2014 PAAM Barrier Qs

Q1. Which is true in psychotic depression:

SSRIs due to risk of suicide
MAOIs are first line
ECT is not indicated
TCAs have best evidence
Psychotherapy?
[Several treatment guidelines recommend either the combination of a secondgeneration antidepressant and atypical antipsychotic or tricyclic antidepressant
monotherapy or electroconvulsive therapy (ECT) as the first-line treatment for
unipolar psychotic depression. Source: Wikipedia]
Q2. 22yo male wants to know risk of developing schizophrenia. His brother has
been diagnosed with schizophrenia at 24. Approximately:
1%
8%
16%
32%
64%
[Chances of Developing Schizophrenia
General population: 1%
Brother or sister has schizophrenia: 8%
One parent has schizophrenia: 12%
Fraternal twin has schizophrenia: 14%
Both parents have schizophrenia: 39%
Identical twin has schizophrenia: 47%]
Source: Psychcentral.com
Q3. Best evidence for oppositional defiant disorder:
Anger management
Clonidine if also ADHD compulsive type
Clonidine if also ADHD not compulsive type
Parent behavior programs
Stop-think-do programs
Q4. Know Alexithymia:
Q5. Which PD LEAST likely to seek medical help/come to medical attention:
Borderline
Antisocial
Schizoid
Dependent
Avoidant
Q6. EMQ: Formal thought disorder:
Repetition with no elaboration

When asked question, goes off topic but can be brought back on topic by
interviewer
Metallic taste

Q7. Likelihood of developing puerperal psychosis in subsequent pregnancy after

episode of puerperal psychosis with first pregnancy:
20%
40%
60%
80%
[Risk of recurrence of puerperal psychosis is 40-70%. Source: SMP lecture
Perinatal psychiatry]
Q8. EMQ: Different types of hallucination/delusion:
Medical student just finished exam. Heard her mum calling out her name
just before she fell asleep. A: Hypnagogic hallucination
Options included:
o Hallucination
o Hypnagogic hallucination
o Pseudohallucination
o Etc
Q9. % of people with bipolar affective disorder who die by suicide:
1%
10%
20%
etc..
Q10.

% of general population that will have a manic episode:

1%
4%
10%
20%
etc

Q11. Patient on carbamazepine and something else. Most appropriate smoking

cessation therapy:
Varenicline & NRT
Nicotine patch
Bupropion and gum (NRT)
Bupropion
Varenicline
Q12. Drugs and side effects in newborns/children of mothers taking
psychoactive drugs during pregnancy:
Ebstein anomaly


Q13.

Persistent pulmonary hypertention

First line treatment in PTSD:
Debrief
SSRIs
SNRIs
Psychotherapies

Q14. Girl overdoses on 8 antidepressant (SSRI) tablets after arguing with

boyfriend. Which next investigation will prevent a serious complication?
FBC?
Paracetamol levels
LFT
Renal function
Q15. Girl has sudden weakness in left arm and decrease in sensation in glove
distribution after arguing with her mother:
Migrainous stroke
Vasculitis
Conversion disorder
Somatisation
Q16.

Length of ECT induced seizure?

2 minutes
1.5 minute
1 minute
0.5 minute
0.1 minute