (A+)
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MRCPSYCH A – Questions With Verified Answers (A+)
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MRCPSYCH A – Questions With Verified Answers (A+)Dilatation of the perihippocampal fissure is a useful radiologic marker for the
initial diagnosis of Alzheimer's disease, with a predictive accuracy of 91%
Functional changes in Alzheimer's disease brain? Right Ans - SPECT
demonstrates temporoparietal hypoperfusion.
PET demonstrates temporoparietal glucose hypometabolism. With disease
progression, frontal involvement may be evident.
What are the structural changes on imaging in Alzheimer's dementia? Right
Ans - mesial temporal lobe atrophy (particularly hippocampus and entorhinal
cortex)
Temporoparietal cortical atrophy
(ventricular enlargement is also seen which is a consequence of atrophy)
Vascular dementia brain structural changes? Right Ans - CT and MRI
demonstrate atrophy, infarcts, and extensive deep white matter lesions.
Functional changes n brain in vascular dementia? Right Ans - SPECT shows
a patchy multi-focal pattern of hypoperfusion
Lewy body dementia brain structural changes? Right Ans - Changes tend to
be non-specific and subtle on structural imaging (hence functional imaging
SPECT and PET often used). On CT and MRI ventricular enlargement is seen
with relative preservation of medial lobe structures. White matter changes
similar to Alzheimer's disease are also seen.
Brain functional changes in LBD? Right Ans - SPECT shows posterior
deficits and reduced D2 receptor density.
Fronttemporal dementia structural and functional brain changes? Right
Ans - Structural changes - CT and MRI show frontal lobe atrophy
Functional changes - SPECT shows anterior perfusion deficits.
Go over gyri Right Ans - :)
, Limb kinetic apraxia - Right Ans - an inability to make fine/ delicate
movements
Ideomotor apraxia - Right Ans - an inability to follow out learned tasks
when given the necessary objects e.g. if given a hairbrush they try to write
with it
Constructional apraxia Right Ans - an inability to copy a picture or combine
parts of something to form a whole
Oculomotor - Right Ans - an inability to control eye movements
Ideational apraxia - Right Ans - an inability to follow a sequence of actions
in the correct order e.g. Take a match out a box and strike it with your left
hand
To make a diagnosis of alcohol dependence syndrome (ICD-10 F1x.2), 3 or
more of the following must be present together at some time in the past year:-
Right Ans - Compulsion
Loss of control
Physiological withdrawal
Tolerance
Neglect of rest of life
Persistence despite clear evidence of harmful consequence
Types of dystonia? Right Ans - Torticollis - cervical muscles spasms,
resulting in a twisted posturing of the neck.
Trismus - contraction of the jaw musculature and can result in lockjaw.
Opisthotonus - arched posturing of the head, trunk, and extremities.
Laryngeal dystonia - difficulty in breathing
Oculogyric crises - involuntary contraction of one or more of the extraocular
muscles, which may result in a fixed gaze with diplopia
Highest and lowest risk of EPSE? Right Ans - Newer antipsychotics tend to
produce less EPSE's and clozapine carries the lowest risk. Haloperidol carries
the highest risk.
MOA PICS Right Ans - :)
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