Paper B Mock Exam 4

An 80-year-old woman recently diagnosed with Alzheimer’s disease has been started on donepezil 10mg. After a few weeks, she presents with ankle swelling. She also reports experiencing gastrointestinal side effects. Which of the following is the most appropriate next step in her management?

An 80-year-old woman with an estimated glomerular filtration rate (eGFR) of 26 mL/min/1.73m² is diagnosed with a condition requiring an antipsychotic medication. Taking into account her renal function, which of the following antipsychotics would be the most appropriate choice?

A 14-year-old female presented to the emergency department after an overdose of paracetamol following a fight with her boyfriend. She appears flushed in the face and tongue and seems confused. She also exhibits psychotic features. Her MMSE score is 21 out of 30. Which of the following diagnoses best explains her presentation?

A 65-year-old man presents with symptoms suggestive of an upper motor neuron lesion. In examining his gait, which of the following patterns would be most indicative of this type of lesion?

You are analyzing the cost-effectiveness acceptability ratio (CEAR) curve for Esketamine, a new treatment for depression. According to your data, Esketamine improved the quality-adjusted life year (QALY) by 0.07 and costed $16,600 in a community setting and $16,900 in a hospital setting. Which of the following statements is correct based on these data?

In health economics, which of the following types of analysis provides outcomes in terms of quality-adjusted life years (QALYs)?

A 12-year-old boy with Autism Spectrum Disorder becomes agitated whenever his mother visits him at his residential care facility. As his psychiatrist, you want to help him better understand and cope with these visits. Which of the following therapeutic interventions would be the most appropriate choice?

A 10-year-old boy with Autism Spectrum Disorder seems to enjoy it and become more interactive when others imitate his behaviors. As a child psychiatrist, you want to use this interest to improve his social engagement and communication skills. Which of the following therapeutic techniques would be the most appropriate choice in this scenario?

A 30-year-old man with Learning Disability (LD) lives in a care facility where activities are scheduled at fixed times throughout the day. To help him understand and prepare for what activities that are happening, which of the following communication aids would be the most appropriate choice?

In assessing risk factors for future violent behavior in a patient, which of the following is considered the most reliable predictor?

Statistically, the majority of violent acts such as homicide and theft are most frequently associated with which of the following factors?

A 40-year-old man charged with a violent offence claims to have no memory of the incident. Which of the following statements about amnesia associated with violent crimes is most accurate?

A 65-year-old man with schizophrenia has been managed on antipsychotic medication. Considering his age and medication, what is the estimated incidence of stroke due to antipsychotic use in older adults?

A woman with a history of post-partum psychosis kills her baby, believing that she is ‘ending the misery’ of the sick child. In the context of legal proceedings, which of the following defences is most applicable to her case?

In the field of health economics, which of the following best describes a cost-benefit analysis?

In the context of health economics, which of the following best describes the Incremental Cost-Effectiveness Ratio (ICER)?

A 5-year-old boy is presented to the clinic by his parents due to unusual behaviors. The parents report that he has been biting his fingers and lips to the point of self-mutilation. Upon examination, the boy is noted to have severe intellectual disability and shows signs of choreoathetosis and spasticity. Given the above findings, which of the following is most likely the underlying condition?

A recent clinical trial explored the efficacy of agomelatine as an antidepressant. It reported a high yield of positive results, suggesting that agomelatine may be a useful antidepressant. The study design incorporated unpublished data to increase the study’s strength. Given this, where is the most appropriate source to find such literature?

A recent systematic review on the efficacy of various treatments for major depressive disorder used a Forest plot to present the study results. Which of the following would be considered a key strength of using a Forest plot in this context?

A recently conducted study investigating the efficacy of a new therapeutic intervention for depression in an inpatient setting reported a “greater than 50% increment in effectiveness compared to the community.” Which of the following statements about the Standard Deviation (SD) from this study is true?

A researcher conducting a meta-analysis of studies on the efficacy of a novel treatment for bipolar disorder creates a funnel plot to assess publication bias. If studies were not imputed in the funnel plot, which of the following would be the most likely effect?

A research team conducting a large-scale randomized controlled trial imputes missing data in their final analysis. What is the primary reason for conducting this imputation?

A psychiatrist is analyzing a drug trial’s results, aiming to prove the effectiveness of a new antipsychotic drug. In terms of statistical analysis, which of the following scenarios best represents a Type I error?

A researcher is investigating the efficacy of a new psychotherapy intervention for treating anxiety disorders. The study concludes that the intervention is not effective in reducing anxiety symptoms, while in reality, the intervention does have a significant effect. In terms of statistical analysis, which of the following scenarios best represents a Type II error?

In a case-control study investigating the association between cannabis use and the development of psychosis, the odds ratio (OR) is calculated to measure the strength of the association. Which of the following formulas correctly represents the calculation of the odds ratio using the information from the study?

In a randomized controlled trial (RCT) investigating the effectiveness of a new antidepressant medication, a Consort diagram was used to depict the flow of participants throughout the study. What is the primary purpose of using a Consort diagram in this context?

In a psychodynamic approach to understanding family functioning, which of the following best describes the focus on previous behaviors?

In the context of family therapy, which of the following best describes paradoxical injunctions?

A 35-year-old female presents to the emergency department with sudden aphonia (loss of voice) after her mother came to live with her due to health issues. The patient denies any physical discomfort or difficulty swallowing. She reports feeling overwhelmed and stressed since her mother’s arrival. Which of the following diagnoses would be most appropriate for this presentation?

A 28-year-old woman with a known history of schizophrenia, currently treated with high-dose olanzapine, presents to the emergency department. She has been non-compliant with her medication for the past several weeks and reports ongoing recreational use of amphetamines. Her family reports increasing social withdrawal and bizarre behavior over the past week. Upon arrival, she is found to be mute, not responding to any verbal stimuli, and showing signs of rigidity and catatonia. Her temperature is recorded at 39.8°C (103.6°F), with other vital signs within normal range. Lab findings reveal slightly elevated liver enzymes and mild leukocytosis, but no other significant abnormalities. What is the most likely diagnosis?

A 62-year-old man is brought to the emergency department by his family after sudden onset of right-sided weakness and agitation. On examination, the patient is found to have a positive Babinski sign on the right and agnosia. He is also disoriented and notably agitated. A non-contrast CT scan reveals a parietal lobe infarct. The family reports no history of psychiatric illness, and he has no known drug allergies. Which of the following is the most appropriate initial management for his agitation and confusion?

A 33-year-old female with a history of moderate intellectual disability presents with recent behavioral changes including a marked increase in talkativeness, decreased need for sleep, and grandiose delusions. She is diagnosed with mania. Based on her presentation and medical history, which of the following medications would you NOT prescribe as a first-line treatment for her condition?

A 51-year-old female with a known history of schizophrenia presents with a 3-day history of mutism and immobility. Her family reports that she has not responded to any stimuli and hasn’t moved or spoken in the last three days. The patient is fully conscious but does not communicate or follow commands. She does not show any signs of an acute medical condition or intoxication. What would be the most appropriate initial management in this case?

An 82-year-old male with a history of depression and psychosis is currently on sertraline 50 mg daily and risperidone 2 mg daily. On routine follow-up, an ECG shows a QTc interval of 490 ms. No symptoms of syncope or palpitations are reported. What is the most appropriate next step in management?

A 48-year-old woman with a history of major depressive disorder has been on citalopram 40 mg daily for the past 2 months. Despite adhering to her medication regimen, she reports no significant improvement in her depressive symptoms. Given this information, what would be the most appropriate next step in the management of her condition?

A researcher is preparing to conduct a study on the relationship between the severity of depressive symptoms and the level of physical activity in a group of patients diagnosed with major depressive disorder. The researcher plans to use a 5-point Likert scale to measure the severity of depressive symptoms and will categorize physical activity into three levels: low, moderate, and high. Considering the type of data, which statistical test should the researcher primarily consider using for this study?

A research team is conducting a study to compare the efficacy of two different antidepressant medications. They are utilizing the Hamilton Depression Rating Scale (HDRS) to evaluate depressive symptoms. During the course of their study, they discover a considerable age difference among the two treatment groups, with one group being significantly older than the other. The team is concerned that this difference could affect the results of the study. What would be the most appropriate statistical method to control for the age difference between groups while analyzing the effects of the antidepressant medications on HDRS scores?

A psychiatrist is conducting a study investigating the association between the duration of untreated psychosis (DUP) in patients with schizophrenia and their cognitive function scores on the Wisconsin Card Sorting Test (WCST). The WCST score is a continuous variable, and so is the DUP. Given this information, which statistical method would be most appropriate to investigate this relationship?

A psychiatric researcher is conducting a study to evaluate the effectiveness of a new cognitive-behavioral therapy (CBT) program in patients diagnosed with social anxiety disorder. She plans to compare pre- and post-intervention scores on the Liebowitz Social Anxiety Scale (LSAS). The LSAS is a continuous variable, and the same participants are tested twice, before and after the CBT intervention. Given this information, which statistical test would be most appropriate to use in this case?

A 65-year-old man with a strong family history of dementia visits your clinic. He’s cognitively healthy but concerned about developing dementia in the future. He asks for your advice on lifestyle modifications to potentially reduce his risk. What would you recommend?

A research team is planning to conduct a study investigating the relationship between cannabis use and psychosis. They are considering various study designs. Which of the following study designs would be considered unethical in this context?

A group of researchers aims to investigate the relationship between socioeconomic levels and the prevalence of depression across various European countries. They want to gather data at one specific point in time. Which study design would be most appropriate for this research?

In the context of dementia in a particular region, data shows that life expectancy is increasing and the total number of dementia cases is also increasing. However, the number of new dementia cases each year is slowly reducing. Which of the following best explains this scenario?

You have recently conducted an audit in your psychiatric hospital that revealed suboptimal adherence to national guidelines for the management of acute psychosis. As the lead psychiatrist, you decide to implement changes to improve care. Which of the following steps is the most appropriate first action?

A 35-year-old woman presents to the psychiatry outpatient department with a 6-month history of depressed mood, loss of interest in previously enjoyed activities, poor concentration, decreased appetite, and chronic fatigue. She’s unable to perform her daily activities and has missed work several times. She’s previously been treated with selective serotonin reuptake inhibitors (SSRIs) and cognitive behavioral therapy (CBT), but has shown little improvement. The patient is eager to try a different approach to managing her symptoms. The psychiatrist decided to try a Plan-Do-Study-Act (PDSA) cycle. The first step of the PDSA cycle for this patient should be?

As a newly appointed consultant psychiatrist in a busy community mental health team (CMHT), you want to understand the perspectives of other members of the multi-disciplinary team (MDT) regarding the role of a psychiatrist. You plan to gather their views to better understand how to contribute effectively and align your role with the team’s expectations. Which of the following research methods is most suitable for achieving this purpose?

Dr. M is a consultant psychiatrist researching the impact of psychotherapy combined with medication on patients suffering from bipolar disorder. To evaluate the efficacy of this approach, he decides to use data from self-reported patient questionnaires, psychiatrist evaluations, and objective biomarker tests. This research strategy can best be described as?

Dr. Miller is a psychiatrist researching the potential correlation between depression and sleep quality among college students. He is interested in using a regression model to predict depressive symptoms based on sleep quality metrics. During the analysis process, Dr. Miller notes a phenomenon where he is modifying his analytical decisions based on the outcomes he is seeing, creating a feedback loop in his research. This is a clear example of which of the following statistical concepts?

Dr. Thompson, a psychiatrist, is conducting a study to understand the distribution of depression scores among adults in her community. She uses the Beck Depression Inventory (BDI) to quantify depression levels, and the scores range from 0 to 63. Upon visualizing the distribution of scores on a histogram, she observes that the majority of the scores are clustered toward the lower end of the scale with a tail extending toward the higher end. This observed pattern in the histogram is an example of which of the following statistical concepts?

Dr. Hudson, a geriatric psychiatrist, is studying time to hospitalization in patients diagnosed with Alzheimer’s disease (AD) versus those diagnosed with Lewy Body Dementia (LBD). She collects data over 5 years and notes that patients with LBD tend to be hospitalized earlier than those with AD. She also notes that more patients with AD stayed at home for a longer duration compared to LBD patients. Upon analyzing her data using the Kaplan-Meier survival analysis, she finds that the differences observed were statistically significant. Which of the following interpretations is most consistent with Dr. Hudson’s findings?

Dr. Patel, a psychiatrist, is studying the mortality rates among patients with schizophrenia. He notes that a significant proportion of the mortality in this patient group is attributable to cardiometabolic causes. Which of the following is the most likely reason for this observation?

Dr. Lewis, a psychiatrist, is treating a patient with bipolar disorder using lithium therapy. The patient presents with symptoms of increased urination, abdominal pain, fine tremors, and myoclonic twitches. Dr. Lewis suspects these symptoms might be related to lithium toxicity. Which of the following symptoms is the most specific sign of lithium toxicity?

Dr. Mitchell, a psychiatrist, is treating a patient who has been on high-potency antipsychotic medication for a prolonged period. Recently, the patient has been presenting with signs of extrapyramidal side effects (EPSEs). Which of the following symptoms is Dr. Mitchell most likely to observe in this patient due to EPSEs?

Dr. Ramirez, a psychiatrist, is treating a 29-year-old patient, who is a year post-partum. The patient describes recurring, intrusive thoughts related to the traumatic birth of her child that cause significant distress and anxiety. She has also started to exhibit compulsive behaviors, such as repeatedly checking on the baby, extreme sterilization of baby’s items, and avoiding certain places or activities that remind her of the birth. Dr. Ramirez suspects the patient is dealing with a mental health disorder. Which of the following is the most likely diagnosis for this patient?

Dr. Martinez, a psychiatrist, is conducting a study on the relationship between loneliness and depression. He uses a validated tool to measure loneliness and a separate validated tool for depression. He performs a linear regression analysis and finds a correlation coefficient (r) of 0.38. What does this correlation coefficient indicate in terms of the relationship between loneliness and depression in his patient sample?

Dr. Thompson, a psychiatrist, is conducting a study to determine the impact of cognitive-behavioral therapy (CBT) on reducing symptoms of anxiety in adolescents. After the data analysis, she is presented with results that include a value represented as F=1.34 (Cl- 1.02-1.5). What does the “F” value in these results typically represent?

Dr. Richards, a psychiatrist, is treating a 30-year-old patient with refractory Obsessive-Compulsive Disorder (OCD). The patient has not responded well to first-line therapies, and Dr. Richards is considering augmenting the current regimen with other medication options. Which combination of medications would be considered a recommended approach in treating refractory OCD according to current clinical guidelines?

Dr. Bailey, a psychiatrist, is reading a study on the effectiveness of a new medication to treat generalized anxiety disorder (GAD). In the study, 65% of the patients who received the new medication showed a significant reduction in anxiety symptoms, while 45% of the patients who received the placebo showed a similar reduction. What is the number needed to treat (NNT) based on these results?

Dr. Allen, a psychiatrist, is conducting a study on the effectiveness of a new Cognitive-Behavioral Therapy (CBT) intervention for depression. He uses the Beck Depression Inventory (BDI) to measure depression levels before and after the intervention in the treatment group and in the control group. After analysing the data, he finds that the mean difference in BDI scores in the treatment group was -1.7. What does this mean difference indicate in the context of this study?

Dr. Adams, a psychiatrist, is treating a 32-year-old woman with schizophrenia. The patient is experiencing significant distress due to persistent auditory hallucinations despite being on optimal antipsychotic therapy. Dr. Adams decides to integrate Cognitive Behavioral Therapy (CBT) into the treatment plan. What is a key role for CBT in managing psychosis, such as auditory hallucinations?

Dr. Stevens, a psychiatrist, is treating a 26-year-old woman diagnosed with borderline personality disorder (BPD). Alongside pharmacotherapy, he is considering introducing a psychotherapeutic intervention. The patient has a history of self-harm and frequent emotional crises. Which form of therapy commonly incorporates telephone contact between the patient and the therapist as part of the treatment protocol?

Dr. Thompson, a psychiatrist, is treating a 38-year-old man diagnosed with obsessive-compulsive disorder (OCD). Alongside pharmacotherapy, he is considering introducing a psychotherapeutic intervention. The patient experiences intense anxiety due to his obsessions and compulsions. In which of the following therapeutic approaches is the development of an anxiety hierarchy commonly employed?

Dr. Gibson, a psychiatrist, is treating a 45-year-old woman with alcohol use disorder. Despite recognizing the negative impact of her drinking on her health and relationships, the patient struggles with ambivalence about quitting. Dr. Gibson decides to use a specific therapeutic approach to enhance her motivation to change. Which of the following therapeutic strategies involves amplifying cognitive dissonance as a means to encourage behavior change?

Considering the implementation of public health interventions to decrease the consumption of alcohol, which of the following statements is the most accurate?

What is the estimated prevalence of Antisocial Personality Disorder (ASPD) among incarcerated populations according to various studies?

What is the estimated percentage of individuals diagnosed with Emotionally Unstable Personality Disorder (EUPD), also known as Borderline Personality Disorder (BPD), who show remission of symptoms 10 years after diagnosis?

Which of the following psychiatric disorders generally shows an increase in severity and prevalence in children between the ages of 10-12?

In Autism Spectrum Disorder (ASD), which of the following statements accurately represents the prevalence and heritability rates?

Regarding suicide in prison, which of the following factors is most strongly associated with increased risk?

Among the following factors, which one is most strongly associated with international suicide rates?

Among the following genetic syndromes, which one is associated with the highest increased risk of psychosis?

Among the following genetic disorders, which one is associated with an equal prevalence in males and females?

Which of the following statements accurately describes the prevalence and presentation of schizophrenia in the child and adolescent population?

A 7-year-old child is brought to a psychiatrist by their parents due to episodes of disruptive sleep disturbances. The parents report that the child frequently wakes up from sleep screaming, sweating, and appearing terrified. These episodes last for a few minutes, after which the child falls back asleep without fully awakening or recalling the event the next morning. The child’s parents also report occasional instances of vivid, disturbing dreams that wake the child up, with the child being able to recall the content of the dreams upon awakening. Which of the following conditions is the most likely explanation for the child’s sleep disturbances?

Which of the following symptom combinations is characteristic of narcolepsy?

In a clinical research study investigating the effects of melatonin supplementation in children with primary insomnia, which of the following outcomes would most likely be observed?

A 30-year-old male presents with a history of multiple instances of theft. He reports stealing items even when they aren’t needed, impulsively, without planning. He admits to regular drug use and struggles with maintaining stable relationships. His past is notable for aggressive behavior, impulsivity, and recurrent episodes of law-breaking. What is the most likely diagnosis in this case?

In the context of randomized controlled trials, the main purpose of employing an Intention-To-Treat (ITT) analysis is to?

Diagrammatic formulations are widely used in Cognitive Analytic Therapy (CAT). Which of the following best describes the purpose of these diagrams in CAT?

In the context of Obsessive-Compulsive Disorder (OCD), which type of conditioning best explains the maintenance of compulsive behaviors?

In a longitudinal cohort study investigating the association between childhood trauma and the development of depressive disorder in adulthood, which of the following strategies would most effectively minimize attrition and maintain the integrity of the study?

A 45-year-old patient with treatment-resistant schizophrenia has been started on clozapine. Two weeks into treatment, he presents with severe abdominal pain, distention, and constipation. What should be the immediate concern?

The Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) was a major study that compared the effectiveness and side effects of first and second-generation antipsychotics. Which of the following statements regarding the CATIE study’s findings is most accurate?

The Cost Utility of the Latest Antipsychotic Drugs in Schizophrenia Study (CUtLASS) was designed to compare the effectiveness and cost-effectiveness of first- and second-generation antipsychotics. Which of the following conclusions can be drawn from the CUtLASS study?

The British study of Antipsychotic Lithium or Valproate – Enhancement by Antipsychotic Non-adherence Prevention (BALANCE) trial compared the effectiveness of lithium, valproate, and their combination in the management of bipolar disorder. Which of the following best summarizes the primary findings of the BALANCE trial?

The Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) study provided valuable information about the effectiveness and side effects of antipsychotic medications. Despite its contributions, which of the following best represents a recognized weakness of the CATIE study?

The Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) was a landmark study that compared the effectiveness and side effects of first and second-generation antipsychotics. Which of the following best represents a recognized strength of the CATIE study?

In psychotherapy, a negative therapeutic reaction occurs when a patient responds adversely to an accurate and well-timed interpretation provided by the therapist. Which of the following is the most likely explanation for a negative therapeutic reaction?

A patient with schizophrenia presents with active psychotic symptoms. In assessing cognitive function, which of the following tests is most likely to demonstrate impairment?

Clonidine is sometimes used as an adjunct treatment for Attention Deficit Hyperactivity Disorder (ADHD). Which of the following ADHD-related symptoms is least likely to show improvement with clonidine therapy?

Methylphenidate is a commonly prescribed medication for Attention-Deficit/Hyperactivity Disorder (ADHD). What is the primary mechanism of action of methylphenidate?

Tics are sudden, rapid, nonrhythmic movements or sounds that can be classified as either simple or complex. Which of the following is the best example of a simple motor tic?

Consider a diagnostic test for a psychiatric disorder that has a sensitivity of 100% and an Area Under the Receiver Operating Characteristic (ROC) Curve (AUC) of 0.86. Which of the following best describes the test?

In a Galbraith plot, which is commonly used in meta-analysis for assessing heterogeneity, what does the x-axis typically represent?

In a Galbraith plot, commonly used in meta-analysis for assessing heterogeneity among studies, what does the y-axis typically represent?

In a box and whisker plot, commonly used in data visualization for descriptive statistics, what does the box, specifically the interquartile range (IQR), represent?

In an enhanced box and whisker plot, what does the addition of a diamond typically represent?

In a box and whisker plot, commonly used in data visualization, what does the position of the middle line within the box represent?

In a forest plot, commonly used in meta-analysis to visually compare the results of several studies, what does the diamond typically represent?

A patient reports experiencing mild euphoria, giggling, and relaxation after using a substance. Which of the following substances is most likely responsible for these effects?

In a research study aiming to balance participant characteristics based on their initial selection, which method would be most appropriate to achieve this balance?

Among the following substances, which is classified as a short-acting depressant and a full agonist?

A 10-year-old child presents with symptoms of mild depression for three weeks, including persistent sadness, decreased interest in activities, and poor concentration. The child’s parents express concern and seek advice on the most appropriate intervention. What is the most suitable initial treatment option for this child?

A 9-year-old child recently experienced a traumatic event and is showing symptoms consistent with post-traumatic stress disorder (PTSD). What is the most appropriate approach to discussing the child’s PTSD symptoms?

What is the estimated prevalence of antisocial personality disorder (ASPD) among individuals in prison?

In a study involving participants with learning disabilities (LD), which statement regarding their consent withdrawal is true?

A pregnant woman who is 10 weeks along and currently taking methadone maintenance treatment for opioid use disorder expresses her desire to discontinue the medication. What is the most appropriate next step in managing her treatment?

What are the most common symptoms observed in postpartum psychosis?

Which aspect of cognitive functioning is primarily affected in individuals who use cocaine?

Among individuals with Alzheimer’s disease, what is the most common behavior observed?

Which of the following statements regarding full opioid agonists is NOT true?

Which of the following is NOT one of the aspects evaluated in the Pritchard criteria?

What was the significant implication of the Bournewood case on psychiatric practice?

What was the major implication of the Tarasoff case on psychiatric practice?

Which of the following is the most common method of suicide among male inmates in prisons?

Which of the following statements is most accurate about male suicide worldwide?

Which of the following statements is NOT accurate concerning infanticide in a psychiatric context?

Which of the following statements about frotteurism is most accurate?

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), all Paraphilic Disorders share certain common features. Which of the following is NOT a common feature of Paraphilic Disorders?

Which of the following statements about the use of Rivastigmine is most accurate?

Galantamine, a cholinesterase inhibitor, has been shown to be beneficial in the treatment of certain cognitive disorders. However, in which of the following conditions is the use of Galantamine currently NOT recommended based on the latest clinical guidelines?

In which of the following conditions is there an equal chance of inheritance from either the father or the mother?

Prolongation of the QT interval on an electrocardiogram (ECG) can be caused by various electrolyte disturbances. Which of the following electrolyte disturbances is MOST likely to cause QT prolongation?

Which of the following statements about the prevalence of eating disorders is most accurate?

Regarding risk factors for sexual assault, which of the following statements is true?

Persistent anxiety and social anxiety are most likely to be associated with which of the following personality disorders?

Which of the following is the most characteristic adverse effect associated with the chronic use of ketamine?

Which of the following statements best describes the concept of concurrent validity in psychometric assessment?

Which of the following best describes the concept of internal validity in the context of research studies?

In the context of a neuropsychological test battery assessing cognitive function in patients diagnosed with Mild Cognitive Impairment, which of the following scenarios best illustrates the concept of “accuracy”?

Which of the following substances has pharmacological action on both GABA-A and NMDA receptors?

A 75-year-old patient with a confirmed diagnosis of advanced Alzheimer’s disease is presented for a CT scan. The radiologist is likely to identify which of the following changes?

A 70-year-old patient presents with progressive memory loss, fluctuations in attention and alertness, recurrent visual hallucinations, and parkinsonism. Another 68-year-old patient presents with personality changes, socially inappropriate behavior, and decline in language ability, but shows no impairment in visuospatial skills or memory. How would you best differentiate the underlying causes of these patients’ symptoms?

According to Susser’s criteria, which of the following is considered a mandatory requirement for establishing causation in epidemiological studies?

A 22-year-old male presents with a one-year history of decreased social interaction, impaired communication, and repetitive behaviors. He also reports auditory hallucinations and delusional beliefs which are not related to his mood state, and has been observed to exhibit periods of unusual postures and absence of motor activity. His early developmental milestones were within normal limits. Which feature in the clinical history would favor a diagnosis of schizophrenia over autism?

A 35-year-old female is admitted to a secure hospital following the homicide of a younger individual. Based on epidemiological data, which of the following age groups of the victim is most likely if the perpetrator is a female?

A 65-year-old woman presents to your clinic with her concerned daughter. Over the past year, the daughter has noticed her mother exhibiting personality changes, such as increased impulsivity, apathy, and socially inappropriate behavior. Additionally, the woman has become increasingly forgetful and seems oblivious to her deteriorating condition. Neuroimaging shows marked atrophy in the frontal and temporal lobes of her brain. Based on this clinical scenario, what type of dysphasia is the patient likely to develop?

A 38-year-old man with Down syndrome presents to your clinic accompanied by his sister. She expresses concern over recent changes in her brother’s behavior, noting that he has become more forgetful, occasionally gets lost in familiar places, and seems to struggle with tasks he could previously perform with ease. She also mentions that their mother was diagnosed with Alzheimer’s disease at an unusually young age. Which gene is most likely implicated in the early-onset Alzheimer’s dementia observed in individuals with Down syndrome?

A 28-year-old woman in her first trimester of pregnancy presents to your clinic with symptoms of a mixed affective state. She describes fluctuating mood swings with periods of extreme energy and agitation followed by bouts of profound sadness and despair. She has been previously diagnosed with bipolar disorder and her condition was well-managed on valproate before pregnancy. What would be the most appropriate treatment option for her at this stage of pregnancy?

A 58-year-old man with a longstanding history of schizophrenia is currently on flupentixol depot and procyclidine 20 mg daily, a regimen he’s been stable on for 20 years. Recently, the patient’s sister notices that he’s developed subtle, rhythmic, involuntary movements of his mouth and tongue. The sister reports that the patient has been stable with no new symptoms of psychosis. The patient himself has not noticed these movements. Based on this clinical picture, which of the following is the most appropriate next step?

A 21-year-old woman with a history of anorexia nervosa presents to the clinic accompanied by her mother. She appears thin, with prominent bone structure, and is weak and fatigued. The mother shares her concern about her daughter’s refusal to eat and her continuous obsession with weight loss. Blood tests show several electrolyte imbalances. Which electrolyte disturbance is most concerning in this patient?

A 65-year-old man with a history of severe depression has not responded to pharmacological treatment. After discussing the risks and benefits with the patient and his family, the decision is made to proceed with electroconvulsive therapy (ECT). The family is particularly concerned about potential cognitive side effects. Which of the following statements is true about cognitive impairment and ECT?

A 43-year-old woman with a 20-year history of alcohol use disorder (AUD) is referred to a psychiatrist for help with her drinking. The patient has previously struggled with conventional treatment methods and is resistant to change, expressing a desire to stop drinking but also an enjoyment of the social aspects of alcohol. The psychiatrist decides to apply the principles of motivational interviewing (MI) to engage the patient in a therapeutic alliance. In the session, which of the following options best illustrates the application of cognitive dissonance amplification, incentive, and goal setting elements in motivational interviewing?

A 10-year-old boy is brought to the clinic by his parents due to concerns about his short stature. On examination, he is found to have multiple café-au-lait spots, freckles in the axillary region, and lisch nodules on slit-lamp examination. He is also struggling academically at school and was recently diagnosed with a learning disability (LD). Which of the following is the most likely diagnosis?

A 67-year-old male patient with chronic kidney disease (CKD) and an estimated glomerular filtration rate (eGFR) of 23 mL/min/1.73m² is diagnosed with schizophrenia. Given his renal impairment, which of the following antipsychotics would be the most suitable for him?

A 75-year-old man presents to the clinic accompanied by his daughter. He is originally from a non-English speaking country and has limited education. His daughter reports that he has been increasingly forgetful, and she suspects he might have dementia. She will serve as an interpreter during the assessment. Among the following dementia screening tools, which would be the most suitable for this patient?

In a case-control study design, the researcher is trying to determine the risk factors for a rare disorder. In this scenario, which of the following best explains why we calculate odds ratios (OR) instead of relative risks (RR)?

A 75-year-old woman with a history of Parkinson’s disease has been experiencing distressing visual hallucinations. Her motor symptoms are well controlled, but she has shown mild cognitive impairment. According to the UK guidelines, which of the following medications would be the most suitable to address her visual hallucinations?

A 32-year-old woman has been taking paroxetine throughout her pregnancy to manage her major depressive disorder. She is now at full term and due to give birth soon. Based on the medication she has been taking, what is the most likely effect of paroxetine use during pregnancy on her newborn?

A 58-year-old man with Type 2 diabetes and diabetic retinopathy presents with psychotic symptoms. He was previously treated with aripiprazole, but his symptoms did not adequately respond. His psychiatrist plans to switch him to another antipsychotic medication. Considering his medical conditions, which of the following would be the most appropriate choice?