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A 40 years old man attends your outpatient carrying his CT scan brain which is suggestive of space-occupying lesions in the parietal lobe. a) What clinical signs would you look for while examining this patient? b) How would you elicit those signs?

Single-photon Emission Tomography SPET

Single-photon Emission Tomography SPET Principle uses single-photon (gamma-ray) emitting isotopes given IV or inhaled the resolution is lower than PET Uses SPET can give information about: regional cerebral blood flow ligand binding Clinical uses include: Alzheimer’s disease When the symptomatology (e.g. hallucinations, epilepsy) occurs when the patient is not near a scanner; we can give a suitable ligand at the material time and the patient scanned afterward Schizophrenia reduced rCBF in frontal regions—‘hypofrontality’ Affective disorders as that in schizophrenia, with reversal after antidepressant therapy Alzheimer’s disease decreased rCBF in posterior parietal and temporal regions Xenon inhalation Shows the failure of activation of frontal lobes in schizophrenics performing the Wisconsin Card Sorting Test

FCPS-2 March 2006 College of Physicians and Surgeons

FCPS-2 March 2006 College of Physicians and Surgeons  Q.1 A 55 years old feudal - lord presents with over six weeks' history of inability to ” face the world”, disinterest in sex, suicidal thoughts, and weight loss. He relates his current plight to losing a large sum of money and a part of his fortune in gambling: What will be the differential diagnosis in this case? What investigations you should undertake? Draw a comprehensive management plan for this patient

History taking, Mental state examination, and making a diagnosis

History taking, Mental state examination, and making a diagnosis What body language and behavior used are most suitable while taking psychiatric history? What is an open-ended question? What question could you ask the patient after they have stopped volunteering their symptoms? "What other changes have your partner/family/friends noticed in you?" What is the definition of Command hallucinations? A voice or person telling them to do things PMH relevant to ask about in a psychiatric history Developmental problems  Head injuries  Endocrine abnormalities  Liver damage Esophageal varices  Peptic ulcers (can show if alcohol problems)  Vascular risk factors What to ask about alcohol/illicit drug use? Regular or intermittent Amount (know the units) Pattern Dependence/withdrawal  Impact on work, relationships, money, police  Screening questionnaires e.g. CAGE What to ask in a forensic history Offenses including sentences Recidivism  Particular attention to violen

The Experience of the Patients Taking Part in the MRCPsych Examinations

The Experience of the Patients Taking Part in the MRCPsych Examinations  This is a draft article on the   experience of the patients taking part in the MRCPsych examinations   that we will soon republish in a clear format, referencing the original source. This is one of the many other articles I am making available here. The purpose is to find all the evidence regarding the RCPsych Exams and make them accessible to help researchers and students prepare for the MRCPsych Examinations. These articles are already available in journals, particularly the BJPsych Bulletin, albeit in the least-accessible format. We are thankful that the Royal College has published previous print-only articles as scanned PDFs under the Creative Commons license. I am trying to review them, enhance them for clarity and readability, and make them available as text. These adaptations are currently NOT creative-common. We will soon discuss and hope to make them available under a similar license so everyone can bene

Evaluation of a Psychiatric Training Scheme

With interest the article 'Evaluation of a Psychiatric Training Scheme' by Khan and Oycbode (Psychiatric Bulletin, March 1993, 17, 158-159). We have kept similar records for the Mersey Region Training Scheme - formerly the Liverpool Training Scheme, and have published data from them in the Bulletin (Birchall & Higgins, 1991). Our records now cover seven years from August 1985to July 1992and it is interesting to compare the two schemes. The Mersey Region Training Scheme now covers all psychiatric units in the Mersey region and includes 37 registrar posts and 49 senior house officer posts, although 12-16 SHO posts are usually filled by general practice trainees. Most psychiatric trainees join the Mersey Scheme at SHO level, often straight from house officer posts. This results in a fairly high dropout rate at the SHO level. From 112 to 434 leaving the scheme in the seven years, 50 of them left without completing four years of training in psychiatry, and of these 16 went into

FCPS-2 Psychiatry Paper CPSP October 1992

College Of Physicians & Surgeons, Pakistan F.C.P.S. PART II EXAMINATION - OCTOBER 1992 SUBJECT:  PSYCHIATRY Paper-I Instructions: 1)   Answer all questions. 2)   Use separate answer books for each question.   Answer the following briefly:- a)     Name five laboratory and four radiological investigations that you would consider while investigating dementia b)     Enumerate five consequences of the victims of child sexual abuse. c)     Name five behavioral methods that are effective in the treatment of obsessional disorders. d)     What are the current indications of psychosurgery? Name four complications and what is its mortality rate. e)     ’Define therapeutic factors in group psychotherapy. Who described them? Name ten of these factors. f)       Name five causes of Wernicke's encephalopathy. What are the three principal features of this syndrome? g)     Define the term ” alexithymia”. Who coined it? Name five of its essential features. h)   Name five clinical featur

MCQs in MRCPsych Exams

This is a draft article that we will soon republish in a clear format, referencing the original source. The purpose is to find all the evidence regarding the RCPsych Exams and make them accessible to help researchers and students prepare for the MRCPsych Examinations. These articles are already available in journals, particularly the BJPsych Bulletin, albeit in the least-accessible format. We are thankful that the Royal College has published previous print-only articles as scanned PDFs under the Creative Commons license. The articles I am publishing here are currently not creative-commons. We will soon discuss and hope to make them available under a similar license so everyone can benefit by sharing them anywhere.  The publication of four articles on MCQs in the MRCPsych (Psychiatric Bulletin, February 1991, 15, 87, 88, 90 and 108) is to be applauded for providing some helpful guidelines on how to approach them and should be welcomed by trainees as the uncertainty of what awaits and i

APRIL 1990 PAPER-I FCPS-2

  F.C.P.S. PART II     EXAMINATION APRIL 1990 PAPER I . SUBJECT:  PSYCHIATRY. Time allowed - 3 hours Instructions ;   1. Answer all questions.   Use separate answer books for each question.   Differentiate between Alzheimer’s and picks dementias.  What investigation will you carry out in an elderly a confused person who has suffered an acute brain dysfunction? Discuss aetiological factors of drug dependence. What preventive measures are needed to check this menace. Discuss the psychiatric aspects of head injury. Give briefly .psychiatric presentation or” hypothyroidism and hyperthyroidism.