MRCPsych UK: Paper A, B, and CASC Prep

Functional Magnetic Resonance Imaging (fMRI) Introduction Structural imaging reveals the static physical characteristics of the brain. It makes it useful in diagnosing disease. Functional imaging reveals dynamic changes in brain physiology that might correlate with cognitive functioning, for example. Neural activity consumes oxygen from the blood. This triggers an increase in blood flow to that region and a change for deoxyhemoglobin in that region. As the brain is always physiologically active, functional imaging needs to measure relative changes in physiological activity. The most basic experimental design in functional imaging research is to subtract the activity in each part of the brain whilst doing one task away from the activity in each part of the brain whilst doing a slightly unfamiliar task.  We call this cognitive subtraction . Other methods, including parametric and factorial designs, can minimize many of the problems associated with cognitive subtraction. There is no foolp

A 37-year-old woman, who is an intelligent computer programmer, presented with insomnia, restlessness, and anxiety. On detailed assessment, she reveals that the symptoms started after some thieves robbed their house 3 months ago. In the incident, they had killed one of her sons. She also experiences intense imagery related to the event and often wakes up after experiencing a nightmare. The woman feels uncomfortable talking about the event and requests not to talk about it. She had experienced another such incident when she was a child. She also received treatment for depression three years ago. Personality assessment revealed neurotic traits. No one else in the family developed such symptoms, even though all of them experienced the event. 

Common Crisis Situations in Clinical Practice Point out the crises seen in day to day clinical practice. Developmental crises common to all occur in  Stressful states of human maturation and transition. e.g. hospitalization Situational crises person faces stressful and traumatic event e.g. flood, earthquake, rape, etc. WHO Guidelines for the Treatment of Alcohol Withdrawal

Transitional Object Mary Ainsworth studied and showed that attachment helps to lessen anxiety. Secure-base-effect: It allows a child to leave the attached figure and explore the surroundings. A transitional object, which is an inanimate object, such as a teddy bear or a blanket, also works as a secure-base. Children carry it along as they examine the environment.  References:  Sadock, B. J., & Sadock, V. A. (2015). Kaplan & Sadock Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry. Wolters Kluwer, Philadelphia, Pa. https://doi.org/10.1097/00004850-198907000-00008 Duschinsky R. The emergence of the disorganized/disoriented (D) attachment classification, 1979-1982. Hist Psychol. 2015;18(1):32–46. doi:10.1037/a0038524

Interactions of Clozapine The cytochrome P450 system of enzymes in the liver inactivates and removes the toxic substances, including drugs, from the body. These enzymes include CYP 2D6, 2C9, 2C19, and 1 A2. But certain drugs can inhibit or induce these enzymes themselves. Some SSRIs are potent inhibitors of an individual or multiple hepatic cytochrome P450 (CYP) pathways and the magnitude of these effects is dose-related. Several clinically significant drug interactions can, therefore, be predicted. For example, fluvoxamine is a potent inhibitor of CYP1A2 which can result in increased theophylline serum levels, fluoxetine is a potent inhibitor of CYP2D6 which can cause increased seizure risk with clozapine, and paroxetine is a potent inhibitor of CYP2D6 which can cause treatment failure with tamoxifen (a prodrug), leading to increased mortality. Escitalopram has the least impact on these enzymes. QID: 20200407130027659

Some candidates do not use SPMM for any of the MRCPsych exams. It is too expensive.

  Types of Learning | Theories of Learning What are the types of learning according to the theories of learning?   Classical Conditioning or associative learning. Operant Conditioning or Instrumental Conditioning   Cognitive learning Signal Response The predictive power of conditioned-response; the higher it is, the greater the conditioned response.  Response-Outcome Relations The cognitive judgment of the individual relating the response to the outcome, rather than an unconscious stamping in of the conditioning.  Latent Learning: Learning but not exhibiting the learned behavior until adequate reinforcement is presented.  Observational Learning through Modeling 

Extended matching items   What are the extended matching questions and how many can you expect in the MRCPsych Exam? An extended-matching items/question  ( EMI  or  EMQ ) is a written examination format similar to multiple-choice questions but with one key difference, that they test knowledge in a far more applied, in-depth, sense. We often use it in medical education and other healthcare subject areas to test diagnostic reasoning. Structure The structure has three key elements: Answer option list Sources suggest using a minimum of eight answer options for a  ratio  of five  scenarios  or  vignettes  to ensure that the probability of getting the correct answer by chance remains reasonably low. [1]  The logical number of realistic options should dictate the exact number of answer options. The logical number of realistic options should dictate the exact number of answer options. This ensures that the test item has authenticity and  validity . Lead-in question: This should be as specific

You do not need to pass MRCPsych paper-A or Paper B before you apply for the MTI. You can apply to the program before passing any part of the MRCPsych exams. The following are your requirements to enter the MTI scheme.  GMC-recognized primary medical qualification from an internationally accepted medical institution.  An acceptable internship (or equivalent) of 12 months.  Three years of experience working in Psychiatry in the last five years.  Working in psychiatry for the last year.  A score of 7.5 in IELTS academic or grade b on OET taken in the last 18 months.   You have received or will work towards a postgraduate qualification in psychiatry.

Development in the first year of life summarised Smiling starts at 3 weeks.  Selective smiling starts at 6 months.  Fear of strangers starts at 8 months, while separation anxiety starts later to that.  At the end of the first year, children also learn a few simple words like mama, dada, etc.  Weaning starts at around 6 months and should have completed by the end of the year.  An ordered sleep-wake cycle has also got established, Children learn to point at objects in the first year of life.

The Safest NSAID for a patient on lithium What is the most suitable non-steroidal anti-inflammatory drug (NSAID) you can prescribe to a patient who is on Lithium therapy? >> Aspirin or Sulindac. 

According to the theory of psychosexual development, subjects develop the following traits with fixation at the oral stage of development:  Dependency Optimism Gullibility Sarcasm Hostility Aggression Pessimism, passivity MNEMONIC: DOG SHAPe

Mnemonic for Freud's Stages of Psychosexual Development The following sentence helps me remember the stages of psychosexual development in order.  O nions A nd P otatoes L ook G reat Oral Anal Phallic Latency  Genital 

Risk Factors for Post-Traumatic Stress Disorder The following description of risk factors also answers QID:919472837474 The best answer would be d) her intelligence quotient. The patient has developed symptoms of post-traumatic stress disorder, including the most specific “intrusive symptoms.” These have occurred after the life-threatening event she went through. Both the international classification of diseases and the diagnostic and statistical manual require such a precipitating factor for making the diagnosis. It is an event that is life-threatening, or according to the diagnostic and statistical manual, one that threatens body-integrity (e.g. rape). One may either be a bystander or directly threatened by the event. However, this factor interacts with other predisposing or vulnerability factors in an individual to trigger the condition. Genetic factors account for about one-third of the vulnerability , according to a study conducted on twins working in the U.S. military. Other no