Risk factors for Parkinsonism The following are some risk factors for Parkinson's disease.  Pesticide exposure Head injury Drinking well water Agricultural occupation Use of beta-blockers.

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.

It is classified into three clusters as: Suspicious: which include Antisocial Paranoid Schizoid Schizotypal Emotional and impulsive: Borderline Histrionic Narcissitic Anxious: Avoidant Dependent Obsessive compulsive Another way to classify them is Mad, Bad and Sad respectively for the suspicious, impulsive and anxious clusters. Remember there are no clusters in ICD11 anymore, The individual personality disorders have been eliminated from ICD11.

How do we define NMS? It is an acute disorder of thermoregulation and neuromotor control that occurs because of exposure to dopaminergic drugs. What drugs or medications can cause NMS? Antipsychotics, especially the ones with high anti-dopaminergic potency. But also dopaminergic agonist withdrawal e.g. withdrawal from levodopa.

Criminal behavior, lack of guilt, and irritability are typical features of antisocial personality disorder. Evidence suggests that a low-activity variant of the MAO-A gene predisposes to adult antisocial behavior in men, especially in those who faced early adversity 1–4 . Catechol-O-methyltransferase enzyme metabolizes dopamine and other monoamines. Its gene, the COMT-gene, occurs in two forms: a high-activity form and a low-activity form. They associate these variants with differential abilities of the prefrontal cortex, especially working memory. People with low-activity form may have a more efficient prefrontal cortex, likely because of the greater dopamine level in the synaptic space 5,6 . We have associated serotonin transporter gene variants with neuroticism and a predisposition to depression. The variants may also influence individual response to SSRIs8. APOE4 gene is a risk factor for Alzheimer’s disease (compared to APOE2 and APOE3).

 COLLEGE OF PHYSICIANS & SURGEONS PAKISTAN 27th February 2019 MCPS UBJECT: PSYCHIATRY ANSWER ALL QUESTIONS (TOTAL QUESTIONS: 10) USE SEPARATE ANSWER BOOK FOR EACH QUESTION PAPER: TIME ALLOWED 3 HOURS 2.4 A young unmarried male of 25-year was diagnosed as a case of schizophrenia. There is family history of psychiatric illness in the family. He developed the disease acutely with prominent positive features. He taq responded to treatment within two months and was well supported by his family, however, his family is still very cautious, inquisitive and worried excessively as the patient has adopted a lonely lifestyle. a) What are the factors ointing towards good and bad prognosis in this patient? b) What are the characteristic features of "high expressed emotions family?stilette 1481 ellipse, c) What family interventions can be done in patients with schizophrenia? CHA Q.5 A 31-year-old male presents with history of episodes of sudden onset of palpitation, trembling of body and fea

Men hanging drug overdose self poisoning by car exhaust fumes drowning and jumping Women drug overdose hanging drowning (UK- Wasserman 2009)

Opioid Epidemiology in Pakistan Nationwide, one per cent of the population –over one million people– were estimated to be regular opiate (heroin or opium) users. The majority (80 per cent) use heroin, while one-third (33 per cent) use opium. Opium users were slightly older (mean age 38.2, standard deviation 10.1 years) than heroin users (mean age 33.8, standard deviation 9.4 years), and more likely to live in rural environments whereas heroin users live in cities. Two-thirds of opium users and one- third of heroin users were married, and while opium users mostly live in a home (84 per cent), nearly forty per cent of heroin users living in a park/road, shrine, or a location other than a home. A daily heroin habit in Pakistan is estimated to cost between 1.50 and 3.00 USD, yet only 6.5 per cent of heroin users are employed full time. To earn money, one-third report donating/selling blood, and forty per cent report exchanging sex for drugs or money. Opiate users also often beg for money

IMPORTANT MOOD DISORDER TOPICS LEARN FOR THE FCPS-2 EXAM Learn the differential diagnosis of depression, dysthymia, stupor,   psychotic depression.   Outline the assessment and treatment of these conditions.   Assess treatment resistance   Enlist or identify risk factors (dysthymia, depression)   Investigate stupor, depression with organic findings Treatment options for refractory depression   Use of lithium in depression   Relevant guidelines, recommendations for depression Patient education about depression and antidepressants Antidepressant response   Association of depression with medical conditions Depression in pregnancy   Lithium (extensively tested from several aspects including risks and benefits used in pregnancy and lactation, predictors of response, efficacy in various conditions, mechanisms/causes of loss of efficacy in the long-term, etc. Take-home message >> wherever you see a line, a para, a topic about lithium READ IT)    (Postnatal) manic episode managemen

Behavioural Treatments For PTSD  Prolonged Exposure  Introduction Prolonged exposure is a manual-guided CBT comprising ten, sixty-to-ninety-minute weekly individual therapy sessions. We can explain the central therapeutic component of prolonged exposure on "Pavlovian learning theory."  Approach The treatment involves repeatedly presenting a conditioned stimulus (e.g., a trauma reminder) in the absence of an unconditioned stimulus (e.g., the traumatic event). They do this through imaginal exposure during therapy sessions and through in vivo exposure in the environment.  Evidence On average, prolonged exposure proves robust symptom severity improvement.  Cognitive Processing  Introduction Another manual-guided cognitive behavioural modality that has received strong empirical support to treat PTSD is cognitive processing therapy.  Approach Cognitive processing therapy comprises twelve weekly, 60-minute individual sessions.   This therapy involves  Imagining and reviewing written